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Baltic amber is often considered the principal Scandinavian commodity exchanged for metal from ore-rich regions in Europe. If correct, this may explain the astonishing metal wealth of the Nordic Bronze Age and the modest social consumption of amber locally. The hypothesis of a metal-for-amber principle behind the trade is here for the first time assessed on scales from micro to macro. Amber finds were charted across Europe, and the result was then compared to evidence for regular shifts in copper ore preferences/availability, as found in the systematically changing isotopic/elemental composition of Nordic metal objects in c. 2100–1200 BC. Comparisons indicate that amber and metal followed similar spatiotemporal trajectories with major reorganizations at the turn from the Early to the Middle Bronze Age. Shifts in amber distribution correlate with the geography of metal sources used in both periods and flows of metal to Scandinavia and amber to Europe appear to be contingent even in subperiods. Major European amber tracks – and the crossroads hubs controlling them – were identified for the transfer of goods, yet again revealing major changes at the transition to the Middle Bronze Age. The social roles and meanings of amber among Nordic communities were likewise examined, suggesting that bearers of amber played a role in exercising social control of this resource. It is concluded that amber almost certainly was exchanged for metal. [ABSTRACT FROM AUTHOR]

The goal of the paper is to examine the hypothesis whereby a higher level of diversification in the structure of activities of a certain settlement indicates a higher level of its economic development. The absolute predominance of employment in the tertiary-quaternary sector in the total employment in Serbia's municipal centres has been brought in correlation with their level of economic development. The nature of this interdependence has been the subject of a detailed analysis in this paper. Using the methods elaborated for the needs of this research, conclusions have been drawn indicating the emergence of a large number of centres where the quantitative prevalence of the tertiary-quaternary sector, along with the distinct incidence of employment in public services, is not accompanied by corresponding qualitative and quantitative changes that would result in a higher level of economic development. Insufficiently developed centres have been identified in order to facilitate decision makers to take proper and timely actions and enable relevant institutions and organisations to apply adequate measures to support balanced economic development. [ABSTRACT FROM AUTHOR]

Cystic tumors of the pancreas (PCN) have increasingly gained importance in the clinical routine as they are frequently diagnosed as an incidental finding due to the continuous improvement in cross-sectional imaging. A differentiation is made between non-neoplastic and neoplastic cysts, whereby the latter has a tendency to malignant transformation to a varying extent. Therefore, they can be considered as precursor lesions of pancreatic cancer (PDAC). In addition to a detailed patient history and examination, imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) with fine needle aspiration (FNA) are used for the differential diagnosis. The indications for surgical resection of these lesions are based on the current European guidelines from 2018; however, the content is not evidence-based but relies on knowledge and recommendations from experts. According to these consensus recommendations asymptomatic serous cystic neoplasms (SCN) are serous lesions with a low tendency for malignant transformation and can be monitored. In contrast resection is warranted for all mucinous cystic neoplasms (MCN) >4 cm and all solid pseudopapillary neoplasms (SPN). Intraductal papillary mucinous neoplasms (IPMN), which are differentiated into main duct (MD-IPMN) and branch duct type (BD-IPMN) IPMN based on the position in the pancreatic duct system, should be resected as MD-IPMN and mixed type (MT)-IPMN. The risk of malignant transformation in BD-IPMN is variable and depends on risk factors, which are defined clinically and by imaging morphology. The treatment management is therefore carried out on an individual basis following risk estimation. In order to quantify the quality of indications in PCN and thereby also contributing to optimized medical care, prospective long-term studies are urgently needed. [ABSTRACT FROM AUTHOR]

Background: Most patients with pancreatic cancer suffer a relapse, which occurs either locally or systemically in the sense of liver and the lung metastases. Surgery for pancreatic cancer has become more radical due to the increased use of multimodal treatment concepts; however, the role of surgery in cases of recurrence remains controversial. Objective: This review summarizes the surgical treatment options for isolated local recurrence and metachronous oligometastatic pancreatic cancer. Material and methods: A selective literature search was carried out and the current evidence for surgical treatment is summarized. Results: There are currently no randomized studies on surgery for metastatic pancreatic cancer. Currently available data, however, show that after surgery long-term survival of up to 32–47 months after metastasectomy can be achieved, especially in patients with local recurrence or isolated pulmonary metastases with low morbidity and mortality. Individualized treatment concepts including surgical resection after initial systemic therapy seem promising even for liver metastases. The greatest survival benefits are consistently shown for all localizations in patients with a long as possible disease-free interval after the first operation. Conclusion: The treatment of isolated local recurrence or metachronous oligometastatic pancreatic cancer is an interdisciplinary challenge that should be performed in specialized pancreatic treatment centers only. Surgical resection embedded in a multimodal treatment concept can be meaningful in selected cases. [ABSTRACT FROM AUTHOR]

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Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Kardiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Healthcare facilities can use certificates to position themselves as experts to their clients and to distinguish themselves from their competitors. Different AWMF societies have addressed this topic und offer healthcare facilities the chance to get certified as a centre. In the course of this the societies develop curricula. Certification according to these curricula is then performed by the healthcare facilities or by an accredited agency. The different certificates show large differences in their certification requirements, which makes comparing them difficult. The present publication provides an overview of societies addressing certification and centres that are currently being certified., (Copyright © 2014. Published by Elsevier GmbH.)