Multimodality Treatment for Early-Stage Hepatocellular Carcinoma: A Bridging Therapy for Liver Transplantation

Purpose: To evaluate the efficiency of a multimodality approach consisting of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) as bridging therapy for patients with hepatocellular carcinoma (HCC) awaiting orthotopic liver transplantation (OLT) and to evaluate the histopathological response in explant specimens. Materials and Methods: Between April 2001 and November 2011, 36 patients with 50 HCC nodules (1.4-5.0 cm, median 2.8 cm) on the waiting list for liver transplantation were treated by TACE and RFA. The drop-out rate during the follow-up period was recorded. The local efficacy was evaluated by histopathological examination of the explanted livers. Results: During a median follow-up time of 29 (4.0-95.3) months the cumulative drop-out rate for the patients on the waiting list was 0, 2.8, 5.5, 11.0, 13.9 and 16.7% at 3, 6, 12, 24, 36 and 48 months, respectively. 16 patients (with 26 HCC lesions) out of 36(44.4%) were transplanted by the end of study with a median waiting list time of 13.7 (2.5-37.8) months. The histopathological examination of the explanted specimens revealed a complete necrosis in 20 of 26 HCCs (76.9%), whereas 6 (23.1%) nodules showed viable residual tumor tissue. All transplanted patients are alive at a median time of 29.9 months. Imaging correlation showed 100% specificity and 66.7% sensitivity for the depiction of residual or recurrent tumor. Conclusion: We conclude that TACE.combined with RFA could provide an effective treatment to decrease the drop-out rate from the OLT waiting list for HCC patients. Furthermore, this combination therapy results in high rates of complete tumor necrosis as evaluated in the histopathological analysis of the explanted livers. Further randomized trials are needed to demonstrate if there is a benefit in comparison with a single-treatment approach. copyright (C) 2012 S. Karger AG, Base

Cutting Ties with Pro-Ana: A Narrative Inquiry Concerning the Experiences of Pro-Ana Disengagement from Six Former Site Users.

Websites advocating the benefits of eating disorders (“Pro-Ana”) tend to reinforce and maintain restrictive eating and purging behaviors. Yet remarkably, no study has explored individual accounts of disengagement from these sites and the associated meanings. Using narrative inquiry, this study sought to address this gap. From the interviews of six women, two overarching storylines emerged. The first closely tied disengagement to recovery with varying positions of personal agency claimed: this ranged from enforced and unwelcomed breaks that ignited change, to a personal choice that became viable through the development of alternative social and personal identities. A strong counternarrative to “disengagement as recovery” also emerged. Here, disengagement from Pro-Ana was storied alongside a need to retain an ED lifestyle. With “recovery” being just one reason for withdrawal from Pro-Ana sites, clinicians must remain curious about the meanings individuals ascribe to this act, without assuming it represents a step toward recovery.Peer reviewedFinal Accepted Versio

A performative-performance analytical approach: infusing Butlerian theory into the narrative-discursive method

Judith Butler’s theory of performativity provides gender theorists with a rich theoretical language for thinking about gender. Despite this, Butlerian theory is difficult to apply, as Butler does not provide guidance on actual analysis of language use in context. In order to address this limitation, we suggest carefully supplementing performativity with the notion of performance in a manner that allows for the inclusion of relational specificities and the mechanisms through which gender, and gender trouble, occur. To do this, we turn to current developments within discursive psychology and narrative theory. We extend the narrative-discursive method proposed by Taylor and colleagues, infusing it with Butlerian theory in order to fashion a dual analytical lens, which we call the performativity-performance approach. We provide a brief example of how the proposed analytical process may be implemented

Prospects for radical emissions reduction through behaviour and lifestyle change

Over the past two decades, scholars and practitioners across the social sciences, in policy and beyond have proposed, trialled and developed a wide range of theoretical and practical approaches designed to bring about changes in behaviours and lifestyles that contribute to climate change. With the exception of the establishment of a small number of iconic behaviours such as recycling, it has however proved extremely difficult to bring about meaningful transformations in personal greenhouse gas emissions at either the individual or societal level, with multiple reviews now pointing to the limited efficacy of current approaches. We argue that the majority of approaches designed to achieve mitigation have been constrained by the need to operate within prevailing social scientific, economic and political orthodoxies which have precluded the possibility of non-marginal change. In this paper we ask what a truly radical approach to reducing personal emissions would look like from social science perspectives which challenge the unstated assumptions severely limiting action to date, and which explore new alternatives for change. We emphasise the difficulties likely to impede the instituting of genuinely radical societal change regarding climate change mitigation, whilst proposing ways that the ground could be prepared for such a transformation to take place

Substrates for seedlings with sewage sludge and biochar.

The objective of this study was to evaluate substrates formulated with proportions of sewage sludge (SS)-solarizedand SS-biochar in the production of seedlings of two indicator crops: lettuce (Lactuca sativa L.) and black wattle(Acacia decurrens Willd). The study was composed of two experiments conducted in greenhouse, in randomized blockdesigns. The treatments consisted of five doses of SS-solarized and SS-biochar, combined with rice husk ash andvermiculite in different proportions (20:40:40, 30:35:35, 40:30:30, 50:25:25 and 60:20:20) and two commercial substrates(controls). Morphophysiological characteristics of the seedlings and the physico-hydric characteristics, pH and electricalconductivity of the substrates were evaluated. The pyrolysis process enhanced the characteristics of SS as a componentof substrates, where the substrate with 20% of SS-biochar, 40% of vermiculite and 40% of rice husk ash, presented thebetter performance

Agronomic performance and optimal ranges of attributes of substrates with biochar from anaerobic sewage sludge for black wattle (Acacia mearnsii) seedlings.

The objective was to evaluate the agronomic performance of black wattle seedlings (Acacia mearnsii) grown on substrates with increasing proportions of biochar based on anaerobic sewage sludge (ASS-biochar). In addition, the present study proposed appropriate ranges for the main physical-hydraulic and chemical attributes of these substrates.Published online: 21 August 2021