Common Aspirations of World Women

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Aspirations of Fisherfolk Communities on Their Children’s Education in Albay, Asid, and Ragay Gulfs of Bicol, Philippines

The study explores the yearnings of fisherfolks on their child’s education, hindrances, and factors that shape their desire as parents. Field observations and key informant interview among elder members of fisherfolk communities surrounding the Albay, Ragay, and Asid Gulfs of the Bicol Region was utilized. The study revealed that the majority of the fisherfolk parents do not want their children to continue fishing as their main source of livelihood because of potential risks, hardships, and cultural factors like collectivism, close family ties, and dependence on the elders. The parents’ aspirations were shaped by their persistence over various threats, fears, personal unfulfilled dreams, and career opportunities thru education. Most of the parents desired a college education and a safe and secure profession for their children. The study deduced that these challenges can be a contributory factor for the declining number of fisherfolks surrounding the gulfs. Influencing this sector is the factor motivating fishers in their aspirations for their children’s education. The study recommends introducing strategies for fisherfolks to develop a strong sense of hope and drive in realizing their aspirations and further research on the impact of culture, the role of women and children, and fisherfolks and their success stories.

Rural Women's Aspirations through Art Work

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Interpretation of “Poetry Expressing Aspirations”—A Discussion on the “Manifesto”of Chinese Poetics

This paper delves into the ancient concept of shi yan zhi(poetry expressing aspirations)within Chinese poetry.It examines the precise meaning of zhi,the dialectical relationship between yan and zhi,and the historical development of“poetry expressing aspirations.”It further looks at how this foundational concept underpins the logical construction of Chinese poetic tradition,reaffirming its historical significance as the“manifesto”of Chinese poetics.

Endoscopic techniques for the diagnosis of pancreatic cystic lesions

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other symptoms.The accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced EUS.Clinical studies have reported varying diagnostic and adverse event rates with these modalities.In addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different recommendations.In this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

Individualized treatment guided by endoscopic ultrasound-guided fine-needle aspiration for adrenocortical oncocytoma:A case report

BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,necessitating pathological validation.CASE SUMMARY We present a case report of a 35-year-old woman with an adrenal mass located on the left side,where endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)was performed after comprehensive diagnostic assessment.Our results are consistent with those of previously documented cases regarding tumor demographics and anatomical location.Given the limited number of reports on this condition,long-term follow-up is crucial to enhance our understanding of its prognosis.CONCLUSION For patients with adrenocortical oncocytoma,EUS-FNA can enables collection of preoperative tissue specimens leading to suitable treatment strategies.

Pancreatic cancer:Future challenges and new perspectives for an early diagnosis

This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced stage.Two main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial neoplasia.In the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic lesions.Nevertheless,the survival rate still remains poor,and alternative screening methods are under investigation.Endoscopic retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its role.Probably a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early diagnosis.Biomarkers could help to predict and follow the progression of early pancreatic lesions.However,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.

Arctic Aspirations

The world community needs to improve the governance of the North Pole for the benefit of all As climate change hastens the disappearance of the Arctic ice cap,

Different Civilizations, Common Aspirations

Shared interests enable China and Arab countries to develop a closer rapport both politically and

High-Altitude Aspirations

Can a planned merger bring two loss-making Shanghai air carriers back to life?By pursuing a merger with Shanghai Airlines Corp. Ltd., the struggling air travel giant China Eastern Airlines Corp. Ltd. is injecting some steam into what looks to be a languid season.

HIGH AMBITIONS CHINA'S BOOMING HEMP INDUSTRY HAS GLOBAL ASPIRATIONS

Though there are many industries where China now commands a leading presence,cannabis production probably isn’t the first that comes to mind.The South China Morning Post recently shone a light on the relatively low-key hemp industry,and how China now accounts for approximately half of the world’s legal

First 30 endobronchial ultrasound-guided transbronchial needle aspirations： a single institution＇s early experience

Background A new technique developed in 2002, aspiration （EBUS-TBNA）, has been one of the most real time endobronchial ultrasound-guided transbronchial needle important tools in lymph nodes （LNs） staging before lung cancer surgery. EBUS-TBNA was introduced into China in 2008. Methods Between June 2009 and October 2009, 30 patients with mediastinal/hilar lymphadenopathy and thoracic masses previously detected with CT scan underwent EBUS-TBNA without rapid onsite cytological examination. Results From 30 patients, 33 samples were obtained from LNs and seven samples from intrapulmonary lesions. Twenty out of the 23 lung cancer diagnoses were clarified through the procedure, with sensitivity, specificity, positive predictive value, negative predictive value and accuracy being 87%, 100%, 100%, 70% and 90%, respectively. All three false negative cases were found in the first five procedures. Additionally, among the 33 LNs examined, three specimens that had no lymphocytes were also found within the first five procedures. There were no major complications, and the procedures were uneventful. Conclusions EBUS-TBNA seems a safe and effective technique in making diagnosis for mediastinal/hilar LNs and intrapulmonary masses. For pulmonologists experienced in bronchoscopy, the sensitivity of the procedure for diagnosing lung cancer should be no less than 90% after the initial five procedures.

Political Aspirations,Participations and Influence of Turkish Muslims in Germany

Germany invited large number of guest workers from Turkey to revitalize its economy after WWII.Following decades of development,the Muslim population has become the largest minority group in Germany making up 5%of today’s German population.The main Muslim political aspiration is to be able to retain Turkish nationality but also access to German citizenship,and to promote the diversified development of German society to recognize their Muslim identity as well.In order to achieve their own political aspirations,they participate in German politics through German political parties,civil society groups and mass media.Their activities not only have great influence on both domestic politics and diplomatic relations,but also in improving their living conditions in Germany.However,the law in both countries will keep them from receiving German citizenship,let alone the dual nationality.Because of the inherent contradiction between Islam and Christianism,Germany has not yet become a truly pluralistic society.

Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent times.These applications range from the diagnosis to the treatment of various liver diseases.Therefore,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver diseases.AIM To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and efficacy.METHODS PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October 2023.The methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias tool.In addition,statistical analyses were performed using the Comprehensive Meta-Analysis software.RESULTS Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver diseases.EUS-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant complications.Similarly,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

Contrast-enhanced guided endoscopic ultrasound procedures

Contrast-enhanced endoscopic ultrasound(CH-EUS)can overcome the limi-tations of endoscopic ultrasound-guided acquisition by identifying microvessels inside inhomogeneous tumours and improving the characterization of these tumours.Despite the initial enthusiasm that oriented needle sampling under CH-EUS guidance could provide better diagnostic yield in pancreatic solid lesions,further studies did not confirm the supplementary values in cases of tissue acquisition guided by CH-EUS.This review details the knowledge based on the available data on contrast-guided procedures.The indications for CH-EUS tissue acquisition include isoechoic EUS lesions with poor visible delineation where CH-EUS can differentiate the lesion vascularisation from the surrounding parenchyma and also the mural nodules within biliopancreatic cystic lesions,which occur in select cases.Additionally,the roles of CH-EUS-guided therapy in patients whose pancreatic fluid collections or bile ducts that have an echogenic content have indications for drainage,and patients who have nonvisualized vessels that need to be highlighted via Doppler EUS are presented.Another indication is represented if there is a need for an immediate assessment of the post-radiofrequency ablation of pancreatic neuroendocrine tumours,in which case CH-EUS can be used to reveal the incomplete tumour destruction.

Is endoscopic ultrasound a promising technique in the diagnosis and treatment of liver diseases?

Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases.In some countries,its use is restricted to radiologists,limiting access for other clinicians,such as gastroenterologists.Endoscopic ultrasound,as a novel technique,plays a crucial role in diagnosis and treatment of digestive diseases.However,its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists,leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.

Fine-needle aspiration technique under endoscopic ultrasound guidance:A technical approach for RNA profiling of pancreatic neoplasms

BACKGROUND Early diagnosis of pancreatic ductal adenocarcinoma(PDAC)has been a longstanding challenge.The prognosis of patients with PDAC depends on the stage at diagnosis.It is necessary to identify biomarkers for the detection and differentiation of pancreatic tumors and optimize PDAC sample preparation procedures for DNA and RNA analysis.Most molecular studies are done using paraffin-embedded blocks;however,the integrity of DNA and RNA is often compromised in this format.Moreover,RNA isolated from human pancreatic tissue samples is generally of low quality,in part,because of the high concentration of endogenous pancreatic RNAse activity present.AIM To assess the potential of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)to obtain specimens from pancreatic neoplasms for subsequent RNA molecular profiling,including next-generation sequencing(NGS).METHODS Thirty-four EUS-FNA samples were included in this study:PDAC(n=15),chronic pancreatitis(n=5),pancreatic cysts(n=14),mucinous cysts(mucinous cystic neoplasia/intraductal papillary mucinous neoplasia)n=7,serous cystic neoplasms n=5,and pseudocysts n=2.Cyst material consisted of cyst fluid and cyst wall samples obtained by through-the-needle biopsy(TTNB).Samples were stored at -80℃ until analysis.RNA purity(A260/230,A260/280 ratios),concentration,and integrity(RIN)were assessed.Real-time polymerase chain reaction was conducted on all samples,and small RNA libraries were prepared from solid mass samples.RESULTS RNA was successfully extracted from 29/34(85%)EUS-FNA samples:100% pancreatic adenocarcinoma samples,100% chronic pancreatitis samples,70% pancreatic fluid cyst samples,and 50%TTNB samples.The relative expression of GAPDH and HPRT were obtained for all successfully extracted RNA samples(n=29)including lowquality RNA specimens.Low concentration and nonoptimal RIN values(no less than 3)of RNA extracted from EUS-FNA samples did not prevent NGS library preparation.The suitability of cyst fluid samples for RNA profiling varied.The quality of RNA extracted from mucinous cyst fluid had a median RIN of 7.7(5.0-8.2),which was compatible with that from solid neoplasms[6.2(0-7.8)],whereas the quality of the RNA extracted from all fluids of serous cystic neoplasms and TTNB samples had a RIN of 0.CONCLUSION The results demonstrate the high potential of EUS-FNA material for RNA profiling of various pancreatic lesions,including low-quality RNA specimens.

Young patient with a giant gastric bronchogenic cyst:A case report and review of literature

BACKGROUND Gastric bronchogenic cysts(BCs)are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period.Gastric bronchial cysts are rare lesions that were first reported in 1956;as of 2023,only 33 cases are available in the PubMed online database.BCs usually have no clinical symptoms in the early stage,and imaging findings also lack specificity.Therefore,they are difficult to diagnose before histopathological examination.CASE SUMMARY A 34-year-old woman with respiratory distress presented at our hospital.Endoscopic ultrasound revealed an anechoic mass between the spleen,left kidney and gastric fundus,with hyperechogenic and soft elastography textures and with a size of approximately 6.5 cm×4.0 cm.Furthermore,a computed tomography scan demonstrated high density between the posterior stomach and the spleen and the left kidney,with uniform internal density and a small amount of calcification.The maximum cross section was approximately 10.1 cm×6.1 cm,and the possibility of a cyst was high.Because the imaging findings did not suggest a malignancy and because the patient required complete resection,she underwent laparotomy surgery.Intraoperatively,this cystic lesion was found to be located in the posterior wall of the large curvature of the fundus and was approximately 8 cm×6 cm in size.Finally,the pathologists verified that the cyst in the fundus was a gastric BC.The patient recovered well,her symptoms of chest tightness disappeared,and the abdominal drain was removed on postoperative day 6,after which she was discharged on day 7 for 6 months of follow-up.She had no tumor recurrence or postoperative complications during the follow-up.CONCLUSION This is a valuable report as it describes an extremely rare case of gastric BC.Moreover,this was a very young patient with a large BC in the stomach.

Parathyroid carcinoma located in the thyroid gland:A case report

BACKGROUND Parathyroid carcinoma(PC)is a difficult-to-diagnose rare disease with low incidence.Relatively accurate preoperative diagnosis is very important in choosing surgical methods and patient prognosis.CASE SUMMARY This study reported the clinical diagnosis and treatment of a rare patient with PC located in the thyroid gland and provided a case reference for the diagnosis and treatment of PC.A case of a 64-year-old male patient who presented to our hospital with systemic muscle and joint pain and palpitations is outlined.Subsequently,the patient was admitted to the Department of Nephrology for the treatment of“multiple myeloma nephropathy pending investigation”.The patient was diagnosed with“primary hyperparathyroidism and hypercalcemic crisis”using thyroid color ultrasound.CONCLUSION The intraoperative frozen section report considered the parathyroid tumor.Surgical tumor resection was promptly performed,and the diagnosis of PC was confirmed.

Pleural effusion,ascites,colon ulcers and hematochezia:What we can learn from the diagnostic process of a patient with plasma cell myeloma:A case report

BACKGROUND Plasma cell myeloma(PCM)is characterized by hypercalcemia,renal impairment,anemia,and bone destruction.While pleural effusion,ascites,abdominal pain,and bloody stool are common manifestations of lung disease or gastrointestinal disorders,they are rarely observed in patients with PCM.CASE SUMMARY A 66-year-old woman presented with complaints of recurrent chest tightness,wheezing,and abdominal bloating accompanied by bloody stools.Computed tomography revealed pleural effusion and ascites.Pleural effusion tests showed inflammation,but the T-cell spot test and carcinoembryonic antigen were negative.Endoscopy showed colonic mucosal edema with ulcer formation and local intestinal lumen stenosis.Echocardiography revealed enlarged atria and reduced left ventricular systolic function.The diagnosis remained unclear.Further testing revealed elevated blood light chain lambda and urine immunoglobulin levels.Blood immunofixation electrophoresis was positive for immunoglobulin G lambda type.Smear cytology of the bone marrow showed a high proportion of plasma cells,accounting for about 4.5%.Histopathological examination of the bone marrow suggested PCM.Flow cytometry showed abnormal plasma cells with strong expression of CD38,CD138,cLambda,CD28,CD200,and CD117.Fluorescence in situ hybridization gene testing of the bone marrow suggested 1q21 gene amplification,but cytogenetic testing showed no clonal abnormalities.Colonic mucosa and bone marrow biopsy tissues were negative for Highman Congo red staining.The patient was finally diagnosed with PCM.CONCLUSION A diagnosis of PCM should be considered in older patients with pleural effusion,ascites,and multi-organ injury.