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BACKGROUND: Solid pseudopapillary neoplasm (SPN) is an uncommon pathology of the pancreas with unpredictable malignant potential. Endoscopic ultrasound (EUS) assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis. However, there is a paucity of data regarding the imaging assessment of these lesions. AIM: To determine the characteristic EUS features of SPN and define its role in preoperative assessment. METHODS: This was an international, multicenter, retrospective, observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers. All cases with postoperative histology of SPN were included in the study. Data collected included clinical, biochemical, histological and EUS characteristics. RESULTS: One hundred and six patients with the diagnosis of SPN were included. The mean age was 26 years (range 9 to 70 years), with female predominance (89.6%). The most frequent clinical presentation was abdominal pain (80/106; 75.5%). The mean diameter of the lesion was 53.7 mm (range 15 to 130 mm), with the slight predominant location in the head of the pancreas (44/106; 41.5%). The majority of lesions presented with solid imaging features (59/106; 55.7%) although 33.0% (35/106) had mixed solid/cystic characteristics and 11.3% (12/106) had cystic morphology. Calcification was observed in only 4 (3.8%) cases. Main pancreatic duct dilation was uncommon, evident in only 2 cases (1.9%), whilst common bile duct dilation was observed in 5 (11.3%) cases. One patient demonstrated a double duct sign at presentation. Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern. EUS guided biopsy was performed using three different types of needles: Fine needle aspiration (67/106; 63.2%), fine needle biopsy (37/106; 34.9%), and Sonar Trucut (2/106; 1.9%). The diagnosis was conclusive in 103 (97.2%) cases. Ninety-seven patients were treated surgically (91.5%) and the post

Nahla M Elsherbiny,1 Mohammed Ramadan,2 Nagla H Abu Faddan,3 Elham Ahmed Hassan,4 Mohamed E Ali,2 Abeer Sharaf El-Din Abd El-Rehim,4 Wael A Abbas,5 Mohamed AA Abozaid,5 Ebtisam Hassanin,6 Ghada A Mohamed,7 Helal F Hetta,1 Mohammed Salah8 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 2Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, Egypt; 3Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt; 4Department of Gastroenterology and Tropical Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Department of Internal Medicine, Gastroenterology and Hepatology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt; 6Clinical Pathology, Ministry of Health, Assiut, Egypt; 7Department of Internal Medicine, Endocrine Unit, Faculty of Medicine, Assiut University, Assiut, Egypt; 8Department of Microbiology and Immunology, Faculty of pharmacy, Port Said University, Port Said, EgyptCorrespondence: Elham Ahmed Hassan, Department of Gastroenterology and Tropical Medicine, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt, Tel +20 882410285, Fax +20 882333327, Email mam_elham75@yahoo.com; elham.abdelhalem@med.aun.edu.egPurpose: To investigate the compositional and functional characteristics of T1DM-associated gut microbiota in two Egyptian cities and to study the geographical locality effects.Patients and Methods: This case-control study included 32 children with controlled T1DM and 16 controls, selected from two different regions of Egypt. The gut microbiota of both diabetic and control children was analyzed through 16S rRNA gene sequencing; this was done using the Illumina MiSeq platform.Results: Consistent findings among the diabetic children included significantly lower alpha diversity than the control children, as well as a lower mean Firmicutes/Bacteroidetes (F/B) ratio, and reduced proportions of Firmicut

In international relations literature, there seems to be some confusion caused by the many contradictory theories on alliance formation patterns. For this reason, this thesis surveys why there is not just one theory that explains most of the alliance formations throughout history. Using logistic regression models and statistical analysis for different historical periods from 1816 to 2012, the thesis explores the effects of four state-level variables—regime type, national material capabilities, geographical proximity, and trade exchange—on alliance formation behaviors. The results show that the four state-level variables have different levels of significance in the different periods. The thesis concludes that alliance formation behaviors differ depending on the prevailing system-level conditions in the different historical periods, especially under conditions of war and peace and based on the polarity of the international system. The approach presented in the thesis provides a new perspective to analyze alliance formation patterns for a better understanding of future alliances.

In international relations literature, there seems to be some confusion caused by the many contradictory theories on alliance formation patterns. For this reason, this thesis surveys why there is not just one theory that explains most of the alliance formations throughout history. Using logistic regression models and statistical analysis for different historical periods from 1816 to 2012, the thesis explores the effects of four state-level variables—regime type, national material capabilities, geographical proximity, and trade exchange—on alliance formation behaviors. The results show that the four state-level variables have different levels of significance in the different periods. The thesis concludes that alliance formation behaviors differ depending on the prevailing system-level conditions in the different historical periods, especially under conditions of war and peace and based on the polarity of the international system. The approach presented in the thesis provides a new perspective to analyze alliance formation patterns for a better understanding of future alliances., http://archive.org/details/understandinglli1094547911, Major, Lebanese Army, Captain, Hungarian Defense Forces, Approved for public release; distribution is unlimited.