Major Worry Research Articles

Crime Type and Occurrence Prediction Using Machine Learning Algorithm

This project is entitled as “Crime Type and Occurrence Prediction Using Machine Learning Algorithm” Crime is still a major worry and a serious problem in our society. As a result, crime prevention is a significant issue that needs to be examined methodically. Detecting and preventing crime requires effective crime analytics, which is also crucial for assessing how well criminal investigations are working. To create precise forecasts, inferences are drawn from trained data. a system that uses user input to forecast different characteristics of crime. Users select the year, offense type, and city name. The method forecasts the population, expected number of occurrences, and expected crime rate for the year in 100,000 units based on this data. The dataset used in this investigation was produced on its own. The system makes use of machine learning techniques, particularly Random Forest, SVM, Logistic Regression, and Linear Regression. To guarantee precise forecasts and dependable results, it has undergone testing and training

Methylene blue for COVID-19 ARDS: insights from a randomized Clinical Trial.

Around the world, the COVID-19 pandemic has presented many difficulties, and acute respiratory distress syndrome (ARDS) has become a major worry. The antiviral and anti-inflammatory characteristics of methylene blue (MB) have garnered interest for potential medicinal applications. The object of the current study is to assess the effect of orally administered MB on the treatment of ARDS associated with COVID-19. A randomized clinical study was carried out on 122 hospitalized patients who had ARDS related to COVID-19. Patients who met the eligibility requirements were randomized at random to either the control group (CG) (n = 60) or the intervention group (IG) (n = 62). Standard treatments were administered to both groups, with the addition of oral MB to the IG. Clinical outcomes, including SpO2 levels, CRP levels were assessed on the third and fifth days. Additionally, at the time of discharge, patients' assessments were made in terms of APACHE II scores, SOFA scores, LDH and CRP levels, SpO2, and respiratory rate in comparison to the day prior to the intervention. Patients were followed for mortality outcomes at one month and three months after the intervention. Significant changes were observed in SpO2 levels over time (P < 0.001) and between groups (P = 0.022), with higher levels in the MB-treated group. The interaction between time and group (P = 0.019) indicated a stronger increase in SpO2 in the IG, with the IG's SpO2 level increasing by 6.42%. Furthermore, CRP levels showed significant changes over time (P < 0.001), but not between groups (P = 0.092). However, the interaction between group and CRP change over time (P = 0.019) suggested a distinct pattern of CRP decrease in the IG. Significant improvement in RR, SpO2, CRP, and APACHE II score were found according to discharge results. However, in terms of SpO2 and the APACHE II score, this improvement was noteworthy for IG. The length of hospitalization and mortality rates at one- and three-month follow-ups did not differ significantly. Oral administration of MB demonstrated positive effects on improving SpO2 levels and reducing inflammatory markers in COVID-19-related ARDS patients. Despite no significant impact on survival rates or hospitalization length, the study supports the potential efficacy of MB as an alternative treatment for COVID-19 ARDS. This study was registered with the Iranian Registry of Clinical Trials ( http://www.irct.ir ) under the registration code IRCT20200409047007N2 on 11/29/2021.

Enhanced therapeutic efficacy of SERCA2a gene-modified adipose-derived mesenchymal stem cell exosomes in doxorubicin-induced cardiomyopathy in male albino rats.

Worldwide, cancer is still the primary cause of death, and one of the most widely used anthracyclines for treating cancer is doxorubicin (DOX). But a major worry is DOX-induced cardiomyopathy, which is primarily resulted from an excess of reactive oxygen species. Heart sarcoplasmic reticulum calcium ion ATPase2a (SERCA2a) controls the amount of calcium ions stored in the sarcoplasmic reticulum (SR). This study aims to evaluate and compare the efficacy of SERCA2a gene modified adipose mesenchymal stem cell-derived exosomes (AMSCs-dE) to nontransfected AMSCs-dE, in DOX induced cardiomyopathy in adult male albino rat. Thirty one adult male albino rats were randomly divided into control group and DOX group that further subdivided into three DOX, AMSCs-dE and SERCA2a AMSCs-dE subgroups. AMSCs-dE were administered intravenously (IV). The levels of serum creatine kinase MB (CK-MB) were assessed after DOX injection and before sacrifice. Cardiac muscle samples were taken for histological analysis using Masson's trichrome and hematoxylin and eosin stains two months after the experiment. Proliferating cell nuclear antigen (PCNA) and connexin 43 were stained using immunohistochemistry. The expression of TNF and SERCA2a genes and proteins was measured by real-time polymerase chain reaction (PCR) and Western blot (Wb) analysis, respectively. Fluorescent microscopy demonstrated non-transfected and transfected exosomes labeled with PKH26 and GFP, respectively, in culture and cardiac muscle. DOX induced myocarditis progressing to degenerative and fibrotic changes in cardiac muscle that regressed in response to AMSCs-dE therapy. However, SERCA2a gene modified AMSCs-dE treatment reversed the mentioned parameters to nearly its normal level. These findings suggest that SERCA2a gene modification enhances the therapeutic efficacy of AMSCs-dE in treating DOX-induced cardiomyopathy.

Deepfake Video Detection Using Res-Next CNN and LSTM

Abstract: Deepfake videos are becoming more and more common in the digital age, which has led to major worries about how they can undermine the trustworthiness of visual media. With deep learning algorithms' rising processing power, producing lifelike human-synthesized films or deepfakes has never been easier. Disinformation and political unrest can be caused by these videos. A novel deep learning-based method has been created to distinguish between actual and AI-generated fraudulent videos to address this problem. The suggested technique uses Attention-based networks (Res-Next CNN), a kind of deep learning architecture that can selectively focus on significant features in a video, to fine-tune the transformer module to search for new sets of feature space to detect false images.

Automated Air Purifier Robot

Abstract: Growing air pollution has become a major worry for all countries since the advent of industrialization and modernity. Each person's health is affected differently by air pollution, which can lead to serious consequences. The largest environmental health concern in the world is air pollution, particularly indoor air pollution, which is connected to over 4 million deaths a year from conditions like lung cancer, ischemic heart disease, stroke, and chronic obstructive pulmonary disease.. The air inside our homes and workplaces can become contaminated with dangerous pollutants as cities and industries grow. This is where air purifiers become crucial, and new developments have introduced autonomous air purifier robots as a new player in the field. These robots are not your normal stationary air purifiers; instead, they move around and clean the air using cutting-edge technologies like robotics, artificial intelligence, and sensors. These robot air purifiers are more dynamic than typical air purifiers because they can adjust to changing indoor settings. The objective of this review paper is to examine autonomous air purifier robots, including their history, essential technological elements, uses, and possible effects on indoor air quality. We want to comprehend the benefits, constraints, and distinct issues these robotic solutions tackle when compared to traditional air purifiers by looking at the state of the art. We will also talk about user experiences, upcoming trends, and the moral issues surrounding the use of these self-governing systems

Enterprise Data Breach: Causes, Challenges, Prevention, and Future Directions

Cloud data is such a valuable and necessary resource, security is a major worry. Despite the widespread misperception that hackers are the source of security lapses, insiders are primarily responsible for data theft. In practically dispersed settings, critical data is routinely moved from the distributor to trustworthy parties. The stability and security of the services must be guaranteed in light of the increasing volume of user requests. When a client discloses important information, the client should be held accountable as soon as possible. Therefore, it's necessary to keep an eye on the data as it moves from the distributor to the agents. In the context of cloud computing, the project identifies data leakage detection, which examines data tampering and concludes that the information leak was caused by a particular employee in the organization

An ARDL estimation is conducted to examine the dynamical connection among energy use and joblessness in Saudi Arabia

The rate of joblessness in Saudi Arabia has been a major worry in the past few years, exhibiting swings because of several economic causes. The nation has the formidable task of accommodating a substantial influx of fresh graduates into the labor market annually, posing an obstacle for government officials to offer sufficient employment prospects. Nevertheless, there has been a lack of comprehensive research on the influence of macroeconomic variables, such as energy consumption, on joblessness. The objective of this study is to examine the influence of several macroeconomic factors, such as foreign and domestic investment, trade liberalization, inflation, urbanization, economic growth, and energy consumption, on the levels of unemployment in Saudi Arabia. The ARDL estimate method was used to assess the yearly data spanning from 1971 to 2022. The findings indicate a varied anticipated influence of the independent and dependent variables over an extended period of time. While there is a short-term negative correlation between energy consumption and rate of joblessness, this relationship does not hold true in the long term. The study culminates with a compilation of policy suggestions.

A descriptive model featuring expansive clinical microbiology approaches and antimicrobial stewardship to control antimicrobial resistance in low- and middle-income countries

The upsurge and escalation of antimicrobial resistance (AMR) poses a major worry on the global scene. Effective antimicrobial stewardship (AMS) programs are critical to combat this challenge, and applied knowledge in clinical microbiology serves as the cornerstone for the successful implementation. Despite technological advances, many low- and middle-income countries (LMICs) still adopt traditional phenotypic techniques in clinical microbiology laboratories. An expansive implementation of clinical microbiology approaches can bridge this apparent gap. Good laboratory assessment, hospital epidemiology, and infection prevention and control, which are the sub-divisions of the expansive clinical microbiology approaches, can be deployed to implement AMS appropriately in LMICs. In this paper, we describe a model featuring a functional AMS equipped with expansive clinical microbiology approaches to control AMR in LMICs. &amp;nbsp;

Impact of olfactory disorders on personal safety and well-being: a cross-sectional observational study

ObjectivesInvestigate safety perceptions, quantify hazardous events, and analyse their manifestations in individuals with olfactory dysfunction through an online cross-sectional survey.MethodsAn online survey, available from 25th February to 28th September 2022, captured data on demographics, olfactory disorder causes, safety concerns, and experienced hazardous events. Distributed via Fifth Sense channels, it targeted individuals with self-claimed olfactory dysfunction.ResultsOf 432 responses, the majority were female (79.6%), aged 41–70, with 20.6% non-UK residents from 21 countries. Leading causes of dysfunction were Covid-19 (22%), idiopathic (20.8%), and congenital (14.4%). Safety concerns were high (85.9%), with gas, smoke, and food as major worries. Over 5 years, 32.2% faced ≥ 1 food incident, 14.8% ≥ 1 gas incident, 34.5% ≥ 1 gas scare, and 18.5% ≥ 1 work incident. Preventative measures were taken by 60.2% at home. Key limitations of this study were self-reported data and sampling bias of charity members.ConclusionThis study highlights the significant impact of smell loss on personal safety and emotional well-being. There is an unmet need in mitigating safety concerns/events for individuals with olfactory dysfunction. We suggest collaborate strategies such as educating the public sector and high-risk sectors (e.g. gas companies), and introducing safety ‘scratch and sniff’ cards as a screening method. Regular assessment of an individual’s olfactory ability, similar to routine assessments for other sensory systems (sight, hearing) may allow proactive identification of at-risk people and corrective measures to take place.

Self-guided imagery rescripting for worry images: A preliminary experimental investigation.

Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re-structure underlying schema. Yet only one known study has applied the technique to treatment of worry. The present study aimed firstto examine the relationship between trait worry and properties of future-oriented worry images, and secondto examine the efficacy of a self-guided imagery rescripting intervention in improving individuals' response to their worries. Participants recruited through Amazon Mechanical Turk (N = 365) identified their major worry and wrote the script of a worst-case scenario mental image. Participants were randomized to three conditions: re-writing the same worry image script (exposure), or writing scripts of either one or three positive alternative future-oriented images (rescripting conditions). In preliminary analyses, trait worry negatively predicted participants' ratings of worry images, including valence and ability to cope, and positively predicted distress, anticipated cost, and belief in their negative meaning. In experimental analyses, linear mixed-effects models revealed anxious response and cognitive appraisal of the threat were significantly lower among participants allocated to rescripting relative to exposure. There was no effect of rescripting type. This investigation demonstrated the impact of a future-oriented imagery rescripting task on anxiety and cognitive biases associated with real worries in an unselected sample. Results may contribute to the development of imagery rescripting interventions for GAD.

Negative stiffness and inerter-based dampers: Novel seismic response control approach for base isolated liquid storage tanks

Liquid storage tanks (LSTs) have become indispensable to civil engineering infrastructure. LSTs are used not only for storing harmless fluids but also explosive, toxic, and hazardous substances. Thus, the ability of LSTs to withstand significant seismic activity without damage is a major worry. Strong pulse-type characteristics in near fault (NF) type of ground motions have shown significant base and sloshing displacements for a commonly adopted structural control measure: base isolation (BI). The current study introduces negative stiffness and inerter dampers (NSIDs) as supplemental response control measures to LSTs with BI (BILSTs). Conventional supplemental damping applications in the isolation system are helpful in displacement reduction at the isolator level, but the upper structure response gets severely affected. This study presents NSIDs, characterised by the damping magnification effect, as supplemental dampers to BILSTs. The continuous liquid mass within the tank is represented by discrete lumped masses referred to as sloshing, impulsive, and rigid mass. The stiffness constants of these lumped masses are derived by considering the tank wall and stored liquid physical parameters. The optimal supplemental damping parameters are deduced by developing contour plots describing the sloshing and base displacement response reduction (mitigation) ratios. Through analytical studies conducted using real earthquake records, it has been demonstrated that appropriately designed Negative Stiffness and Inerter Devices (NSIDs) yield enhanced performance for Base Isolated Liquid Storage Tanks (BILSTs). These optimised combinations of NSIDs effectively mitigate isolator displacement, base shear, lumped sloshing mass displacement, and sloshing mass height in response to both near-field (NF) and far-field (FF) base excitations.

The development of new cyber security and networking solutions using Artificial Intelligence and machine learning

The convergence of Artificial Intelligence (AI) and Machine Learning (ML) has ushered in a revolutionary period in networking as well as cybersecurity. This paper explores the important impact of ML and AI on certain fields. Data shows that their use has increased dramatically, particularly in threat detection and predictive modelling. Security measures have been significantly strengthened by automated incident response systems and behavioural analysis powered by AI. The integration of threat intelligence and artificial intelligence has transformed the battle against cyberattacks, whereas real-time data analysis facilitates proactive maintenance. As long as privacy, and surveillance, alongside prejudice concerns, exist, the moral implementation of AI will remain a major worry. This analysis emphasizes the critical importance of ethical AI development. Future scope will include increased integration and more accurate threat detection, but there will also be issues with data quality, and privacy, including the requirement for strong ethical standards. It is of the utmost importance to strike a balance between these difficulties and the amazing promise of AI and ML in order to shape networking and cybersecurity in the future.

Chitosan/Alginate nanocomposites containing magnetic nanoparticles and multi-wall carbon nanotubes for efficient iron sorption

The widespread presence of iron pollution in groundwater is a major global worry, as increased levels can lead to severe health hazards. To tackle this urgent problem, we engaged in a synthesis procedure where magnetic nanoparticles (MNPs) and multi-wall carbon nanotubes (CNTs) were combined with a mixture of chitosan (CS) and sodium alginate (Alg) to produce a magnetic composite material. This novel composite, known as CS/Alg/MNPs/CNTs, was crafted with the primary aim of effectively removing iron from groundwater through adsorption. A thorough physicochemical analysis using FTIR, SEM, PSA, XRD, DSC, and TGA confirmed the composition's characteristics. The study delved into the influence of parameters such as retention time, sorbent dose, initial Fe concentration, pH, agitation rate, and temperature on the adsorption process. The Langmuir isotherm model fittingly represented the adsorption data, indicating a monolayer coverage of 12.43 mg/g and aligning with the pseudo-second-order kinetic model. Additionally, the adsorption of iron ions by the composite material was identified as a endothermic process. Furthermore, the study highlights the sorption process's inherent spontaneity and survivability, as demonstrated by the negative ΔG value. In conclusion, the results of this study indicate that the magnetic composite adsorbent (CS/Alg/MNPs/CNTs) holds considerable promise for effectively removing iron ions from groundwater, making it a viable and attractive choice for use in water purification applications.

Chemical Profile of Essential Oils of Selected Lamiaceae Plants and In Vitro Activity for Varroosis Control in Honeybees (Apis mellifera).

The most significant ectoparasitic mite of honeybees, Varroa destructor, has a detrimental effect on bee health and honey output. The principal strategy used by the control programs is the application of synthetic acaricides. All of this has resulted in drug resistance, which is now a major worry for beekeeping. As a result, research on alternate products and techniques for mite management is now required. The aim of this study was to determine whether essential oils (EOs) extracted from botanical species of Lamiacae, typical of the Calabria region of Southern Italy, could reduce the population of the mite V. destructor. Among the best-known genera of the Lamiaceae family are oregano, rosemary and thyme, whose EOs were employed in this study. By steam distillation, the EOs were extracted from Origanum vulgare subsp. viridulum (Martrin-Donos) Nyman, Thymus capitatus Hoffmanns. and Link, Thymus longicaulis C.Presl and Salvia rosmarinus Schleid. plant species harvested directly on the Calabrian territory in their balsamic time. Each EO went to the test in vitro (contact toxicity) against V. destructor. Fifty adult female mites, five for each EO and the positive and negative control, were used in each experimental replicate. The positive controls comprised five individuals treated to Amitraz dilute in acetone, and the negative controls included five individuals exposed to acetone alone. To create the working solution to be tested (50 μL/tube), the EOs were diluted (0.5 mg/mL, 1 mg/mL, 2 mg/mL and 4 mg/mL) in HPLC-grade acetone. After 1 h of exposure, mite mortality was manually assessed. Origanum vulgare subsp. viridulum, Thymus capitatus and Thymus longicaulis were the EOs with the highest levels of efficiency at 2 mg/mL, neutralizing (dead + inactivated), 94%, 92% and 94% of parasites, respectively. Salvia rosmarinus EO gave a lower efficacy, resulting in a percentage of 38%. Interestingly, no adverse effects were highlighted in toxicity tests on honeybees. These results show that these OEs of the Lamiaceae family have antiparasitic action on V. destructor. Therefore, they could be used, individually or combined, to exploit the synergistic effect for a more sustainable control of this parasite mite in honeybee farms.

Practice of Business Intelligence System in Nepalese Small and Medium Enterprises

Everywhere, competition has increased in the digital age. Modern technology makes small business management difficult as well. Customers are aware of the international market. The most recent advancement in management is business intelligence. A data-driven decision to address the challenge encountered by any corporate organization is the current dilemma in management, as opposed to an intuitive or constrained logical decision. Any corporate organization should be concerned with decoding the message from data via scientific analysis. The analysis in this study included 504 Nepalese SEMs. We questioned companies in the manufacturing, service, wholesale, and retail industries on how they used business intelligence in their operations. The survey found that Nepalese SMEs are only just beginning to use business intelligence. For Nepalese businessmen, technological literacy is of the utmost importance. The major worry of Nepalese SMEs is the fear of losing sensitive data.

A comprehensive review on prevention and management of hospital-acquired infections: Current strategies and best practices

Hospital-acquired infections (HAIs) are a significant global public health issue, impacting millions of patients annually. Another name for HAIs is nosocomial infections (NI).These infections arise from illnesses that patients contract while they are in the hospital and can have major negative effects on their health, such as increased morbidity, prolonged hospital stays, or even death. The rise of antibiotic-resistant pathogens has only added to the complexity and severity of HAIs. Healthcare facilities need to take a thorough, evidence-based strategy to HAI prevention and control in order to solve this issue. This entails carrying out evidence-based procedures, like cleaning the environment, using the proper antimicrobial agents, and practicing hand hygiene, in addition to continuously assessing and evaluating their HAI prevention program. Improving patient outcomes, cutting healthcare costs, and preserving public confidence in the healthcare system all depend on lowering the prevalence of HAIs. Improvements in hospital epidemiological surveillance, infection control practices, and the implementation of HAI prevention guidelines should lead to a decrease in the frequency of morbidity and mortality. Nonetheless, HAIs continue to be a major worry for high-risk populations.

Exploring Current Trends and Challenges in Cybersecurity: A Comprehensive Survey

Cyber security is the process of preventing unauthorized access, theft, damage, and interruption to computers, servers, networks, and data. It entails putting policies into place to guarantee the availability, confidentiality, and integrity of information and information systems. Cyber security seeks to protect against a variety of dangers, including as hacking, data breaches, malware infections, and other nefarious actions. Cyber security has grown to be a major worry as a result of the quick development of digital technology and the growing interconnection of our contemporary society. In order to gain insight into the constantly changing world of digital threats and the countermeasures put in place to address them, this survey seeks to study current trends and issues in the area of cyber security. The study includes responses from end users, business executives, IT administrators, and experts across a wide variety of businesses and sectors. The survey gives insight on important problems such the sorts of cyber threats encountered, the efficacy of current security solutions, future technology influencing cyber security, and the human elements leading to vulnerabilities via a thorough analysis of the replies. The most important conclusions include an evaluation of the most common cyber dangers, such as malware, phishing scams, ransom ware, and data breaches, as well as an investigation of the methods and tools used to counter these threats. The survey explores the significance of staff education and awareness in bolstering cyber security defenses and pinpoints opportunities for development in this area. The survey also sheds insight on how cutting-edge technologies like cloud computing, artificial intelligence, and the Internet of Things (IoT) are affecting cyber security practices. It analyses the advantages and disadvantages of using these technologies while taking into account issues like data privacy, infrastructure security, and the need for specialized skills. The survey also looks at the compliance environment, assessing how industry norms and regulatory frameworks affect cyber security procedures. The survey studies the obstacles organizations encounter in attaining compliance and assesses the degree of knowledge and commitment to these requirements. The results of this cyber security survey help to better understand the current status of cyber security and provide organizations and individual’s useful information for creating effective policies to protect digital assets. This study seeks to promote a proactive approach to cyber security, allowing stakeholders to stay ahead of threats and build a safe digital environment by identifying relevant trends and concerns.

Review on the Drug Intolerance and Vaccine Development for the Leishmaniasis.

Leishmaniasis is one of the Neglected Tropical Diseases (NTDs), a zoonotic disease of vector-borne nature that is caused by a protozoan parasite Leishmania. This parasite is transmitted by the vector sandfly into the human via a bite. Visceral leishmaniasis (VL), also called kala-azar, is the most fatal among the types of leishmaniasis, with high mortality mostly spread in the East Africa and South Asia regions. WHO report stated that approximately 3.3 million disabilities occur every year due to the disease along with approximately 50,000 annual deaths. The real matter of concern is that there is no particular effective medicine/vaccine available against leishmaniasis to date except a few approved drugs and chemotherapy for the infected patient. The current selection of small compounds was constrained, and their growing drug resistance had been a major worry. Additionally, the serious side effects on humans of the available therapy or drugs have made it essential to discover efficient and low-cost methods to speed up the development of new drugs against leishmaniasis. Ideally, the vaccine could be a low risk and effective alternative for both CL and VL and elicit long-lasting immunity against the disease. There are a number of vaccine candidates at various stages of clinical development and preclinical stage. However, none has successfully passed all clinical trials. But, the successful development and approval of commercially available vaccines for dogs against canine leishmaniasis (CanL) provides evidence that it can be possible for humans in distant future. In the present article, the approaches used for the development of vaccines for leishmaniasis are discussed and the progress being made is briefly reviewed.

PDNA of Post Flood Event in Pasir Mas, Kelantan, Malaysia

Extreme rainfall variations generally result in either extreme precipitation accompanied by flood risk events. Globally, flooding has been a major worry, particularly in Malaysia. In recent years, the frequency and magnitude of floods have grown substantially. Severe precipitation has caused significant devastation to human life and property. Exposure, vulnerability, and risk analysis use inventories of elements-at-risk (EaR), also known as assets, to determine who and what is at risk. The recent occurrence that occurred in February and December 2022 were unprecedented and cause RM29.8 million of economic losses in Kelantan. Numerous problems that range from structural, social, environmental, economical to psychological impacts strike over the community in this flood prone area. Almost 230, 424 people and 54, 924 houses were directly impacted by this flood event. The primary objective is to determine the entire amount of a disaster’s effect on a nation and based on these findings, to develop an executable and sustainable Recovery Plan for mobilising financial and technical resources. The methodology and procedure for a full evaluation of damages, losses, and requirements, leading to the establishment of a Recovery Strategy. Assessment and Recovery Strategy produced during the PDNA is a necessity as it is a more thorough recovery planning, especially in the event of large-scale disasters. Mapping the impact of the flood catastrophe and gathering all information related to the communities to get back to their daily lives a comprehensive assessment is imperative. With these building back better is feasible for this exposed community. The PDNA analyses disaster consequences and implications. It uses analytical approaches, tools, and strategies for post-disaster evaluations and recovery planning to ensure comparability and uniformity. It provides complete picture of the post-disaster situations highlighting the various requirements and goals of different sectors, social groups, and sub-groups.

Immunohistological Analysis of Lichen Sclerosus of the Foreskin in Pediatric Age: Could It Be Considered a Premalignant Lesion?

A major worry of juvenile penile LS is potential malignant degeneration to spinocellular carcinoma (SCC) in adulthood. LS is characterized by increased CD8+ and CD57+ cells, dermal sclerosis, epidermal atrophy, and hyperkeratosis. p53 and Ki67 are reliable premalignant markers. Our aim was to define the LS immunohistochemical profile of foreskin in children, focusing on tissue immune response and cell proliferation. Thirty specimens of foreskins removed from pediatric patients during circumcision were included: six from ritual operation (A), twelve from phimosis (B), and twelve from phimosis with LS (C). Formalin-fixed paraffin-embedded sections were stained for histomorphology and immunohistochemistry. A quantitative evaluation for CD8, CD57, p53, and Ki-67 and a statistical analysis were performed. As compared to groups A and B, the samples from group C patients showed an acanthotic epidermis, a dermal band of lymphoid infiltrate with a significant enhancement of CD8+ CD57+ lymphocytes, and a keratinocytic hyperplasia with an overexpression of Ki67+ and p53+ cells. Immunohistological findings confirmed an immune reaction and proliferative behavior in juvenile LS of foreskin. We believe that radical circumcision should be the first treatment of choice in pediatric patients with clinical suspicious of LS for the potential risk of transformation to SCC in adulthood.