Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Perencanaan dan strategi pembelajaran matematika

xxi, 371 hlm. ill. ; 23 cm

Failure investigation of natural gas pipeline

A study was carried out to investigate the probable cause or events that might have led to the failure of two parallel natural gas pipes, API 5L X42 carbon steel (NPS 8) and the SDR 17, 125 mm medium density polyethylene pipes. These two pipes were laid side by side in the same trench with a water pipe. The investigation was performed by analyzing the existing design and construction data, visual inspection of failed pipes, and pipe material analysis. Investigation from the relevant pipes data suggests that the leaked water pipe was the first to fail. The leaked water pipe created high pressure water jetting that mixed with the back?lling soil to form water–sand–soil slurry with high erosive properties. The impact of this erosive slurry upon the NPS 8 pipe had caused serious losses of pipe coating materials. This phenomenon explains the rapid thinning of the steel pipe body which later led to its failure. Evidence from the metallurgical study using photomicrograph showed that the morphology of the steel material was consistent and did not show any evidence of micro fractures

Simulation of drop-off recycling method for recyclable waste in Malaysia

The drop-off center is one of the efficient waste collection methods for recycling and has been implemented in several developed countries. This study was conducted on three selected states in Malaysia, namely the states of Pahang, Selangor and Johor. From the construction of the model, the amount of waste recycled per year, the cost of the drop-off center per state and the profit from marketing recyclable waste materials can be obtained. With the construction of drop- off centers for each state, the waste collection process becomes more efficient and indirectly the amount of waste that has the potential to be recycled can be optimally recycled. In addition, production costs to open new landfills can be reduced

Borneo Jurnal Ilmu Pendidikan LPMP Kalimantan Timur Vol. II, NO. 1, Juni 2008

Pada edisi ini, jurnal Borneo memuat beberapa artikel yang ditulis oleh Widyaiswara LPMP Kalimantan Timur maupun yang ditulis oleh penulis diantaranya, Quality leadership, manajemen peserta didik dalam menghadapi kreatifitas anak, melalui motivasi kepala sekolah dapat meningkatkan minat guru dalam pembuatan perangkat pembelajaran pada SMA Negeri 2 Samarinda jurusan Bahasa, penerapan metode kooperatif dalam peningkatan motivasi dan partisipasi siswa serta kualitas hasil belajar matematika di SMK Negeri 1 Balikpapan, upaya peningkatan kemampuan menulis kreatif siswa kelas II SMP Negeri 35 Samarinda melalui pendekatan kontekstual, pengaruh penerapan model pembelajaran role playing terhadap aktifitas guru dan hasil belajar dalam mata pelajaran pendidikan IPS di sekolah dasar, peningkatan prestasi belajar IPS sejarah melalui model pembelajaran berbasis portofolio pada siswa kelas VIII SMP Negeri 5 Krayan tahun pelajaran 2006 / 2007, bimbingan belajar untuk meningkatkan aktifitasn pembelajaran IPS di kelas V SD Negeri 014 Tanah Grogot, peningkatkan pemahaman materi lembaga Internasional pada bidang studi IPS siswa di Kelas VI SDN 012 Pasir Belengkong dengan menggunakan metode tanya jawab tahun ajaran 2007/2008, dan upaya meningkatakan pembelajaran operasi hitung bilangan cacah siswa kelas IV SD Negeri 011 Malinau dengan metode berdasarkan masalah (problem posing)

Halaqah: Keagamaan dan Moderasi Beragama

BUKU ini merupakan kumpulan tulisan pendek dari sejumlah penulis. Buku terdiri dari dua bagian sesuai dengan tahapan kegiatan focus group discussion yang melibatkan para penulis. Setiap penulis memperoleh giliran untuk memapar-kan tulisannya. Satu pertemuan membahas dua judul tulisan. Dengan demikian, setiap penulis memperoleh kesempatan memberi dan menerima masukan dari teman sejawat. Ini dimaksudkan agar semua tulisan berisi pesan yang seirama pada setiap tahapan diskusi