A bibliometric analysis of global research on united nations security council sanctions (1990-2023).

UNSC sanctions have been referred to as a powerful tool increasingly used by the UNSC to maintain international peace and security based on Chapter VII of the United Nations Charter. This study conducts a bibliometric analysis to provide a comprehensive overview of the current research status, developments trends, and research hotspots in UNSC sanctions research from 1990 to 2023. This study uses CiteSpace to visualize and analyze datasets of 345 articles about UNSC sanctions obtained from the Web of Science (WOS) database. The research on UNSC sanctions has three stages: the initial development stage (1990-2006), the transitional development stage (2007-2017), and the rapid development stage (2018-2023). This study describes UNSC sanctions research status, trends, hotspots, and distributions of publications by journal sources, disciplines, countries, institutions, and authors. It also describes the knowledge-based mapping and research hotspots on UNSC sanctions, including keywords, citation burst, keyword clusters, keyword clusters timeline view, cited references, intellectual base, and descriptive analysis. In addition, this study analyzed UNSC sanctions research divided into four domain categories: implementation, human rights, impacts, and specific regimes. The results showed that the topic of UNSC sanctions was multidisciplinary research and that scholars from different research disciplines had different focuses on UNSC sanctions. This study offers valuable insights into the current hot topics within the field of UNSC sanctions and offers recommendations for future research directions.

Machine learning based multi-method interpretation to enhance dissolved gas analysis for power transformer fault diagnosis.

Accurate interpretation of dissolved gas analysis (DGA) measurements for power transformers is essential to ensure overall power system reliability. Various DGA interpretation techniques have been proposed in the literature, including the Doernenburg Ratio Method (DRM), Roger Ratio Method (RRM), IEC Ratio Method (IRM), Duval Triangle Method (DTM), and Duval Pentagon Method (DPM). While these techniques are well documented and widely used by industry, they may lead to different conclusions for the same oil sample. Additionally, the ratio-based methods may result in an out-of-code condition if any of the used gases fall outside the specified limits. Incorrect interpretation of DGA measurements can lead to mismanagement and may lead to catastrophic consequences for operating power transformers. This paper presents a new interpretation technique for DGA aimed at improving its accuracy and consistency. The proposed multi-method approach employs s scoring index and random forest machine learning principles to integrate existing interpretation methods into one comprehensive technique. The robustness of the proposed method is assessed using DGA data collected from several transformers under various health conditions. Results indicate that the proposed multi-method, based on the scoring index and random forest; offers greater accuracy and consistency than individual conventional interpretation methods alone. Furthermore, the multi-method based on random forest demonstrated higher accuracy than employing the scoring index only.

Robustness evaluations of pathway activity inference methods on gene expression data.

BACKGROUND: With the exponential growth of high-throughput technologies, multiple pathway analysis methods have been proposed to estimate pathway activities from gene expression profiles. These pathway activity inference methods can be divided into two main categories: non-Topology-Based (non-TB) and Pathway Topology-Based (PTB) methods. Although some review and survey articles discussed the topic from different aspects, there is a lack of systematic assessment and comparisons on the robustness of these approaches. RESULTS: Thus, this study presents comprehensive robustness evaluations of seven widely used pathway activity inference methods using six cancer datasets based on two assessments. The first assessment seeks to investigate the robustness of pathway activity in pathway activity inference methods, while the second assessment aims to assess the robustness of risk-active pathways and genes predicted by these methods. The mean reproducibility power and total number of identified informative pathways and genes were evaluated. Based on the first assessment, the mean reproducibility power of pathway activity inference methods generally decreased as the number of pathway selections increased. Entropy-based Directed Random Walk (e-DRW) distinctly outperformed other methods in exhibiting the greatest reproducibility power across all cancer datasets. On the other hand, the second assessment shows that no methods provide satisfactory results across datasets. CONCLUSION: However, PTB methods generally appear to perform better in producing greater reproducibility power and identifying potential cancer markers compared to non-TB methods.

A review of dairy cattle heat stress mitigation in Indonesia.

Indonesia is a tropical country with a hot climate. In tropical nations such as Indonesia, heat stress is a key reason for the reduced productivity of dairy cattle. Heat stress is a combination of internal and external stimuli that affects an animal, raises its body temperature, and causes it to react physiologically. Most Indonesian dairy cattle are Friesian Holstein (FH), imported from European nations with a temperate environment with low temperatures in the range of 5°C-25°C. Indonesia has a tropical climate with a high ambient temperature that can reach 34°C during the day and the local relative humidity varies between 70% and 90%. Temperature and humidity are two microenvironment factors that may impact the production and heat release in FH cattle. More than 98% of the entire dairy cattle population in Indonesia is found on Java Island. On Java Island, there are between 534.22 and 543.55 thousand heads of cattle, while the dairy cattle population outside Java Island is just 6.59 thousand heads of cattle. The milk output climbs by an average of 3.34% per year, or approximately 909.64 thousand tons and the average annual growth in whole milk consumption was 0.19 L/capita. Indonesian cow milk output has been unable to keep pace with the country's increasing demand. This study aimed to review the strategies to mitigate heat stress in FH dairy cattle in Indonesia.

Giant lumbar schwannoma with retroperitoneal extension and vertebral body invasion: a case report.

Schwannoma is a type of peripheral nerve sheath tumor derived from Schwann cells. There have been only a few cases of giant lumbar schwannoma with retroperitoneal extension eroding the vertebral body documented. Thus, managing these tumors presents various challenges. This paper reports a case of a 59-year-old woman who experienced lower back radicular pain for a year. A lumbar magnetic resonance imaging revealed the presence of a giant extradural soft tissue tumor measuring 8.6x7.4x9.7 cm, compressing the right L5-S1 neural foramen and extending into the retroperitoneal space while eroding the L5 vertebral body. The patient underwent surgery via a retroperitoneal approach, and the tumor was successfully resected. Histopathological examination confirmed the diagnosis of schwannoma. In conclusion, giant retroperitoneal lumbar schwannomas with bone invasion are rare, and gross total resection is the preferred treatment option, but the size and location of the tumor can make the surgery challenging.

The effects of heat-moisture treatment on resistant starch levels in cassava and on fermentation, methanogenesis, and microbial populations in ruminants.

Background and Aim: Resistant starch (RS) is difficult to digest in the digestive tract. This study aimed to evaluate the effects of heat-moisture treatment (HMT) on RS in cassava and examined its impact on rumen fermentation. Materials and Methods: Cassava flour was used as a raw material and used in a randomized block design with four different cycles of HMT as the treatments and four different rumen incubations in vitro as blocks. Treatments included: HMT0: without HMT (control), HMT1: one HMT cycle, HMT2: two HMT cycles, and HMT3: three HMT cycles. Heat-moisture treatment processes were performed at 121°C for 15 min and then freezing at -20°C for 6 h. Analyzed HMT cassava starch characteristics included components, digestibility, and physicochemical properties. In in vitro rumen fermentation studies (48 h incubation) using HMT cassava, digestibility, gas production, methane, fermentation profiles, and microbial population assessments were performed. Results: Heat-moisture treatment significantly reduced (p < 0.05) starch, amylopectin, rapidly digestible starch (RDS), and slowly digestible starch levels. In contrast, amylose, reducing sugars, very RDS, RS, and protein digestion levels were significantly increased (p < 0.05). Additionally, a reduced crystallinity index and an increased amorphous index were observed in starch using Fourier-transform infrared analyses, while a change in crystalline type from type A to type B, along with a reduction in crystallinity degree, was observed in X-ray diffraction analyses. Heat-moisture treatment significantly (p < 0.05) reduced rumen dry matter (DM) degradation, gas production, methane (CH4 for 12 h), volatile fatty acid (VFA), and propionate levels. In addition, acetate, butyrate, and acetate/propionate ratios, as well as population of Streptococcus bovis and Bacteroides were significantly increased (p < 0.05). However, pH, ammonia, and organic matter digestibility were unaffected (p > 0.05) by HMT. Conclusion: Cassava HMT altered starch characteristics, significantly increased RS, which appeared to limit rumen digestion activity, decreased rumen DM degradation, gas production, VFAs, and CH4 production for 12 h, but increased S. bovis and Bacteroides levels.

Heterochely and handedness in the orange mud crab Scylla olivacea: implication for future culture practice optimisation.

Asymmetric body traits in bilateral organisms are common and serve a range of different functions. In crustaceans, specifically among brachyuran crabs, heterochely and handedness in some species are known to aid in behavioural responses such as food acquisition, and sexual and territorial displays. However, the heterochely of the intertidal mud crab genus Scylla is still poorly understood. This study investigated the cheliped morphometric characteristics of orange mud crab Scylla olivacea and the relation of heterochely and handedness to sex. Scylla olivacea is heterochelous, with predominant right-handed (70.2%). Three morphometric variables, i.e., propodus length (PL), propodus depth (PD), and propodus width (PW) were significantly larger in the right cheliped and the estimated handedness based on these three variables were consistent with the presence of molariform teeth. The effect of sex had no influence on the occurrence of heterochely or handedness. The frequency of left-handedness increased with size, especially in males. We postulate that handedness reversal, a phenomenon seen in other crab species when the dominant hand is lost, also occurs in S. olivacea, thereby resulting in a change in left-handedness frequency. The use of chelipeds by males in mate and territorial defenses might provide an explanation for the higher risk of losing a dominant cheliped and thus, higher left-handedness frequency compared to females. Future behavioural research could shed light on the selective forces that affect the handedness distribution in mud crabs. Knowledge on heterochely and handedness of mud crabs could be useful for future development of less aggressive crab populations by claw reversal and the optimisation of limb autotomy techniques.

An Entropy-Based Directed Random Walk for Cancer Classification Using Gene Expression Data Based on Bi-Random Walk on Two Separated Networks.

The integration of microarray technologies and machine learning methods has become popular in predicting the pathological condition of diseases and discovering risk genes. Traditional microarray analysis considers pathways as a simple gene set, treating all genes in the pathway identically while ignoring the pathway network's structure information. This study proposed an entropy-based directed random walk (e-DRW) method to infer pathway activities. Two enhancements from the conventional DRW were conducted, which are (1) to increase the coverage of human pathway information by constructing two inputting networks for pathway activity inference, and (2) to enhance the gene-weighting method in DRW by incorporating correlation coefficient values and t-test statistic scores. To test the objectives, gene expression datasets were used as input datasets while the pathway datasets were used as reference datasets to build two directed graphs. The within-dataset experiments indicated that e-DRW method demonstrated robust and superior performance in terms of classification accuracy and robustness of the predicted risk-active pathways compared to the other methods. In conclusion, the results revealed that e-DRW not only improved the prediction performance, but also effectively extracted topologically important pathways and genes that were specifically related to the corresponding cancer types.

Fatores e escores clínicos relacionados a candidemia em pacientes críticos com e sem HIV com infecção de corrente sanguínea / Clinical factors and scores related to candidemia in critically ill patients with and without HIV with bloodstream infection

Introdução: Infecções de Corrente Sanguínea (ICS) por Candida spp. apresentam alta letalidade em casos de atraso terapêutico. Na Unidade de Terapia Intensiva (UTI) do Instituto de Infectologia Emílio Ribas, a taxa de candidemia correspondeu a aproximadamente 20% das ICS em 2016, sendo o segundo agente mais frequente de ICS desde 2011. Dada tamanha relevância e demanda por métodos baratos e acessíveis de triagem de pacientes de alto risco para tal complicação, criar escores para detecção de candidemia tem se tornado uma prática frequente. De tal forma, avaliamos três escores preditores publicados na literatura aplicados em pacientes críticos com resultado sorológico majoritariamente HIV positivo. Objetivo: Identificar os fatores de risco para candidemia e o escore preditor de candidemia com melhor correlação estatística para uma população com HIV atendida em UTI especializada. Metodologia: Estudo epidemiológico retrospectivo, observacional. Por meio de revisão de literatura, onde foram identificados os escores de Leon et al, Ostrosky et al e Guillamet et al, para cálculo de amostra mínima necessária para o estudo. A seguir, foram incluídos todos os casos notificados de ICS de novembro de 2015 a setembro de 2019, de acordo com os critérios laboratoriais da ANVISA, 2017. Foram então analisados os fatores de risco para candidemia a partir de prontuários eletrônicos. Para comparar os escores, foi empregado cálculo de Kolmogorov Smirnov para definição de normalidade, Qui-quadrado e depois Teste de Fisher ou U de Mann-Whitney para amostras não dicotômicas. Resultados: Para candidemia na amostra total, na regressão univariada, infecção hospitalar prévia nos últimos 90 dias [OR 5,68, IC 95% 1,62 ­ 19,94, p = 0,007], uso de nutrição parenteral total (NPT) durante a internação [OR 3,54, IC 95% 1,49 ­ 8,41, p = 0,004], NPT nos 3 dias anteriores ao desfecho [OR 3,34 IC 95% 1,39 ­ 8,03, p = 0,007], pancreatite nos 7 dias anteriores ao desfecho [OR 3,72, IC 95% 1,19 ­ 11,59, p = 0,024] e choque séptico de foco não pulmonar [OR 2,69, IC 95% 1,07 ­ 6,81, p = 0,036], apresentaram significância. Já no modelo de regressão logística múltipla, manteve-se NPT [OR 3,55, IC 95% 1,43-8,78, p = 0,006] e pancreatite há menos de 7 dias [OR 5,68, IC 95% 1,58-20,47, p = 0,008] como fatores associados a candidemia. Nenhum dos escores de risco, quando com a pontuação mínima atingida, apresentou significância estatística ao desfecho candidemia para a amostra total. Na análise restrita aos pacientes com HIV, para desfecho candidemia, a regressão logística univariada revelou significância estatística para pancreatite nos últimos 7 dias [OR 3,58, IC 95% 1,35 ­ 12,37, p = 0,044], o uso de NPT em qualquer momento da internação [OR 3,37, IC 95% 1,26-8,98, p = 0,015), o uso de NPT nos últimos 3 dias prévios à manifestação de ICS [OR 3,13, IC 95% 1,15-8,49, p = 0,025], choque séptico de foco pulmonar [OR 3,34, IC 95% 1,20-9,31, p = 0,021], e um escore de Guillamet et al igual ou superior a 3 [OR 3,72, IC 95% 1,34-10,39, p = 0,012]. Já no modelo de regressão logística múltipla, manteve-se o escore de Guillamet et al, [OR 3,47, IC 95% 1,21 ­ 9,90, p = 0,02] e uso de NPT durante a internação [OR 3,09, IC 95% 1,12 ­ 8,54, p 0,03] como fatores associados ao desfecho candidemia. Corticoterapia nos últimos 7 dias prévios à ICS [OR 2,42, IC95% 1,06 ­ 5,49], sepse grave [OR 3,89, IC 95% 1,57 ­ 9,66], neutropenia [OR 7,26, IC 95% 1,43 ­ 37,01] e qualquer cirurgia prévia [OR 3,38, IC 95% 1,23 ­ 9,33] foram fatores associados a óbito na amostra total. Conclusão: Em UTIs com grande prevalência de pacientes com HIV, NPT e pancreatite podem ser fatores clínicos associados a candidemia. Caso tal indivíduo seja PVHA, a presença de NPT e o escore de Guillamet et al podem ser relevantes em estudos para descartar ou aumentar suspeição clínica sobre candidemia, sendo necessário mais análises sobre esse desfecho e a relevância desses escores nessa população. (AU)

Introduction: Bloodstream Infections (BSI) by Candida spp presents high lethality in cases of therapeutic delay. In the Intensive Care Unit (ICU) of our institution, the candidemia rate corresponded to approximately 20% of the BSI in 2016, being the second most frequent agent of BSI since 2011. Given such relevance and demand for easy to use and affordable methods of screening patients at high risk for such complication, creating scores for candidemia has become a frequent practice. Thus, we evaluated three predictive scores published in the literature applied in critically ill patients with HIV positive status. Objective: To identify the risk factors for candidemia and the predictor score of candidemia with the best statistical correlation for a population with HIV treated in a specialized ICU. Methodology: Retrospective, observational study. Through literature review, the scores of Leon et al, Ostrosky et al and Guillamet et al were identified, and the minimum sample required for the study was calculated. Next, all reported cases of CSI from November 2015 to April 2018 were included, according to ANVISA laboratory criteria, 2017. Risk factors for candidemia were analyzed from electronic medical records. To compare the scores, Kolmogorov Smirnov was calculated for normality definition, Chi-square and then Fisher's Test or Mann-Whitney U test for non-dichotomic samples. Results: For the whole ICU population, on univariate analysis for candidemia outcome, previous hospital acquired infection over the last 90 days [OR 5.68, IC 95% 1.62 ­ 19.94 (p = 0.007)], Total Parenteral Nutrition (TPN) use during hospital stay [OR 3.54, IC 95% 1.49 ­ 8.41, p = 0.004], TPN use over the the last 3 days before BSI incidence [OR 3.34 IC 95% 1.39 ­ 8.03, p = 0.007], pancreatitis 7 days prior to BSI incidence [OR 3.72, IC 95% 1.19 ­ 11.59, p = 0.024] and non-pulmonary septic shock syndrome [OR 2.69, IC 95% 1.07 ­ 6.81, p = 0.036] were significant. On the multivariate regression, TPN [OR 3.55, IC 95% 1.43-8.78, p = 0.006] and pancreatitis 7 days prior to BSI incidence [OR 5.68, IC 95% 1.58-20.47, p = 0.008] remained as candidemia associated factors. No candidemia risk score was significant to candidemia outcome when minimum requirements were attained for the whole sample. For HIV positive patients only, on univariate analysis, pancreatitis 7 days prior to BSI incidence [OR 3.58, IC 95% 1.35 ­ 12.37, p = 0.044], TPN use during hospital stay [OR 3.37, IC 95% 1.26-8.98, p = 0.015], TPN use over the the last 3 days before BSI incidence [OR 3.13, IC 95% 1.15-8.49, p = 0.025], non-pulmonary septic shock syndrome [OR 3.34, IC 95% 1.20-9.31, p = 0.021], and a Guillamet et al score point equal or superior to 3 [OR 3.72, IC 95% 1.34-10.39, p = 0.012] were significant. On the multivariate analysis, Guillamet et al, [OR 3.47, IC 95% 1.21 ­ 9.90, p = 0.02] and TPN use during hospital stay [OR 3.09, IC 95% 1.12 ­ 8.54, p = 0.03] remained significant towards candidemia outcome. Corticoid use on the last seven days before BSI [OR 2,42, IC95% 1,06 ­ 5,49], severe sepsis [OR 3,89, IC 95% 1,57 ­ 9,66], neutropenia [OR 7,26, IC 95% 1,43 ­ 37,01] and any previous surgery [OR 3,38, IC 95% 1,23 ­ 9,33] were associated with death outcome on the whole sample. Conclusion: When a patient manifest BSI in ICUs with high prevalence of HIV positive patients among its population, TPN and pancreatitis may be clinical factors associated with candidemia. Nonetheless, in HIV positive critical patients who manifest BSI, besides TPN, Guillamet et al score might also be a relevant tool to discard or raise suspicion of candidemia, although more clinical trials are required about such outcome and candidemia risk scores accuracy on this population. (AU)

Differences in the length of postoperative care of endoscopic endonasal surgery in simple and complex surgical procedure groups.

Background: The rapid development of endoscopic endonasal surgery has made the procedure widely used in nasal and sinus surgery. Endoscopic endonasal surgery is a minimally invasive procedure, but the possibility of postoperative damage to the sinonasal mucosa cannot be ruled out. The aim of this study was to analyze the difference in the length of postoperative care between complex and simple endoscopic endonasal surgeries which can be used as a reference in planning postoperative care.   Methods: This was a retrospective cross-sectional observational study. The participants were divided into two groups, i.e., simple, and complex surgical procedures groups. The simple procedure group consisted of middle meatal anstrostomy, uncinectomy, endoscopic septoplasty, and endoscopic turbinoplasty. The complex procedure group included frontal sinusotomy, sphenoidectomy, as well as anterior and posterior ethmoidectomy. The length of postoperative care between the two groups were measured and analyzed using the Chi-square test.   Results: The median length of care in the complex procedure group was significantly longer than that in the simple procedure group (p = 0.028), 12 weeks and 9 weeks, respectively. The number of postoperative outpatient visits was significantly less in the simple procedure group compared with the complex procedure group (Median 4 vs. 5; p=0.015). There was a significant correlation between length of care and the endonasal endoscopic surgical procedure group (p = 0.023).   Conclusions: The complex endoscopic endonasal surgery group required a longer length of care and more postoperative outpatient visit than the simple procedure group.

Reshaping the Management of Allergic Rhinitis in Primary Care: Lessons from the COVID-19 Pandemic.

The COVID-19 pandemic presented unique challenges to the delivery of healthcare for patients with allergic rhinitis (AR) following its disruption and impact on the healthcare system with profound implications. Reliance on self-care for AR symptom management was substantial during the pandemic with many patients encouraged to only seek in-person medical care when necessary. The advantage of digital technology becomes apparent when patients and healthcare providers had to change and adapt their method of interaction from the regular physical face-to-face consultation to telehealth and mobile health in the provision of care. Despite the pandemic and the ever-evolving post pandemic situation, optimal management of AR remains paramount for both patients and healthcare professionals. A reshaping of the delivery of care is essential to accomplish this goal. In this paper, we present what we have learned about AR management during the COVID-19 pandemic, the role of digital technology in revolutionizing AR healthcare, screening assessment in the identification and differentiation of common upper respiratory conditions, and a framework to facilitate the management of AR in primary care.

Comparison of Deep Learning Algorithms in Predicting Expert Assessments of Pain Scores during Surgical Operations Using Analgesia Nociception Index.

There are many surgical operations performed daily in operation rooms worldwide. Adequate anesthesia is needed during an operation. Besides hypnosis, adequate analgesia is critical to prevent autonomic reactions. Clinical experience and vital signs are usually used to adjust the dosage of analgesics. Analgesia nociception index (ANI), which ranges from 0 to 100, is derived from heart rate variability (HRV) via electrocardiogram (ECG) signals, for pain evaluation in a non-invasive manner. It represents parasympathetic activity. In this study, we compared the performance of multilayer perceptron (MLP) and long short-term memory (LSTM) algorithms in predicting expert assessment of pain score (EAPS) based on patient's HRV during surgery. The objective of this study was to analyze how deep learning models differed from the medical doctors' predictions of EAPS. As the input and output features of the deep learning models, the opposites of ANI and EAPS were used. This study included 80 patients who underwent operations at National Taiwan University Hospital. Using MLP and LSTM, a holdout method was first applied to 60 training patients, 10 validation patients, and 10 testing patients. As compared to the LSTM model, which had a testing mean absolute error (MAE) of 2.633 ± 0.542, the MLP model had a testing MAE of 2.490 ± 0.522, with a more appropriate shape of its prediction curves. The model based on MLP was selected as the best. Using MLP, a seven-fold cross validation method was then applied. The first fold had the lowest testing MAE of 2.460 ± 0.634, while the overall MAE for the seven-fold cross validation method was 2.848 ± 0.308. In conclusion, HRV analysis using MLP algorithm had a good correlation with EAPS; therefore, it can play role as a continuous monitor to predict intraoperative pain levels, to assist physicians in adjusting analgesic agent dosage. Further studies may consider obtaining more input features, such as photoplethysmography (PPG) and other kinds of continuous variable, to improve the prediction performance.

Study on the Quality of Life among Cancer Survivors Attending a Tertiary Care Cancer Center in Malaysia.

Background: Cancer is a major public health problem across the globe. According to the Malaysian National Cancer Registry Report (MNCR), between 2007 and 2011, there has been a greater increase in the number of reported cancer cases among females (99.3 per 100,000 people) than males (86.9 cases per 100,000 people). Nearly 15 million new cancer cases were projected by 2020. We conducted this study to assess the quality of life (QoL) among cancer patients. Design and Methods: This was a cross-sectional study conducted in the oncology department of Malaysian hospitals from October to November 2019. The study population comprised Malaysians in the age range of18 to 100 years diagnosed with cancer, irrespective of their treatment status, cancer type and prognosis. A pre-tested structured questionnaire was used in seventy cancer patients' using a convenient sampling method. Data were collected using a questionnaire survey after obtaining permission from the hospital administrators. Data were entered in MS Excel and analysis was done using the SPSS-version 23. Participants' socio-demographic characteristics were described using descriptive statistics. Results are presented using graphs, tables, mean, percentages, standard deviation, frequency, and significance. Analysis of variance (ANOVA) test was performed to find out the association between socio-demographic variables and overall QoL scores of the patients. Results: Of the seventycancer patients, 29 (41.43%) were males and 41 (58.57%) were females. The most affected socio-demographic factors were marital status and occupation (employment). It was found that there were 55 (78.57%) married patients and 49 (70%) employed patients. QoL of most of the patients was influenced by the education level and treatment. It was found that 35 (50%) of them had low QoL scores. It was observed that QoL among the study participants was significantly (p<0.05) associated with their level of education and the level of treatment. Conclusions: There is a need to develop measures for community education, involvement of family physicians for the treatment of cancer and to increase awareness to improve the QoL among cancer patients. The focus should be on the development of strategies empowering patients to seek treatment and gain control over their illness with the collaboration with primary care physicians.

Extraction of sphenochoanal polyp with functional endoscopic sinus surgery approach: A rare case and review article.

BACKGROUND: Sphenochoanal polyp, a rare case of nasal polyp, is a benign mass that originates in the sphenoid sinus and develops into a choanal polyp. CASE PRESENTATION: A 36-year-old Indonesian male complained of irregular right nasal obstruction and runny nose for one year. Physical examination showed soft tissue mass in the right nasal cavity, cyst retention in the right maxillary sinus, right sphenoid sinus, and cervical spondylosis. Diagnosis of sphenochoanal polyp was supported by nasoendoscopy and CT-Scan of paranasal sinuses. The patient got medical care and underwent functional endoscopic sinus surgery (FESS) and rinsed the nose with normal saline and topical steroids. Evaluation at six months after the surgery, the patient came without complaint and showed no sign of polyp mass or cysts recurrence, so the patient was declared to have a full recovery. DISCUSSION: FESS is proven effective for managing sphenochoanal polyp and minimizes complications post-surgery and repetition of the polyp. CONCLUSION: FESS is recommended for management of sphenochoanal polyp in term of minimizing recurrency.

Improving the Accuracy of Rainfall Prediction Using Bias-Corrected NMME Outputs: A Case Study of Surabaya City, Indonesia.

Generating an accurate rainfall prediction is a challenging work due to the complexity of the climate system. Numerous efforts have been conducted to generate reliable prediction such as through ensemble forecasts, the North Multi-Model Ensemble (NMME). The performance of NMME globally has been investigated in many studies. However, its performance in a specific location has not been much validated. This paper investigates the performance of NMME to forecast rainfall in Surabaya, Indonesia. Our study showed that the rainfall prediction from NMME tends to be underdispersive, which thus requires a bias correction. We proposed a new bias correction method based on gamma regression to model the asymmetric pattern of rainfall distribution and further compared the results with the average ratio method and linear regression. This study showed that the NMME performance can be improved significantly after bias correction using the gamma regression method. This can be seen from the smaller RMSE and MAE values, as well as higher R 2 values compared with the results from linear regression and average ratio methods. Gamma regression improved the R 2 value by about 30% higher than raw data, and it is about 20% higher than the linear regression approach. This research showed that NMME can be used to improve the accuracy of rainfall forecast in Surabaya.

Olfactory neuroblastoma resection through endoscopic endonasal approach: A rare case report.

BACKGROUND: Olfactory neuroblastoma (ON) is a rare malignant tumor originating from the nasal cavity and/or skull base. CASE PRESENTATION: A 53-year-old female complained of a runny nose mixed with blood on the left nasal cavity since 1 year ago. Histopathology result showed malignancy and immunohistochemistry showed ON supported by CT-Scan result. The patient underwent endoscopic endonasal approach resection with anterior septectomy followed by debulking with cautery and cutting instruments. The patient received 35 times of radiotherapy combined with 6 times chemotherapy subsequently. DISCUSSION: Firstly, reported successful management of ON in Indonesia. CONCLUSION: An ON case of an Indonesian female was successfully resected without complication through a join operation of endoscopic endonasal approach four-hand technique with a neurosurgeon.

Management of cerebrospinal fluid leak in the lateral recess of the sphenoid sinus with transpterygoid approach: A case report.

BACKGROUND: Cerebrospinal fluid (CSF) leak that occurred in the lateral sphenoid sinus is a rare and difficult case. This paper aims to report a case of defect closure in the lateral recess of the sphenoid sinus endoscopically with a transpterygoid approach. CASE PRESENTATION: A 38-year-old Indonesian woman reported a CSF leak, and identified a defect in the lateral recess of the left sphenoid sinus. CSF leak was repaired with endoscopic transethmoid-pterygoid or transpterygoid endoscopic surgery and no CSF leak was found. The surgical procedure was successful even though it was only performed by an otorhinolaryngologist. DISCUSSION: Endoscopic transethmoid-pterygoid or transpterygoid endoscopic surgery is effective in repairing defects in the lateral recess of the sphenoid sinus in which surgical procedure is performed by a single otorhinolaryngologist. CONCLUSION: Endoscopic transpterygoid approach gained access to lateral site of sphenoid sinus was an effective approach in managing CSF leak of lateral sphenoid recess. Closure of the defect using a bone graft and mucosa of the middle turbinate was proven to be effective. It had been carried out successfully in Indonesia.

Transnasal endoscopic neochoanal technique: An effective procedure for bilateral choanal atresia in adult female.

BACKGROUND: Surgery on bilateral choanal atresia surgery is challenging and this case is rare in adults. In addition, stenosis issue postoperatively is commonly seen. CASE PRESENTATION: Transnasal endoscopic neochoanal technique was performed on a 27 years old female with the detailed surgical procedure was described. Neither stent nor nasal tamponade was applied. Ten months follow-up revealed a patent-wide neochonae. DISCUSSION: Transnasal endoscopic neochoanal technique without stent and nasal tamponade can be considered the procedure of choice in the management of CA cases. CONCLUSIONS: Transnasal endoscopic neochoanal technique is considered an effective surgical procedure on bilateral choanal atresia.

A rare case of allergic fungal rhinosinusitis in Indonesian elderly: A case report and diagnostic procedure.

BACKGROUND: Allergic fungal rhinosinusitis (AFRS) is a rare case. CASE PRESENTATION: A 63-year-old-man presented right nasal congestion one year ago. There was a polyp in the right nasal cavity supported CTScan showed a solid mass with central hyperattenuating of ±8.4 × 2.4 × 4.4 cm. Total IgE value was 1,227 IU/ml, while Aspergillus specific IgE and Mucorous specific IgE using the micro-Elisa technique were negative or less than 0.35 IU/ml. The skin prick test was positive on exposure to house dust, cotton, chicken meat, and cow's milk. Mucosal polypoid and allergic mucin were found during functional endoscopic sinus surgery (FESS). Histopathology showed inflammatory cells of eosinophils. DISCUSSION: These results lead to a diagnosis of AFRS according to the Bent and Kuhn criteria. The highest incidence rate is in adolescents and young adults but it occurs in the elderly. So, some of the signs and symptoms of AFRS in adolescents and young adults do not appear. CONCLUSION: AFRS can only be diagnosed during FESS when mucins are found, this case appear in the elderly to be very interesting.