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BackgroundSurgery with radical intent is the only potentially curative option for entero-pancreatic neuroendocrine tumors (EP-NETs) but many patients develop recurrence even after many years. The subset of patients at high risk of disease recurrence has not been clearly defined to date.ObjectiveThe aim of this retrospective study was to define, in a series of completely resected EP-NETs, the recurrence-free survival (RFS) rate and a risk score for disease recurrence.Patients and MethodsThis was a multicenter retrospective analysis of sporadic pancreatic NETs (PanNETs) or small intestine NETs (SiNETs) [G1/G2] that underwent R0/R1 surgery (years 2000–2016) with at least a 24-month follow-up. Survival analysis was performed using the Kaplan–Meier method and risk factor analysis was performed using the Cox regression model.ResultsOverall, 441 patients (224 PanNETs and 217 SiNETs) were included, with a median Ki67 of 2% in tumor tissue and 8.2% stage IV disease. Median RFS was 101 months (5-year rate 67.9%). The derived prognostic score defined by multivariable analysis included prognostic parameters, such as TNM stage, lymph node ratio, margin status, and grading. The score distinguished three risk categories with a significantly different RFS (p < 0.01).ConclusionsApproximately 30% of patients with EP-NETs recurred within 5 years after radical surgery. Risk factors for recurrence were disease stage, lymph node ratio, margin status, and grading. The definition of risk categories may help in selecting patients who might benefit from adjuvant treatments and more intensive follow-up programs.

Radiofrequency ablation (RFA) is a novel technique for the treatment of liver malignancies that is becoming increasingly more popular because of its feasibility, effectivity, repeatability, and safety. However, an increased number of complications after RFA has been reported in literature. The aim of this paper is to discuss the possible role of RFA in rapid intrahepatic spreading of hepatocellular carcinoma (HCC). We treated a 66-year-old woman who had a 3.5-cm HCC with two courses of percutaneous RFA using a modified needle with seven hooks. The effectiveness of the treatment was assessed 1 month later by enhanced computed tomography. Two courses of treatment were needed owing to the nodule position (close to the inferior vena cava). Computed tomography scan performed 1 month after the second RFA showed an intrahepatic arteriovenous fistula. Angiography performed after 1 month showed a rapid intrahepatic spreading of HCC. Radiofrequency ablation can create an arteriovenous fistula that can facilitate migration of tumoral cells from the nodule to the hepatic portal system and rapid intrahepatic dissemination of HCC.

This dissertation is concerned with the funeral of the \"Guguletu Seven,\" staged by members of the South African resistance on March 15, 1986 in the township of Guguletu. An example of counter-spectacle, the funeral will be treated as a discursive event, a process in and through which a temporary shift in power-relations was effected, contributing to the consolidation of a resistance community that eventually led to the overthrow of the apartheid regime in South Africa in 1994. The funeral, ephemeral in nature, is represented in discourse through texts and images from the South African and the American press. The entire funeral cannot be reconstituted, so that certain semiotic themes will be emphasized: the Guguletu seven as martyrs and Mandela as leader in exile. Key to this study is a discussion of the component parts of the spectacular event, with its heterogeneous mass of subjects (children, women, and men of different ages and races---\"white,\" \"black,\" \"Coloured,\" and \"Indian\") with different affiliations (from the armed branch of the African National Congress to workers' unions and student organizations) provisionally cohering as a crowd around the bodies of the newest martyrs to the anti-apartheid cause. A detailed analysis of the mourners' forms of dress, including para-military attire, will be followed by discussion of the banners that were displayed, with signs, symbols, and text appropriated from various forms of state spectacle. Key to my analysis is the concept of performativity; the dissertation, then, will also take up the coded acts of the participating subjects, including acts of speech and gesture that are similar to ritual in their conventionality and iterability. I will argue that these signs, symbols and forms of dress, gesture and speech have associations with the modern state in its various and often incommensurable manifestations (from capitalist to state socialist), as well as with other resistance-movements in the second half of the twentieth century. Their operation in the meaning-event of this funeral, I shall argue, reveals that meaning does not inhere in the signs themselves, but is consolidated relationally and performatively, at the level of production as well as reception.

Cosmic radiation experienced during space travel may increase the risk of cognitive impairment. While simulated galactic cosmic radiation (GCRsim) has led to memory deficits in wildtype (WT) mice, it has not been investigated whether GCRsim in combination with genetic risk factors for Alzheimer’s disease (AD) worsens memory further in aging mice. Here, we investigated the central nervous system (CNS) effects of 0 Gy (sham) or 0.75 Gy five-ion GCRsim or 2 Gy gamma radiation (IRR) in 14-month-old female and male APPNL-F/NL-F knock-in (KI) mice bearing humanized ApoE3 or ApoE4 (APP;E3F and APP;E4F). As travel to a specialized facility was required for irradiation, both traveled sham-irradiated C57BL/6J WT and KI mice and non-traveled (NT) KI mice acted as controls for potential effects of travel. Mice underwent four behavioral tests at 20 months of age and were euthanized for pathological and biochemical analyses 1 month later. Fecal samples were collected pre- and post-irradiation at four different time points. GCRsim seemed to impair memory in male APP;E3F mice compared to their sham counterparts. Travel tended to improve cognition in male APP;E3F mice and lowered total Aβ in female and male APP;E3F mice compared to their non-traveled counterparts. Sham-irradiated male APP;E4F mice accumulated more fibrillar amyloid than their APP;E3F counterparts. Radiation exposure had only modest effects on behavior and brain changes, but travel-, sex-, and genotype-specific effects were seen. Irradiated mice had immediate and long-term differences in their gut bacterial composition that correlated to Alzheimer’s disease phenotypes.

Topological magnon bands enable uni-directional edge transport without backscattering, enhancing the robustness of magnonic circuits and providing a novel platform for exploring quantum transport phenomena. Magnetic skyrmion lattices, in particular, host a manifold of topological magnon bands with multipole character and non-reciprocal dispersions. These modes have been explored already in the short and long wavelength limit, but previously employed techniques were unable to access intermediate wavelengths comparable to inter-skyrmion distances. Here, we report the detection of such magnons with wavevectors ∣q∣ ≃ 48 rad μm −1 in the metastable skyrmion lattice phase of the bulk chiral magnet Cu 2 OSeO 3 using Brillouin light scattering microscopy. Thanks to its high sensitivity and broad bandwidth various multipole excitation modes could be resolved over a wide magnetic field regime. Besides the known counterclockwise, breathing and clockwise modes with dipole character, quantitative comparison of frequencies and spectral weights to theoretical predictions enabled the additional identification of a quadrupole mode and, possibly, a sextupole mode. Our work highlights the potential of skyrmionic phases for the design of magnonic devices exploiting topological magnon states at GHz frequencies. Topological magnon bands in magnetic skyrmion lattices offer robust, unidirectional edge transport, crucial for advancing magnonic circuits and quantum transport studies. Here, Brillouin light scattering microscopy is used to detect intermediate wavelength magnons in Cu 2 OSeO 3 , revealing multipole excitation modes with inactive dipole character, including a novel quadrupole mode and, possibly, a sextupole mode, enhancing GHz frequency magnonic device design.

En abordant le débat autour de l’intergouvernementalisme et du supranationalisme, l’article soulève la question suivante : vers quel modèle de gouvernance interne et externe l’UE s’oriente-t-elle dans le contexte de la Politique de Sécurité et de Défense Commune (PSDC) ? En nous référant à la conception hobbesienne de l’État et de la souveraineté, en particulier à l’ouvrage Léviathan, nous examinerons comment la PSDC s’éloigne de cette conception classique tout en gardant des similitudes avec la pensée de Thomas Hobbes. La réflexion se poursuit aux niveaux spéculatif et empirique en se référant à la crise ukrainienne de 2014, à la récente guerre de 2022 ainsi qu’aux négociations sur le nucléaire iranien de la même période. Starting with the debate between intergovernmentalism and supranationalism, the article delves into the EU’s evolving governance model within the Common Security and Defense Policy (CSDP). For this purpose, we employ the Hobbesian conception of state and sovereignty, particularly Leviathan, which characterized the evolution of modern and contemporary political organizations. We put forward the hypothesis that the CSDP distances itself from this ‘classical’ conception of sovereignty and political organization, although some similarities exist with the English philosopher, especially from the point of view of external governance. Reflecting on the Ukrainian crisis (and the recent 2022 war) and the Iranian nuclear negotiations, the article explores both speculative and empirical dimensions.

En abordant le débat autour de l’intergouvernementalisme et du supranationalisme, l’article soulève la question suivante : vers quel modèle de gouvernance interne et externe l’UE s’oriente-t-elle dans le contexte de la Politique de Sécurité et de Défense Commune (PSDC) ? En nous référant à la conception hobbesienne de l’État et de la souveraineté, en particulier à l’ouvrage Léviathan , nous examinerons comment la PSDC s’éloigne de cette conception classique tout en gardant des similitudes avec la pensée de Thomas Hobbes. La réflexion se poursuit aux niveaux spéculatif et empirique en se référant à la crise ukrainienne de 2014, à la récente guerre de 2022 ainsi qu’aux négociations sur le nucléaire iranien de la même période. Starting with the debate between intergovernmentalism and supranationalism, the article delves into the EU’s evolving governance model within the Common Security and Defense Policy (CSDP). For this purpose, we employ the Hobbesian conception of state and sovereignty, particularly Leviathan, which characterized the evolution of modern and contemporary political organizations. We put forward the hypothesis that the CSDP distances itself from this ‘classical’ conception of sovereignty and political organization, although some similarities exist with the English philosopher, especially from the point of view of external governance. Reflecting on the Ukrainian crisis (and the recent 2022 war) and the Iranian nuclear negotiations, the article explores both speculative and empirical dimensions.

Whole-body exposure to high-energy particle radiation remains an unmitigated hazard to human health in space. Ongoing experiments at the NASA Space Radiation Laboratory and elsewhere repeatedly show persistent changes in brain function long after exposure to simulations of this unique radiation environment, although, as is also the case with proton radiotherapy sequelae, how this occurs and especially how it interacts with common comorbidities is not well-understood. Here, we report modest differential changes in behavior and brain pathology between male and female Alzheimer’s-like and wildtype littermate mice 7–8 months after exposure to 0, 0.5, or 2 Gy of 1 GeV proton radiation. The mice were examined with a battery of behavior tests and assayed for amyloid beta pathology, synaptic markers, microbleeds, microglial reactivity, and plasma cytokines. In general, the Alzheimer’s model mice were more prone than their wildtype littermates to radiation-induced behavior changes, and hippocampal staining for amyloid beta pathology and microglial activation in these mice revealed a dose-dependent reduction in males but not in females. In summary, radiation-induced, long-term changes in behavior and pathology, although modest, appear specific to both sex and the underlying disease state.

ABSTRACTPURPOSE: To determine the frequency and clinical characteristics of corneal infiltrates after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and to evaluate the efficacy of treatment.METHODS: We retrospectively reviewed the records of 8508 eyes treated with PRK or LASIK in a university-based clinic for the correction of refractive errors for 60 days postoperatively.RESULTS: Corneal infiltrates were observed in 35 (0.8%) of 4492 PRK-operated eyes and in 4 (0.1%) of 4016 LASI K-operated eyes. The mean time of diagnosis was 5.46 days. Among the 39 eyes with infiltrates, 10 (9 PRK, 1 LASIK) had culture-verified infectious keratitis. Coagulase-negative Staphylococcus was the most frequently isolated bacterium (50%), followed by S aureus (20%), Corynebacterium xerosis (10%), Streptococcus viridans (10%), and an unidentified gram-positive coccus (10%). Final visual acuity of ≥20/30, without correction, was achieved in 79.5% of the 39 eyes.CONCLUSIONS: Corneal infiltrates occurred in 0.8% of PRK eyes and 0.1% of LASIK eyes. Bacterial smears were positive for several eyes. In all cases, prompt treatment was responsible for good visual outcome. [J Refract Surg. 2006;22:159-165.]