Background: The association of body mass index (BMI) and long-term prognosis and outcome of patients with perihilar cholangiocarcinoma (pCCA) has not been well defined. The aim of this study was to evaluate clinicopathologic and oncologic outcomes with pCCA undergoing resection, according to their BMI. Methods: Patients undergoing liver resection in curative intention for pCCA at a tertiary German hepatobiliary (HPB) center were identified from a prospective database. Patients were classified as normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2) and obese (>30 kg/m2) according to their BMI. Impact of clinical and histo-pathological characteristics on recurrence-free survival (RFS) were assessed using Cox proportional hazard regression analysis among patients of all BMI groups. Results: Among a total of 95 patients undergoing liver resection in curative intention for pCCA in the analytic cohort, 48 patients (50.5%) had normal weight, 33 (34.7%) were overweight and 14 patients (14.7%) were obese. After a median follow-up of 4.3 ± 2.9 years, recurrence was observed in totally 53 patients (56%). The cumulative recurrence probability was higher in obese and overweight patients than normal weight patients (5-year recurrence rate: obese: 82% versus overweight: 81% versus normal weight: 58% at 5 years; p = 0.02). Totally, 1-, 3-, 5- and 10-year recurrence-free survival rates were 68.5%, 44.6%, 28.9% and 13%, respectively. On multivariable analysis, increased BMI (HR 1.08, 95% CI: 1.01–1.16; p = 0.021), poor/moderate tumor differentiation (HR 2.49, 95% CI: 1.2–5.2; p = 0.014), positive lymph node status (HR 2.01, 95% CI: 1.11–3.65; p = 0.021), positive resection margins (HR 1.89, 95% CI:1.02–3.4; p = 0.019) and positive perineural invasion (HR 2.92, 95% CI: 1.02–8.3; p = 0.045) were independent prognostic risk factors for inferior RFS. Conclusion: Our study shows that a high BMI is significantly associated with an increased risk of recurrence after liver resection in curative intention for pCCA. This factor should be considered in future studies to better predict patient’s individual prognosis and outcome based on their BMI.

Although several investigations have shown a relationship between increased epicardial adipose tissue (EAT) and atrial fibrillation (AF), the association between EAT and ventricular tachycardia (VT) has not been evaluated. We investigated the association between EAT and post-ablation VT recurrence. In this study, sixty-one consecutive patients (mean age=62.0±13.9) undergoing VT ablation with pre-procedural cardiac magnetic resonance imaging (MRI) were recruited. EAT thickness was measured using cardiac MRI in the right and left atrioventricular grooves (AVGs), RV free wall, anterior, inferior, and superior interventricular grooves (IVGs). During a mean follow-up period of 392.9±180.2 days, post-ablation VT recurrence occurred in 15 (24.6%) patients. EAT thickness was significantly higher in the VT recurrence group than that in the non-recurrent VT at the right (18.7±5.7 vs. 14.1±4.4 mm; p=0.012) and left (13.3±3.9 vs. 10.4±4.1; p=0.020) AVGs. The best cut-off points for predicting VT recurrence were calculated as 15.5 mm for the right AVG (area under ROC curve=0.74) and 11.5 mm for the left AVG (area under ROC curve=0.72). Multivariate Cox regression analysis showed that pre procedural right AVG-EAT (HR: 1.2; 95% CI: [1.06-1.39], p=0.004) was the only independent predictor of VT recurrence after adjustment for covariates. Kaplan–Meier analysis showed a difference for post-ablation VT recurrence between the two groups with right AVG-EAT thickness cut-off value of <15.5 mm versus ≥15.5 mm (log-rank, p=0.003). Based on the finding of this study, we suggested a new possible imaging marker for risk stratification of post-ablation VT recurrence. A higher EAT may be associated with VT recurrence after catheter ablation of VTs.:Epicardial Adipose Tissue Anatomy Embryology Physiology and Pathophysiology Measurement of EAT EAT and heart disorders Future direction VT Catheter Ablation History of VT ablation Catheter ablation for VT in structural and non-structural heart Outcome of VT catheter ablation Predictors of VT recurrence after catheter ablation Objectives of the thesis Publication Summary References

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Despite increasing levels of military spending and a growing number of recurring conflicts, research has until now failed to consider the impact of arms transfers on the durability of peace. Investigating the recurrence of conflicts allows us to delve deeper into the enduring impact of arms transfers, shedding light on whether weapons induce, suppress, or merely postpone conflict relapse. This thesis studies the impact of post-conflict arms transfers on the likelihood of conflict recurrence, hypothesizing that the effect is conditional on the outcome of the previous conflict. By conducting a multinomial logistic regression analysis, the initial results of this study imply that post-conflict arms transfers can have a stabilizing effect, regardless of whether the initial conflict ended in a military victory or a negotiated settlement. However, a closer analysis of results implies that the advantages and disadvantages of arms transfers are highly contextual and depend on a series of factors that may fuel or contain violence.

No / Objectives Previous studies have demonstrated that intravesical administration of apaziquone (EOquin) has ablative activity against superficial bladder cancer marker lesions with 8 out of 12 complete responses recorded. We present a comparison between the rates of tumor recurrence before and after treatment with apaziquone. Methods The rate of tumor recurrence after treatment with apaziquone was compared with each patient's historical record of recurrences obtained from a retrospective analysis of the patients' case notes. The time to each recurrence event before apaziquone treatment and the time to the first recurrence after apaziquone treatment were recorded, and the data were analyzed using a population-averaged linear regression model using Stata Release, version 9.2, software. Results Of the eight complete responses obtained in the Phase I study, tumor recurrence occurred in 4 patients and the remaining 4 patients remained disease free after a median follow-up of 31 months. The time to the first recurrence after apaziquone treatment was significantly longer (P <0.001) compared with the historical pattern and recurrence interval before apaziquone. Before apaziquone instillation, the mean ± SE recurrence rate and tumor rate per year was 1.5 ± 0.2 and 4.8 ± 1.2, respectively, and these decreased to 0.6 ± 0.25 and 1.5 ± 0.8, respectively, after apaziquone treatment (P <0.05). Conclusions The results of this study indicate that early recurrences after treatment with apaziquone are infrequent and the interval to recurrence is significantly greater compared with the historical recurrence times for these patients. Larger prospective randomised trials are warranted to confirm these results. Aapaziquone (EOquin, USAN, E09, 3-hydroxy-5-aziridinyl-1-methyl-2[indole-4,7-dione]¿prop-¿-en-¿-ol) belongs to a class of anticancer agents known as bioreductive drugs that require metabolism by cellular reductases to generate a cytotoxic species.1 Although it is chemically related to mitomycin C, apaziquone has a distinctly different mechanism of action and preclinical activity profile.1 and 2 The initial optimism generated by its preclinical activity profile rapidly evaporated after the demonstration that intravenously administered apaziquone was clinically inactive against a range of solid tumors in Phase II clinical trials.3 and 4 Several possible explanations were considered for its lack of efficacy, but poor drug delivery to the tumor because of the rapid pharmacokinetic elimination of apaziquone in conjunction with relatively poor penetration through avascular tissue was considered to be the principal reason.5 On the basis of the rationale that intravesical administration would circumvent the problem of drug delivery and any apaziquone absorbed into the blood stream would be rapidly cleared,6 a Phase I-II clinical pilot study of intravesical administration of apaziquone to superficial bladder tumors was established.7 The results of that trial demonstrated that intravesically administered apaziquone has ablative activity against superficial bladder transitional cell carcinoma (TCC) marker lesions.7 These results were confirmed and extended in a Phase II clinical trial of 47 patients with superficial bladder TCC, in which complete responses were obtained in 67% of patients.8 Because all the enrolled patients in the original trial7 had had multiple recurrences after previous intravesical chemotherapy and/or immunotherapy, the purpose of the present study was, first, to report the recurrences that occurred after apaziquone treatment and, second, to study the effect of apaziquone instillation on the recurrence rate by statistically comparing these results with the historical pattern of recurrences for each patient before treatment with apaziquone.

在這篇論文裡，我們將要討論一類古典的問題，這類問題已經經由許多方法解決，例如：遞迴關係式、差分方程式、尤拉公式等等。接著我們歸納低維度的特性，並藉由定義出一組方程式-標準n維空間分割系統-來推廣這些特性到一般的$n$維度空間中。然後我們利用演算法來提供一個更直接的組合論證法。最後，我們會把問題再細分成有界區域與無界區域的個數。 / In this article, we will discuss a class of classical questions had been solved by Recurrence Relation, Difference Equation, and Euler's Formula, etc.. And then, we construct a system of equations -Standard Partition System of n-Dimensional Space- to generalize the properties of maximizing the number of regions made up by k partitioner in an n-dimensional space and look into the construction of each dimension. Also, we provide a more directly Combinatorial Argument by Algorithm for this kind of question. At last, we focus on the number of bounded regions and unbounded regions in sense of maximizing the number of regions.

I am interested in two spaces obverse to each other: open and closed. An open space develops organically based on how people inhabit it. Interacting with an open space is a dynamic, sporadic, multisensory, immersive, and subjective experience. In such spaces, we are confronted with an alternative aesthetic, one that is in conflict with the seamlessness of a closed space. A closed space is anchored on definite variables like structure, use and boundaries. While interaction between people and space is important, the space is tightly controlled and interaction is designed. Through this thesis project, I present a method that metaphorically transforms the experience of a walk through a closed space into an open-ended and immersive experience. When space develops as a response to our actions, it affords intimacy and a sense of belonging. It facilitates deeper expressiveness through engagement. By applying a method that uses fragmentation, recurrence and motion, I am metaphorically transforming an urban closed space to open. Through this transformation I am creating a fresh person-space dialogue that temporarily destabilizes perception and encourages physical sensation which allows for an intimate experience of the space. An immersive interaction with an open space transgresses the urban sterility of a closed space and is capable of creating a diversity of distinct experiences.

La papillomatose respiratoire récurrente (PRR) juvénile est causée par les génotypes 6 et 11 du virus du papillome humain (VPH). Cette maladie est caractérisée par des verrues récurrentes généralement au larynx. La forme sévère peut avoir un impact dévastateur sur la santé et la qualité de vie de l’enfant atteint et de sa famille en raison des conséquences des multiples chirurgies nécessaires et du risque d'obstruction des voies respiratoires. Objectif: Examiner les facteurs de risque associés aux manifestations sévères de la PRR. Méthode: Étude rétrospective des 31 cas diagnostiqués entre janvier 1995 et décembre 2008. Les données démographiques, cliniques, génétiques et virologiques ont été évaluées. Des régressions logistiques furent effectuées afin d'évaluer le rôle des variables indépendantes sur la sévérité de la maladie. Résultats: Nos données suggèrent que les facteurs de risque de sévérité de la PRR seraient associés au genre féminin (Rapport de cotes (RC)=2.60, intervalles de confiance (IC) 95% : 0.44-15.44), au fait d’être premier-né (RC=3.51, IC 95% : 0.17-72.32), à un statut économique faible (RC=5.31, IC 95% : 0.17-164.19), à un jeune âge (RC=0.83, IC 95% : 0.68-1.01), à une charge virale élevée (RC=3.81, IC 95% : 0.23-63.16) et aux condylomes chez la mère pendant la grossesse (RC=12.05, IC 95% : 0.97-149.85). Conclusion: La sévérité de la PRR serait le résultat d'une combinaison de déterminants qui favoriseraient la croissance cellulaire particulièrement chez les jeunes enfants. Des mesures préventives et thérapeutiques visant à restreindre la contamination et la réplication du virus pourraient réduire le fardeau de la maladie. / Juvenile Recurrent Respiratory Papillomatosis is caused by Human Papillomavirus genotypes 6 or 11. It is characterised by recurring warts most commonly in the larynx. The severe form of the disease has a devastating impact on health and life quality of the child and its family because of the consequences of multiple surgical procedures and the constant risk of airway obstruction. Objectives: To study the risk factors associated with severe forms of RRP. Method: We conducted a retrospective case series of the 31 patients diagnosed between January 1995 and December 2008. We analyzed demographic and clinical variables, as well as viral and host factors. Logistic regressions were performed to evaluate the impact of each of independent variables on the disease severity. Results: Our data suggest that risk factors for severe forms of RRP in children could be associated with female gender (OR=2.60, 95% CI: 0.44-15.44), being first-born (OR=3.51 95% CI: 0.17-72.32), lower socio-economic status (OR=5.31, 95% CI: 0.17-164.19), younger age (OR=0.83, 95% CI: 0.68-1.01), high viral load (OR=3.81, 95% CI: 0.230-63.16) and history of condylomas of the mother during pregnancy, (OR=12.05, 95% CI: 0.97-149.85). Conclusion: The severity of the RRP would be the result of a combination of factors which would favor the cellular growth particularly in the young children. Therapeutics and preventive measures to restrict the contamination and the replication of the virus could reduce considerably the burden of this disease.