Size Criteria Research Articles

Data saturation in qualitative research: A literature review in entrepreneurship study from 2004–2024

This systematic literature review examines data saturation in qualitative research within the context of entrepreneurship studies from 2004 to 2024. Data saturation, a critical concept in ensuring the rigor of qualitative research, remains inadequately defined in terms of sample size and assessment criteria across various studies. This review synthesizes 11 empirical studies, focusing on strategies such as stopping criterion, code frequency counts, and comparative methods for determining saturation. It identifies sample sizes ranging from 7 to 39 interviews, with an average saturation occurring between 10 and 12 interviews. Furthermore, the study explores the influence of different sampling methods and homogeneity of study populations on saturation outcomes. Despite the reliability of existing methods, the findings underscore the need for greater transparency and consistency in reporting saturation criteria. The review offers valuable insights for entrepreneurial researchers aiming to design qualitative studies, emphasizing the importance of tailored saturation standards based on research objectives and methodologies. This research contributes to a clearer understanding of data saturation in entrepreneurial studies and highlights the necessity for further empirical investigation into saturation across diverse qualitative methods.

Comparative prognostic value of tumor volume in IOIO and IOTKI treatment for metastatic renal cancer

ObjectivesWe aimed to investigate the prognostic significance of tumor size in metastatic renal cell carcinoma (mRCC) by comparing the effectiveness of dual immune checkpoint inhibitor (IOIO) and immune checkpoint inhibitor combined with tyrosine kinase inhibitor (IOTKI) therapies. MethodsThis retrospective observational study included patients with mRCC diagnosed between October 2014 and February 2024 who received IOIO or IOTKI treatment at Kobe University Hospital and 5 affiliated hospitals. Clinical and imaging data were collected, and target lesions were measured according to RECIST v.1.1 criteria. Time-dependent ROC curve analysis was performed to evaluate the prognostic value of tumor size, nephrectomy status, and IMDC risk criteria for progression-free survival (PFS) and overall survival (OS). ResultsThe study included 180 mRCC patients, consisting of 99 receiving IOIO therapy and 81 receiving IOTKI therapy. Time-dependent AUC analysis showed that tumor size had a higher predictive ability for PFS and OS in the IOIO group than the IOTKI group. In multivariate analysis, tumor size was a significant independent prognostic factor for PFS (HR: 1.010, 95% CI: 1.004–1.016, P < 0.001) in the IOIO group. Moreover, the AUC for tumor size was consistently superior in predicting outcomes compared to nephrectomy status and IMDC risk classification in the IOIO group. Kaplan-Meier curves indicated that tumor size effectively stratified PFS in both nephrectomized and non-nephrectomized cases. ConclusionTumor size significantly impacts the prognosis of mRCC patients treated with IOIO therapy, demonstrating greater predictive ability than nephrectomy status and IMDC risk classification. These findings suggest that tumor volume should be considered a critical factor in treatment decision-making for renal cancer, particularly in patients undergoing IOIO therapy.

Ablative Dose Y90 Radiation Segmentectomy for Treatment of Neuroendocrine Liver Metastases

PurposeTo assess the safety and efficacy of Y90 radiation segmentectomy (RS) for neuroendocrine tumor liver metastases (NELMs). Materials and MethodsThis single-institution retrospective study included 18 patients with 23 liver tumors not amenable to resection or ablation, who underwent RS between 2009 and 2021. Tumor grades by Ki-67/mitotic indices were Grade I (n=9/23, 39%), Grade II (n=10/23, 45%) and Grade III (n=4/23, 17%). Eleven patients (61%) were previously treated with somatostatin analogs, five (28%) with chemotherapy, and two (11%) with peptide receptor radionuclide therapy. Safety was assessed with pre/post liver chemistries, blood counts and clinical adverse events (AEs) using National Cancer Institute Common Terminology Criteria for AEs v5.0. Tumor response was assessed per Response Evaluation Criteria in Solid Tumors 1.1 and modified RECIST criteria. Kaplan-Meier analysis was used to estimate median overall survival (OS), progression-free survival (PFS), and time to progression (TTP) from the date of Y90. ResultsMedian follow-up was 31.9 months. Grade 1 fatigue was observed in 13/18 patients (72%), with 1/18 patient (6%) experiencing grade 3 fatigue. Three patients (17%) exhibited grade 3 lymphopenia. No other grade 3 or any grade 4 AE was observed. Tumor objective response was achieved in 83% of patients by RECIST size criteria and 100% by mRECIST enhancement criteria. Median OS was 69.4 months (95% CI, 23.1-99.4) and median PFS was 12.2 months (95% CI, 4.6-28.8). Median overall TTP was 13.0 months (95% CI, 4.6-45.1), with median treated tumor TTP not reached. ConclusionY90 RS demonstrates high rates of antitumor response with a favorable toxicity profile and durable OS in the treatment of NELMs.

A Meta-analysis of Horticultural Therapy Programs for Older Adults with Dementia

Background and objective: This study analyzed the effect size of each element to secure the expertise of horticultural therapy programs for older adults with dementia.Methods: This study conducted a meta-analysis to analyze the effectiveness of horticultural therapy programs for older adults with dementia using 'horticulture' as a search term. To this end, 29 articles were selected and analyzed from a total of 147 articles published between 2003 and 2022.Results: First, the overall effect size of horticultural therapy for older adults with dementia was .522, which is statistically significant. This is considered a medium effect size according to Cohen's (1988) criteria for effect size. Second, the group size, a variable related to the number of subjects, showed the largest effect size when the group had 21–30 participants, and the number of sessions per week showed the largest effect size when the number of sessions was once a week, followed by twice a week, and so on. The effect size was largest when the total number of sessions was 21 or more, and when each session was conducted for 90-120 minutes.Conclusion: This study examined previous studies related to horticultural therapy programs for older adults with dementia through a meta-analysis and presented the results of a systematic effect size analysis. The significance of this study is that it summarized the factors that have a large effect and quantified the effect sizes so that it can be used in various horticultural therapy programs for older adults with dementia.

Lymphoid Aggregates in Canine Cutaneous and Subcutaneous Sarcomas: Immunohistochemical and Gene Expression Evidence for Tertiary Lymphoid Structures.

Canine cutaneous/subcutaneous soft-tissue sarcomas (STS) are diversely derived mesenchymal neoplasms with a risk of recurrence and/or metastasis depending on the extent of surgical excision and histologic grade. Lymphoid aggregates (LAs) are often described in these tumours but not characterised. In humans, LA characterised as tertiary lymphoid structures (TLSs) improve the prognosis of many tumours, including sarcomas. We sought to determine if LA meeting a size criterion (> 700 cells) in canine sarcomas met the criteria of TLS and the overall prevalence of LA of any size. RNA expression in large LAs versus aggregate-adjacent sarcoma tissue (AAS) was measured in laser capture microdissected tissue and compared to curl-derived RNA from aggregate-free sarcomas and lymph nodes. CD3, CD20, MUM-1 and PNAd expressions were measured using immunohistochemistry. CD20 and CD3 mRNA were more highly expressed in LA versus AAS (13.8 fold, p = 0.0003 and 2.3 fold, p = 0.043). This was supported by the IHC findings. The large LAs were also enriched in chemokine RNA expression characteristic of TLS (CXCR5 5.8 fold, p < 00001, CCL19 3.68 fold, p = 0.0209, CCL21 6.87 fold, p = 0.0209 and CXCL13 2.68 fold, p = 0.0924). Plasma cells and high endothelial venules were identified in LA containing tumours but not in control tissue. Large LAs were present in 12% of tumours, and LA of any size in 30%. We conclude that large LAs in canine STS are consistent with TLS.

Normal size of retropharyngeal lymph nodes in children on three dimensional magnetic resonance imaging.

Age-specific normal measurements or specific size criteria for retropharyngeal lymph nodes in children have not been defined. We aimed to determine the normal measurements and distribution of retropharyngeal lymph nodes on three-dimensional magnetic resonance imaging (3-D MRI) in children. In this retrospective study, we included 440 patients (213 girls) aged 0-17years who were admitted to our center with seizures and headaches and underwent brain and neck MRI with T2-sampling perfection with application-optimized contrasts using different flip angle evolution sequences. We evaluated the number, laterality, and level distribution of lateral and medial group lymph nodes according to the skull base-cervical vertebrae. For both groups, we measured the short and long diameters of the largest lymph node in the axial plane and the craniocaudal diameter in the sagittal plane. The short/long diameter ratios and volumes were determined. In 433 cases (98%), 1,554 lateral group lymph nodes were detected. Medial group lymph nodes were less common (7%). The lateral group was mostly bilateral, while the medial group was unilateral. Lateral group lymph nodes extended from the skull base-first cervical (C1) vertebral level to the C4, while the medial group extended from the C2 vertebral level to the C4. The mean axial short axis, axial long axis, and sagittal long axis diameters were 5.8mm, 10.1mm, and 15.5mm for the lateral group and 3.8mm, 7.6mm, and 10.8mm for the medial group, respectively. The findings of the study show that normally retropharyngeal lymph nodes are frequently seen in children and provide valuable information for lateral and medial lymph nodes depending on age.

7708 Navigating Thyroid Cancer With Differences in Thyroglobulin Assessment Techniques

Abstract Disclosure: M.S. Shah: None. S. Humayon: None. N.A. Mungo: None. This case report delves into the diagnostic journey of a patient with papillary thyroid carcinoma, emphasizing the importance of precise thyroglobulin measurement methods. The case highlights the differences between immunoassay and mass spectrometry in monitoring disease progression and treatment response.A 42-year-old female with a family history of thyroid-related issues, was found to have a thyroid nodule on physical exam. She underwent fine-needle aspiration (FNA) revealing papillary thyroid carcinoma, Bethesda category VI. Lymphatic invasion was present necessitating total thyroidectomy and lymph node dissection. Left level 3 and 4 lymph node excision showing 2 of 15 positive for metastatic papillary thyroid carcinoma without extranodal extension. Left superficial jugular lymph node excision showing 1 of 3 lymph node being positive for metastatic thyroid carcinoma without extranodal extension. RAI therapy and post-ablative scan showed focal moderate increased activity adjacent to the left hyoid bone. CT scan of the neck later showed stable appearance of the thyroidectomy bed with no new suspicious soft tissue mass. A small crescentic focus of enhancing soft tissue medial to the left common carotid artery is favored to represent residual thyroid tissue. Multiple small enhancing lymph node in the left neck at level llB and junction of levels ll and lll. Several of these are new or increased in size from prior examination and somewhat acidly enhanced. Although these are within normal limits by size criteria, recurrent diseases cannot be excluded. She underwent another surgical neck dissection with no cancer found. Given the negative findings, a shift from checking thyroglobulin (TG) from immunoassay to mass spectrometry was ideal.Patient was found to have persistent thyroglobulin elevation with Immunoassay, thyroglobulin level (60.5 ng/mL, n&amp;lt;35 ng/ml), without the presence of TG antibodies, whereas liquid chromatography-tandem mass spectrometry (LC-MS/MS) showing (&amp;lt;0.5 ng/mL), highlighting the methodological divergence. To date she has no imaging concerns and repeat testing from different labs similarly demonstrated undetectably Tg by LC-MS/MS and varying levels when tested by Immunoassay. Her levels by Immunoassay have trended down to her most recent level of (38 ng/ml).This case emphasizes the critical role of accurate thyroglobulin assessment in thyroid carcinoma follow-up. Immunoassay and mass spectrometry present divergent results, with LC-MS/MS proving more reliable in monitoring disease progression but more expensive and time consuming. Clinicians should consider the implications of methodological choices on patient management, particularly in cases of persistent elevation despite treatment. The potential discrepancies between these methods should be emphasized considering the impact on treatment decisions. Presentation: 6/1/2024

Integrated Micro-Destination: A Conceptual Framework

The purpose of this research is to develop a different perspective on the classification of the concept of destination, which is one of the important components of the tourism sector, by introducing the concept of 'integrated micro-destination' and evaluating its importance for the tourism sector, especially concerning destinations. In the study, the concept of destination is first defined, and a new concept is developed from a marketing and competitiveness perspective based on the geographical and size criteria used in destination classifications. The theoretical framework of destination classifications is examined, and it is observed in the literature review that the overall competitiveness of a holistic macro-destination is influenced by the competitiveness within its various micro-destinations. The factors affecting the integrated micro destination concept were evaluated from both the prosody and consumer perspectives.

Interobserver variability in the histopathological classification and grading of dysplasia in elevated colon lesions in the city of Lima

Colonic polyp refers to lesions that exhibit a protrusion of the mucosa, regardless of histology. The most recent WHO classification is based on a better understanding of these lesions; however, its application in daily practice could be subject to interobserver variability biases that could have clinical implications. Objectives: To determine the interobserver variability in the histopathological reporting and grading of dysplasia of samples obtained from elevated colon lesions in a private laboratory in the city of Lima. Materials and methods: Observational, descriptive, and prospective study: Case series type. All biopsies of elevated colon lesions received over a period of 3 months were evaluated by two observers without clinical information of the cases, to diagnose the lesions according to the WHO classification. In cases of diagnostic differences, the cases were evaluated together to reach a consensus. Results: A Kappa coefficient value of 0.458 was obtained in the diagnostic classification of elevated colon lesions, while a Kappa value of 0.416 in the evaluation of dysplasia; indicating moderate agreement. Conclusions: Despite achieving moderate agreement between evaluators, this work demonstrates the importance of not only relying on morphological criteria for diagnostic classification, but also including criteria of location and size of these lesions to increase diagnostic accuracy.

Size Dependency of Elastic and Plastic Properties of Metallic Polycrystals Using Statistical Volume Elements

We present an efficient approach to evaluate the size dependency of elastic and plastic properties of metallic polycrystalline materials. Specifically, we consider different volume fractions of ferrite and martensite phases for the construction of three macroscopic domains. Statistical Volume Elements (SVEs) of different sizes are extracted from these domains using the moving window method. Linear and Crystal Plasticity (CP) simulations provide elastic and plastic properties of the SVEs such as the bulk and shear moduli, yield strength, and hardening modulus. We use a variation-based criterion to determine the Representative Volume Element (RVE) size of these properties. This RVE size corresponds to a size beyond which the given property can be idealized as homogeneous. We also use anisotropy indices and an additional RVE size criterion to determine the size limits beyond which these properties can be idealized as isotropic. Numerical results show that the plastic properties often reach their homogeneity and isotropy limits at larger sizes compared to elastic properties. This effect is more pronounced for the hardening modulus compared to the yield strength.

FP4.9 - Adherence to post Colonic polypectomy surveillance guidelines

Abstract Aims The British Society of Gastroenterology updated its guidelines in 2020 regarding polyps follow-up following colonoscopy. The surveillance depends on type, size, number, and histology criteria. Our aim was to assess adherence of our hospital's endoscopy department to these new guidelines. Methods A retrospective analysis of all consecutive adult patients who underwent colonoscopy were included between January and March 2022 at our hospital. Data were collected and analyzed on excel. The endoscopy report was identified from MediLogik-EMS.Histology from PICS system. Demographics including the specialty of endoscopist was also included. Non-parametric data were expressed in their Median and IQR. Results Out of the 108 patients examined 50/108 (49%) were found to have polyps and were included in the analysis. F: M =1:2, median age 64 with IQR 18.5(59-77.5). Tubular adenoma was found in 58%, hyperplastic polyps in 12%, sessile serrated polyps in 10%, tubulovillous adenoma in 8%, adenocarcinoma in 8%, and inflammatory polyps in 4%. Histopathology revealed tubular adenoma with LGD in 58%, inflammatory polyps in 16%, adenocarcinoma in 8%. Polyps were removed using cold biopsy in 58% and hot snare in 38%. BSG guidelines were followed in 92% (46/50). The reason for not adherence was either histologically incomplete excision, requiring a site check within 2-6 months which was not performed in6%(3)or high-risk features requiring 3 yearly surveillance colonoscopy follow-ups not requested in 2%(1). Conclusion There is high adherence to the guidelines but still not 100%. Our aim is to achieve 100% adherence in the re-audit.

Assessing the Diagnostic Accuracy of TI-RADS in Pediatric Thyroid Nodules: A Multi-Institutional Review

PurposeThyroid nodules are uncommon in children and adolescents but carry an increased risk of malignancy when present. The Thyroid Imaging Reporting and Data System (TI-RADS) is an adult-validated ultrasound-based risk assessment providing a prediction of malignant potential for thyroid nodules, thereby guiding recommendations for fine needle aspiration biopsy (FNAB). Minimal data exist regarding the applicability of TI-RADS to predict malignancy in pediatric thyroid nodules. This study aims to analyze the performance of TI-RADS for children and adolescents with thyroid nodules, hypothesizing that applying TI-RADS criteria would improve accuracy and reduce the number of recommended FNAB compared to American Thyroid Association (ATA) size criteria alone. MethodsA multi-institutional retrospective analysis was conducted including patients < 21 years with a thyroid nodule by sonographic thyroid imaging between 2015-2020. TI-RADS scores were assigned at each institution by a pediatric radiologist trained in thyroid imaging and TI-RADS criteria. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of TI-RADS scoring were compared to existing ATA size-based recommendation for performing a FNAB. Accounting for relative size differences between adults and children, a novel PED TI-RADS category was developed and tested, recommending FNAB for thyroid nodules with a TI-RADS 3 and >1.5cm, TI-RADS 4 and >1.0cm, and TI-RADS 5 any feasible size. Results291 nodules from 260 patients (median age 14.9 years, 78.8% female) were assessed using TI-RADS. Applying adult TI-RADS criteria resulted in recommendation of FNAB for 35.1% of nodules, in contrast to 76.6% recommended by ATA guidelines (p<.0001) (Table). Utilizing the adult TI-RADS score ≥ 3 as an FNAB indicator resulted in 100% sensitivity and 28.5% specificity, with 0 cases of missed malignant nodules on pathology. When novel PED TI-RADS criteria were applied, 88 patients would have been spared an unnecessary FNAB with improved sensitivity and accuracy over ATA criteria. ConclusionsThe application of adult and PED TI-RADS scoring to thyroid nodules in pediatric patients enhances the accuracy of malignancy prediction compared to current American Thyroid Association size criteria alone. The utilization of PED TI-RADS scoring eliminated unnecessary biopsies in many children while not missing a single thyroid malignancy. Level of EvidenceLevel III

Impaired Pre-operative Ambulatory Capacity in Patients Undergoing Elective Endovascular Infrarenal Abdominal Aortic Aneurysm Repair is Associated with Increased Peri-operative Death

While ambulatory capacity is a readily assessable clinical indicator of functional status, its association with outcomes after endovascular aneurysm repair (EVAR) remains underexplored. This study aimed to investigate the association between pre-operative ambulatory status and outcomes following elective EVAR. A retrospective review of the multi-institutional Vascular Quality Initiative database was conducted for all patients who underwent elective infrarenal EVAR from 2009 - 2022. Patients were categorised into independent ambulation and impaired ambulation groups. A propensity score matched analysis was performed to produce two well matched cohorts in a 1:1 ratio without replacement. The primary outcome was 30 day death. Secondary outcomes included one year survival and in hospital major complications. Among 11 474 patients, 10 539 (91.8%) were independently ambulatory pre-operatively. Propensity score matching resulted in 885 matched pairs. The impaired ambulation group, although older (mean 77.6 vs. 76.3 years; p= .001), showed comparable baseline characteristics. Post-operatively, the impaired ambulation group had higher cumulative in hospital complications and death as well as 30 day death. Even after adjustment for age, impaired pre-operative ambulation was associated with increased in hospital and 30 day death (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.26 - 3.95; p= .006). Multivariable analysis demonstrated increasing cumulative risk of 30 day death in the setting of impaired pre-operative ambulatory status with age > 75 years requiring post-operative red blood cell transfusion > 2 units (HR 5.75, 95% CI 2.09 - 15.88; p < .001). Beyond 30 days, impaired pre-operative ambulation was not associated with increased one year death (HR 1.09, 95% CI 0.81 - 1.48; p= .570). Among patients who underwent elective infrarenal EVAR in this matched analysis, impaired pre-operative ambulatory capacity was associated with an increased risk of in hospital and 30 day death, further compounded by advanced age and post-operative transfusion. As such, a threshold higher than the traditional size criteria should be considered in shared decision making when determining options for the management of abdominal aortic aneurysm in this high risk cohort.

Predicting Survival of Metastatic Clear Cell Renal Cell Cancer Treated with VEGFR-TKI-Based Sequential Therapy.

(1) Objective: To develop a clinically useful nomogram that may provide a more individualized and accurate estimation of cancer-specific survival (CSS) for patients with clear-cell (CC) metastatic renal cell carcinoma (mRCC) treated with nephrectomy and vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI)-based sequential therapy. (2) Methods: A prospectively maintained database of 145 patients with mRCC treated between 2008 and 2018 was analyzed to predict the CSS of patients receiving sunitinib and second- and third-line therapies according to current standards of practice. A nomogram based on four independent clinical predictors (Eastern Cooperative Oncology Group status, International Metastatic RCC Database Consortium score, the Morphology, Attenuation, Size and Structure criteria and Response Evaluation Criteria in Solid Tumors response criteria) was calculated. The corresponding 1- to 10-year CSS probabilities were then determined from the nomogram. (3) Results: The median age was 60 years (95% CI 57.9-61.4). The disease was metastatic at diagnosis in 59 (40.7%), and 86 (59.3%) developed metastasis during follow-up. Patients were followed for a median 48 (IQR 72; 95% CI 56-75.7) months after first-line VEGFR-TKI initiation. The concordance probability estimator value for the nomogram is 0.778 ± 0.02 (mean ± SE). (4) Conclusions: A nomogram to predict CSS in patients with CC mRCC that incorporates patient status, clinical risk classification and response criteria to first-line VEGFR-TKI at 3 months is presented. This new tool may be useful to clinicians assessing the risk and prognosis of patients with mRCC.

How to develop, validate, and update clinical prediction models using multinomial logistic regression

ObjectivesMulticategory prediction models (MPMs) can be used in health care when the primary outcome of interest has more than two categories. The application of MPMs is scarce, possibly due to added methodological complexities compared to binary outcome models. We provide a guide of how to develop, validate, and update clinical prediction models based on multinomial logistic regression. Study Design and SettingWe present guidance and recommendations based on recent methodological literature, illustrated by a previously developed and validated MPM for treatment outcomes in rheumatoid arthritis. Prediction models using multinomial logistic regression can be developed for nominal outcomes, but also for ordinal outcomes. This article is intended to supplement existing general guidance on prediction model research. ResultsThis guide is split into three parts: 1) outcome definition and variable selection, 2) model development, and 3) model evaluation (including performance assessment, internal and external validation, and model recalibration). We outline how to evaluate and interpret the predictive performance of MPMs. R code is provided. ConclusionWe recommend the application of MPMs in clinical settings where the prediction of a multicategory outcome is of interest. Future methodological research could focus on MPM-specific considerations for variable selection and sample size criteria for external validation.

Impact of Tumor Size on Prognosis in Differentiated Thyroid Cancer with Gross Extrathyroidal Extension to Strap Muscles: Redefining T3b.

The prognostic significance of tumor size in T3b differentiated thyroid cancer (DTC) remains debated and underexplored. This study aimed to examine the varying impact of T3b based on tumor size, analyzing disease-specific survival, disease-free survival, and overall survival. A retrospective review of 6282 DTC patients who underwent thyroid surgery at Seoul St. Mary's Hospital from September 2000 to December 2017 was conducted. T3b was classified into three subcategories, T3b-1 (≤2 cm), T3b-2 (2-4 cm), and T3b-3 (>4 cm), using the same size criteria for T1, T2, and T3a. T3b-1 showed no significant difference in disease specific survival compared to T1, and both disease-free and disease-specific survival curves were sequentially ranked as T1, T3b-1, T2, T3a, T3b-2, and T3b-3. The modified T category, reclassifying T3b-1 as T1, demonstrated superior staging performance compared to the classic T category (c-index: 0.8961 vs. 0.8959 and AUC: 0.8573 vs. 0.8518). Tumors measuring 2 cm or less within the T3b category may require downstaging, and a modified T category could improve the precision of prognostic staging compared to the current T category.

Prevalence of Squamous Cell Carcinoma of The Tongue In Dr. Hasan Sadikin General Hospital During 2017 – 2022

Introduction: Squamous cell carcinoma is the most common malignant neoplasm in the oral cavity, accounting for 90% of all malignancies in the oral cavity. Exposure of the oral epithelium to carcinogenic substances can cause squamous cell carcinoma. This study was show the prevalence of squamous cell carcinoma of the tongue in West Java which is used as education for the prevention of squamous cell carcinoma of the tongue. Purpose: This research is a descriptive study and carried out using purposive sampling method. The sample in this study were patients with a diagnosis of squamous cell carcinoma of the tongue at Dr. Hasan Sadikin Hospital Bandung during January 2017 - January 2022 who had been confirmed by histopathological examination results. Data analysis will be carried out on secondary data from collected medical records and the results of the pathologist's interpretation, then the results of the data analysis will be arranged and presented in tabular and percentage form. Methods: The data obtained were 218 cases. Based on age, the most patients were in the age group above 48 years (58%). Based on gender criteria, it shows more women (57%). Based on domicile criteria, the highest domicile was in Bandung (38%). Based on family history criteria, there were 215 patients with no family history or 99%. Based on the predisposing factor criteria, it shows more patients with a history of chronic irritation (48%). Based on the mass size criteria, it shows more patients with mass size T4 (60%). Based on KGB criteria, it shows more patient showed N1 lymph nodes involvement (63%). Based on tumor metastasis criteria, it shows more patients with Mx tumor metastasis (50%). Based on the therapy status criteria, it shows more patients with combined therapy (32%). Results: Type the result of your research, including statistical analysis. Conclusion: Patients suffering from squamous cell carcinoma in the tongue are mostly patients over 48 years old with female gender who live in Bandung City, West Java, and have no family history but have predilection factors such as irritation and infection. The size of the tumor mass in patients with squamous cell carcinoma mostly has a mass size &gt; 3 cm, with lymph node involvement mostly on the ipsilateral with a size &lt; 3 cm and metastasis to other organs is difficult to assess due to lack of supporting modalities. The therapy received was mostly combined therapy (surgery and chemotherapy or radiotherapy) Keywords: Squamous cell carcinoma of the tongue, prevalence, patient characteristics

Economical Prosthodontic Management of Microstomia Patient with Hinge Denture -

Microstomia is an abnormally reduced oral aperture. In the literature, it is not classified by any particular size criteria, rather defined by its effects on function and esthetics. Prosthodontic management of edentulous patients with microstomia is a challenging task. Use of conventional methods for recording an impression and fabricating prosthesis is not effective in such patients. To fabricate well-fitting prosthesis, accuracy of impression recording important anatomic landmarks is essential. Formation of an exacting custom tray and diagnostic cast is critical for final impression accuracy. Provision of a well-fitting prosthesis in microstomia patient will restore esthetics, comfort, and function with oral and systemic patient wellbeing. This paper presents a case report of managing an edentulous microstomia patient with sectional removable prosthesis.

Assessment of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS™) with modification of the management recommendations for pediatric thyroid nodules.

Thyroid nodules are unusual in children, but when present, they carry a higher risk for malignancy, as compared to adults. Several guidelines have been created to address the risk stratification for malignancy of thyroid nodules in adults, but none has been completely validated in children. A few authors have proposed lowering the size threshold to the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS™) management guidelines to decrease missed carcinomas at presentation in children; however, little information is known regarding their accuracy. To assess the performance of proposed modifications of the ACR TI-RADS™ size criteria to guide management decisions in pediatric thyroid nodules and to assess the associated increase in number of fine needle aspiration (FNA) and follow-up exams. This is a retrospective study of children under 18years old who underwent ultrasound assessment of a thyroid nodule at a tertiary care pediatric institution between January 2006 and August 2021. The largest dimension, maximum ACR TI-RADS™ score, and final thyroid nodules' diagnoses were documented. The course of action based on the adult ACR TI-RADS™ and after modifying the size threshold for management recommendations was documented and compared. Statistics included descriptive analysis, weighted Kappa statistics, sensitivity, specificity, accuracy, and positive/negative predictive values of the ACR TI-RADS™ presented with 95% confidence intervals (CI) using either Clopper-Pearson or standard logit methods. Of 116 nodules, 18 (15.5%) were malignant. Most malignant nodules (94.4%, n = 17) were ACRTI-RADS™ 4 and ACRTI-RADS™ 5 categories. Based on the adult ACR TI-RADS™ criteria, 24 (24.5%) benign and 15 (83.3%) malignant nodules would have undergone FNA; 14 (14.3%) benign and 3 (16.7%) malignant nodules would have been followed up; and 60 (61.2%) benign and none of malignant nodules would have been dismissed. Three (16.7%) malignant nodules would not have been recommended FNA at presentation, delaying their diagnoses. By lowering the size-threshold criteria of the ACR TI-RADS™ guidelines, no malignancy would have been missed at presentation, but this also resulted in a higher number of FNA from 24 (24.5%) to 36 (36.7%) and follow-up ultrasound exams from 14 (14.3%) to 62 (63.3%). Applying potential modifications to the ACR TI-RADS™ guideline lowering the size threshold criteria of the thyroid nodule to guide management decisions for pediatric thyroid nodules can lead to early detection of malignant nodules in children, but at the cost of a significantly increased number of biopsies or ultrasound exams. Further tailoring of the guideline with larger multicentric studies is needed, before warranting its acceptance and general use in the pediatric population.

The Effect of Using E-modules in Biology Learning on Learning Outcomes of High School and University Students: Meta-Analysis

This study aims to determine the effect size (ES) of the application of e-modules in biology learning on student's learning outcomes. This study uses the type of meta-analysis research. The research sample consisted of 14 articles sourced from the results of article identification through Google Scholar and Eric. The research data were collected based on the reference of inclusion and exclusion criteria. Data analysis was conducted by calculating the ES value using Cohen’s d formula. The results of data analysis showed that there were 14 articles divided into two levels of education, namely high school (9 articles) and university (5 articles) with a total average effect size score of 1,14 which means the effect size criteria are very large (VL). The ES average score for the high school level is 1,20 or very large (VL) ES average, while the ES average score for the university level is 1,02 or categorized as large (L) ES average. Therefore, it can be concluded that the effect size of the application of e-modules in biology learning has a significant impact on improving student learning outcomes.