Eastern Centers Research Articles

Artificial Intelligence to Predict the Risk of Lymph Node Metastasis in T2 Colorectal Cancer.

To develop and externally validate an updated artificial intelligence (AI) prediction system for stratifying the risk of lymph node metastasis (LNM) in T2 colorectal cancer (CRC). Recent technical advances allow complete local excision of T2 CRC, traditionally treated with surgical resection. Yet, the widespread adoption of this approach is hampered by the inability to stratify the risk of LNM. Data from patients with pT2 CRC undergoing surgical resection between April 2000 and May 2022 at one Japanese and one Italian center were analyzed. Primary goal was AI system development for accurate LNM prediction. Predictors encompassed 7 variables: age, sex, tumor size, tumor location, lymphovascular invasion, histologic differentiation, and carcinoembryonic antigen level. The tool's discriminating power was assessed through area under the curve, sensitivity, and specificity. Out of 735 initial patients, 692 were eligible. Training and validation cohorts comprised of 492 and 200 patients, respectively. The AI model displayed an area under the curve of 0.75 in the combined validation data set. Sensitivity for LNM prediction was 97.8%, and specificity was 15.6%. The positive and the negative predictive value were 25.7% and 96%, respectively. The false negative rate was 2.2%, and the false positive was 84.4%. Our AI model, based on easily accessible clinical and pathologic variables, moderately predicts LNM in T2 CRC. However, the risk of false negative needs to be considered. The training of the model including more patients across western and eastern centers - differentiating between colon and rectal cancers - may improve its performance and accuracy.

Ассортимент изделий из цветного металла раннего железного века поселения Исетское 3 в Нижнем Приисетье

Metal production in the Trans-Ural region in the Early Iron Age is known mainly from materials from the Itkul and Sargat cultures. The article introduces into scientific circulation the largest collection of objects (80 items) made of non-ferrous metal of the Baitovo culture of this period from the settlement of Isetskoye 3, located in the Lower Iset river area. The purpose of the study is to morphometrically characterize and determine the complex typology, as well as to conduct a comparative analysis with synchronous materials. The studied series of items includes weapons (arrowheads), labor tools (knives, a celt, an awl), elements of horse harness (a fragment of a bit), toilet items, jewelry (a mirror, rings, plaques), etc., as well as slags, ingots, and waste bronze foundry production. Preliminary conclusions on production technology were obtained, indicating that stone and clay molds were used for casting. The authors experimentally tested the hypothesis, which was not confirmed, on the possibility of using wooden knife models in the manufacture of clay casting molds. Signs of forging and abrasive casting processing were recorded on several metal objects. Based on their typology and the identified analogies, it was concluded that the complex is characteristic of the Scythian-Siberian cultures and can be dated back to the 7th – 6th/3rd centuries BC, which testifies to the contacts and connections of the Baitovo population with both the western (Itkul) and the eastern metallurgical centers. The presence of slag, a significant amount of bronze casting waste, and mold fragments confirms its local nature, which, however, does not exclude the import of some metal products from other territories.

Global Outcomes Benchmarks in Laparoscopic Liver Surgery for Segments 7 and 8: International Multicenter Analysis.

In recent years, there has been growing interest in laparoscopic liver resection (LLR) and the audit of the results of surgical procedures. The aim of this study was to define reference values for LLR in segments 7 and 8. Data on LLR in segments 7 and 8 between January 2000 and December 2020 were collected from 19 expert centers. Reference cases were defined as no previous hepatectomy, American Society of Anesthesiologists score less than 3, BMI less than 35 kg/m 2 , no chronic kidney disease, no cirrhosis and portal hypertension, no COPD (forced expiratory volume 1 <80%), and no cardiac disease. Reference values were obtained from the 75th percentile of the medians of all reference centers. Of 585 patients, 461 (78.8%) met the reference criteria. The overall complication rate was 27.5% (6% were Clavien-Dindo 3a or more) with a mean Comprehensive Complication Index of 7.5 ± 16.5. At 90-day follow-up, the reference values for overall complication were 31%, Clavien-Dindo 3a or more was 7.4%, conversion was 4.4%, hospital stay was less than 6 days, and readmission rate was <8.33%. Patients from Eastern centers categorized as low risk had a lower rate of overall complication (20.9% vs 31.2%, p = 0.01) with similar Clavien-Dindo 3a or more (5.5% and 4.8%, p = 0.83) compared with patients from Western centers, respectively. This study shows the need to establish standards for the postoperative outcomes in LLR based on the complexity of the resection and the location of the lesions.

Response to: Comment on: Textbook Outcomes following Open Live Donor Right Hepatectomy and Open Right Hepatic Lobectomy for Cancer in 686 patients: Re-defining the Benchmark.

We read the letter to the editor by Liu et al regarding our recently published study on right hepatectomy (RH) textbook outcomes (TO) with great interest.1,2 We want to thank Liu et al for acknowledging our work and for their insightful comments, which we are hoping to address below. First, the authors mention that in their experience, “real-world” RH for cancer is more commonly performed for hepatocellular carcinoma (HCC), while in our study, the most common indication was colorectal cancer liver metastasis (CRLM) in 58.4% of patients. Consequently, we observed a low rate of cirrhosis (5.4%) in our RH population, whereas Liu et al argue that the rate of cirrhosis could be higher in their patient population where RH is more often performed for HCC. We acknowledge that liver resection is often performed for HCC in Eastern centers, but in Western countries CRLM remains the most common indication for liver resection, including RH.2–5 The authors point that the presence of cirrhosis could affect the patient’s ability to achieve a TO is well taken. In fact, this could be one of the reasons why we observed a much higher rate of TO (92.2%) in live donor patients, where the prevalence of cirrhosis was zero, compared to TO in cancer patients (53.7%), where cirrhosis was present in 5.4% of patients. Second, we agree with the authors that abnormal BMI, either too low, indicating malnutrition, or too high, indicating obesity, is an important marker of patient’s baseline health. Liu et al have previously published on the association of abnormal BMI with failure of TO after liver resection for HCC.6 Although, in our study, logistic regression did not reveal BMI to be associated with TO in either the cancer or the live donor patients, this could be due to fact that we analyzed BMI as a continuous variable. However, similar to the discussion about cirrhosis above, live donor patients had lower BMI on average compared cancer patients, and this difference could partially account for the higher TO rates in the live donor cohort. We certainly aim to investigate the association of BMI with TO rates in a more granular fashion in the future, by grouping BMI similarly to the methodology described by Liu et al. Third, the authors make the interesting suggestion of using advanced statistical methods, such as propensity score matching, to balance the baseline clinicopathologic factors of the cancer and live donor patients and then compare TO rates between the 2 groups. They argue that the baseline large differences in the 2 populations may not make direct TO comparisons statistically appropriate without matching. Although we definitely considered the above when designing our study, we decided that our main goal was to report on our entire and unedited experience with 686 RH patients over a decade and we did not want to exclude patients that could not be matched. Consequently, the data reported in our article represent true “real-world” TO rates after RH performed either for cancer or live donor purposes in a high-volume Western center. We acknowledge that the live donor group consisted of younger, healthier, and thinner patients, and we discuss how these factors likely contributed to the much higher TO rates in that group. However, we believe that this unique population of patients that underwent RH while otherwise healthy, gave us the opportunity to uncover the “best-achievable” TO results following this operation. In summary, we want to thank Liu et al for their thoughtful appraisal of our work and we are content that our study is generating productive discussion amongst liver surgeons with the ultimate goal of improving outcomes for our patients. Acknowledgments E.D., D.G., and A.H. contributed equally to this work.

Analysis of tail morphology and osteology in Ethiopian indigenous sheep

Sheep adaptive diversity, including tail morphology, has been shaped by various factors, including natural and/or artificial selection for different traits. The Horn of Africa has historically been a major livestock entry point on the African continent from the Near Eastern centers of initial domestication. Ethiopia, in particular, possesses a marked sheep diversity, including the presence of breeds with four distinct tail morphotypes (short fat-tail, long fat-tail, fat-rump, and thin-tail) that do not co-exist elsewhere. The origin and development of the fat-tail, as well as the fat-rump, are still poorly known, and the osteological and metrical differences between the fat-tail morphotypes have never been studied. Here, we characterized the phenotypic diversity of Ethiopian sheep tails from morphological and osteological perspectives. Three tail measurements and 14 osteological traits were recorded in six breeds (Menz, Washera, Afar, Blackhead Somali, Bonga, and Gumz), representative of the four sheep tail morphotypes. Both linear discriminant and principal component analyses categorize the six sheep breeds into four distinct tail morphotypes. Analysis of variance of the morphological and osteological traits shows significant differences (P < 0.05) between the four tail morphotypes. The highest mean values of tail length, total caudal vertebrae length and the number of caudal vertebrae were recorded in the thin-tailed sheep, followed by the long fat-tailed sheep, whereas the lowest average values were recorded in the fat-rumped and short fat-tailed sheep. These traits are significantly and positively correlated with each other. Based on regression model analysis, it is possible to use tail length alone as a predictive tool to estimate the sheep tail osteology without killing the animal. Moreover, based on measurements of sheep caudal vertebrae, the osteologist can estimate other osteological traits and the tail length of that sheep, further differentiating its tail morphotypes. Significant differences (P < 0.05) were also observed in individual caudal vertebra length and breadth, tail breadth and tail circumference, and flat and concave-shaped caudal vertebrae between the short-tailed and long-tailed sheep. Our results provide important phenotypic baselines for genome diversity and adaptation studies and an osteological baseline for archeozoological work aiming to understand the history of sheep farming and breed development in past societies.

Preoperative inflammatory markers as prognostic predictors after hepatocellular carcinoma resection: data from a western referral center

BackgroundRecent studies from eastern centers have demonstrate an association between inflammatory response and long-term outcomes after hepatocellular carcinoma (HCC) resection. However, the prognostic impact of inflammatory markers in western patients, with distinct tumor and epidemiologic features, is still unknown.AimTo evaluate the prognostic impact of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as their impact according to tumor size (< 5 cm, 5–10 cm, > 10 cm) in patients undergoing HCC resection with curative intent.MethodsOptimal cut-off values for NLR, PLR, and MLR were determined by plotting the receiver operator curves. Overall survival (OS) and disease-free survival (DFS) curves were calculated using the Kaplan–Meier method and compared using the log-rank test. The Cox method was used to identify independent predictors of OS and DFS.ResultsIn total, 161 consecutive adult patients were included. A high NLR (> 1.715) was associated with worse OS (P = 0.018). High NLR (> 2.475; P = 0.047) and PLR (> 100.25; P = 0.028) were predictors of short DFS. In HCC < 5 cm, MLR (> 1.715) was associated with worse OS (P = 0.047). In the multivariate analysis, high PLR was an independent predictor of worse DFS [hazard ratio (HR) 3.029; 95%CI 1.499–6.121; P = 0.002].ConclusionInflammatory markers are useful tools to predict long-term outcomes after liver resection in western patients, high NLR was able to stratify subgroups of patients with short OS and DFS, an increased PLR was an independent predictor of short DFS, while high MLR was associated with short OS in patients with early HCC.

Long-Term Outcomes of Mesohepatectomy for Centrally Located Liver Tumors: Two-Decade Single-Center Experience.

Mesohepatectomy is a viable treatment option for patients diagnosed with centrally located liver tumors (CLLTs). There are several reports from Eastern centers, but few data are available on this topic from Western centers. Data of 128 consecutive patients who underwent mesohepatectomy between September 2000 and September 2020 in our center were analyzed from a prospectively collected database. Patient demographic data, liver tumor characteristics, and intraoperative data were collected. In addition, posthepatectomy bile leakage (PHBL), posthepatectomy hemorrhage (PHH), posthepatectomy liver failure (PHLF), and 90-day mortality after mesohepatectomy were assessed. Long-term outcomes were also reported, and factors that may influence disease-free survival were evaluated. Of 128 patients, 113 patients (88.3%) had malignant hepatic tumors (primary and metastatic tumors in 41 [32%] and 72 [56.3%] patients, respectively), and 15 patients suffered from benign lesions (11.7%). Among the relevant surgical complications (grade B or C), PHBL was the most common complication after mesohepatectomy and occurred in 11.7% of patients, followed by PHLF in 3.1% of patients and PHH in 2.3% of patients. Only four patients (3.1%) died within 90 days after mesohepatectomy. The 5-year overall survival and overall recurrence (for malignant lesion) rates were 76.5% and 45.1%, respectively. Mesohepatectomy is a safe and feasible surgical treatment with low morbidity and mortality for patients with CLLT. Long-term outcomes can be improved by increased surgical expertise.

Политические позиции ливийских племен в ходе гражданской войны (2019–2020 гг.)

In this article, the author analyzes one of the most difficult problems in the Arab region, the civil war in Libya after the overthrow of Colonel Muammar Gaddafi in 2011. The author focuses on the fresh round of the escalation of the conflict (2019–20) between the eastern and western centers of power. The paper presents the importance of the political positions of Libyan tribes in the course of hostilities and their impact on the internal situation. The key issue of the study considered in the article directly concerns the political positions of the main clans within Libya. The author explains why some of the clans decided to participate in the military campaign on the side of the Libyan National Army, while the other defended the Government of National Accord; there were also those who adopted the position of non-interference in national affairs, since they sought to maintain autonomy. The main purpose of this work is to demonstrate the specifics of the Libyan problem, which is not only the desire of Tripolitania, Cyrenaica and Fezzan for their autonomous existence but also the internal contradictions between different tribes. It remains one of the most important factors hindering the unification of the country. After analyzing the publications in the modern Arabic-language press, the author offered her vision of the reasons for the ongoing armed confrontation in Libya and also presented and analyzed the full range of political positions and the role of the main Libyan tribes during the civil conflict, especially its latest round, which gives an idea of the complexity of the internal situation in Libya. The conclusion indicates the main reasons why Libya as a country cannot currently be a single and whole entity. The problem lies mainly in the complex ethnic and tribal situation as well as in the desire of individual tribes for an autonomous existence.

Погребения с изделиями из шелка эпохи Золотой Орды: проблемы интерпретации

Introduction. The Golden Horde epoch in the East European steppe was marked, among other things, by the emergence of urban culture in the region. The urban centers and, first of all, the Golden Horde capital in the Lower Volga were the seats of the ruling elite, but also the centers of trade and crafts people coming from all over the places. Around the towns, there were cemeteries with hundreds of burials that were opened and examined by specialists. In the steppe, near the bank of the river, the Golden Horde epoch is represented by a limited number of burials scattered among a variety of kurgan groups. The article aims to examine Golden Horde burials which comprise silk items; these Volga-Manych sites have previously been part of the studies of steppe elite burials. Materials and methods. The grave goods of most sites in question comprised weaponry, ceramics, and animal bones, the traces of funeral feasts, while luxury items were few. Of much interest in this respect are a Volga-Manych series of Golden Horde burials that comprised silk items. According to numerous data of the written sources, silk was equaled to gold in the medieval time. The fact that the Volga-Manych nomads had clothes made of silk was not only the evidence of their high social status and wealth but also a mark that they were the subjects of the Mongolian Empire. Results. In the burials under study, the silk finds were exclusively the clothing and headdress items of the buried. The fabric originated from the eastern (China, Egypt) and western (Byzantium) production centers. Remains of silk products were found both in the burials of men and women. These were both latitudinal-oriented graves, in which the buried were laid with their heads to the west, and meridionally-oriented graves, with the person’s head to the north. According to the present authors, the latter type may be interpreted as a feature characteristic of ethnic Mongolians’ funeral practice, while the former type graves were those of the Polovtsy and other Turkic-speaking groups.

Lateral lymph node dissection in rectal cancer: State of the art review

Half of the local regional recurrences from rectal cancer are nowadays located in the lateral compartments, most likely due to lateral lymph node (LLN) metastases. There is evidence that a lateral lymph node dissection (LLND) can lower the lateral local recurrence rate. An LLND without neoadjuvant (chemo)radiotherapy in patients with or without suspected LLN metastases has been the standard of care in the East, while Western surgeons believed LLN metastases to be cured by neoadjuvant treatment and total mesorectal excision (TME) only. An LLND in patients without enlarged LLNs might result in overtreatment with low rates of pathological LLNs, but in patients with enlarged LLNs who are treated with (C)RT and TME only, the risk of a lateral local recurrence significantly increases to 20%. Certain Eastern and Western centers are increasingly performing a selective LLND after neoadjuvant treatment in the presence of suspicious LLNs due to new scientific insights, but (inter)national consensus on the indication and surgical approach of LLND is lacking. An LLND is an anatomically challenging procedure with intraoperative risks such as bleeding and postoperative morbidity. It is therefore essential to carefully select the patients who will benefit from this procedure and where possible to perform the LLND in a minimally invasive manner to limit these risks. This review gives an overview of the current evidence of the assessment of LLNs, the indications for LLND, the surgical technique, pitfalls in performing this procedure and the future studies are discussed, aiming to contribute to more (inter)national consensus.

The MIDA quantitative mortality risk score: prognostic model in floppy mitral valves

Abstract Background The Mitral Regurgitation International Database (MIDA) score is a validated tool for Degenerative Mitral Regurgitation (DMR) management, being able to position a given patient within a continuous spectrum of short and long term mortality. However, whether this score may be applicable and incremental in the entire span of Floppy Mitral Valves (FMV), regardless of DMR severity, remains unsubstantiated. Methods The MIDA-Quantitative (MIDA-Q) unprecedented registries include 8187 consecutive patients (age 64±17 years, 45% women, follow-up 5.5±3.4 years) with isolated degenerative mitral valve disease diagnosed at tertiary (European/ North-American/ Middle Eastern) centers in whom DMR severity used both integrative and quantitative grading. The MIDA-Q Score ranged from 0 to 15 depending on accumulating risk factors. Long-term survival overall, under medical management and post-mitral surgery was analysed. Results By quantitative grading, MR was no/trivial in 1938 (24%), mild in 1423 (17%), moderate in 2027 (25%) and severe in 2799 (34%), with ERO 0.24±24cm2, RVol 37±35mL, and posterior leaflet prolapse in 49%. MIDA-Q Scores stratified in 8 categories were 0 (score 0, n=851), 1 (score 1–2, n=1301), 2 (score 3–4, n=2043), 3 (score 5–6, n=1581), 4 (score 7–8, n=1273), 5 (score 9–10, n=718), 6 (score 11–12, n=331) and 7 (score 13–15, n=89). In the whole MIDA-Q population (n=8187 patients), 5-year survival under medical management with Scores categories 0–1, 2–4, and 5–7 was 96±1%, 73±1%, and 61±3% respectively (P&amp;lt;0.0001). Five-year mortality ranged from 3% with MIDA Q-score 0 to 95% with MIDA Q-score 13–15 (P&amp;lt;0.0001). After mitral surgery, 1-year mortality with Scores categories 0–1, 2–4, and 5–7 was 0%, 1%, and 6% respectively and 5-year post-operative survival was 99±1%, 94±1%, and 82±2% (all P&amp;lt;0.0001). In models including age, sex and all guideline-provided prognostic markers, the EuroScoreII and the MIDA Score without DMR severity, the MIDA-Q Score provided incremental prognostic information (P&amp;lt;0.001). Conclusion This unheard international cohort of patients with FMV and prospective mitral severity quantitative grading, enables for the first time the calculation of a MIDA-Q Score, highly determinant of survival after diagnosis of FMV with any degree of DMR, that may be very useful for mitral valve prolapse management. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Mayo Fundation Figure 1

Long-term reverse remodeling and clinical improvement by MultiPoint Pacing in a randomized, international, Middle Eastern heart failure study

PurposeCardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing, MPP) has been shown to improve CRT response, although MPP response using automated pacing vector programming has not been demonstrated in the Middle East. The purpose of this study was to compare the impact of MPP to conventional biventricular pacing (BiV) using echocardiographic and clinical changes at 6-month post-implant.MethodsThis prospective, randomized study was conducted at 13 Middle Eastern centers. After de novo CRT-D implant (Abbott Unify Quadra MP™ or Quadra Assura MP™) with quadripolar LV lead (Abbott Quartet™), patients were randomized to either BiV or MPP therapy. In BiV patients, the LV pacing vector was selected per standard practice; in MPP patients, the two LV pacing vectors were selected automatically using VectSelect. CRT response was defined at 6-month post-implant by a reduction in LV end-systolic volume (ESV) ≥ 15%.ResultsOne hundred and forty-two patients (61 years old, 68% male, NYHA class II/III/IV 19%/75%/6%, 33% ischemic, 57% hypertension, 52% diabetes, 158 ms QRS, 25.8% ejection fraction [EF]) were randomized to either BiV (N = 69) or MPP (N = 73). After 6 months, MPP vs. BiV patients experienced greater ESV reduction (25.0% vs. 15.3%, P = 0.08), greater EF improvement (11.9% vs. 8.6%, P = 0.36), significantly greater ESV response rate (68.5% vs. 50.7%, P = 0.04), and significantly greater NYHA class improvement rate (80.8% vs. 60.3%, P = 0.01).ConclusionsWith MPP and automatic LV vector selection, more CRT patients in the Middle East experienced reverse remodeling and clinical improvement relative to conventional BiV pacing.

КСЕРОФИЛЬНЫЕ ЭНДЕМЫ ФЛОРЫ РОССИЙСКОГО КАВКАЗА И ИХ РОДСТВЕННЫЕ СВЯЗИ

The article is devoted to the study of endemics of xerophilous flora of various regions of the Russian Caucasus, adjacent and remote territories (Western Mediterranean, Caucasus, Greater Caucasus, Transcaucasia. Asia Minor and Western Asia, Eastern Mediterranean, Pontic region, Palaearctic). The purpose of the study is to identify their species composition, genetic links between them, which are necessary for solving the problems of florogenesis. The article analyzes the results of many years of floristic research in different territories of the Caucasus, publications on the flora of these, adjacent and alienated territories. The study used methods of historical reconstruction, morphological-ecological-geographical analysis, including the method of evolutionary series, as well as the method of phlorogenetic analysis and synthesis. Information on the genetic and geographical relationships of the taxa under discussion was obtained by analyzing the position of the species in the genus system (in the case of monotypic genera, the position in the family system), which made it possible to identify the closest relatives, determine their geographic localization, and suggest the time and directions of migration flows of ancestral species. As a result of the analysis of the distribution of 52 species of endemics of the xerophilic flora of the studied regions of the Russian Caucasus, as well as the flora of adjacent and remote areas, possible genetic links between them were revealed. The closest relationships of endemic euxerophytes were noted within the territory of the Greater Caucasus (26.3%), they are significant with endemic species of the Western Mediterranean, Anterior and Asia Minor (9.6% each) and weaker - with species of the Eastern Mediterranean (5.1%), The Pontic region and the Palaearctic (1.3% each). Based on the analysis of the relationship of paleoand neoendemics, it was concluded that the process of formation of the endemic nucleus of the flora of euxerophytes took place at least in three stages: due to heterochronous waves of migration from distant western and eastern centers of formation of xerophilic flora of the Ancient Mediterranean, through the formation of secondary centers in Asia Minor and Western Asia, and then in the Western Mediterranean; the most recent most intensive speciation, which took place in the territories of Inland Dagestan, the Central Caucasus and Northwestern Transcaucasia, on a Caucasian genetic basis in Tertiary speciation centers, led to the loss of many types of distant family ties. The results obtained expand our understanding of migration processes and the history of the formation of the flora of the Caucasus.

Bright Growth in the Darkness: Mysticism in Selected English and Kurdish Poems

Mysticism and its relevant associate, mystic, are so complicated words and concepts that dealing with them needs a very minute care and pierce look and observation. To worsen the case, eastern and western centers of knowledge differ in some aspects about the two concepts and even sometimes are at odds with each other. This study, therefore, is an attempt to clarify the bridge between the two camps in this respect and show the cases and states in which they differ as far as mystic and mysticism are concerned. The study hypothesizes some key resemblance and other disagreements due to the religious impacts on each party. It tries to reach possible conclusions through five sections that discuss the hypothesis in brief. It goes through some definitions of the concept, its origin in the east and the west, and some types of mysticism. The result is a good number of conclusions like the fact that for the English mystic poet, man is God and God is man; while their Kurdish counterparts stress that the spirit that dwells within man is divine because it is sent by God. These attempts and achievements were done thanks to a number of first hand English and Kurdish academic sources about the subject.

Risk factors for para-aortic nodes metastasis: Preliminary analysis from far Eastern and Western centers

The appropriate extent of lymphadenectomy in advanced gastric cancer and who can really benefit from extended dissection remains controversial worldwide.

Risk Factors for Para-Aortic Nodes Metastasis: Preliminary Analysis of Far Eastern and Western Centers

Risk Factors for Para-Aortic Nodes Metastasis: Preliminary Analysis of Far Eastern and Western Centers

ALABANDA PAYANDALI SARNIÇ AFRİKA KIRMIZI ASTARLI SERAMİKLERİ

Aydin Province, Cine District’s located about 7 km. the ancient city of Alabanda (Araphisar) to the west is it is a Carian city located at west of the Marsyas River. In the hilly area of the northeastern part of the city center, a two-chambered cistern was identified within the scope of archaeological excavations conducted in 2012 and 2013.The Terra Sigillata examined as the characteristic ceramics of the Roman Period dated to the perennial Roman and Early Byzantine Period in the cistern have not been cleaned from the red slipped ceramics (Africa, Phokaia, Cyprus, Egyptian Red Slipped) in the derivatives in the eastern centers. This group was evaluated for the first time by grouping 45 African red slip ceramics, 21 bowls, 21 bowls and 3 plate profiles, in 17 forms and analogically comparing them with parallel samples in other centers. In the classification here, similar examples from Anatolian origin and outside Anatolia were identified. Parallel examples are closely similar to Myndos, Nysa, Perge, Laodikeia, Tripolis, Hadrianopolis, Hac Dagi, Sarachane, Gozlukule, Kelenderis, Tarsus, Antiokheia, Anemurium, Alexandria, Kartaca and Athens Agora ceramics and Alabanda Palaces Cistern ceramics. As a result of it was defined that the red-lined ceramic groups of African origin in in the city of Alabanda were used extensively in the II nd and VII th centuries AD.

Multicenter Validation Study of the American Joint Commission on Cancer (8th Edition) for Gastric Cancer: Proposal for a Simplified and Improved TNM Staging System.

Objective: To evaluate the prognostic significance of the eighth edition of the American Joint Committee on Cancer (AJCC) TNM staging classification for gastric cancer.Methods: Prospective databases were reviewed to identify patients who underwent radical gastrectomy at two specialized eastern centers. The prognostic value of the eighth edition TNM classification was estimated and compared with that of the seventh edition. Additional external validation was performed using a dataset from a Western population.Results: Significant differences in 5-year overall survival (OS) rates were observed for each TNM stage when using the eighth edition system, and smaller Akaike information criteria (AIC) values and a higher c-statistic were observed relative to those of the seventh edition. However, the OS rates in each subgroup of stage III patients based on the eighth edition were significantly different. Patients with the same pN stage, namely, the pT4a and pT4b groups, showed similar 5-year OS (P>0.05). Based on the survival data, we propose a simplified staging system. In the improved TNM (iTNM) staging system, the subgroups of a given TNM stage do not show statistically significant differences in OS. The iTNM staging exhibits superior prognostic stratification, with lower AIC values and a higher c-statistic than the eighth edition TNM classification. Similar results were obtained with the external validation dataset from the IMIGASTRIC database.Conclusion: The prognostic prediction of the eighth edition of the AJCC TNM classification is superior to that of the seventh edition. However, it remains associated with some stage migration. The iTNM staging system permits simplification and slightly better prognostic prediction.

New Lead Scale Weights from Olbia and its Chora

&nbsp;In the article scale weights of ancient time, stored in the collection of funds of the Institute of Archaeology of the National Academy of Sciences of Ukraine, donated by V. O. Anokhin, are published. The collection contains weights in the form of sub-square and sub-rectangular tiles made of lead and bronze, round lead weights, weights made of bronze coins that come from random finds made from the territory of Olbia and its chora, and other monuments. For this work there were selected lead weights of sub-square and sub-rectangular shapes related to antique money-weight systems of the VI—I c. BC. The total number of examined items is 147, selected from the general collection. Each weight was measured and studied in detail. The weight of each item was correlated with the existing monetary systems of antiquity. Thus, it was possible to determine to which of the metrological standards each particular item belongs. The article contains a catalogue of 76 scale lead weights. A description, dimensions, weight and metrological system to which the find belongs are also mentioned. During processing the materials, it was possible to distinguish items related to the North Pontic money-weight systems: a group of small weights of Olbian normative metrological system, as well as the early Panticapaeum, Bosporan, Chersonesus, and directly to the systems of ancient Greek and ancient Eastern centers: Phoenician, Euboea-Attica, heavy late Attica, Aeginian, Chios-Rhodesian, Corinthian. The largest group of examined weights was the group related to the Phoenician coin-weight system; it included 20 finds. Among the weights studied, Olbian metrological system is represented by 14 scale tiles. The early Panticapaeum and the Chios-Rhodesian system consist of 10 items each. The group of Attica weights included 8 finds. 6 weights belong to the Bosporan group. The Corinthian regulatory weight system is represented in the collection by four items. Chersonesus weighing system is represented by two examples. Also, during the research, it was possible to separate out one weight each related to the Samos, heavy late Attica and Euboea-Attica systems

Multi-institutional validation of the 8th AJCC TNM staging system for gastric cancer: Analysis of survival data from high-volume Eastern centers and the SEER database.

The clinical relevance and general applicability of the 8th American Joint Committee on Cancer TNM gastric cancer staging system vs the 7th version have not been examined using datasets from both the East and West. Patients (n = 29 984) treated for gastric adenocarcinoma at two high-volume centers (Severance Hospital [SH] and Gangnam Severance Hospital [GSH]) in Korea and data from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. Survival curves, the performance of tumor staging, and the homogeneity of modified subgroups were compared. Minute changes were noted in the stage IIB subgroup; most changes were noted in stage III. Applying the 8th staging system facilitated better prediction of survival than applying the 7th version for SH data according to the log-rank test, C-index, and AIC (8444.5 vs 9263.8, 0.796 vs 0.798, and 104152 vs 103909, respectively). Its performance was also superior for GSH and SEER data. In a subgroup analysis of stages IIB to IIIC in SH, GSH, and SEER data, the 8th staging system showed similar or more homogeneous survival for each sub-classification than the 7th version. Compared with the 7th gastric cancer staging system, the newer version more accurately predicted prognosis and stratified subgroups more homogeneously.