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

Chapter 5. How to Use a Classic: Petar Petrović Njegoš in the Twentieth Century

“[Njegoš is] the immortal apostle and herald of the unity of our people.”King Aleksandar “Njegoš is Montenegro and Montenegro is Njegoš.”Josip Vidmar “Njegoš is a Serbian writer and this emerges logically from his work.”Zora Latinović It is a truth self-evident that an East European nation in search of its identity must have a national literature and a national poet. Following the model proposed originally by Herder in the early nineteenth century, East European nation-builders have generally..

Chapter 5. How to Use a Classic: Petar Petrović Njegoš in the Twentieth Century

“[Njegoš is] the immortal apostle and herald of the unity of our people.”King Aleksandar “Njegoš is Montenegro and Montenegro is Njegoš.”Josip Vidmar “Njegoš is a Serbian writer and this emerges logically from his work.”Zora Latinović It is a truth self-evident that an East European nation in search of its identity must have a national literature and a national poet. Following the model proposed originally by Herder in the early nineteenth century, East European nation-builders have generally..

Ideologies and National Identities

Twentieth-century Southeastern Europe endured three, separate decades of international and civil war, and was marred in forced migration and wrenching systematic changes. This book is the result of a year-long project by the Open Society Institute to examine and reappraise this tumultuous century. A cohort of young scholars with backgrounds in history, anthropology, political science, and comparative literature were brought together for this undertaking. The studies invite attention to fascism, socialism, and liberalism as well as nationalism and Communism. While most chapters deal with war and confrontation, they focus rather on the remembrance of such conflicts in shaping today's ideology and national identity. "This ably edited volume dealing with twentieth-century southeastern Europe is most welcome. ...the project coorrdinators came to an agreement with their collaborators to foicus on nationalis, communism, fascism, liberalism, and religion. And indeed, all of these elements may be found between the covers of this volume, although the contributors were evidently given free rein. ...this volume offers insights into some neglected areas and is a most welcome addition to the literature on the history of East Central Europe." - The American Historical Review "A truly unique and splendid addition to historical writing on southeastern Europe... Unique is the editors' insistence that each author include several translated primary sources. The diversity of sources is unrivaled by any documentary reader available to those of us who teach European, east European or Balkan history." - Slavic Revie

Ideologies and National Identities

Twentieth-century Southeastern Europe endured three, separate decades of international and civil war, and was marred in forced migration and wrenching systematic changes. This book is the result of a year-long project by the Open Society Institute to examine and reappraise this tumultuous century. A cohort of young scholars with backgrounds in history, anthropology, political science, and comparative literature were brought together for this undertaking. The studies invite attention to fascism, socialism, and liberalism as well as nationalism and Communism. While most chapters deal with war and confrontation, they focus rather on the remembrance of such conflicts in shaping today's ideology and national identity. "This ably edited volume dealing with twentieth-century southeastern Europe is most welcome. ...the project coorrdinators came to an agreement with their collaborators to foicus on nationalis, communism, fascism, liberalism, and religion. And indeed, all of these elements may be found between the covers of this volume, although the contributors were evidently given free rein. ...this volume offers insights into some neglected areas and is a most welcome addition to the literature on the history of East Central Europe." - The American Historical Review "A truly unique and splendid addition to historical writing on southeastern Europe... Unique is the editors' insistence that each author include several translated primary sources. The diversity of sources is unrivaled by any documentary reader available to those of us who teach European, east European or Balkan history." - Slavic Revie