Background: Cardiac myxoma is the most common benign tumor of the heart. It presents with a variety of clinical signs and symptomatology making diagnosis frequently quite a challenge. Objective: The aim of this article is to present a case report of giant right atrial myxoma with symptoms of right heart failure in adult patient. Case report: We present a case of large right atrial myxoma which is an uncommon location for this type of heart neoplasms, discovered incidentally in a female patient 77-year-old who came to our polyclinic for cardiological exam with hypertension last 11 years and obesity. Results and Discussion: Various clinical signs and symptoms produced by cardiac myxomas have been reported in the literature. Depending on location and morphology, cardiac tumors can produce four types of clinical manifestations: systemic-constitutional, embolic, cardiac, and secondary metastatic manifestation. Echocardiography as non-invasive imaging method and Transesophageal echocardiography has superior role for precise evaluation of cardiac tumors. Transesophageal echocardiography has superior role for accurate diagnostic evaluation of cardiac mass. Surgical excision of cardiac myxoma carries a low-operative risk and gives excellent short- and long-term results. Conclusion: Myxoma is the most prevalent primary heart tumor. It is rare to find a myxoma in the right atrium, occurring only in 15-20% of myxoma cases. Clinical manifestations of myxomas consist in a triad: constitutional symptoms, embolization and intracardiac obstruction. Transesophageal echocardiography has superior role for precise evaluation of cardiac tumors. Currently, there is no effective medical treatment, and surgical excision of the tumor is necessary.

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.

Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Systematic review registration PROSPERO CRD42020196301

Hip osteoarthritis (HOA) is characterized by degradation of the cartilage and synovitis. However, the pathohistological effects of synovial tissue inflammation on HOA are not clear. The aim of this study was to evaluate the expression of iNOS, BCL-2 and MMP-9 markers in different synovial cell populations. A total of 32 patients were evaluated retrospectively. Age, sex, height, weight, body mass index were recorded and lymphocyte, fibrocytes and macrophages were analysed in tissue sections. Osteoarthritis cartilage histopathology assessment system (OARSI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Krenn score, Harris Hip Score (HHS) and Kellgren–Lawrence (K-L) grading of the hip joints were performed. Total hip arthroplasty was performed on 32 patients and controls. Patients were divided into two groups according to their disease severity. The tissues were immunohistochemically analysed. K-L grade and Krenn score differ between all three groups, but also between moderate and severe OA. Synovial lining cell layer, resident cells in stroma and especially inflammatory infiltration were increasing with severity of OA. iNOS expression in both intima and subintima was positively correlated with Krenn score in moderate and severe osteoarthritis (OA) groups. Expression of BCL-2 in intima of severe OA patients was positively correlated with Krenn score. In conclusion, iNOS, BCL-2 and MMP-9 are involved in the regulation of HOA. Our study indicates a relationship between the pathohistological features, the synovial inflammation and the cartilage condition at the time of hip replacement due to OA or femoral neck fracture.

The presence of a high-density material object such as the vascular access port made of titanium, can affect the homogeneity of dose distribution in underlying tissues. This influence depends on numerous factors but in the first place on the composition material of such an object and its geometry. In this work an influence of the various titanium-made vascular ports, placed in the 6 MV photon field, have been analyzed. The vascular ports of various sizes were placed on the top of thepolymethyl-methacrylate (PMMA) phantom which is then scanned on a computed tomography (CT) simulator to generate the digitized 3-dimensional images for the purpose of treatment planning. The treatment plans were prepared in matRad treatment planning toolkit. The beam profiles and the percentage depth doses have been analyzed. The observed maximum dose values, for ports A, B, C and D, relatively to the maximum dose value in PMMA phantom alone, were 102.25%, 100.62%, 101.78% and 102.48%, respectively. The titanium edges of the ports reduce the dose below them in amount of 8.52%, 8.64%, 10.01% and 10.04% observed for ports A, B, C and D, respectively, in comparison to the central axis dose value obtained in PMMA phantom for the port-free case. The established changes in PDD curves and beam profiles depend on the vascular access port dimensions, reservoir volumes as well as of the amount of titanium content.

In 2013, the Journal “Periodical of Engineering and Natural Sciences” was launched. By now, the journal achieved a global spread of authorship and Editorial Board. In this period, we have been publishing mainly original research articles, reviews, and case studies. In addition to the current article types, we are going to start publishing Book reviews, Minireviews, Short Communication, Commentaries, Methodology/Method starting from the next Issue. To familiarize authorship with the different types of articles we publish, here below each of them is particularly described, including the paper structure and length.

The rapid urbanization of cities creates a need for construction of new collective residential buildings in all major cities of Bosnia and Herzegovina. However, residential facilities are often built without any analyses, creating unsustainable architectural structures with a very high market price. The traditional monolith construction of residential units does not allow for any transformation or adaptation of the system. This paper aims to explore the possibility of the application of alternative solutions for the construction of sustainable collective residential buildings using shipping and prefabricated modular containers. Analyzing Bosnia and Herzegovinas market, it was found that there are no empty shipping container storages, but there are a few companies which produce prefabricated modular containers which are currently not planned for residential use. These prefabricated units could be transformed and used for the construction of sustainable residential buildings with the application of simple interventions suggested in this paper. The usage of prefabricated modular containers offers the possibility of transformation of space, simple assembly and disassembly, placement on existing structures, and the lower price of living area.

The aim of this randomized prospective study was to evaluate the quality of life (QoL) using the "Seattle Angina Questionnaire" (SAQ) in patients with chronic total occlusion (CTO) in coronary arteries treated with either percutaneous coronary intervention (PCI) or optimal medical therapy (OMT), or only with OMT.The potential benefits of recanalization of CTO by PCI have been controversial because of the scarcity of randomized controlled trials.A total of 100 patients with CTO were randomized (1:1) prospectively into the PCI CTO or the OMT group (50 patients in each group). There were no baseline differences in the SAQ scores between the groups, except for physical limitation scores (P = 0.03). During the mean follow-up (FUP) of 275 ± 88 days, patients in the PCI group reported less physical activity limitations (72.7 ± 21.3 versus 60.5 ± 27, P = 0.014), less frequent angina episodes (89.8 ± 17.6 versus 76.8 ± 27.1, P = 0.006), better QoL (79.9 ± 22.7 versus 62.5 ± 25.5, P = 0.001), greater treatment satisfaction (91.2 ± 13.6 versus 81.4 ± 18.4, P = 0.003), and borderline differences in angina stability (61.2 ± 26.5 versus 51.0 ± 23.7, P = 0.046) compared to patients in the OMT group. There were no significant differences in SAQ scores in the OMT group at baseline and during the FUP. There was a statistically significant increase in all five domains in the PCI group.Symptoms and QoL measured by the SAQ were significantly improved after CTO PCI compared to OMT alone.

Abstract Orbital metastatic lesions are rare entities1-3 best treated with radical surgical resection with preservation/improvement of neurological and visual function.1-9 Renal cell metastases, in particular, respond less favorably to radiation.9 To our knowledge, an operative video of microsurgical resection of a renal cell carcinoma metastasis to the superior orbital fissure and orbit has not been reported. A patient presented with worsening right eye vision as demonstrated on preoperative visual field testing and found to have a 3 × 1 × 1 cm lesion in the orbit and superior orbital fissure. The patient was placed supine and stealth neuronavigation was used to aid in tumor localization and extension. A cranio-orbital craniotomy and pretemporal exposure2,10,11 were performed to allow extradural dissection of the dura propria off the lateral wall of the cavernous sinus. Right-sided extradural cranial nerves II, III, IV, V1, and V2 were identified, and a high-speed diamond drill was used to perform extradural anterior clinoidectomy and optic nerve decompression. Microsurgical resection of the intraorbital tumor components was performed by the senior author (KIA) to delineate the plane between tumor and periorbita. An oval-shaped dural opening was made to resect the dura involved by tumor, confirmed on histological analysis, followed by closure via dural allograft. The patient's right-sided visual field improved markedly after surgery. Metastatic renal cell carcinoma of the orbit should be resected while preserving and improving preoperative neurological and visual function. The orbitocranial pretemporal approach offers wide visualization to achieve surgical resection. The patient provided written consent and permission to publish her image.