Primary mediastinal synovial sarcoma: a case report and review of the literature

Primary mediastinal synovial sarcoma is a rare malignancy with only a few cases reported so far. A 56-year-old woman was admitted to our hospital for an investigation of a nodule in the left middle lung on chest radiography. Computed tomography revealed a mediastinal mass first described as a solitary fibrous tumor. The diagnosis of synovial sarcoma was established by computed tomography-guided percutaneous needle biopsy. Work up showed no metastasis to distant organs or contralateral pleural cavity. The mass was surgically resected; pathological and immunohistochemical analyses confirmed the diagnosis of a monophasic spindle cell synovial sarcoma probably originating from phrenic nerve. The patient received adjuvant chemotherapy and radiation and is free of recurrence after a follow up of 16 months

Social Cohesion as the Missing Link between Natural Resource Management and Peacebuilding: Lessons from Cocoa Production in Côte d’Ivoire and Colombia

Social cohesion plays a key role in processes of peacebuilding and sustainable development. Fostering social cohesion might present a potential to enhance the connection of natural resource management and peacebuilding and better functioning of sustainable land use systems. This contribution explores the nexus between social cohesion, natural resource management, and peacebuilding. We do so by (1) reviewing literature on the three concepts and (2) studying four different key action areas in the context of sustainable cocoa production for their potential to enhance social cohesion, namely (a) agroforestry; (b) cooperatives; (c) certification schemes; and (d) trade policies. Research is based on experience from cocoa production in two post-conflict countries, Côte d’Ivoire and Colombia. Our findings show that by fostering environmentally sustainable agricultural practices, these key action areas have a clear potential to foster social cohesion among cocoa producers and thus provide a valuable contribution to post-conflict peacebuilding in both countries. However, the actual effects strongly depend on a multitude of local factors which need to be carefully taken into consideration. Further, the focus in implementation of some of these approaches tends to be on increasing agricultural productivity and not directly on fostering cocoa farmers’ wellbeing and societal relations, and hence a shift toward social objectives is needed in order to strengthen these approaches as a part of overall peacebuilding strategies.Peer Reviewe

Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review.

Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients. Methods: A systematic consultation of literature was carried out. Search terms included: "CA and sepsis," "CA and surgery," and "CA and non-brain injury." Results: Our research individualized 294 studies and after screening, 22 studies were analyzed in this study. Studies were divided in three groups: CA in sepsis and septic shock, CA during surgery, and CA in the pediatric population. Studies in sepsis and intraoperative setting highlighted a relationship between the incidence of sepsis-associated delirium and impaired CA. The most investigated setting in the pediatric population is cardiac surgery, but the role and measurement of CA need to be further elucidated. Conclusion: In non-brain injured patients, impaired CA may result in cognitive dysfunction, neurological damage, worst outcome, and increased mortality. Monitoring CA might be a useful tool for the bedside optimization and individualization of the clinical management in this group of patients

A genome-wide association study identifies risk alleles in plasminogen and P4HA2 associated with giant cell arteritis

Giant cell arteritis (GCA) is the most common form of vasculitis in individuals older than 50 years in Western countries. To shed light onto the genetic background influencing susceptibility for GCA, we performed a genome-wide association screening in a well-powered study cohort. After imputation, 1,844,133 genetic variants were analysed in 2,134 cases and 9,125 unaffected controls from ten independent populations of European ancestry. Our data confirmed HLA class II as the strongest associated region (independent signals: rs9268905, P = 1.94E-54, per-allele OR = 1.79; and rs9275592, P = 1.14E-40, OR = 2.08). Additionally, PLG and P4HA2 were identified as GCA risk genes at the genome-wide level of significance (rs4252134, P = 1.23E-10, OR = 1.28; and rs128738, P = 4.60E-09, OR = 1.32, respectively). Interestingly, we observed that the association peaks overlapped with different regulatory elements related to cell types and tissues involved in the pathophysiology of GCA. PLG and P4HA2 are involved in vascular remodelling and angiogenesis, suggesting a high relevance of these processes for the pathogenic mechanisms underlying this type of vasculitis

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Driving and Monitoring Provisional Trust Negotiation with Metapolicies

We introduce the provisional trust negotiation framework PROTUNE, for combining distributed trust management policies with provisional-style business rules and accesscontrol related actions. The framework features a powerful declarative metalanguage for driving some critical negotiation decisions, and integrity constraints for monitoring negotiations and credential disclosure.