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Lung cancer is the leading cause of death worldwide. Physical and chemical agents such as tobacco smoke are the leading cause of various lung cancers. The intrinsic heterogeneity of normal lung tissue may be affected in different ways, giving rise to different types of lung cancers classified as either small‐cell lung cancer (SCLC) or non‐small cell lung cancer (NSCLC). Adenocarcinoma, a NSCLC, accounts for 40 percent of all lung cancer cases and the incidence is increasing worldwide, especially among women. The survival rate and prognosis is poorest for adenocarcinoma. Therefore, diagnosis at the earliest stage (Stage I, localized) is critical for increasing survival rates of those suffering from lung cancer. However, many factors affect early diagnosis including the variable natural growth of tumors plus technological and human factors associated with manipulation of tissue samples and interpretation of results. This article reviews potential problems associated with diagnosing lung cancer and considers future directions of diagnostic technology.

The purpose of this paper is to bring both Simondonian and Deleuzian insights to bear upon the nature of documents and documentation by viewing them as non-representationalist, and as products of transduction and reticulation that render documents assemblages that are in constant negotiation with an environment as instances of a perpetually renewing problematic.

Simondon's work on metastability and transduction can offer particular insights into how the author views documents in terms of their materiality, signification, and possibly to move beyond the phenomenological bias in the treatment of documents.

In understanding or describing the process of documentation as a reticulation or unfolding, the author also comes to view the document as an assemblage in perpetual negotiation. This paper adapts Deleuze and Guattari's articulation framework of expression-signification and provides a bit of groundwork towards two registers of information (first and second order) according to the preindividual process of that allows for the individuation of documents.

This paper makes an original contribution to understanding the process of documentation and the product of documents in a more fluid, interdynamic context by shifting or displacing the traditional view of information.

Presents an inductive machine learning algorithm, CLILP2 that learns multiple covers for a concept from positive and negative examples. Although inductive learning is an error‐prone process, multiple meaning interpretation of the examples is utilized by CLILP2 to compensate for the narrowness of induction. The algorithm is tested on data sets representing three different domains. The complexity of the algorithm is analysed and the results are compared with those obtained by others. Employs measures of specificity, sensitivity, and predictive accuracy not usually used in presenting machine learning results, and shows that they evaluate better the “correctness” of the learned concepts. Published in two parts: I – The CLILP2 algorithm; II – Experimental results and conclusions.

Orthopaedics, rheumatology, pain management, specialist radiology and therapy services were brought under one umbrella to form Northwest Surrey integrated musculoskeletal (IMSK) services and introduced advance clinical practice, a multi-disciplinary team triage with a formalised straight to test (STT) process defined in 2018. Historically, prior to these services' integration, there were a primary and second care triage systems within individual specialities. The aim of this service evaluation is to assess the impact of a single IMSK multidisciplinary triage (MDT) system and the efficacy of STT from triage, which allows patients to be sent for diagnostics based on the cluster of symptoms and past medical history in order to achieve early identification of serious pathologies. This is a complex adaptive system with pathways spanning into the core areas of orthopaedics, rheumatology, therapies, pain management services, radiology and some less frequent specialities such as neurology, oncology, vascular and gynaecology. One of the objectives of this study was to identify how many referrals were triaged to consultants, Advance practice and therapies. In addition, the authors wanted to highlight the proportion of referrals that were sent straight to test from triage and the percentage of these that had sinister pathology identified. This information would then be compared against existing red flag literature to identify common themes. This study aims to discuss the aforementioned objectives.

Data were extracted retrospectively from a hospital database from January to December 2019 for all the adult musculoskeletal service referrals. The data collected were analysed on a Microsoft Excel sheet with information including date of triage, hospital number, ordering clinician, body part, type of diagnostic, indications for scanning, outcome for STT, serious pathology findings (named code 5 within our trust) and outcome of appointment.

A total of 47,039 referrals were received into the IMSK service. Of these referrals 19,967 were directly referred to therapies, with 27,072 referrals received into the IMSK service MDT process. Within triage, 718 patients were directed to STT to rule out serious pathology. A total of 28 patients (3.9%) had sinister pathology identified on their investigation. A total of 46% of patients were discharged from their first consultation following STT. Overall, 50% of the total number of referrals into the IMSK service was seen by advanced practitioners with 16% of patients directed to consultants with pre-consultation diagnostic work up.

This service evaluation highlights that STT allows early access to diagnostics, resulting in quicker access to identification of sinister pathology. A one stop MDT system has been shown to be effective in guiding the referral to the right place with increased referrals into allied health advance practice clinics and access to therapies directly. It has resulted in a reduction of unwarranted referrals to consultant care, duplication of investigations and identified patients on multiple pathways.

The purpose of this study is to develop a hybrid algorithm for segmenting tumor from ultrasound images of the liver.

After collecting the ultrasound images, contrast-limited adaptive histogram equalization approach (CLAHE) is applied as preprocessing, in order to enhance the visual quality of the images that helps in better segmentation. Then, adaptively regularized kernel-based fuzzy C means (ARKFCM) is used to segment tumor from the enhanced image along with local ternary pattern combined with selective level set approaches.

The proposed segmentation algorithm precisely segments the tumor portions from the enhanced images with lower computation cost. The proposed segmentation algorithm is compared with the existing algorithms and ground truth values in terms of Jaccard coefficient, dice coefficient, precision, Matthews correlation coefficient, f-score and accuracy. The experimental analysis shows that the proposed algorithm achieved 99.18% of accuracy and 92.17% of f-score value, which is better than the existing algorithms.

From the experimental analysis, the proposed ARKFCM with enhanced level set algorithm obtained better performance in ultrasound liver tumor segmentation related to graph-based algorithm. However, the proposed algorithm showed 3.11% improvement in dice coefficient compared to graph-based algorithm.

The image preprocessing is carried out using CLAHE algorithm. The preprocessed image is segmented by employing selective level set model and Local Ternary Pattern in ARKFCM algorithm. In this research, the proposed algorithm has advantages such as independence of clustering parameters, robustness in preserving the image details and optimal in finding the threshold value that effectively reduces the computational cost.

The aim of this study was to devise a simple proforma for reporting staging CT scans of the thorax, to ensure that all essential information is included on the report, in a logical manner, and that a TNM classification and tumour stage is given. Once the design of the proforma had been agreed, its utilisation and effectiveness was audited. In an initial six month period, every proforma filled in had resulted in a TNM classification being given, although in only 20 out of 40 (50 per cent) had a tumour stage been given. In a subsequent six month period, 39 out of 44 patients (89 per cent) with lung cancer undergoing a staging CT scan had proformas completed, and a TNM classification and tumour stage given (95 per cent CI is (0.75, 0.96)). Therefore, a proforma can be a useful aid to reporting staging scans, and is an effective method of ensuring that tumours are staged as fully as possible, radiologically. In addition, relevant information is presented in a clear format that allows accurate collection of data for audit purposes.

This study aims to examine the relationship between the chemical composition of juices obtained from fruits of autochthonous wild pomegranate (Punica granatum L.) grown in Montenegro and their cytotoxic effects on cancer cells.

To explore the potential value of wild pomegranate fruits, in vitro biological assays were carried out with juices whose composition was analyzed in detail for sugars, organic acids, vitamin C and phenolic compounds. The effect of juices on survival was determined in human lung A549, cervical HeLa and breast MCF-7 carcinoma cells by MTT assay. As a control, the cytotoxicity against normal fetal lung fibroblasts (MRC-5) was monitored.

Among cancer cell lines, considering the IC50 related to total phenolics, the lowest value – 13 µg/mL was found for the A549. The strongest effect on lung cells was assumed due to the favorable contribution of ellagitannins to total phenolics in juice as well as the given combination of anthocyanins and their synergistic action. For HeLa cells, the lowest IC50 value was obtained at 88 µg/mL, and the cytotoxicity could be matched with the effects of anthocyanins and catechin. For MCF-7 cells, the lowest IC50 was 504 µg/mL, and the elevated levels of vitamin C and ellagic acid derivatives should have a noticeable effect on these cells.

This study provides an important contribution to the knowledge on the effect of phytochemicals from wild pomegranate juice on lung, cervical and breast cancer cells, in vitro. The present observations suggest that the juice of wild pomegranate has the potential in the fight against cancer.

This scientific article aims to evaluate the efficacy of the drug Doxorubicin for treating hepatocellular carcinoma (HCC) in Egypt. The study analyzes data from patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University. The study includes 40 intermediate-stage HCC patients who underwent treatment with either Doxorubicin-Lipiodol or Doxorubicin-loaded drug-eluting beads-trans-arterial chemoembolization (DEB-TACE).

Patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University with a possible diagnosis of HCC in the intermediate stage were eligible for the study.

The study finds that the plasma peak concentration of Doxorubicin is significantly higher in patients treated with Lipiodol compared to those treated with DEB-TACE. The median plasma peak concentration of patients treated with Lipiodol was significantly higher 424 (202.5–731) than the peak level of patients treated with beads 84.95 (26.6–156.5) with p-value = 0.036. However, there is no significant difference in other pharmacokinetic parameters between the two treatment groups. The research article also investigates the genetic polymorphisms in HCC patients treated with Doxorubicin-Lipiodol and Doxorubicin-loaded DEB-TACE. It identifies a significant association between the ABCB1 gene (C3435T) and the concentration of Doxorubicin in plasma. Patients with the CCand computed tomography (CT) genotypes of ABCB1 have higher concentrations of Doxorubicin compared to those with the TT genotype. Furthermore, the study examines the progression-free survival rates and tumour response in the two treatment groups. It demonstrates that DEB-TACE patients have a higher progression-free survival rate compared to cTACE patients. DEB-TACE also leads to better tumour regression.

The current study helps to increase the understanding of the genetic factors that may contribute to HCC susceptibility in the Egyptian population. However, it is essential to consider that genetic polymorphism is just one aspect of HCC risk, and other factors such as environment, lifestyle and viral infections also play crucial roles. Further research is needed to elucidate the complex interactions between genetic and environmental factors in HCC development among Egyptians.

This paper reports some preliminary lessons from a qualitative study of services that have cared for a person with learning disabilities during a terminal illness. It reflects current concern about access to health care as well as the national priority being placed on improvements in cancer services for all patients. The study documents how the service learned of the person's illness, how they mobilised services and made decisions, how agencies worked together (or not!) and what support staff needed in the person's last months and weeks. It also considers the way staff, as individuals and as teams, made sense of their experiences and evaluated the input of other professionals.