Histopathological Features of Whipple Pancreaticoduodenectomy in Sudan: A Single-center Experience

Background: Periampullary tumors (PATs) are rare and Whipple pancreaticoduodenectomy is the commonest surgical approach for its management. The aim of this study was to analyze the histopathological features of Whipple-resected periampullary tumors in Sudanese patients.Methods: This retrospective descriptive study included 62 cases of Whipple resection seen in a center in Khartoum, Sudan from January 2016 to June 2021. The specimens were assessed for nine features of the tumor: site of the tumor (whether within the periampullary region), size of the tumor, histological type of the tumor, grade, perineural invasion, lymph vascular invasion, surgical margin status, lymph node metastasis status, and the pathological stage (pTNM).Results: In total, 62 cases, 40 (64.5%) males and 22 (35.5%) females, were included. Age ranged from 20 to 90 years with a mean age of 56.08 years (±12.98 SD). Of the 62 cases, 58 were malignant (93.5%), while 4 cases were benign (6.5%). The pancreas was the commonest site for malignant tumors (53.4%), followed by the ampulla (24.1%), duodenum (15.5%), and distal common bile duct tumors (DCBD) (7%). The maximum tumor size was 8 cm, and the number of lymph nodes resected ranged from 3 to 33. Pancreatic ductal adenocarcinomas (PDACs) showed the highest percentage of perineural (62.1%) and lymphovascular (55.2%) invasions, and a positive margin was seen in four cases. The most common tumor stage was pT3pN1pMx.Conclusion: PATs in the Sudanese population showed histological diversity regarding subtyping, grading, and staging. Further studies involving molecular prognostic features will support improving patient management. Keywords: periampullary tumors; Whipple pancreaticoduodenectomy; resection; histological features; Suda

The injured coast: the degradation of the Italian coastal landscape between unauthorized development, eco-mafia and regulations

The coastal landscapes are an important part of the identity, history and collective memory of Italy, in addition to being a natural heritage of extraordinary value and an important tourist resource. Yet still, the substantial and uncontrolled transformations that occurred in the last decades in almost all coastal regions attest to an alarming reality that shows no sign of changing. The unauthorized development is in fact an extremely widespread phenomenon in Italy and in particular in coastal sites, and it is configured in a first time as a form of spontaneous urbanization to become soon a purely speculative phenomenon. The paper aims to illustrate the main causes of this process, outlining the main stages of historical development, but also the role of eco-mafia and the regulatory response of the Italian government, not always effective. Only in recent years the preservation, the requalification and the enhancement of the coastline have become priorities for the future of our country. The unauthorized development can’t be suppressed by healing the illegal buildings and selling off our coastal landscape heritage, but by elevating the levels of control for enhanced protection of the territory, by starting the process of demolition to all buildings constructed without the necessary permits and especially by raising public awareness to the inestimable value of the landscape and to the social mobilization. Focusing on some examples of significant landscape impact, the paper aims also to offer a reflection on the implemented methods to eradicate the phenomenon of unauthorized development from the Italian coasts and on the most significant results

Working Paper 119 - Migration Patterns, Trends and Policy Issues in Africa

This paper documents the pattern, trend and determinants of migration in Africa using rich cross-country migration matrix data and household surveys from Burkina Faso, Ghana, Nigeria and Senegal. Results show that despite increase in the absolute number of migrants, Africa, particularly Sub-Saharan Africa has one of the lowest rate of emigration in the world and a majority of them migrate to other African countries signifying the importance of south-south migration. Poorer countries generally have lower rate of emigrationand higher rate of intra-African migrant. Bad socio-economic conditions generally seem to lead to higher rate of emigration by highly skilled individuals. Generally, migration is driven by motives to improve livelihoods with notable evidence on changes in labor market status. Often, self-employed or unemployed émigré ended up in wage employment. The paper outlines policy issues emerging from the migration trend in Africa.

Macchie di leopardo

Diese Arbeit „Macchie di leopardo – Eine Diskursanalyse über Raumaneignung und Raumzuweisung am Beispiel der Siedlung 'Serenissima' in Padua“ geht anhand eines Fallbeispiels der Frage der Raumnutzung in einem urbanen Umfeld nach. Beschrieben wird die Wandlung, die sich in der Siedlung „Serenissima“ in der Peripherie Paduas (Stadt im Nordosten Italiens), vollzogen hat. Diese Siedlung mit ihren 279 Miniappartements war in den 1970er-Jahren entstanden. Durch verschiedene Faktoren, die in der Arbeit aufgezeigt werden, war die „Serenissima“ Anfang der 1990er-Jahre mehrheitlich von MigrantInnen bewohnt und zudem völlig überbevölkert. Das nicht-Eingreifen von öffentlicher Seite ließ es zu, dass die Siedlung zudem zu einem Drogenumschlagplatz für die gesamte Region Venetien wurde. Mit den Jahren entstand also eine „Raumzuweisung“, die die „Serenissima“ vor allem für die Majoritätsbevölkerung als Drogenumschlagort per exzellent definierte. Diese festgeschriebene Zuschreibung beeinflusste das Leben aller BewohnerInnen der Serenissima, auch derjenigen die mit dem Geschäft des Drogenverkaufs nicht zu tun hatten. Im Jahr 2005 beschloss die Gemeindeverwaltung die Siedlung zu schließen, der Vorgang dauerte bis ins Jahr 2007. In Folge der Schließung vergab der Gemeinderat denjenigen Menschen, die gewissen bürokratischen Auflagen nachkommen konnten, eine Sozialwohnung. Die BewohnerInnen der „Serenissima“, mehrheitlich MigrantInnen, wurde auf verschiedene Stadtviertel verteilt. Anhand von drei Themen – Einwanderung, Stadt und Raum – wird versucht einzelne Diskursebenen, die diesen Prozess geprägt haben, hervorzuheben. Die Berücksichtigung der einzelnen Diskursebenen ermöglicht es interne und externe Faktoren zu berücksichtigen und somit die Ereignisse in der „Serenissima“ in ein urbanes Untersuchungsfeld einzubauen. Der prozessorientierte Charakter dieser Arbeit ist durch eine diachrone Herangehensweise gegeben. Somit wird die Dezentralisierung der Menschen auf die Stadt mit den vorher geschehenen Ereignissen in der „Serenissima“ in Zusammenhang gebracht

Analysis of Transition Nuclear Fuel Cycles from LWRs to Gen-IV Reactors

The present activity provides a contribution to the analysis of advanced fuel cycles with special attention to resources, waste inventory and infrastructures needs. The activity has been developed to get an overview about the challenges, implications, boundary conditions, assumptions and correlated consequences of different scenarios suggested or envisaged for the deployment of nuclear energy (mainly for electricity production) on a global or regional basis. In this context, the implications of the LWRs use (in terms of resources, fuel cycle facilities, waste production, etc.) and the possible transition to FRs, in terms of Pu availability, enlargement of reprocessing capacities, etc., are key points of the analysis. A reference scenario has been studied in detail and used as "unit of measure" for extrapolation to more complex scenarios (e.g. European scenarios). The "once-through" strategy, where only LWRs are deployed has been compared with respect to advanced fuel cycle based on P&T. Several FR concepts (lead and sodium cooled) have been compared in terms of fuel cycle performances

The proportion of different BCR-ABL1 transcript types in chronic myeloid leukemia. An international overview

There are different BCR-ABL1 fusion genes that are translated into proteins that are different from each other, yet all leukemogenic, causing chronic myeloid leukemia (CML) or acute lymphoblastic leukemia. Their frequency has never been systematically investigated. In a series of 45503 newly diagnosed CML patients reported from 45 countries, it was found that the proportion of e13a2 (also known as b2a2) and of e14a2 (also known as b3a2), including the cases co-expressing e14a2 and e13a2, was 37.9% and 62.1%, respectively. The proportion of these two transcripts was correlated with gender, e13a2 being more frequent in males (39.2%) than in females (36.2%), was correlated with age, decreasing from 39.6% in children and adolescents down to 31.6% in patients ≥ 80 years old, and was not constant worldwide. Other, rare transcripts were reported in 666/34561 patients (1.93%). The proportion of rare transcripts was associated with gender (2.27% in females and 1.69% in males) and with age (from 1.79% in children and adolescents up to 3.84% in patients ≥ 80 years old). These data show that the differences in proportion are not by chance. This is important, as the transcript type is a variable that is suspected to be of prognostic importance for response to treatment, outcome of treatment, and rate of treatment-free remission