bluuebunny/crossref_metadata_2025 huggingface dataset:
Cystic Adenoid Carcinomas in Ear, Nose and Throat: Unusual Localizations and a Literature Review
Authors: Hadid F. , Hakimi M. , Oulghoul O. , Benhommad O. , Rochdi Y. , Raji A.
Published: May 2021

Introduction: adenoid cystic carcinoma account 1% for all cancers of the ear nose and throat. Despite slow growth, their recurrence is frequent. This study concerns 5 cases of cystic adenoid carcinoma with atypical ear nose and throat locations (outside the main salivary glands).

Materials and methods: Our work is a study of 5 cases of cylindromes with atypical localizations collected at the ear nose throat and cervico-facial surgery department of Mohamed IV university hospital of Marrakesh: 1 case located at the external auditory meatus, 1 case at the infratemporal fossa, 1 case on the inside of the cheek, 1 case in the soft palate and one laryngotracheal case.

Results and discussion: The management of adenoid cystic carcinoma remains delicate because of their insidious growth, their neurological tropism and their metastatic potential. These associated elements delay the diagnosis that is often made while those tumors are locally advanced, which can make surgery difficult, and be responsible of a lot of late recurrences. The treatment of these tumors has long relied on exclusive surgery. Cystic adenoid carcinomas were considered radio resistant. Retrospective studies have shown the benefit of treatment combining surgery and radiotherapy, in terms of local control and disease-free survival, compared to surgery or radiotherapy alone.

Conclusion: The essential problem of adenoid cystic carcinoma remains the long-term control of the disease. Our results confirm that the gold-standard treatment should be both surgery and radiotherapy.
Trends in Lassa Fever Outbreak in Plateau State Nigeria
Authors: Okoh Elizabeth O. , Gomerep Simji S. , Envuladu Esther A. , Tagurum Yetunde O. , Okoh Adokole F. , Mohammed Amina , Zoakah Ayuba I.
Published: May 2021

Background: Since the first case of Lassa fever was reported in Plateau State, Nigeria in 1969, several outbreaks have occurred, and many more cases are being reported every year. This study aimed to describe the trends in Lassa fever outbreak in Plateau State, Nigeria from 2015 to the first half of 2019.

Methodology: A time series study was carried out employing a retrospective analysis of records of Lassa fever cases (from January 2015 – June 2019) obtained from Plateau State Epidemiological Unit. Cases were identified using the WHO case definition. Age-adjusted cumulative incidence, case positivity and case fatality rates were calculated for each year to study the trends. Data were retrieved and analyzed using Microsoft Excel.

Results: Cases were mainly of the younger age group and were more concentrated in the Northern senatorial zone. Despite the increasing trend in incident cases from 5 in 2015 to 126 in 2019, and age-adjusted cumulative incidence from 1 case per 10,000 population in 2015 to 348 per 10,000 population in 2019, case fatality rate showed a downward trend from 29.6% in 2016 to 12.9% in 2019. Case positivity rates varied from 27.3% to 34.1% to 19.4% and back to 27.3% from 2016 to 2019, and the cumulative Case Positivity Rate was 25.7%.

Conclusion: The incidence of Lassa fever in Plateau State showed an increasing trend while that of mortality was on a downward trend. More efforts should be put in place by the State government and other stakeholders to reduce the burden of this disease.
Knowledge, Attitudes, and Practices of Patients on COVID-19 Epidemic Attending a Primary Health Care Setting Durban, South Africa
Authors: Hoque A. M. , Buckus S. , Hoque M. , Mahbub Alam A. B. M. , Hoque M. E. , Singh N.
Published: May 2021

There is no proven specific treatment or adequate vaccination roll out against COVID-19 infection in South Africa. Optimal infection control measures encompass primary intervention to minimize the spread of COVID-19. Public knowledge, attitude, and practices of dealing with this highly infectious respiratory disease play a vital role in limiting the spread of the infection. Aim was to identify knowledge, attitudes, and practices gaps on COVID-19 pandemic for possible health education intervention. The objectives were to determine the knowledge, attitude and practices of out-patients attending a primary health care facility. A cross-sectional descriptive survey was conducted. The Student’s t-test and ANOVA test were carried out to determine the different mean scores for knowledge, attitudes and practices. Pearson’s correlation test was conducted to determine the relationship between knowledge, attitudes, and practices scores. Binary logistic regression was undertaken to determine the predictor of good knowledge, positive attitude, and preventive practices. A total of 345 out-patient attendees participated of which 51% were male. Over half (52%) of respondents were evaluated as having good knowledge, 59% as having positive attitudes and almost all (95%) were practicing prevention of COVID-19. The knowledge of the respondent was correlated with preventive practices (r=.173, p<0.05). Multiple regression showed that respondents in the age groups 35-44 years and 45-54 years were 2.8 times and 5.7 times more likely to have good knowledge respectively. Non-smokers were 79% less likely to have good knowledge (OR=.219, p<0.05). Respondents with no comorbidity were 50% less likely to have good knowledge (OR=.503, p <0.05), when compared to those having co-morbidities. Respondents with the highest level of education was found to be positive predictor of positive attitudes (OR =7.3, p <0.05). Primary Health Care users have poor knowledge, negative attitudes but practiced properly for the prevention of the transmission of COVID-19. Mass education is required to educate communities to improve knowledge and attitudes on COVID-19 epidemic in SA.
Clinical Medical Students’ Preferred Teaching Methods: A Study at the National Defense University of Malaysia
Authors: Ahmed Sheikh Salahuddin , Reddy Sagili Chandrasekhara
Published: May 2021

Background: Providing appropriate teachings in the curriculum have a great impact on learning by the students.

Objectives: The aim of this study was to determine the clinical undergraduate medical students’ preferred teaching methods provided by the medical educators.

Material and Methods: This study was conducted on 89 medical students in the 4th and 5th year of the Faculty of Medicine and Defense Health, National Defense University of Malaysia, from 1st November 2019 to 31st July 2020. Each of the students was approached with a structured questionnaire for their responses to determine their preferred teaching methods.

Results: Out of 89 students, 46 were male (51.7%); the mean age of the study students was 23.5 years. Among the various teaching methods, bedside teaching was the most preferred (76.4%) one followed by lectures (14.6%), tutorials (7.9%) and seminars (1.1%). 66.3% of students would use e-learnings’ uploaded teaching materials, whereas the remainder would not. Bedside demonstrations of clinical skills by the tutors were preferred by 77.5% of students. Practicing clinical skills by the students on a real patient rather than on a mannequin or a simulated patient was preferred by 94.4% of students. Regarding case discussions, problem-based learnings (PBL) were preferred by 80% of students.

Conclusions: Bedside teachings, demonstrations of clinical skill by a teacher, practicing skills by the students on a real patient rather than on a simulated patient or a mannequin, and PBLs are highly preferred by the students. Adequate teaching materials uploaded in the e-learning management system provide a good source for the teachings and learnings.
New Insights on Diagnosis and Treatment of Cerebral Venous Thrombosis – A Narrative Review
Authors: Schreiner Thomas Gabriel
Published: May 2021

Cerebral venous thrombosis (CVT), although accounting for only 0.5-1% of all strokes, remains a potentially fatal neurological emergency, which must be promptly diagnosed and treated. Consisting of two parts, this review aims to highlight the most important data from recent years regarding diagnosis and treatment of CVT, illustrating both the current modern therapeutic approach and the future research directions in the field. Regarding the clinical diagnosis, the neurologist may sometimes have difficulties in recognizing this pathology, given the diverse clinical picture of the acute stage of CVT that can mimic various neurological disorders. In addition, although most risk factors (procoagulation status, infections, trauma, systemic diseases) are known and can be easily detected, in a significant percentage of cases the etiology remains uncertain. For paraclinical diagnosis, among the imaging investigations essential to support the diagnosis, CT angiography and MRI venography are reliable alternatives to digital subtraction angiography which represent the gold standard nowadays. In terms of treatment, international guidelines provide general directions for anticoagulation, with low molecular weight heparin being highly recommended. Regarding invasive treatment methods (thrombolysis, thrombectomy) that could be used in severe cases where anticoagulation has been shown to be insufficient, as well as symptomatic therapy, the evidence is often insufficient, new randomized clinical trials with large cohorts of patients being required.
Removal of Silicon Oil from the Vitreous Cavity via the Anterior Chamber. Eight Years of the Author’s Experiences
Authors: Cywinski Adam
Published: May 2021

Purpose: To evaluate usefulness and safety of removal of silicone oil from the vitreous cavity via the anterior chamber.

Methods: The procedures were performed between 2012 and 2020 in 31 patients who required endotamponade with the use of light silicone oils. In most of the patients, the procedure was combined with cataract removal, secondary lens implantation or transscleral fixation of an artificial lens. A passive bimanual technique was used to replace silicone oil with fluid.

Results: The procedure to remove silicon oil via the anterior chamber proceeded without serious intra- and postoperative complications. There were no hypotony observed in first postoperative day.

Conclusion: Patients eligible for the procedure are those who have preoperative indications for silicone oil removal and whose removal path via the anterior chamber is not associated with a special need to remove the lens from the eye.
Influence of Having Breakfast on Happiness and Attention-Concentration among High School Students
Authors: Irfan S. Marriyah , Irfan S. Fatima
Published: May 2021

Background: Healthful nutrition has a positive connection with both physical and mental health. Breakfast is often considered as the most important meal of the day. Despite the benefits, skipping the morning meal is highly prevalent among adolescents. Healthy eating has an effect on happiness and concentration but a firm connection has not been established. Breakfast skipping can be a factor and a gap in the literature exists in this regard. The aim of this study was to evaluate the relationships between eating breakfast, happiness and attention concentration among high school students.

Methods: In this descriptive cross-sectional study, a convenient sampling strategy was used to select the students from an International school located in Riyadh, Saudi Arabia. The 29-item Oxford Happiness Questionnaire along with demographic variables was employed as research instrument. Chi-square test, student t-test and ANOVA were used to compare different categorical variables.

Results: The overall Happiness mean score was 3.621 ± 0.6637. Students who were regular at having breakfast every day had higher happiness mean scores. Overall, 40% of the participants reported to have decreased concentration/attentiveness during the first 4 lectures at school. Majority (55%) of the breakfast skippers were distracted in the lessons. A regular breakfast eating habit was found to be significantly associated with happiness (p=0.04) and concentration during lectures (p=0.04) respectively. Majority of the students had insufficient physical activity (72%) and had experienced stress (88%) in the last six months respectively. The prevalence of being overweight/ obese among breakfast skippers was higher (39%) than was in breakfast consumers (26%).

Conclusion: Eating breakfast was associated with higher happiness scores and better concentration among high school students. An alarmingly high prevalence of stress among students is a cause of concern. Schools should start breakfast eating programs and promote physical activity to reduce stress. Future studies are needed to explore the factors associated with stress.
Caesarean Section in a Tertiary Hospital in South-South, Nigeria: A 3-year Review
Authors: Allagoa Dennis O. , Oriji Peter C. , Tekenah Ebiye S. , Obagah Lukman , Ohaeri Onyekachi S. , Mbah Kanayochukwu M. , Ikoro Chima , Wagio Tonebimonyo J. , Nwanze Nnamdi C. , Atemie Gordon
Published: May 2021

Background: Caesarean section is the delivery of the foetus, placenta, and foetal membranes through an incision on the abdominal and uterine walls after the age of foetal viability. It is a life-saving surgical procedure, which has helped reduce maternal and perinatal morbidity and mortality over the years.

Objective: To determine the rates, indications, outcomes, and complications of Caesarean section at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.

Materials and Methods: This research was carried out at the Department of Obstetrics and Gynaecology, Federal Medical Centre (FMC), Yenagoa, Bayelsa State, South-South, Nigeria between 1st January 2018 and 31st December 2020. It was a retrospective study.

Data was retrieved from the labour ward records, delivery register, theatre records, and patients’ folders during the period under review, and entered into a pre-designed proforma.

Data were analysed with IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables.

Results: About 959 women had Caesarean section (CS) out of 2,263 deliveries, giving a Caesarean section rate of 42.4%. The commonest indication for emergency Caesarean section was cephalopelvic disproportion (36.0%), while that for elective Caesarean section was repeat Caesarean section (19.6%).

Conclusion: The Caesarean section rate in our Centre is extremely high, almost three times the acceptable upper limit set by the WHO. Encouraging vaginal birth after Caesarean section as a means to reduce this high rate is recommended as it was noted that previous Caesarean section was a leading indication for surgeries.
Gastric Cancer Case with Skin Metastases and Scleroderma-like Paraneoplastic Rheumatic Syndrome
Authors: Lavrinovica Alisa , Gasenko Evita , Plate Signe
Published: May 2021

In this case report, we will describe a gastric cancer case, which presented with rare manifestation of skin metastases and unrelated to the mechanical impact of distant metastases scleroderma-like paraneoplastic rheumatic syndrome.

72-year-old woman was referred to hospital with complaints gradual during the time period of one year. Skin changes included - thickening, dermal induration mostly seen on her upper body – arms, neck, face, chest and abdominal wall, causing contracture and limited movements. In the area of her upper arms, neck and upper part of her chest multiple small, painless, hard subcutaneous nodules were present and hyperpigmentation in the neck area. There were no signs of Raynaud’s phenomenon, telangiectasia, alopecia, hypopigmentation or muscle weakness and pain. Upon further examination and multiple biopsies (gastric and skin nodules) poorly differentiated gastric carcinoma was confirmed with peritoneal dissemination, ascites, cutaneous, subcutaneous metastasis and scleroderma-like paraneoplastic syndrome. After systemic treatment for gastric cancer patient showed improvement of paraneoplastic syndrome manifestations, quality of life and radiologically stable disease.
Is an Anion Generating Face Mask the Ultimate Solution for Airborne Pollutants?
Authors: Khalid Madiha , Madvin Jeremy
Published: May 2021

Airborne negatively charged ions have long been used for cleaning spaces by removing dust particles and stunting bacterial, fungal, and viral growth. Likewise, the ongoing pandemic has made the use of face masks inevitable. A novel concept has been established by integrating the benefits of negatively charged air ions with the advantages of conventional facemasks to tackle the current situation and offer additional advantages as well. The newly devised concept can be used by any individual who can wear a mask but will be especially useful for healthcare workers, infected individuals and those concerned about the possibility of inhaling harmful airborne particles. This new facemask concept may be crucial in reducing the risk of airborne diseases and is a far better choice in adequate protection as opposed to the standard single or multi layered cloth mask. This new mask concept is simple, cost effective, and appears to perform extraordinarily well. It requires no outside power source and is even washable and reusable. It is also remarkably comfortable and can be designed so that one size fits most adults.
Measuring Stress Experienced by University Students
Authors: Istasy Marco , Elias Rana , Raheb Maria , Cernovsky Zack
Published: May 2021

Background: University students often report feeling intense stress, high anxiety, depressive feelings, low self-esteem, suicidal ideation, and substance abuse. This study presents a new questionnaire measure of student stress consisting of 30 items to investigate the symptoms of stress and potentially protective factors.

Method: A total of 100 Canadian university students (mean age 20.2 years, SD=2.5, 33 males, 67 females) participated in an internet survey. They all completed our 30 item questionnaire dealing with the perceived stress of studying and exams, and with symptoms such as nightmares, depression, feelings of “being better off dead,” low self-esteem, and with potentially protective factors such as the extent of positive attitude to professors and pride in or contentment with the social status as a university student.

Results: High proportions of students reported feeling, at least at times, better off dead (52%). About a half of them felt that most professors do not seem to like them (56%) and many reported nightmares about exams (53%). Lower perceived levels of student stress were associated with more positive feelings towards the professors (r=-.37) and with more pride in being a university student and the contentment with the related social status (r=-.25). The Cronbach alpha coefficient of internal consistency of our questionnaire was .87, i.e., satisfactory.

Discussion: The high prevalence of nightmares about exams, feeling of “being better off dead,” or of not being liked by the professors is worrisome. Positive relations towards the professors or pride in or contentment about being a university student function as statistically significant but only weak and hence insufficient protective factors.

Conclusions: More than 50% of students reported nightmares about exams, feeling of “being better off dead,” or of not being liked by the professors. Further research is needed to evaluate correlates of student stress to other protective factors than those explored in the present study.
Validation of the PTSD Checklist for DSM-5 (PCL-5) on Patients Injured in Car Accidents
Authors: Cernovsky Zack Z. , Fattahi Milad , Litman Larry C. , Diamond David M.
Published: May 2021

Background: The PTSD Checklist for DSM-5 (PCL-5), is presently the most widely used psychological measure of PTSD along the criteria of DSM-5. We examined the criterion validity of PCL-5 separately for each of its 20 items by comparing scores of patients injured in high impact motor vehicle accidents (MVAs) to scores of persons in a control group. In addition, we evaluated criterion and convergent validity of the PCL-5 total scores.

Method: De-identified data of 80 post-MVA patients (mean age 38.9 years, SD=12.8) included their scores on the PCL-5, Brief Pain Inventory (BPI), Insomnia Severity Index (ISI), Rivermead Post-concussion Symptoms Questionnaire, Subjective Neuropsychological Symptoms Scale (SNPSS), ratings of depression, anger, and anxiety (Items 10 to 12 of the Whiplash Disability Questionnaire), and three questionnaire measures of driving anxiety (Steiner’s, Whetstone’s, and DAQ). The patients were assessed, on the average, 49.7 weeks (SD=36.3) after their MVA, but all still experienced active post-MVA symptoms requiring therapy.

The PCL-5 scores were also available from 21 controls (mean age 43.0 years, SD=20.3).

Results and Discussion: With respect to criterion validity of the PCL-5, the post-MVA patients differed significantly from the control group not only with respect to their total PCL-5 scores, but also on all 20 individual items of the PCL-5, and also on all 4 subscales of PCL-5 (Intrusion, Avoidance, Altered Cognitions/Mood, and Arousal). The PCL-5 total scores correlated significantly to all three measures of post-MVA driving anxiety, post-MVA pain and insomnia, post-MVA depression, anger, and generalized anxiety, and to post-MVA subjective neuropsychological symptoms in the post-concussion and whiplash spectrum.

Conclusions: Both the criterion and convergent validity of the PCL-5 for the use on post-MVA patients are excellent.
Examining Alopecia through Selected Case Studies in Bangladesh
Authors: Barbhuiyan Zahed Parvez , Akter Samina
Published: May 2021

The COVID-19 pandemic has been triggered unprecedented health crisis across the globe. Millions have lost their lives to the virus while many are still coping with post-covid complications. Much of the health impacts are still unknown. The horror unleashed by the virus has been a major source of stress for many people. Indeed, this situation is a difficult process for the individuals to cope up with and this resulting in psychosocial stress. This increased psychosocial stress can affect the individuals suffering from stress sensitive skin diseases. Most of the people notice heavy hair fall during quarantine. We also observed increasing cases of alopecia in our clinic for last several months among those who have recovered from COVID-19. The pandemic has been spreading in Bangladesh since March 2020 and numerous methods were taken including quarantine in order to prevent the spreading of the disease that were at the highest point in May 2020. Thus, we noticed the percentage of the patients with alopecia in 2020 is higher compared to the corresponding period of previous year.
Frequency of Hypertension after 10 Years of Military Services in Bangladesh Army
Authors: Khaleduzzaman H.M. , Mishu Nafisa Jabin
Published: May 2021

Bangladesh army performs different activities in war and peace in all terrain so physical fitness is the prime requirement for military services. Though military personnel perform regular physical activities they are not immune from hypertension. Hypertension is a multivariate disease ranging from physical and psychological factors. In this study hypertension found among 16% of participants where some modifiable factors were found associated with development of early onset hypertension like lack of physical activities, increase mental stress, overweight, smoking, pattern of dietary habit, lack of awareness and abnormalities in lipid profile. Further study is required to establish these modifiable risk factors and their intervention to prevent early onset hypertension among military service personnel in Bangladesh. Which not only improve the health condition of military personnel but also increase the efficiency of Bangladesh Army as well as it will reduce the health expenditure related to hypertension.
Mechanisms Lead towards Improved Health: Massage with Earthing
Authors: Khalid Madiha , Madvin Jeremy
Published: May 2021

Massage can alleviate the inflammatory process, help to accelerate recovery, and relieve pain resulting from muscular injuries. In this paper, we combine the idea of mechanotransduction (conversion of mechanical stimulus into electrochemical activity) using grounding in massage to investigate beneficial mechanisms. Grounding massage has been discovered to stabilize the physiology of the body, help reduce pain, inflammation, stress, enhance sleep, increase energy, and blood flow, and enhance well-being by connecting the body with the electrical charges of the Earth. Such effects are systemic and basic, and often quickly evolve. This process can reduce secondary injury, collateral sprouting, and nerve sensitization by modifying inflammatory signaling pathways, resulting in improved damage recovery and pain reduction or prevention. Research shows that grounding, when simultaneously combined with many CAM clinical practices, can offer great potential to improve their effectiveness. The paper aims to explain how massage therapy, combined with geographically and simultaneous earthing, causes a potentially beneficial and properly activated immunomodulatory pathway.
A Camouflaged Case of Disseminated Tuberculosis Presenting as Adrenal Crisis
Authors: Siddiqui Saquib Navid
Published: May 2021

Lymphohematogenous spread of mycobacterium tuberculosis to multiple organs presents a complex diagnostic challenge to any physician. A holistic and vigilant approach is required in the quest to diagnose disseminated tuberculosis causing adrenal failure. Although tuberculosis can affect various endocrine glands of the body yet adrenal remains the most common.[1] It is also the fifth most common site for extra-pulmonary tuberculosis.[2] The incidence of tuberculous Addison’s disease has lowered courtesy of anti-tubercular medications accounting for only 7-20% of cases.[1] Here we showcase a rare incidence where a 39 years old gentleman with no constitutional symptoms and no known co-morbidities presenting with neck pain went into adrenal crisis and eventually was found to be due to disseminated tuberculosis which affected his lungs, adrenal glands, cervical spine, and brain.
Fibromatosis Colli: A Review of 4 Cases
Authors: Hakimi Maha , Oulghoul Omar , Othmane Benhoummad , Rochdi Youssef , Raji Abdelaziz
Published: May 2021

Fibromatosis colli is a rare congenital pseudotumor of the sternocleidomastoid muscle, mainly found in the pediatric population. We propose to present four cases diagnosed in the ENT-Neck and head surgery department of the university medical center Mohammed VI in Marrakech, moreover we will recap the management strategy of this entity but also its evolution. We received in the pediatric emergency three infants of 1, 3 and 6 months old and one child of 7 years old, with as a main symptom a painful congenital torticollis. The ultrasound added to our clinical inspection allowed us fairly easily to diagnose the patients. No drug or surgical treatment was prescribed in the infant cases, though surgical treatment was inevitable in the 7 years old patient’s case. During the follow-up, carried out each month, we observed a gradual regression of swelling and torticollis. The prevalence of FC is estimated at 0.3-2% of births. The diagnosis is made at the age of 3 to 4 weeks of life by a thorough inspection of a torticollis associated with a later cervical mass in the framework of a difficult delivery (use of forceps or suction cup). Ultrasonography allows us to diagnose this entity due to the typical aspect of a fusiform thickening of the Sternocleidomastoid muscle. Surgical and medical treatment is rarely useful, and only symptomatic treatment is indicated. The spontaneous evolution of Fibromatosis colli is, even in the absence of treatment, the regression spontaneously in 4 to 6 months. Fibromatosis colli is a relatively rare entity, its frequency in Africa remains to be established, but it is clear that an early diagnosis is key to a speedy recovery.
Incidence of Synchronous Multiple Primary Melanoma in Patients with Solitary Melanoma: a Prospective Comparative Study
Authors: Egorenkov V. V. , Moiseenko F. V. , Volkov N. M. , Molchanov M. S. , Ravkina M. S. , Abduloeva N. Kh. , Linets A. V. , Khairutdinov V. R. , Aksenov M. S. , Moiseyenko V. M.
Published: May 2021

Background. Malignant melanoma is steadily exaggerating over the recent decades. Nonetheless, improved systemic therapies have substantially increased life expectancy in patients with a locally advanced or disseminated disease. Higherincidence recurrent melanocytic skin lesions become essentially problematic and require more attention and control.

Aim. Cross-survey on the incidence of synchronous multiple primary melanomas in patients with solitary melanoma and those with other operable solid tumours.

Materials and methods. A total of 289 patients with suspected malignant pigmented skin melanoma were included in the survey. Patients were divided in two cohorts by the presence of primary skin melanoma and its tractability for radical excision. Patients with operable melanoma comprised the study cohort, and those with other solid tumours were the control.

Results and discussion. The survey covered 289 patients, with 148 in the study and 141 in the control cohort. The study148 patients revealed 112 malignant pigmented melanomas, but none in the control cohort. A chi-square statistical analysis of clinical values in single and multiple melanoma cases showed a slightly higher prevalence of first-visit melanomas in patients with synchronous tumours (30% pT4 — p = 0.007).

Conclusion. The observed 10% rate of second melanoma in the study cohort and a zero melanoma incidence in the control support the alternative hypothesis of a higher rate of newly detected melanomas in primarily diagnosed melanoma patients vs. those with solid tumours.
Accelerated Recovery Protocol in Extended Combined and Single-Stage Surgery for Pelvic Cancer
Authors: Lyadov V. K. , Garipov M. R. , Moskalenko A. N. , Cherepanova E. V. , Dikova T. S.
Published: May 2021

Introduction.The study aimed to evaluate a routine accelerated recovery management in patients with extended combined pelvic surgery.

Materials and methods.We surveyed the records and outcomes in various oncological patients following the accelerated recovery protocol after a routine extended combined pelvic surgery at the Moscow City Oncology Hospital No. 1 during 2018–2020.

Results and discussion.Locally advanced tumours comprised 37 (75.5 %) cases, and the remaining 12 (24.5 %) were nonpelvic resections due to metastasis. Radical surgery was achieved in 41 (83.7 %) cases, while the other 8 (16.3 %) were symptomatic due to the emerged complications of intestinal permeability disruption, bleeding, urinary obstruction, paracancrotic abscess, internal fistulae or pain syndrome. Postoperative complications were evaluated in the Clavien-Dindo classification.

Conclusion.The results obtained suggest the feasibility of an accelerated recovery protocol-based practice in extended combined pelvic surgery.
Efficacy of Videoendoscopic Inguinal Femoral Lymphadenectomy for Management of Metastatic Skin Melanoma
Authors: Egorenkov V. V. , Moiseenko F. V. , Volkov N. M. , Molchanov M. S. , Ravkina M. S. , Abduloeva N. Kh. , Linets A. V. , Khairutdinov V. R. , Ibragimov A. M. , Moiseyenko V. M.
Published: May 2021

Aim. Assessment of the utility and advantage of videoendoscopic inguinal femoral lymphadenectomy (VE-LAD) over the standard open technique (OLAD) in patients with malignant skin melanoma and metastatic lesions of regional inguinal and/or femoral lymph nodes.

Materials and methods. The Saint-Petersburg Clinical Research Centre for Specialty Medical Aid in Oncology managed 86 inguinal femoral LADs in melanoma patients over 2013–2016. VE-LAD was rendered in 48 (54.7 %) cases, and OLAD otherwise.

Results and discussion. A total of 72 patients were included in the study. VE-LAD was performed in 48 (54.7 %) cases, and OLAD otherwise. An average VE-LAD duration was 90 (60 to 160) min. Severe complications were observed in 4/48 (8 %) VE-LAD and 16/24 (66 %) OLAD cases, which reveals a significantly lower complication rate in the study cohort (chi-square p > 0.000). Lymphorrhoea was shorter in the study cohort (> 7 days in 5 patients vs. 3/24 and > 14 days only in 11/24 OLAD cases; chi-square p > 0.000). No significant differences in relapse-free survival were observed between the cohorts, with higher absolute values of 22.6 months in the VE-LAD (95 % CI 14.8–30.4, p = 0.087) vs. 9.4 months (95 % CI 0.0–18.9, p = 0.087) in OLAD cohort. A median OS was 52.3 months (95 % CI 30.5–74.1, p = 0.996) in the VE-LAD vs. 39.9 months (95 % CI 30.6–49.2, p = 0.996) in OLAD cohort.

Conclusion. Videoendoscopic inguinal femoral lymphadenectomy allows a radical inguinal femoral lymph node removal alike in conventional surgical dissection. Our results indicate the method performance towards reduced postoperative wound complications. The oncological indicators are comparable to the traditional surgery cohort.
Neuroendocrine Breast Cancer. Clinical Observation. Personalized Approach
Authors: Gantsev Sh. Kh. , Schaller G. , Gantsev K. Sh. , Plikhta A. N. , Kzyrgalin Sh. R. , Rustamkhanov R. A.
Published: May 2021

Introduction. Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain.

Materials and methods. The article presents a rare clinical observation of a neuroendocrine breast tumor. A breast fibroadenoma was diagnosed at the initial diagnosis stage in a private clinic; after a surgical treatment and further morphological study, it was estimated: a diagnosis of Cancer in situ of the left breast T1N0M0, stage I. Next, 3D-conformal remote radiation therapy was performed on the area of the left breast.

Results and discussion. After conducting positron emission tomography, multiple metastases were detected in the lymph nodes, bones, and liver. Additionally, micropreparations were consulted at the Federal Reference Center in St. Petersburg and at an independent third-party molecular biological laboratory in Germany (Munich). Given all the instrumental, molecular biological, histological and immunohistochemical studies of the patient, an individual regimen of drug therapy was selected.

Conclusion. After 18 months of personalized drug therapy, we observed a positive trend and a significant decrease in metabolic activity according to positron emission tomography.
Genetic Predictors of Malignancy: a Literature Review
Authors: Pushkarev A. V. , Galeev M. G. , Pushkarev V. A. , Sultanbaev A. V.
Published: May 2021

The review covers recent research on cancer as a genetic disease manifesting both sporadically and in germline through variant genomic mutations or DNA rearrangements. This change can be point mutations, chromosomal aberrations or hypermethylation leading to DNA repair failures. Defects in tumour suppressor genes (BRCA1, BRCA2, CHEK2, PTCH1, etc.) underly hereditary predisposition to breast cancer (BC) and ovarian cancer (OC) due to genome instability. Studying somatic mutations is key to the understanding of carcinogenesis mechanisms and finding apt therapies. Heterogeneity of cancers renders the tumour mutation profiling uneasy. The treatment choice and efficacy in BC and OC depends on homologous recombination defects in tumour cells usually imposed by damaged BRCA1/2 genes. CHEK2- associated neoplasms account for most hereditary BCs linked to flaws in the DNA repair machinery. Overexpression of the PTCH1 protein is the target in breast, lung, ovarian, colonic cancers, etc.

Genetic research has fundamentally altered our understanding of the aetiology and pathogenesis of human malignancy. The molecular cancer phenotype is of paramount importance in the disease prognosis and treatment personalisation.
Prognostic Value of BRCA1 and BRCA2 Gene Mutations in Prostate Cancer: a Literature Review
Authors: Loginova M. V. , Pavlov V. N. , Gilyazova I. R.
Published: May 2021

Prostate malignancies aggressively grow worldwide frequently occurring inoperable at diagnosis. A proper choice of treatment strategy is currently a challenge. Metastatic castration-resistant prostate cancer remains fatal and poor-prognosis, albeit the list of chemotherapeutic agents and androgen receptor signalling inhibitors has recently been extending towards a certain therapeutic success. Numerous studies suggest a frequent association of the unfavourable prognosis with germline or somatic damage of DNA repair genes. Such are mutations in the BRCA1 and BRCA2 genes bearing important clinical implications for the patient outcome through an adverse clinical manifest of primary tumours and poor treatment in metastatic castration-resistant prostate cancer. This review attempts to describe the BRCA1/2 mutations in prostate cancer with a focus on their prognostic value.
Thematic Review of Studies about Preschool Astronomy Education in Turkey1
Authors: EZBERCİ ÇEVİK Ebru , TANIK ÖNAL Nagihan
Published: May 2021

This study aimed to examine thematically the articles and dissertations made in Turkey about preschool astronomy education. In the research, a descriptive study was conducted, and the survey model was used. The study covered researches of preschool astronomy education that can be accessed in the national databases. Studies in analyzing data were; the type of publication, the distribution of the studies according to the years and the indexes in which they are included, the keywords used, the subject/concept of astronomy, the purpose of the studies, and the distribution according to the provinces, the methodologies used in the studies, the basic results achieved in the studies and the suggestions. The studies were first coded separately by researchers, and the reliability of the coding was ensured by forming a common opinion. As a result, most of the studies determined were articles of the year 2015 and above, and these studies are generally published in ULAKBIM indexed journals. Most repetitive keywords in research; preschool, astronomy, and mental model. The concept of astronomy focuses on studies of the Sun, Earth, and Moon. The studies mostly aimed to reveal the students' level of knowledge, misconceptions, and mental models related to basic astronomy concepts. The most preferred research method in the studies was the qualitative paradigm; the most preferred research designs were case studies and survey models. The researches were mostly carried out with the children in preschool age and the provinces of Balıkesir and Trabzon with samples smaller than 100 people. In most of the studies, interviews, drawings, and observations were used as data collection tools, and the content analysis technique was used in the analysis of the data. The general results of the studies showed that the mental models of preschool children about astronomy consist of concrete concepts and the participants lack knowledge on astronomy. In the studies, suggestions were made to researchers and practices.
Metallic Ratios : The Mathematical Relationships between different Metallic Means
Authors: Rajput Chetansing
Published: May 2021

This paper introduces the precise mathematical relationships between different Metallic Ratios. Certain distinctive mathematical correlations are found to exist between various Metallic Means. This work presents the empirical formulae those provide the exact mathematical relationships between different Metallic Ratios.
Metallic Means; The Geometric Substantiation of all Metallic Ratios
Authors: Rajput Chetansing
Published: May 2021

This paper introduces certain new geometric aspects of the Metallic Ratios. Each Metallic Ratio is observed to be closely associated with a special right triangle, which provides the precise fractional expression of that Ratio. This work explicates the geometric substantiation of Metallic Ratio, on basis of the right angled triangle which is the quintessential form of that particular ratio.
Golden Ratio, Silver Ratio and other Metallic Means ; Geometric Substantiation of all Metallic Ratios
Authors: Rajput Chetansing
Published: May 2021

This paper introduces the concept of special right angled triangles those epitomize the different Metallic Ratios. These right triangles not only have the precise Metallic Means embedded in all their geometric features, but they also provide the most accurate geometric substantiation of all Metallic Means. These special right triangles manifest the corresponding Metallic Ratios more holistically than the regular pentagon, octagon or tridecagon, etc
DETERMINAN TINGKAT PENGANGGURAN ANTAR PROVINSI DI INDONESIA
Authors: Kharisma Bayu , Wardhana Adhitya
Published: May 2021

Indonesia is one of the countries with the largest unemployment in ASEAN countries. This condition is because some provinces still have unemployment rates that exceed unemployment in Indonesia. Low public education, high poverty and population in several provinces of Indonesia are among the causes of the increase in the unemployment rate in Indonesia. This research will discuss how much influence the education sector has on the average years of schooling (RLS), population, poverty rate and government spending on housing in Indonesia. The research model uses data panel regression method with a scope of 33 provinces in Indonesia. The results explain the average length of school and spending negatively affect unemployment. Then variable population numbers, the poverty rate affects positively towards unemployment.
HUBUNGAN RETURN ON ASSETS YANG DIPENGARUHI PENDAPATAN BAGI HASIL
Authors: Vitaningrum Mineva Riskawati , Mubarokah Isro'iyatul
Published: May 2021

Mayoritas penduduk di Indonesia adalah muslim, dimana telah timbul suatu kebutuhan dalam menginvestasikan , pembiayaan usaha serta menampung dana yang berdasarkan prinsip Syariah. Kegiatan Lembaga keuangan syariah dengan prinsip bagi hasil yang paling diminati adalah musyarakah dan mudharabah. Tujuan dari penelitian ini untuk mengetahui hubungan Return On Assets yang dipengaruhi pendaptan bagi hasil diwakili oleh pendapatan mudharabah dan pendapatan musyarakah. Populasi dari penelitian ini bank umum syriah yang terdaftar di www.ojk.go.id. Data penelitian menggunakan laporan keuangan triwulan dari tahun 2017-2019. Penelitian ini berjenis kuantitatif dengan pengujian hipotesa menggunakan SPSS ver.23. Pengujian menggunakan uji analisis linear berganda, uji t, dan uji F. Hasil dari penelitian menunjukan pendapatan mudharabah berpengaruh terhadap ROA hal ini dibuktikan dari uji statistik yang menghasilkan thitung sebesar 3,551 dan ttabel sebesar 2,002 dimana thitung lebih besar dari ttabel  (thitung > ttabel) dan pendapatan musyarakah tidak berpengaruh terhadap ROA hal ini dibuktikan dari uji statistic thitung sebesar -1,924 dan ttabel sebesar 2,002  dimana thitung lebih kecil dari ttabel  (thitung < ttabel). Secara simultan pendapatan mudharabah dan pendapatan musyarakan berpengaruh terhadap ROA. Hal ini ditunjukan hasil dari uji f Fhitung sebesar 6,485 dengan nilai signifikasi 0,003 < 0,05 dan nilai Ftabel 3,16, maka nilai Fhitung > Ftabel dengan besar pengaruh 18,5%.
PENGARUH UMR DAN PENDIDIKAN TERHADAP KESEMPATAN KERJA DAN PERTUMBUHAN EKONOMI KABUPATEN/KOTA PROVINSI BALI
Authors: Gunawan I Wayan , Arka Sudarsana
Published: May 2021

Pertumbuhan ekonomi merupakan suatu bentuk perkembangan kegiatan/aktvitas dalam perekonomian yang ditandai dengan meningkatnya produksi barang dan jasa serta meningkatnya kesejahteraan masyarakat. Kesejahteraan masyarakat dapat tercapai apabila pemenuhan kebutuhan hidup dapat terpenuhi melalui besaran pendapatan yang dihasilkan masyarakat, terdukungnya tingkat pendidikan yg memumpuni, serta akses kesempatan kerja untuk masyarakat dapat terpenuhi secara berkelanjutan dan berkesinambungan.

Tujuan dari penelitian ini untuk menganalisis pengaruh UMR dan pendidikan terhadap kesempatan kerja di kabupaten/kota Provinsi Bali, untuk menganalisis pengaruh UMR, pendidikan dan kesempatan kerja terhadap pertumbuhan ekonomi di kabupaten/kota Provinsi Bali, dan untuk menganalisis peran kesempatan kerja memediasi pengaruh UMR dan pendidikan terhadap pertumbuhan ekonomi di kabupaten/kota Provinsi Bali. Data yang dipergunakan dalam penelitian ini adalah data sekunder. Penelitian ini menggunakan data panel dengan jumlah pengamatan sebanyak 45 dengan menggunakan metode pengumpulan data secara observasi non partisipan. Teknik analisis yang digunakan dalam penelitian ini adalah analisis jalur (path analysis).

Hasil penelitian menunjukkan bahwa UMR tidak berpengaruh signifikan terhadap kesempatan kerja di kabupaten/kota di Provinsi Bali, sedangkan pendidikan berpengaruh positif dan signifikan terhadap kesempatan kerja di kabupaten/kota di Provinsi Bali. UMR berpengaruh negatif dan signifikan terhadap pertumbuhan ekonomi di kabupaten/kota di Provinsi Bali, sedangkan pendidikan dan kesempatan kerja berpengaruh positif dan signifikan terhadap pertumbuhan ekonomi di kabupaten/kota di Provinsi Bali. Kesempatan kerja tidak memediasi pengaruh UMR terhadap pertumbuhan ekonomi di kabupaten/kota di Provinsi Bali. Sedangkan Kesempatan kerja memediasi pengaruh pendidikan terhadap pertumbuhan ekonomi di kabupaten/kota di Provinsi Bali.

Kata kunci: Upah, pendidikan, kesempatan kerja, pertumbuhan ekonomi.
PENGARUH BANTUAN SOSIAL TUNAI TERHADAP KONSUMSI ROKOK RUMAH TANGGA MISKIN DI PROVINSI LAMPUNG
Authors: Saksono Erika Haryulistiani
Published: May 2021

Kemiskinan merupakan sebuah masalah yang memiliki sifat multidimensional karena berkaitan dengan aspek sosial, ekonomi, budaya dan lainnya. Kemiskinan merupakan masalah global yang menjadi prioritas negara di seluruh di dunia untuk ditangani termasuk di Indonesia khususnya dalam penelitian ini adalah Provinsi Lampung. Rumah tangga miskin yang menerima bantuan seperti Program Indonesia Pintar, Raskin dan Jamkesda merupakan rumah tangga yang berpotensi memiliki pengeluaran konsumsi rokok setara dengan beras. Apabila hal tersebut terus menerus terjadi, pengentasan kemiskinan melalui bantuan sosial hanyalah retorika belaka. Populasi dalam penelitian ini adalah individu rumah tangga miskin  yang  merupakan populasi sampel rumah tangga miskin SUSENAS Maret 2019 yang menerima bantuan sosial tunai di Provinsi Lampung. Data yang digunakan adalah data sekunder raw data SUSENAS Maret 2019 Provinsi Lampung sebanyak 3700 individu rumah tangga miskin. Metode penelitian yang digunakan adalah regresi logistik biner. Hasil dari penelitian ini adalah bantuan sosial tunai ,pendapatan per kapita dan klasifikasi wilayah/area tidak berpengaruh secara signifikan terhadap kejadian merokok pada rumah tangga miskin. Sedangkan status/kedudukan dalam pekerjaan dan jenis kelamin individu rumah tangga miskin berpengaruh secara signifikan terhadap kejadian merokok pada rumah tangga miskin di Provinsi Lampung.