The symbolic power of the state: inheritance disputes and litigants' judicial trajectories in Cotonou

peer reviewedOver the last 10 years, scholars have started to focus on African states’ bureaucracies by investigating public servants’ relationships with the state, their professional ethos, how they appropriate reforms, and the way they interact with citizens. With inheritance disputes as a focal point, this article highlights the users’ perspective—which is often overlooked—and asks how litigants in Cotonou (Benin) see the state, appropriate legal reforms, and use the courts. It shows that citizens, despite a general sense that the court system is corrupt and ineffective, continue to use it because state institutions convey a form of authority that allows them either to legitimize or challenge family decisions in inheritance matters

Editorial: Terrestrial Ecosystem Nitrogen Fluxes via the Atmosphere-Land System

info:eu-repo/semantics/publishedVersio

Baseline staging tests after a new diagnosis of breast cancer: further evidence of their limited indications

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Effects of climate, soil, structure and management on functional traits in forest understory

Many studies explored how the observed pattern of plant functional traits (PFTs) may be influenced by environmental variables. However, studies on forest ecosystems including also stand structure and management are lacking. A first attempt to test the relative effect of variables related to the latter groups, together with climate and soil gradients, on the community weighted mean (CWM) values of PFTs was performed on forest understory in Italy. The Level I biodiversity dataset (extensive CONECOFOR network) has been used, based on a probabilistic sampling design, by 201 sites on a representative 16 x 16 km systematic grid. Following a harmonized protocol (ICP Forests, BioSoil-Biodiversity project) 29 explanatory variables were recorded and four plots 10x10 m have been surveyed for vascular specific cover, on each site. Variance partitioning was used to identify the relative role of climatic, soil, structural and management variables on the CWM values of specific leaf area (SLA), plant height (H) and seed mass (SM). Redundancy analysis was used to assess the relation between traits and variables. The combination of the selected variables explained the variation of H (34.3%) better than SLA (14.9%) and SM (11.1%). Climate alone, and in combination with other variables, demonstrated to explain the largest proportion of the variation for H (29.5%) and SM (9.3%); however, also structure and soil showed a relevant role. Forest management (9.9%) and structure (5.4%) were the main drivers for SLA. Considering a gradient of increasing temperature, aridity and nutrient availability, we detected plant understory communities with higher mean values of H and SM. High-SLA communities appeared in forests characterized by a larger amount of deadwood.In forest understory vegetation, the PFTs pattern is linked to a complex combination of variables. Not only climate and soil, but also forest structure and management played a role, suggesting the importance of taking into account such parameters in future research, at larger spatial scale including different Country-level policies. The variation of SLA, H and SM is controlled by different variables, making no obvious any attempt to predict the effects of climate and land-use changes on understory functional signature

HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review

Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with interval debulking surgery (IDS) constitutes an adjunctive treatment strategy in advanced ovarian cancer (AOC). This approach is based on the concept of perfusing chemotherapy targeting directly the site of residual tumor after optimal surgical debulking. It improves patients' outcome in terms of overall survival (OS) and disease free survival (DFS). The correct selection of patients eligible for IDS + HIPEC is crucial: in particular, they must have shown a good response to neoadjuvant chemotherapy (NACT) and have a good performance status (PS). The application of HIPEC at the end of debulking does not seem to increase neither the rate of intra/postoperative complications nor the time of hospitalization. Clinical Cases: After approving an internal protocol for the application of HIPEC in our hospital, we have submitted four patients to IDS + HIPEC in the past 12 months. One of these patients underwent a minimally invasive procedure. No intra- or postoperative complications were observed. Results: All patients underwent IDS + HIPEC after being assessed as eligible and after showing a good response to NACT. In the course of IDS in all cases complete debulking was achieved. No patient developed intra- or postoperative complications. Conclusions: The addition of HIPEC to interval debulking surgery should be offered to all eligible patients, considering that the association of HIPEC to IDS seems to improve patients' outcomes in terms of OS and DFS, without increasing post-operative morbidity

CUP-syndrome: Inguinal high grade serous ovarian carcinoma lymph node metastases with unknown primary origin – a case report and literature review

Objective: High-grade serous ovarian carcinoma (HGSC) often presents lymph node involvement. According to the paths of lymphatic drainage, the most common site of nodal metastasis is in the aortic area. However, pelvic lymph nodes are also involved and inguinal metastases are less frequent. Methods: Our report concerns the case of a 78-year-old woman with an inguinal lymph node relapse of HGSC, with the prior positivity of a right inguinal lymph node, after the primary surgery. Ovaries and tubes were negative on histological examination. A comprehensive search of the literature published from January 2000 to October 2021 was conducted on PubMed and Scopus. The papers were selected following the PRISMA guidelines. Nine retrospective studies were evaluated. Results: Overall, 67 studies were included in the initial search. Applying the screening criteria, 36 articles were considered eligible for full-text reading of which, after applying the exclusion criteria, 9 studies were selected for the final analysis and included in the systematic review. No studies were included for a quantitative analysis. We divided the results according to the relapse location: loco-regional, abdominal, and extra-abdominal recurrence. Conclusions: Inguinal node metastasis is a rare but not unusual occurrence in HGSC. A reasonable level of suspicion should be maintained in patients with inguinal adenopathy and high CA125 values, especially in women with a history of gynecologic surgery, even in the absence of negative imaging for an ovarian origin

Circulating MyomiRs as Potential Biomarkers to Monitor Response to Nusinersen in Pediatric SMA Patients

Spinal muscular atrophy (SMA) is an autosomal recessive disorder caused by mutations in survival motor neuron (SMN) 1 gene, resulting in a truncated SMN protein responsible for degeneration of brain stem and spinal motor neurons. The paralogous SMN2 gene partially compensates full-length SMN protein production, mitigating the phenotype. Antisense oligonucleotide nusinersen (Spinraza®) enhances SMN2 gene expression. SMN is involved in RNA metabolism and biogenesis of microRNA (miRNA), key gene expression modulators, whose dysregulation contributes to neuromuscular diseases. They are stable in body fluids and may reflect distinct pathophysiological states, thus acting as promising biomarkers. Muscle-specific miRNAs (myomiRs) as biomarkers for clinical use in SMA have not been investigated yet. Here, we analyzed the expression of miR-133a, -133b, -206 and -1, in serum of 21 infantile SMA patients at baseline and after 6 months of nusinersen treatment, and correlated molecular data with response to therapy evaluated by the Hammersmith Functional Motor Scale Expanded (HFMSE). Our results demonstrate that myomiR serological levels decrease over disease course upon nusinersen treatment. Notably, miR-133a reduction predicted patients’ response to therapy. Our findings identify myomiRs as potential biomarkers to monitor disease progression and therapeutic response in SMA patients

Mesonephric-Like Adenocarcinomas a Rare Tumor: The Importance of Diagnosis

Mesonephric-like adenocarcinomas (MLA) are rare neoplasms that arise in the uterine body and ovary and have been added to the World Health Organisation’s recent 2020 classification of female genital cancers. The pathogenesis of MLA is unknown and it remains debated whether they represent mesonephric carcinomas (Wolffian) arising in the endometrium/ovary or endometrioid carcinomas (Müllerian) closely mimicking mesonephric carcinomas. Here we report the case of a 57-year-old woman with an initial misdiagnosis of endometrioid adenocarcinoma on diagnostic biopsy. The patient came to our clinical evaluation for the appearance of menometrorrhagia complicated by anemia for several months. Therefore, she underwent pelvic echo-flowmetry, with indication for diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrioid endometrial adenocarcinoma. Following staging CT scan and targeted examinations on pulmonary findings, the patient underwent surgery with surprise of definitive diagnosis deponent for endometrial MLA. Our intention is to establish a brief review of the scientific evidence in the literature and the tools available for a correct histological diagnosis, in the light of the scant anatomopathological evidence. Our question gives rise to the motive for the publication: is immunohistochemistry the right way to resolve the diagnostic error at histology, which is usually the only source of diagnostic certainty? This case is intended to alert of diagnostic error that risked having the patient treated as a neoplasm with a favorable prognosis and low degree of aggressiveness instead of for a very aggressive and poor prognosis tumor such as MLA