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Background: Small bowel neuroendocrine tumours often present with locally advanced or metastatic disease. The aim of this paper is to provide evidence-based recommendations regarding (controversial) topics in the surgical management of advanced small bowel neuroendocrine tumours. Methods: A working group of experts was formed by the European Society of Endocrine Surgeons. The group addressed 11 clinically relevant questions regarding surgery for advanced disease, including the benefit of primary tumour resection, the role of cytoreduction, the extent of lymph node clearance, and the management of an unknown primary tumour. A systematic literature search was performed in MEDLINE to identify papers addressing the research questions. Final recommendations were presented and voted upon by European Society of Endocrine Surgeons members at the European Society of Endocrine Surgeons Conference in Mainz in 2023. Results: The literature review yielded 1223 papers, of which 84 were included. There were no randomized controlled trials to address any of the research questions and therefore conclusions were based on the available case series, cohort studies, and systematic reviews/meta-analyses of the available non-randomized studies. The proposed recommendations were scored by 38–51 members and rated 'strongly agree' or 'agree' by 64–96% of participants. Conclusion: This paper provides recommendations based on the best available evidence and expert opinion on the surgical management of locally advanced and metastatic small bowel neuroendocrine tumours. This paper provides evidence-based recommendations on the surgical management of locally advanced and metastatic small bowel neuroendocrine tumours, primary tumour resections in the setting of metastatic disease, and surgical indications for grade 3 small bowel neuroendocrine tumours and small bowel neuroendocrine carcinomas. The recommendations are the result of a working group of experts, created by the European Society of Endocrine Surgeons. The group addressed 11 relevant clinical questions regarding surgery for advanced disease, emphasizing and confirming the key role of the surgeon for advanced small bowel neuroendocrine tumours. [ABSTRACT FROM AUTHOR]

This paper presents the preliminary results of an investigation on the unexplored topic of polychromy on provincial stone sculptures from the Roman provinces in Germania through the innovative application of heritage materials science techniques. A group of three life-sized statues dating to the 1st Century CE recovered from Ingelheim, near Mainz, retains remarkably well-preserved traces of pigments. These are ripe for emerging non-invasive technologies supplemented by micro-sampling to validate results and provide information relating to mixing and layering not available to the naked eye. The most strikingly visible areas of extant polychromy were retained on the sculpture of a young woman, reported on here as the first phase of this programme of research. The results suggest that the statue was originally covered in a gypsum layer before the application of complex and diverse recipes of pigment applied as mixtures and in layers to create required hues and shadowing on sculpted features. The palette includes ochres and green earth mixed with small amounts of minium (red lead), realgar and lapis lazuli (ultramarine blue) added to create skin tones, and a vibrant blue-green tunic created from Egyptian blue, bone black, ochres, cinnabar and green earth; the palla and peplos contained ochres, bone black, and orpiment, and mixes of these created the detail of coloured jewellery. Of great interest was the detection of bone black on many features, particularly as a shading agent to enhance sculpted features, such as folds in cloth, providing a more realistic and flowing articulation. This is a revolutionary observation that provides previously unexplored insights into artistic polychromic practice in Antiquity. [ABSTRACT FROM AUTHOR]

In 1789, during the outset of the French Revolution, Jens Baggesen (1764–1826) embarked on a journey traversing Germany, Switzerland, and France. His experiences were later crystallized into a two-volume travelogue, Labyrinten , published between 1792 and 1793. In a similar vein, in 1793, Adam Moltke (1765–1843), a close friend of Baggesen, visited the besieged city of Mainz and subsequently chronicled his experiences in Reise nach Maynz (1794), also a two-volume work. Both authors, profoundly impacted by their travels, expressed a compulsion to write as an outlet. Intriguingly, their texts employ alimentary and metabolic metaphors to depict the act of experiencing as a form of ingestion, where impressions are consumed, assimilated, and eventually transformed into written narrative. This portrayal of memory and writing as a bodily process sharply diverges from the classical ideals of artistic and literary purity. This article argues that these alimentary and metabolic metaphors represent a subversive poetics, challenging conventional literary norms and offering a novel perspective on the interplay between human experience, bodily processes, and literary creation. [ABSTRACT FROM AUTHOR]