SARS-CoV-2 inhibitory activity of a short peptide derived from internal fusion peptide of S2 subunit of spike glycoprotein.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has posed a great concern in human population. To fight coronavirus emergence, we have dissected the conserved amino acid region of the internal fusion peptide in the S2 subunit of Spike glycoprotein of SARS-CoV-2 to design new inhibitory peptides. Among the 11 overlapping peptides (9-23-mer), PN19, a 19-mer peptide, exhibited a powerful inhibitory activity against different SARS-CoV-2 clinical isolate variants in absence of cytotoxicity. The PN19 inhibitory activity was found to be dependent on conservation of the central Phe and C-terminal Tyr residues in the peptide sequence. Circular dichroism spectra of the active peptide exhibited an alpha-helix propensity, confirmed by secondary structure prediction analysis. The PN19 inhibitory activity, exerted in the first step of virus infection, was reduced after peptide adsorption treatment with virus-cell substrate during fusion interaction. Additionally, PN19 inhibitory activity was reduced by adding S2 membrane-proximal region derived peptides. PN19 showed binding ability to the S2 membrane proximal region derived peptides, confirmed by molecular modelling, playing a role in the mechanism of action. Collectively, these results confirm that the internal fusion peptide region is a good candidate on which develop peptidomimetic anti SARS-CoV-2 antivirals.

Niche Differentiation at Multiple Spatial Scales on Large and Small Mediterranean Islands for the Endemic Silene velutina Pourr. ex Loisel. (Caryophyllaceae).

The aim of this work is to investigate niche variations in endemic Silene velutina (Caryophyllaceae, Angiosperms) on Mediterranean islands that differ in size. Six populations on both large and small islands were sampled across the geographic range of the species. For each population, 10 plots (1 × 2 m, with a 25 cm grill) were randomly placed to quantify environmental (abiotic and biotic factors and disturbance) and population (demographic structure and reproductive success) parameters. Niche parameters related to substrate, plant cover, community diversity and composition and disturbance showed significant variation in relation to island size. At the regional scale, we detected a broader niche on large islands associated with spatial heterogeneity and island size. In contrast, at the local scale, populations on small islands showed a broader niche, potentially due to a release from competition (low diversity and plant cover and absence of phanerophytes). Populations on large islands had a demographic structure biased towards vegetative individuals (seedlings and juveniles) with few reproductive individuals, while those on small islands had a majority of adults. Together, the results on niche breadth and demographic structure concord with the idea of a strategy based on adult persistence on small islands.

The Combination of Sonographic Features and the Seven-Gene Panel May be Useful in the Management of Thyroid Nodules With Indeterminate Cytology.

Introduction: The management of patients with indeterminate thyroid nodules, which account for 10-25% of thyroid fine needle aspiration biopsies (FNABs), is still very challenging. Aim: To verify the utility of the seven-gene panel in combination with ultrasound features in the clinical management of indeterminate thyroid nodules. Results: The study group included 188 indeterminate thyroid nodules, divided into TIR3A (56.4%) and TIR3B (43.6%). A significant correlation between US categories and both cytological and molecular results was observed. In detail, TIR3B cytology was more frequent in EU-TIRADS 4 and 5 nodules (54.7 and 50%, respectively) than in EU-TIRADS 2 and 3 nodules (31%, p = 0.04). Similarly, the rate of a nodule with a mutation increased with the increase of US risk class (6.0% in EU-TIRADS 2 and 3, 9.3% in EUTIRADS-4 and 27.8% in EUTIRAD-5, p = 0.01). Among thyroid nodules submitted to surgery, final histology was benign in 61.4% nodules, while malignancy was diagnosed in 38.6% nodules. Using US score as tool for decision-making in TIR3A subgroup, we correctly classified 64.5% of thyroid nodules. The second tool (seven-gene panel test) was used in the subgroup of US high-risk nodules. By multiple tests with a series approach (US in all cases and US plus seven-gene panel in US high risk nodules) 84% of cases were correctly classified. In TIR3B nodules, using only seven-gene panel as tool for decision making, we correctly classified 61.9% of indeterminate nodules. By multiple tests with series approach (seven-gene panel in all cases and seven-gene panel plus US score in non-mutated nodules) only a slight improvement of thyroid nodule classification (66.6%) was observed. Conclusions: US score seems able to correctly discriminate between TIR3A nodules in which a conservative approach may be used, and those in which additional test, such as molecular test, may be indicated. On the contrary, in TIR3B nodules both US risk stratification and seven-gene panel seem to be of little use, because the risk of thyroid cancer remains high regardless of US score and mutational status.

Medidas da região mamária: antropometria direta ou indireta? / Breast region measurements: direct or indirect anthropometry?

Introdução: As medidas precisas dos seios femininos são difíceis de obter devido à topografia, volume e projeções presentes. Portanto, este estudo teve como objetivo comparar medidas da região mamária obtidas por antropometria direta (fita métrica) e indireta (fotogrametria computadorizada). Métodos: Este é um estudo transversal. Foram avaliadas 40 mulheres, com idades entre 18 e 60 anos, índice de massa corporal <29,2 kg / m², que tinham 12 marcas anatômicas na região das mamas e braços. A união desses pontos formou 7 segmentos lineares e 1 ângulo para cada hemicorpo, e 1 segmento comum a ambos os hemicorpos. As fotografias obtidas de forma padronizada foram mensuradas por fotogrametria computadorizada com o software Image Tool®. Os mesmos segmentos também foram medidos por antropometria direta, com fita métrica. O teste de Shapiro-Wilk foi usado para avaliar se cada variável tinha uma distribuição normal. O teste de correlação de Pearson foi aplicado para avaliar a correlação entre os diferentes métodos: antropometria direta (medição com fita) e indireta (fotogrametria por Image Tool®). O nível de significância adotado para os testes estatísticos foi de 5% (p <0,05). Resultados: Diferenças significativas foram encontradas nas comparações entre a fita métrica e a fotogrametria computadorizada para todos os segmentos analisados (p> 0,05). Conclusão: Existe correlação entre as medidas dos seios da face obtidas pela antropometria direta (medição com fita métrica) e indireta (fotogrametria pelo software Image Tool®), principalmente nas medidas da papila.

Introduction: Accurate female breast measurements are difficult due to the topography, volume, and projections present there. Therefore, this study aimed to compare breast region measurements obtained by direct (tape measurement) and indirect (computer-based photogrammetry) anthropometry. Methods: This is a transversal study. Forty women were evaluated, aged 18-60 years, body mass index of <29.2kg/m² that had 12 anatomical marks on the breast region and arms. These points' union formed 7 linear segments and 1 angle for each hemibody, and 1 segment common to both hemibodies. The photographs obtained in a standardized way were measured using computer-based photogrammetry with Image ToolTM software. The same segments were also measured by direct anthropometry, using a tape measure. The Shapiro-Wilk test was used to assess whether each variable was normally distributed. The Pearson correlation test was applied to evaluate the correlation between different methods: the direct (tape measurement) and indirect (photogrammetry by Image ToolTM) anthropometry. The significance level adopted for statistical tests was 5% (p<0,05). Results: Significant differences were found in the comparisons between the tape measurement and computer-based photogrammetry for all segments analyzed (p>0.05). Conclusion: There is a correlation between the breast measurements obtained by direct (tape measurement) and indirect (photogrammetry by Image ToolTM software) anthropometry, especially the papilla measures.

Evaluating germinability of eight desert halophytes under long-term seed storage: Implications for conservation.

Ex situ conservation in seed banks is a potential complementary conservation strategy for native plant species. It is well established that ex situ seed banking of native wild plants prolongs seed viability and thereby preserves genetic and species diversity for future use. We evaluated ex situ storage potential of eight halophytic species from deserts in the United Arab Emirates (UAE) by studying seed germination. Specifically, we examined the germinability of freshly collected seeds and seeds stored for three years in a seed bank. We also examined the effect of light conditions on fresh and stored seed germination. Fresh seeds of seven of the eight species tested had a higher germination rates under 12/12 h light/dark fluctuations than did those exposed to total darkness. Storage reduced light sensitivity in Halocnemum strobilaceum, Suaeda aegyptiaca, Salsola drummondii and Salsola imbricata, but increased the requirement for light in Arthrocnemum macrostachyum. In Anabasis setifera, storage decreased germination percentage when there was a 12-hour light/dark fluctuation, but increased germination rate when exposed to the dark treatment. Storage significantly reduced germination in both the light/dark and dark treatments in Suaeda vermiculata and S. aegyptiaca. Germination speed also responded differently to storage; whereas Timson's index significantly increased in A. macrostachyum and H. strobilaceum, it significantly decreased for S. drummondii, S. aegyptiaca and S. vermiculata. Germination of these species at a range of temperatures requires further testing; additionally, we strongly suggest that these laboratory findings be complemented by field studies.

Medição das mamas com o Adobe Photoshop® / Breast measurement using Adobe Photoshop®

Introdução: Com a globalização e melhora dos meios digitais e, consequentemente, a crescente utilização de fotografias digitais, faz-se necessária a criação de métodos de mensuração confiáveis. Na prática clínica, a medida direta utilizando-se fita métrica, régua e compasso é mais comumente utilizada. Porém, existem fatores intrínsecos (relevos corporais) e extrínsecos (colaboração do paciente ou movimentos respiratórios) que podem influenciar nos dados obtidos. A fotografia e os softwares gráficos podem ser uma alternativa precisa, mais cômoda e reprodutível à medida direta. O objetivo é demonstrar a forma de medir as mamas pelo software Adobe Photoshop. Métodos: Foram descritas a posição das voluntárias, a captação das imagens, calibração do software até a obtenção mensuração final das mamas. Em 40 mulheres voluntárias, com idade entre 18 e 60 anos, foram demarcados pontos sobre a região mamária e braços em posição frontal. A união destes pontos em cada hemicorpo formou 7 segmentos lineares, 1 angular e 1 segmento mediano comum a ambos os hemicorpos. Essas fotografias foram avaliadas no arquivo RAW, por 3 observadores, com auxílio do software Adobe Photoshop CS6®. Resultados: O Photoshop CS6® demonstrou ser eficaz na mensuração das mamas no arquivo RAW. Conclusão: O Photoshop® apresentou precisão nas medidas e ser factível para mensuração das mamas.

Introduction: With the globalization and improvement of digital media and, consequently, the increasing use of digital photography, it is necessary to create reliable measurement methods. In clinical practice, direct measurement using tape measure, ruler, and compass, is most commonly used. However, there are intrinsic (body contour) and extrinsic (patient collaboration or respiratory movements) factors that may influence the data obtained. Photography and graphics software can be an accurate, comfortable, and reproducible alternative to direct measurement. The objective is to demonstrate how to perform breast measurement using Adobe Photoshop software. Methods: Participants were described the position to assume. Imaging capturing techniques and software calibration were performed in order to obtain the final breast measurement. Markers were placed on the breast and arms of 40 women volunteers aged 18 to 60 years using an anterior view. The union of these markers in each hemibody resulted in seven linear segments, one angle and one transverse segment common to both hemibodies. These photographs were evaluated as a RAW file, by 3 evaluators, assisted by Adobe Photoshop CS6® software. Results: Photoshop CS6® proved effective in the breast measurement using RAW files. Conclusion: Photoshop® showed precision and effectiveness for breast measurement.

Conhecendo os tipos de arquivo de fotografia JPEG e RAW utilizados em pesquisa / Getting to know the types of JPEG and RAW photo files used in research

Introdução: Mensurações por antropometria indireta são importantes na área de pesquisa, mas também podem se tornar significativas na área jurídica, como instrumento quantitativo de avaliação pré e pós-operatória. O tipo de arquivo utilizado determina variações na manipulação das imagens. O objetivo é evidenciar tipos de arquivos de imagens utilizados na fotografia digital que será utilizada na pesquisa. Métodos: Foram realizadas mensurações das mamas em 80 hemitórax de 40 mulheres voluntárias. Foram demarcados pontos sobre a região mamária e braços em posição frontal. A união destes pontos em cada hemicorpo formou sete segmentos lineares, uma medida angular e um segmento mediano comum a ambos os hemicorpos. Essas fotografias foram avaliadas em arquivos RAW e JPEG de alta definição, por 3 observadores, com auxílio do software Adobe Photoshop CS6®. Resultados: Os arquivos RAW e JPEG demonstraram serem eficazes na mensuração das mamas. Conclusão: Os arquivos RAW e JPEG apresentaram medidas semelhantes na mensuração das mamas femininas.

Introduction: Indirect anthropometric measurements are important in research but may also be significant in the legal area as a quantitative instrument for pre- and post-operative evaluation. The type of file used determines variations in the manipulation of the images. The objective is to study the types of image files used in digital photography that will find utility in research. Methods: The breasts of 40 women volunteers were measured in 80 hemithoraces, and the mammary region and arms were marked in the frontal position. The union of these points in each hemithorax formed seven linear segments, an angular measure, and a median segment common to both hemithoraces. These photographs were evaluated as high definition RAW and JPEG files by three observers using Adobe Photoshop CS6® software. Results: RAW and JPEG files were shown to be effective in breast measurement. Conclusion: RAW and JPEG files presented similar results in the measurement of female breasts.

Population change of Trillium govanianum (Melanthiaceae) amid altered indigenous harvesting practices in the Indian Himalayas.

ETHNOBOTANICAL RELEVANCE: Trillium govanianum Wall. ex D. Don (Melanthiaceae) is valued as a traditional medicinal herb in the Himalayan region. Applications include treatment of cancer, hypertension, neurasthenia, giddiness, arthritis, dysentery, inflammation, sepsis and reproductive disorders. Its range is highly specific, and limited to cold, shaded and moist habitats at 2400-3500 m a.s.l. Rhizomes are gathered from wild populations for trade, and this has recently emerged as a significant source of income among indigenous people of the Indian Himalayan region. AIM: To assess the impact of changing rhizome prices on T. govanianum in the Indian Himalayan region by observing the status of existing populations and assessing the typical methods used for gathering and trade of rhizomes. MATERIAL AND METHODS: Ecological attributes were assessed in 17 sites from Tirthan Valley (Himachal Pradesh), Munsiyari and Tunghnath (Uttarakhand). Socio-economic attributes assessed through communal focus groups and interviews with 579 medicinal plants gatherers and 19 traders, using semi-structured open ended questionnaires. RESULTS: Population decline was highest in Munsiyari, followed by Tirthan Valley and Tunghnath, indicating that the species may become locally extinct in some areas. Methods used for gathering did not consider regeneration. CONCLUSION: Gathering of T. govanianum from wild populations is unselective and unmanaged, raising the potential threat of local extinctions. Sustainable utilization and effective conservation is needed to protect the species and maintain community incomes. A status of 'threatened' is justified for the species in the Indian Himalayan region, due to its slow life cycle, specific habitat requirement, low population density, and commercial value.

Functional evaluation in orthodontic surgical treatment: long-term stability and predictability.

BACKGROUND: The introduction of electromyographic and kinesiographic technology in orthodontics allows to obtain objective data regarding the functional aspects of the mandibular movements and the masticatory muscular activity. It is then important to be able to correlate the data obtained by instrumental activity with the clinical ones. The aim of this study consists to analyse the post ortodontic surgical stability through instrumental evaluation of the masticatory muscles and mandibular movements. METHOD: 30 patients undergo electromyographic and kinesiographic evaluations through all the surgical orthodontic iter and were than followed during other 4 years. JMP software was used to analyze and correlate the electromyographic and knesioographic data during treatment and during the follow up. RESULTS: A linear correlations between some functional objective values collected from the examinations at the beginning and during therapy and the follow up one has been demonstrated. CONCLUSION: It is important to submit patients in surgical ortodontic treatment to instrumental analysis which can evidence how masticatory function and mandibular movements are performed. It is also important to highlight some functional values also from the beginning of the treatment because an alteration of such values can be related to a better or worse postsurgical rehabilitation.

Avaliação da qualidade de vida e do sono de atletas paralímpicos brasileiros / Evaluation of the quality of life and sleep in Brazilian paralympic athletes / Evaluación de la calidad de vida y sueño de atletas paralímpicos brasileños

INTRODUÇÃO: o esporte paralímpico brasileiro vem ganhando destaque no cenário mundial e, com isso, a avaliação de variáveis que possam influenciar positivamente no desempenho desses atletas é de suma importância para o acompanhamento durante o seu período de treinamento. OBJETIVO: avaliar a qualidade de vida e do sono de atletas paralímpicos brasileiros. MÉTODOS: foram estudados 49 atletas paralímpicos das modalidades natação (n=20) e atletismo (n=29). Os atletas responderam a questionários que avaliaram seu padrão e queixas de sono e qualidade de vida. RESULTADOS: a maioria dos atletas (65,30%) relatou má qualidade do sono, visto que a latência do sono neste grupo foi significativamente maior do que em atletas com boa qualidade de sono. Cinquenta por cento dos atletas relataram o desejo de fazer mudanças em seu horário de sono e 52% gostariam de aumentar o seu tempo de sono. A sonolência diurna excessiva foi observada em 53,06% dos atletas. Quanto às queixas de distúrbios do sono, foram relatados chute ou espasmos das pernas e ronco. Menores índices de qualidade de vida foram encontrados no meio ambiente em comparação com os domínios físicos, psicológicos ou sociais. CONCLUSÕES: os resultados sugerem que a maioria dos atletas apresentou uma má qualidade do sono e, consequentemente, um alto índice de insatisfação com o sono. Além disso, menores escores de qualidade de vida foram encontrados no domínio ambiental, que está relacionado com a segurança física, proteção e condições em casa. .

INTRODUCCTION: Brazilian paralympic sports are gaining prominence on the world stage. That's why the evaluation of some characteristics that may influence positively the athletes' performance is so important to be observed during the training sessions. OBJECTIVE: to assess the quality of life and sleep quality of Brazilian paralympic athletes. METHODS: 49 paralympic athletes participating in swimming (n=20) and athletics (n=29) were studied. The athletes answered questionnaires assessing their sleep patterns and complaints and their quality of life. RESULTS: most athletes (65,30%) reported poor sleep quality, and the sleep latency in this group was significantly greater than in the athletes with good sleep quality. Fifty percent of the athletes reported a desire to make changes in their sleep schedule and 52% would like to increase their sleep time. Excessive daytime sleepiness was observed in 53.06% of the athletes. Regarding complaints of sleep disorders, there were reported kicking or jerking of the legs and snore. Lower scores for quality of life were found in the environment if compared to the physical, psychological or social relationship domains. CONCLUSION: most athletes reported poor sleep quality and, consequently, a high index of dissatisfaction with their sleep. Moreover, lower quality of life scores were found in the environmental domain, which is related to physical safety, protection and conditions at home. .

INTRODUCCIÓN: El deporte paralímpico brasileño viene ganando destaque en el escenario mundial y con eso la evaluación de variables que puedan influenciar positivamente en el desempeño de esos atletas es de suma importancia para el acompañamiento durante su período de entrenamiento. OBJETIVO: Evaluar la calidad de vida y del sueño de atletas paralímpicos brasileños. MÉTODOS: Fueron estudiados 49 atletas paralímpicos de las modalidades natación (n=20) y atletismo (n=29). Los atletas respondieron a cuestionarios que evaluaron su estándar y quejas de sueño y calidad de vida. RESULTADOS: La mayoría de los atletas (65,30%) relató mala calidad del sueño, visto que la latencia del sueño en este grupo fue significativamente mayor que en atletas con buena calidad de sueño. Cincuenta por ciento de los atletas relató el deseo de hacer cambios en su horario de sueño, y a 52% le gustaría aumentar su tiempo de sueño. La somnolencia diurna excesiva fue observada en 53,06% de los atletas. Cuanto a las quejas de disturbios del sueño, fueron relatadas patadas o espasmos de las piernas y ronquido. Menores valores de calidad de vida fueron encontrados en el medio ambiente en comparación con los dominios físicos, psicológicos o sociales. CONCLUSIONES: Los resultados sugieren que la mayoría de los atletas presentó una mala calidad del sueño y, consiguientemente, un alto índice de insatisfacción con el sueño. Además, menores valores de calidad de vida fueron encontrados en el dominio ambiental, que está relacionado con la seguridad física, protección y condiciones en casa. .

Nodules in autoimmune thyroiditis are associated with increased risk of thyroid cancer in surgical series but not in cytological series: evidence for selection bias.

BACKGROUND: The association of thyroid cancer and autoimmune thyroiditis (AIT) has been widely addressed, with conflicting results in surgical and cytological series, likely affected by selection bias. OBJECTIVE: The objective of the study was to evaluate the association between the cytological features suggestive or indicative of malignancy and AIT in 2504 consecutive patients (2029 females and 475 males, mean age 58.3 ± 14.1 y) undergoing fine-needle aspiration cytology for thyroid nodules. PATIENTS: Based on the clinical diagnosis, patients were divided into four groups: AIT with nodules (N-AIT, 14.9%); nodular Graves disease (N-GD, 2.8%); nodular goiter and negative thyroid antibodies (NGAb-, 68.4%); and nodular goiter with positive thyroid antibodies (NGAb+, 13.9%). RESULTS: The prevalence of patients with cytological features suggestive (Thy4) or indicative of malignancy (Thy5) was 4.5 % in the N-AIT group, not different compared with the other groups (N-GD, 5.6%; NGAb-, 5.0%; NGAb+, 4.3%). No difference was also found in the other categories (Thy2 and Thy3). When the same analysis was performed in the subgroup of patients (14.3%) with a histological confirmation, we found that the prevalence of differentiated thyroid cancer was significantly higher (P = .01) in the N-AIT group (67.8%) compared with the other groups (N-GD, 40.0%; NGAb-, 37.2%; NGAb+, 36.9%). CONCLUSIONS: The results of our cytological series do not support a link between N-AIT and thyroid cancer. The association between cancer and N-AIT found in the histology-based series is likely due to a selection bias represented by the fact that the prevalent indication for surgery in the N-AIT group was suspicious cytology (60.7% of patients) more frequently than in the other groups.

Orthodontic-surgical treatment: neuromuscular evaluation in open and deep skeletal bite patients.

BACKGROUND: The aim of this study was to compare electromyographic data of two groups of patients (open and deep skeletal bite) before and after surgical orthodontic treatment. METHODS: All patients who underwent orthognathic surgery at the Department of Orthodontics (University of Milan) were subjected to periodic electromyographic evaluation of the masticatory muscles (masseter and anterior temporal muscles) and to electrokinesiographic evaluation of mandibular movements. The sample comprised 72 patients (35 open skeletal bite patients and 37 deep skeletal bite patients) at the end of craniofacial growth. The electromyographic instruments used in the study included a Freely and a K6-I electromyograph. Statistical evaluation was carried out with Student's t tests for independent samples. RESULTS: Lots of differences between open and deep skeletal bite patients have been underlined by the analysis of the electromyographic data obtained. These results have been obtained with both electromyographic systems. Muscular activity in microvolts is higher in deep skeletal bite patients at the beginning of the treatment than in open bite ones, but during the following phases of the treatment, the two values became similar. CONCLUSIONS: Morphologic differences between open and deep bite patients can also be demonstrated by instrumental examinations, and their correction after surgical treatment is observable on electromyographic and electrognatographic exams.

Impact of proto-oncogene mutation detection in cytological specimens from thyroid nodules improves the diagnostic accuracy of cytology.

CONTEXT: Fine-needle aspiration cytology (FNAC) is the gold standard for the differential diagnosis of thyroid nodules but has the limitation of inadequate sampling or indeterminate lesions. OBJECTIVE: We aimed to verify whether search of thyroid cancer-associated protooncogene mutations in cytological samples may improve the diagnostic accuracy of FNAC. STUDY DESIGN: One hundred seventy-four consecutive patients undergoing thyroid surgery were submitted to FNAC (on 235 thyroid nodules) that was used for cytology and molecular analysis of BRAF, RAS, RET, TRK, and PPRgamma mutations. At surgery these nodules were sampled to perform the same molecular testing. RESULTS: Mutations were found in 67 of 235 (28.5%) cytological samples. Of the 67 mutated samples, 23 (34.3%) were mutated by RAS, 33 (49.3%) by BRAF, and 11 (16.4%) by RET/PTC. In 88.2% of the cases, the mutation was confirmed in tissue sample. The presence of mutations at cytology was associated with cancer 91.1% of the times and follicular adenoma 8.9% of the time. BRAF or RET/PTC mutations were always associated with cancer, whereas RAS mutations were mainly associated with cancer (74%) but also follicular adenoma (26%). The diagnostic performance of molecular analysis was superior to that of traditional cytology, with better sensitivity and specificity, and the combination of the two techniques further contributed to improve the total accuracy (93.2%), compared with molecular analysis (90.2%) or traditional cytology (83.0%). CONCLUSIONS: Our findings demonstrate that molecular analysis of cytological specimens is feasible and that its results in combination with cytology improves the diagnostic performance of traditional cytology.