A 65-year-old woman with a negative family history of breast cancer presented with a palpable mass in the left breast’s central portion. Mammography revealed an oval heteroechogenic, partly solid, partly cystic, sharply demarcated mass, measuring 100×90 mm in greatest diameter, classified as BI-RADS 4c, according to ACR BI-RADS Atlas Fifth Edition (Figure 1A-B). Breast MRI showed a lobulated mass with smooth margins appearing hypointense on T1WI and high signal intensity on T2WI (Figure 1C-D). A core needle biopsy revealed a cellular neoplasm, composed of small, closely packed tubules with spindle cell intervening stroma without prominent atypia and mitotic activity, classified as B3 category according to the UK National Coordinating Committee for Breast Screening Pathology (Figure 2A). The multidisciplinary tumor board discussed the case and recommended a wide surgical excision. With the patient’s approval, a left mastectomy was recommended and performed. The axillary clearance was not performed. The 100×90 mm tumor was grossly well-circumscribed, grayish-white, and predominantly solid, with a smaller cystic component, without necrosis and hemorrhage (Figure 2B). Histopathologic examination revealed a well-circumscribed tumor with two distinct components (tubular adenoma and phyllodes tumor) with the transition to one another (Figure 2C). The larger portion of the tumor was composed of closely packed small round to oval tubules with little intervening spindle cell stroma consistent with tubular adenoma. The smaller component showed a biphasic fibroepithelial tumor with leaf-like projections with moderately cellular stroma (Figure 2D-E). The stromal cells exhibited mild to moderate atypia, and their mitotic activity was up to six mitoses/10 hpf (Figure 2F). Stromal overgrowth was absent, while the malignant heterologous elements were not observed despite the exhaustive tumor sampling (25 paraffin blocks). The final diagnosis was a complex fibroepithelial tumor composed of borderline phyllodes and tubular adenoma. Clinical Science

This year the journal "Medical Archives" celebrates 75 year of existing. "Medicinski Arhiv/Medical Archives" was founded in 1947 as official journal of the Association of Physicians (Sabor ljekara Bosne i Hercegovina) of Bosnia and Herzegovina and the first Editorial board was consisted of academicans: Vladimir Cavka (Professor of Oftalmology), Blagoje Kovacevic (Professor of Surgery), Bogdan Zimonjic (Professor of Internal medicine), and Ibro Brkić (Professor of Internal medicine). Exactly the Medical Archives journal was a key milestone that helped in education of all academic and professional staff that became the foundation of Bosnian and Herzegovinian medicine as a science and health care as a profession. Medicinski Arhiv was included in largest bimedical database Medline in 1947 and till now in that database is deposited more than 7000 papers. Also this journal has highest h-Index in Scopus database ranked by SCImago rank. In Medicinski Arhiv journal authors from more than 60 countries from whole the world published their papers, some of them with very high Scopus h-Index.

Unmanned aerial vehicle (UAV) assisted wireless caching networks (WCN) have been recognized as a promising way to reduce the network load and improve the energy efficiency in the sixth generation (6 G) communication systems. Aiming to improve spectrum efficiency and system capacity, we apply non-orthogonal multiple access (NOMA) in UAV-assisted WCN to serve multiple users on the same spectrum simultaneously and propose the cross-layer resource allocation strategy including the scheduling of UAVs, the grouping of users, and the allocation of power. First, the $\rho$-K-means algorithm is proposed to assign users to multiple clusters and deploy UAVs according to the distance from UAVs to the base station in the UAV deployment layer. Then, the base station broadcasts the popular files to UAVs via NOMA in the content placement layer. Based on the existing fixed power allocation strategy, we propose a statistic quality of service (QoS) based fixed (SQF) power allocation method to take the statistic QoS of the popular files into consideration and improve the energy efficiency through introducing the discount factor. On the basis of SQF, an instantaneous QoS based adaptive (IQA) strategy allocates power according to the instantaneous QoS of the popular files to reduce the file outage probability. Furthermore, we propose an improved method that is a cross-layer based optimal (CLO) power allocation strategy to maximize the system hit probability. Finally, in the content delivery layer, users in each cluster are grouped according to the channel gain from users to UAVs. In addition, each UAV serves two users on the same time-frequency resource block based on the cognitive radio inspired power allocation for the NOMA user pairs. Simulation results confirm that the proposed $\rho$-K-means algorithm and CLO strategy reduce the file outage probability and improve the hit probability.

O atual cenário da engenharia brasileira tem requerido esforço maior de todas as áreas para que sejam operados projetos em BIM (Building Information Modeling). No país, o uso da plataforma BIM ainda não é unanimidade no âmbito da infraestrutura rodoviária, mesmo diante dos benefícios adicionais que esta apresenta em relação a outras formas de projeção consideradas ultrapassadas. Mas já existem iniciativas previstas, como é o caso de uma sequência de projetos pilotos definida pelo Departamento Nacional de Infraestrutura de Transporte (DNIT) em busca do aperfeiçoamento dos profissionais envolvidos no projeto para que dentro de alguns anos todos os processos em questão aconteçam a partir da modelagem da informação da construção de forma obrigatória (Silva, 2018).

O trabalho tem como objetivo pesquisar os APLs de Gemas e de Joias na Região Metropolitana do Distrito Federal e verificar a possibilidade e o interesse na criação de uma Indicação Geográfica para esse setor. No decorrer da pesquisa, bibliográfica e qualitativa, foi detectado que no DF existia inicialmente um APL de gemas e de joias que foi desativado, permanecendo o APL de Gemas e de Joias da Região Metropolitana do DF em Cristalina (GO). São analisados os destaques e as tendências do mercado de joias no Brasil. A coleta de dados se deu por meio de entrevistas, observação não participante e análise documental. Como resultado preliminar, verificou-se que existem muitos problemas a serem superados, como a questão da organização das associações, da diversificação dos fornecedores pela rapidez de produção e dos acordos sobre concorrência que comprometem a qualidade dos produtos. Foi evidenciada também a falta de incentivos fiscais para o crescimento do setor na Região.

Purpose: The primary purpose of this paper is to identify the most important factors related to the successful implementation of TQM in the literature and to compare the identified factors with the existing research. Methodology/Approach: By conducting a systematic literature review in three main stages, this research analyzes 13 empirical papers published between 1995 and 2017. Three main stages included: formulation of the problem to be solved by the systematic literature review; definition of inclusion criteria and exclusion of articles; and article search and selection. Findings: Analysing previous research and conducting a literature review, we identify six main critical success factors (CSF): top management leadership and commitment, customer focus, training (employees), procurement management (suppliers), information and analysis, and process management. Research Limitation/Implication: In this paper, we focused solely on the influence of TQM practices on the financial performance of a company. As such, the non-financial performance indicators were not considered. Originality/Value of paper: This paper adds value to the existing literature as it focuses on critical factors of TQM implementation examined in relation to the financial performance of the company and provides a good basis for understanding and developing more complex models. Category: Literature review

During cancer evolution, constituent tumor cells compete under dynamic selection pressures. Phenotypic variation can be observed as intratumor heterogeneity, which is propagated by genome instability leading to mutations, somatic copy-number alterations, and epigenomic changes. TRACERx was set up in 2014 to observe the relationship between intratumor heterogeneity and patient outcome. By integrating multiregion sequencing of primary tumors with longitudinal sampling of a prospectively recruited patient cohort, cancer evolution can be tracked from early- to late-stage disease and through therapy. Here we review some of the key features of the studies and look to the future of the field. SIGNIFICANCE: Cancers evolve and adapt to environmental challenges such as immune surveillance and treatment pressures. The TRACERx studies track cancer evolution in a clinical setting, through primary disease to recurrence. Through multiregion and longitudinal sampling, evolutionary processes have been detailed in the tumor and the immune microenvironment in non-small cell lung cancer and clear-cell renal cell carcinoma. TRACERx has revealed the potential therapeutic utility of targeting clonal neoantigens and ctDNA detection in the adjuvant setting as a minimal residual disease detection tool primed for translation into clinical trials.

Histological diagnosis of differentiated vulvar intraepithelial neoplasia (dVIN), the precursor of human papillomavirus (HPV)-independent vulvar squamous cell carcinoma (VSCC), can be challenging, as features of dVIN may mimic those of non-dysplastic dermatoses. To aid the diagnosis, p53-immunohistochemistry (IHC) is commonly used, and mutant expression patterns are used to support a histological diagnosis of dVIN. However, a proportion of dVIN can show wild-type p53-expression, which is characteristic of non-dysplastic dermatoses. Furthermore, recent research has identified a novel precursor of HPV-independent VSCC—the p53-wild-type differentiated exophytic vulvar intraepithelial lesion (de-VIL). Currently, there are no established diagnostic IHC-markers for p53-wild-type dVIN or de-VIL. We evaluated IHC-markers, cytokeratin 17 (CK17), and SRY-box 2 (SOX2), as diagnostic adjuncts for dVIN. For this, IHC-expression of CK17, SOX2, and p53 was studied in dVIN (n = 56), de-VIL (n = 8), and non-dysplastic vulvar tissues (n = 46). For CK17 and SOX2, the percentage of cells showing expression, and the intensity and distribution of expression were recorded. We also performed next generation targeted sequencing (NGTS) on a subset of dVIN (n = 8) and de-VIL (n = 8). With p53-IHC, 74% of dVIN showed mutant patterns and 26% showed wild-type expression. Median percentage of cells expressing CK17 or SOX2 was significantly higher in dVIN (p53-mutant or p53-wild-type) and de-VIL than in non-dysplastic tissues (p < 0.01). Diffuse, moderate-to-strong, full epithelial expression of CK17 or SOX2 was highly specific for dVIN and de-VIL. With NGTS, TP53 mutations were detected in both dVIN and de-VIL. We infer that immunohistochemical markers CK17 and SOX2, when used along with p53, may help support the histological diagnosis of dVIN.

Here we describe the major genetic and genomic aberrations found in myeloid malignancies and how those markers are used in patients' diagnosis, prognosis, and targeted treatment. In Bosnia and Herzegovina, cytogenetic and molecular diagnostics for myeloid malignancies have been established and continually improved since 2005. We report the current state of available diagnostic tools for myeloid malignancies in Bosnia and Herzegovina. Myeloid malignancies are a heterogeneous group of clonal blood diseases characterized by defects in hematopoietic stem cells and myeloid progenitors that lead to abnormal proliferation, differentiation, localization, and self-renewal. Most common myeloid malignancies include myeloproliferative neoplasms (MPNs), myelodysplastic syndrome (MDS), and acute myeloid leukemia (AML). Molecular diagnostics of myeloid malignancies have significantly expanded in the last decade with new genetic and genomic markers for diagnosis, prognosis, and treatment. CONCLUSION: In the last decade, several new genomic markers important for patient diagnosis, prognosis, and therapy have been discovered that need to be implemented in routine molecular diagnostics not only in developed nations but also in developing nations such as Bosnia and Herzegovina.

This review provides a brief overview of the state-of-the-art molecular pathology approaches emphasizing the increasingly important pathology role in clinical precision cancer medicine. Recent advances in molecular biology and genetics have tremendously affected the practice of anatomic pathology, gradually transforming it from a morphology-based into a molecularbased discipline. Molecular diagnostics has a long tradition in pathology, especially in clinical pathology. The improvement of methodology for genomic testing in recent years has made it one of the cornerstones of precision cancer medicine. The decisions related to cancer treatments are no longer solely based on the histopathological diagnosis. Various genomic analyses of human cancers are being incorporated into diagnostic and decision-making algorithms. CONCLUSION: The pathologists continue to play an essential role in developing and implementing molecular and genomic tests in practice and communicate the results and their relevance with clinicians. Such activities are of utmost importance for successfully translating scientific advancements into a benefit to patients ("next-generation pathologists").