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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.

Biodiversity loss is one of the most pressing environmental challenges of our time, with species extinction rates accelerating due to habitat destruction, climate change, and other human activities. To combat this crisis, a concept known as \"rewilding\" has gained momentum. Rewilding involves restoring and conserving ecosystems by allowing natural processes to unfold with minimal human interference. In this article, we will explore the concept of rewilding, its principles, and its critical role in stemming biodiversity loss.

A high percentage of patients with COPD report chronic nasal symptoms. The study aims to evaluate the clinical impact of a 2-month treatment with inhaled nasal budesonide (100 µg per nostril twice daily) in patients affected by COPD with chronic rhinitis comorbidity. Fifty-three stable COPD patients in therapy according to the Global initiative for chronic Obstructive Lung Disease recommendations were enrolled; 49 completed the study. At enrollment (visit 0), patients underwent skin prick test and rhinoscopy. At visit 0 and after 1 month (visit 1) and 2 months (visit 2) of therapy with nasal budesonide, patients underwent spirometry, and COPD assessment test (CAT), Sinonasal Outcome Test (SNOT 22), and modified Medical Research Council dyspnea scale were administered. Differences in continuous variables, after 2 months of treatment with nasal budesonide, were evaluated using a paired -test or Wilcoxon matched-pairs signed-ranks test. Two months of treatment with nasal budesonide showed a significant statistical improvement in the total scores of CAT, SNOT 22, and modified Medical Research Council ( <0.001). A significant relationship between CAT and SNOT 22 total scores at baseline and after treatment was observed. The results of the present study indicate the importance of careful evaluation of the presence of chronic nasal symptoms in all COPD patients and suggest beneficial clinical effect from treatment with nasal budesonide in terms of COPD symptoms and quality of life.

Elettra Merola,1 Giovanni Mario Pes,1 David Yates Graham,2,3 Maria Pina Dore1,2 1Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; 2Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA; 3Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USACorrespondence: David Yates Graham, Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, 2002 Holcombe Blvd (111D), Houston, TX, 77030, USA, Email dgraham@bcm.eduAbstract: Helicobacter pylori (H. pylori) is a human bacterial pathogen that causes one of the most common chronic bacterial infections worldwide. The microorganism has been classified by the International Agency for Research on Cancer as a Group I carcinogen. While the etiological link to gastric cancer is well established, the precise molecular and cellular mechanisms driving this transformation are highly complex and incompletely understood. Fundamentally, the infection results from the chronic presence of acute on chronic gastric mucosal inflammation. H. pylori pathogenicity is increased by bacterial virulence factors including the cytotoxin-associated gene A (CagA) and Vacuolating cytotoxin A (VacA) which may interfere with the host’s cell communication and create a pro-tumorigenic microenvironment. Host microRNAs (miRNAs) may amplify these effects by modulating immune responses, enhancing oncogenic signalling. Despite the proven benefits of H. pylori eradication in reducing cancer risk, especially in high-incidence regions, rising antibiotic resistance and host-related variables impede its global implementation. Recent advances in genomics and multi-omics profiling potentially offer new opportunities for targeted prevention. Moreover, emerging evidence suggests H. pylori may also negatively influence immunotherapy outcomes, underscoring its broader relevance in cancer treatment planning. By synthesizing molecular insights, epidemiological trends, and clinical data, this narrative review examines the multifaceted pathways through which H. pylori contributes to gastric carcinogenesis, integrating current knowledge on microbial virulence, host signalling disruption, immune modulation, and epigenetic remodelling.Keywords: Helicobacter pylori, gastric cancer, pathogenesis, CagA, VacA, virulence

This dissertation consists of three self-contained essays on the study of economic inequality and public opinion. The first essay explores the question of why inequality is positively associated with beliefs in economic fairness. By incorporating behavioral research, in particular a dual-motives framework, the essay provides a behavioral model for how people process and select information about inequality. As inequality increases, the information becomes more threatening for the people at the bottom, and becomes more important for the people at the middle of the economic distribution. This is demonstrated using experimental evidence in Sweden, and has important implications for how we think about information and perceptions about inequality, as well as support for social welfare policies more broadly. The second essay provides a framework by which to understand how social identities and groups affect economic views, such as expectations of mobility, class perceptions, beliefs in meritocracy, and affinity toward economic groups. Utilizing a similar dual-motives assumption, the essay highlights how groups can provide heuristic information, as well as a motivational impetus; both of which shape economic perceptions and beliefs. The implication is that perceived social distance between economic groups should strongly influence economic views, which is demonstrated using an incentivized laboratory experiment, based on economic redistribution. Inequality within and between groups thus has the potential to affect peoples economic perceptions and expectations, even if such beliefs are objectively biased, which brings attention to the importance of the structure of inequality in the formation of individual economic views. The third essay, meanwhile, demonstrates how greater inequality also results in a more authoritarian population, in particular among the poor. The theory developed emphasizes how inequality increases feelings of powerlessness among the economically less fortunate, which results in their greater psychological insecurity. Such an insecurity is often manifest through increased demands for order and stability – the key goals associated with an authoritarian disposition – which implies a greater sensitivity and opposition to immigration, as well as social and cultural change. This is demonstrated using both experimental and cross-national observational evidence, and has implications for the role of inequality in social conflict and democratic consolidation, as well as broader debates about modernization and the influence of economic conditions in public opinion. In short, the dissertation advances our understanding of the motivational and information effects of economic inequality on public opinion, and highlights the often neglected, yet powerful, ways in which inequality impacts political behavior.