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Objective: To investigate temporal trends in prostate cancer (PCa) radical prostatectomy (RP) candidates.
Materials and Methods: Patients who underwent RP for PCa between January 2014 and December 2019 were identified form our institutional database. Trend analysis and logistic regression models assessed RP trends after stratification of PCa patients according to D'Amico classification and Gleason score. Patients with neoadjuvant androgen deprivation or radiotherapy prior to RP were excluded from the analysis.
Results: Overall, 528 PCa patients that underwent RP were identified. Temporal trend analysis revealed a significant decrease in low-risk PCa patients from 17 to 9% (EAPC: −14.6%, p < 0.05) and GS6 PCa patients from 30 to 14% (EAPC: −17.6%, p < 0.01). This remained significant even after multivariable adjustment [low-risk PCa: (OR): 0.85, p < 0.05 and GS6 PCa: (OR): 0.79, p < 0.001]. Furthermore, a trend toward a higher proportion of intermediate-risk PCa undergoing RP was recorded.
Conclusion: Our results confirm that inverse stage migration represents an ongoing phenomenon in a contemporary RP cohort in a European tertiary care PCa center. Our results demonstrate a significant decrease in the proportion of low-risk and GS6 PCa undergoing RP and a trend toward a higher proportion of intermediate-risk PCa patients undergoing RP. This indicates a more precise patient selection when it comes to selecting suitable candidates for definite surgical treatment with RP.
Objective: To investigate the value of standard [digital rectal examination (DRE), PSA] and advanced (mpMRI, prostate biopsy) clinical evaluation for prostate cancer (PCa) detection in contemporary patients with clinical bladder outlet obstruction (BOO) scheduled for Holmium laser enucleation of the prostate (HoLEP).
Material and Methods: We retrospectively analyzed 397 patients, who were referred to our tertiary care laser center for HoLEP due to BOO between 11/2017 and 07/2020. Of those, 83 (20.7%) underwent further advanced clinical PCa evaluation with mpMRI and/or prostate biopsy due to elevated PSA and/or lowered PSA ratio and/or suspicious DRE. Logistic regression and binary regression tree models were applied to identify PCa in BOO patients.
Results: An mpMRI was conducted in 56 (66%) of 83 patients and revealed PIRADS 4/5 lesions in 14 (25%) patients. Subsequently, a combined systematic randomized and MRI-fusion biopsy was performed in 19 (23%) patients and revealed in PCa detection in four patients (5%). A randomized prostate biopsy was performed in 31 (37%) patients and revealed in PCa detection in three patients (4%). All seven patients (9%) with PCa detection underwent radical prostatectomy with 29% exhibiting non-organ confined disease. Incidental PCa after HoLEP (n = 76) was found in nine patients (12%) with advanced clinical PCa evaluation preoperatively. In univariable logistic regression analyses, PSA, fPSA ratio, and PSA density failed to identify patients with PCa detection. Conversely, patients with a lower International Prostate Symptom Score (IPSS) and PIRADs 4/5 lesion in mpMRI were at higher risk for PCa detection. In multivariable adjusted analyses, PIRADS 4/5 lesions were confirmed as an independent risk factor (OR 9.91, p = 0.04), while IPSS did not reach significance (p = 0.052).
Conclusion: In advanced clinical PCa evaluation mpMRI should be considered in patients with elevated total PSA or low fPSA ratio scheduled for BOO treatment with HoLEP. Patients with low IPSS or PIRADS 4/5 lesions in mpMRI are at highest risk for PCa detection. In patients with a history of two or more sets of negative prostate biopsies, advanced clinical PCa evaluation might be omitted.
Objective: Research on visual working memory has shown that individual stimulus features are processed in both specialized sensory regions and higher cortical areas. Much less evidence exists for auditory working memory. Here, a main distinction has been proposed between the processing of spatial and non-spatial sound features. Our aim was to examine feature-specific activation patterns in auditory working memory.
Methods: We collected fMRI data while 28 healthy adults performed an auditory delayed match-to-sample task. Stimuli were abstract sounds characterized by both spatial and non-spatial information, i.e., interaural time delay and central frequency, respectively. In separate recording blocks, subjects had to memorize either the spatial or non-spatial feature, which had to be compared with a probe sound presented after a short delay. We performed both univariate and multivariate comparisons between spatial and non-spatial task blocks.
Results: Processing of spatial sound features elicited a higher activity in a small cluster in the superior parietal lobe than did sound pattern processing, whereas there was no significant activation difference for the opposite contrast. The multivariate analysis was applied using a whole-brain searchlight approach to identify feature-selective processing. The task-relevant auditory feature could be decoded from multiple brain regions including the auditory cortex, posterior temporal cortex, middle occipital gyrus, and extended parietal and frontal regions.
Conclusion: In summary, the lack of large univariate activation differences between spatial and non-spatial processing could be attributable to the identical stimulation in both tasks. In contrast, the whole-brain multivariate analysis identified feature-specific activation patterns in widespread cortical regions. This suggests that areas beyond the auditory dorsal and ventral streams contribute to working memory processing of auditory stimulus features.
Cephalization is a major innovation of animal evolution and implies a synchronization of nervous system, mouth, and foregut polarization to align alimentary tract and sensomotoric system for effective foraging. However, the underlying integration of morphogenetic programs is poorly understood. Here, we show that invagination of neuroectoderm through de novo polarization and apical constriction creates the mouth opening in the Caenorhabditis elegans embryo. Simultaneously, all 18 juxta-oral sensory organ dendritic tips become symmetrically positioned around the mouth: While the two bilaterally symmetric amphid sensilla endings are towed to the mouth opening, labial and cephalic sensilla become positioned independently. Dendrite towing is enabled by the pre-polarized sensory amphid pores intercalating into the leading edge of the anteriorly migrating epidermal sheet, while apical constriction-mediated cell–cell re-arrangements mediate positioning of all other sensory organs. These two processes can be separated by gradual inactivation of the 26S proteasome activator, RPN-6.1. Moreover, RPN- 6.1 also shows a dose-dependent requirement for maintenance of coordinated apical polarization of other organs with apical lumen, the pharynx, and the intestine. Thus, our data unveil integration of morphogenetic programs during the coordination of alimentary tract and sensory organ formation and suggest that this process requires tight control of ubiquitin-dependent protein degradation.
This book questions colonial and apartheid ideologies on being human and being African, ideologies that continue to shape how research is conceptualised, taught and practiced in universities across Africa. Africans immersed in popular traditions of meaning-making are denied the right, by those who police the borders of knowledge, to think and represent their realities in accordance with the civilisations and universes they know best. Often, the ways of life they cherish are labelled and dismissed too eagerly as traditional knowledge by some of the very African intellectual elite they look to for protection. The book makes a case for sidestepped traditions of knowledge. It draws attention to Africa's possibilities, prospects and emergent capacities for being and becoming in tune with its creativity and imagination. It speaks to the nimble-footed flexible-minded 'frontier African' at the crossroads and junctions of encounters, facilitating creative conversations and challenging regressive logics of exclusionary identities. The book uses Amos Tutuola's stories to question dualistic assumptions about reality and scholarship, and to call for conviviality, interconnections and interdependence between competing knowledge traditions in Africa.
Marginality does not mean isolation. In Africa where people are permanently on the move in search, inter alia, of a 'better elsewhere', marginality means disconnection to obvious possibilities and the invisibility of the myriad connections that make life possible for the ordinarily sidestepped. This book is about the workings of networks of the mobile in Africa, a continent usually associated with the 'global shadows' of the world. How do changes in the possibilities for communication, with the recent hype of mobile technology, influence the social and economic dynamics in Africa's mobile margins? To what extent is the freedom associated with new Information and Communication Technologies reality or disillusion for people dwelling in the margins? Are ordinary Africans increasingly Side@Ways? How social are these emergent Side@Ways? Contributions to answering these and related questions are harvested from ethnographic insights by team members of the WOTRO funded 'Mobile Africa revisited' research programme hosted by the African Studies Centre, Leiden, The Netherlands.
This rich conversational auto-biography tells the story of the political life of Ndeh Ntumazah who was born in Mankon in 1926, spent the best part of his life suffering and sacrificing for the freedom of Cameroon, and died in London on January 21, 2010, at the age of 83, as President of the Union of the Populations of Cameroon (UPC). Ntumazah was a political activist for nearly 60 years. He joined the UPC around 1950 and remained a militant of the party until his demise. When the UPC was banned in French Cameroon in 1955, he was advised by his comrades to create another party in the Southern Cameroons, which would be the UPC in disguise. The party was called 'One Kamerun Movement - OK', with Ndeh Ntumazah as its President. Following its banning, the UPC started a war of liberation in French Cameoon, so Ntumazah from the safety of Southern Cameroons, liaised with his comrades in French Cameroon to carry out their underground operations. Ndeh Ntumazah left Cameroon to seek political asylum abroad in 1962. He stayed in Ghana, Guinea, Algeria and finally in Britain where he spent most of his time sensitising the world about the plight of Cameroon using various avenues like writing, conferences and deputations. Ntumazah is dead, but he lives on because his life stands out as a point of focus.
The volume draws from René Devischs encounters with groups in southsaharan Africa, primarily. The author had the privilege to immerse himself, around the clock, in the Yakaphones activities and thoughts in southwest DR Congo from 1972 to 1974, and intermittently in Kinshasas shanty towns, from 1986 to 2003. The author first examines what sparked his choice to come to Congo, and then to pursue research among the Yakaphones in the borderland with Angola. He then invites us to follow the trajectory of his plural anthropological view on todays multicentric world. It leads us to his praise for honorary doctor Jean-Marc Elas work. He then examines the proletarian outbursts of violence that rocked Congos major cities in 1991 and 1993. These can be read as a settling of scores with the disillusioning colonial and missionary modernisation, along with president Mobutus millenarian Popular Movement of the Revolution. Furthermore, after considering the morose reduction of a major Yaka dancing mask into a mere museum-bound curio in Antwerp, the book unravels the Yakaphones perspectives on spirits and sorcerys threat. It also analyses their commitment to classical Bantu-African healing cults, along with their parallel consulting physicians and healers. By sharing the Yakaphones life-world, the analysis highlights their body-group-world weave, interlaced by the principle of co-resonance. A phenomenological and perspectivist look unfolds the local actors views, thereby disclosing the Bantu-African genius and setting for a major reversal of perspectives. Indeed, seeing 'here' from 'there' allows the author to uncover some alienating dynamics at work in his native Belgian Flemish-speaking culture. To better grasp the realm of life beyond the speakable and factual reasoning, the approach occasionally turns to the later Lacans focus on the unconscious desire, the body and its affects. The book addresses students and researchers in the humanities and, more broadly, all those immersed in the heat of the encounter with the culturally different.
In a tribute to Hon. Justice Iorhemen Hwande CFR, Chief Judge of Benue State this book includes contributions from a variety of scholars from Nigeria. 14 essays cover a wide range of topics such as: Insider Dealing by Company Directors and the Nigerian Capital Market; United Nations Conventions on the Law of the Sea as a Tool for the Resolution of Climate Change Disputes; Is a Practicing Christian Lawyer/Judge in Nigeria an Anachronism?; The Justiciability and Enforcement of Social Rights; and International Economic Law and Development.
Vestiges
(2013)
The poems in this collection are adequate, with great lines. The rhythm is stimulating to all the five senses thanks to the use of multiple images. A lot of imagery in Vestiges gives a picture of a war front after a ferocious battle. The objects, animals, and images in the poems disorient and lead the reader to focusing on putting flesh to the bones than just getting the juice of the poems... The rhythm more than anything else carries the reader through this chaotic tableau painted in Vestiges. In a way, this comes across as a substantiation of the poet's vision of our world and an explanation as to why he considers this collection as a skeleton; and precisely skeletons left by the ravages of war. Is the poet's world and ours a field of ruins and topsy-turvydom to which we are all blind? The answer is yours.