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Článek je rozdělen na tři hlavní části – po úvodu následuje první část zaměřující se na přehled dosavadní literatury o úloze náboženství v zahraniční politice. Druhá část se věnuje metodologickému rámci. Třetí, analytická část, se skládá z představení africké zahraniční politiky Saúdské Arábie s důrazem na roli náboženství a z pěti případových studií afrických států, které se zabývají jejich vztahy se Saúdskou Arábií. The role and importance of religion in many countriesʼ foreign policy seem to be rising again. Many scholars have shown that Saudi Arabia uses the spread of religion, specifically Salafi Islam, as a tool for its foreign policy and to strengthen its inf luence. Saudi Arabia is a crucial player in the MENA region and the entire Islamic world, and its regional and international importance is constantly increasing. The author considers understanding Saudi Arabia’s activities and its foreign policy strategies, mechanisms, and tools in Africa as very important, as Africa is becoming an arena for new powers once again. The article aims to identify how Saudi Arabia penetrates African states and spreads Salafism. It focuses on analyzing Saudi foreign policy, emphasizing the role of religion and its export. The author analyzes Saudi Arabia’s relations with five selected African states, where Salafism is spreading, in the period from 2015 to the present.

Short bowel syndrome (SBS) is a severe, life-threatening condition and one of the leading causes of intestinal failure in children. Here we were interested in changes in muscle layers and especially in the myenteric plexus of the enteric nervous system (ENS) of the small bowel in the context of intestinal adaptation. Twelve rats underwent a massive resection of the small intestine to induce an SBS. Sham laparotomy without small bowel transection was performed in 10 rats. Two weeks after surgery, the remaining jejunum and ileum were harvested and studied. Samples of human small bowel were obtained from patients who underwent resection of small bowel segments due to a medical indication. Morphological changes in the muscle layers and the expression of nestin, a marker for neuronal plasticity, were studied. Following a SBS, muscle tissue increases significantly in both parts of the small bowel, jejunum, and ileum. The leading pathophysiological mechanism of these changes is hypertrophy. Additionally, we observed an increased nestin expression in the myenteric plexus in the remaining bowel of SBS. Our human data also showed that in patients with SBS, the proportion of stem cells in the myenteric plexus have risen by more than two times. Our findings suggest that the ENS is tightly connected with changes in intestinal muscle layers and is critically involved in the intestinal adaptation process to SBS.

The extensive clinical and genetic heterogeneity of congenital limb malformation calls for comprehensive genome-wide analysis of genetic variation. Genome sequencing (GS) has the potential to identify all genetic variants. Here we aim to determine the diagnostic potential of GS as a comprehensive one-test-for-all strategy in a cohort of undiagnosed patients with congenital limb malformations. We collected 69 cases (64 trios, 1 duo, 5 singletons) with congenital limb malformations with no molecular diagnosis after standard clinical genetic testing and performed genome sequencing. We also developed a framework to identify potential noncoding pathogenic variants. We identified likely pathogenic/disease-associated variants in 12 cases (17.4%) including four in known disease genes, and one repeat expansion in HOXD13. In three unrelated cases with ectrodactyly, we identified likely pathogenic variants in UBA2, establishing it as a novel disease gene. In addition, we found two complex structural variants (3%). We also identified likely causative variants in three novel high confidence candidate genes. We were not able to identify any noncoding variants. GS is a powerful strategy to identify all types of genomic variants associated with congenital limb malformation, including repeat expansions and complex structural variants missed by standard diagnostic approaches. In this cohort, no causative noncoding SNVs could be identified. Polish National Science Centre [UMO-2016/22/E/NZ5/00270]; Deutsche Forschungsgemeinschaft (DFG)German Research Foundation (DFG) [SP1532/3-1, SP1532/4-1, SP1532/5-1]; Max Planck FoundationFoundation CELLEX; Deutsches Zentrum fur Luft-und Raumfahrt (DLR)Helmholtz AssociationGerman Aerospace Centre (DLR) [01GM1925]; Projekt DEAL Open Access funding enabled and organized by Projekt DEAL. A.J. was supported by the grant from the Polish National Science Centre UMO-2016/22/E/NZ5/00270. M.S. is supported by grants from the Deutsche Forschungsgemeinschaft (DFG) (SP1532/31, SP1532/4-1 and SP1532/5-1), the Max Planck Foundation and the Deutsches Zentrum fur Luft-und Raumfahrt (DLR 01GM1925).

This article examines Boko Haram’s alternatives to the contemporary secular Nigerian state of Westphalian style. This article is focused on analysing the relationship between Boko Haram and the secular state that they reject. The reality of what Boko Haram in Nigeria has managed to create, rather than a caliphate, corresponds to a terrorist semi-state (TSS). Therefore, the article also performs an analysis of Boko Haram from the perspective of the TSS concept.

Introduction Extensive thermal or traumatic full-thickness injuries to the foot, though rare in children, can lead to severe complications. They are often associated with significant skin loss and underlying tendon or bone exposure. Timely wound closure is essential to minimize the risk of deep infection and to avoid subsequent loss of function. Tried and tested animal- or human-derived biological dermal templates have always come with a risk of infection and subsequent scar contraction. A biodegradable temporizing matrix (BTM) consisting of a polyurethane scaffold is a synthetic alternative to cover deep defects and promote the development of neodermis. We report on our first experience with this dermal matrix in the reconstruction of complex foot injuries in children. Methods From August 2020 to June 2021, we treated four patients with severe full-thickness injuries of the foot and need for necrectomy with BTM, as the prevalence of exposed bone or tendon prohibited primary wound closure via skin grafting. All cases were caused by contact burns or mechanical trauma. In three of these cases, we utilized a temporary negative pressure wound therapy. Wound closure was achieved by application of full-thickness (3/4) or split-thickness (1/4) skin grafts after delamination of the fully integrated BTM. Results Wound monitoring through regular outer dressing changes showed that BTM remained in place and was fully integrated after 3-6 weeks. We saw excellent dermal regeneration in all patients. Swab cultures at first patient contact detected pre-existing wound contamination with Pseudomonas aeruginosa in two children and MRSA in one case. Wound healing before and after skin grafting was unimpaired, though, under topical antimicrobial treatment with polyhexanide. There were no signs of systemic infection. The take rate of skin grafts was excellent with no graft failure, resulting in pliable, smooth scars. Long-term outcome showed minimal to no scar shrinkage without any functional impairment. Conclusions BTM is a good alternative to established dermal templates for complex foot injuries in children. In our experience, even in cases of bacterial wound contamination the synthetic material integrates well and promotes unimpaired tissue regeneration. Contraction and hypertrophic scarring is minimal with very good quality of the developing neodermis.

At the age of 4 months, an infant was presented to us with a nodular subcutaneous tumor on the right thumb measuring 2cm, already seen prenatally via ultrasound. An MRI in sedation performed at the age of 4.5 months had no diagnostic specificity. By a biopsy at the age of 5 months malignancy could be excluded. Finally at the age of 16 months the tumor which had meanwhile grown to a monstrous size (5 cm of diameter) could be entirely removed by microsurgical technique maintaining the integrity of all intrinsic structures. The diagnosis of myxoid lipoblastoma was confirmed. According to literature, Lipoblastomas often present as connatal rapid growing soft tissue tumors and are benign. Total removal is essential for avoiding a local recurrence.Ein Säugling wurde uns im Alter von 4 Monaten aufgrund eines ca. 2 cm messenden rundlichen subcutanen Tumors am rechten Daumen vorgestellt, der bereits in der pränatalen Sonographie dargestellt werden konnte. Zur weiteren Abklärung führten wir eine MRT mit MR-Angiografie in Sedierung durch, ohne spezifisches Ergebnis. Daher wurde im Alter von 5 Monaten eine offene Biopsie entnommen, bei der in der Histologie die Malignität ausgeschlossen werden konnte. Schließlich konnte die komplette Tumorentfernung des mittlerweile monströsen Tumors (Durchmesser 5 cm) in mikrochirurgischer Technik im Alter von 16 Monaten erfolgen, dabei konnte die Integrität aller intrinsischen Strukturen gewahrt bleiben. Die Diagnose eines myxoiden Lipoblastoms wurde bestätigt. Adipocytäre Tumoren treten im Kindesalter selten auf, wie die Literaturrecherche aufzeigt. Lipoblastome sind benigne und zeigen sich klinisch häufig als konnatale, sehr schnell wachsende Weichteiltumoren. Die komplette Entfernung ist essentiell für die Vermeidung von Rezidiven.

Objectives In recent years laparoscopic fundoplication is increasingly performed in pediatric surgery. The aim of this study was to compare the long-term outcomes between open and laparoscopic Thal fundoplication in children. Methods This retrospective study includes children who underwent a Thal fundoplication between 3/1997 and 7/2009. The minimum follow-up time to enter the study was 2years; the overall median follow-up was 77months (range, 29–176months). Results A total of 101 patients were included, of which 47 underwent an open and 54 a laparoscopic Thal. Intraoperative problems, early postoperative complications, time to establish enteral feeds and length of stay did not differ among both groups. The mean duration of surgery was significantly less in the open group (OPG) (108.0 (± 7.72) versus 144.1 (± 6.36) minutes; p=0.001) and this was mainly attributed to patients with neurological problems. Severe dysphagia requiring endoscopy was observed in 10 patients, but this did not differ significantly between groups (n=2 in the OPG vs. n=8 in the laparoscopic group (LAPG); p=0.10). Overall 12 patients (11.9%) (6 in each group) required a redo-fundoplication after a median of 18.7months (range, 6–36months). In the whole study group, 80 patients (79.2%) were classified as having surgical results being excellent, good or satisfactory and this did not differ significantly between groups. Conclusions In the long-term open and laparoscopic Thal fundoplication have similarly good outcomes. The laparoscopic approach can be considered as an alternative, however there is not a clear superiority compared with the open counterpart.

INTRODUCTION:: The clinical impact of sentinel lymph node biopsy (SLNB) in colon cancer is still controversial. The purpose of this prospective multicenter trial was to evaluate its clinical value to predict the nodal status and identify factors that influence these results. METHODS:: Colon cancer patients without prior colorectal surgery or irradiation were eligible. The sentinel lymph node (SLN) was identified intraoperatively by subserosal blue dye injection around the tumor. The SLN underwent step sections and immunohistochemistry (IHC), if classified free of metastases after routine hematoxylin and eosin examination. RESULTS:: At least one SLN (median, n = 2) was identified in 268 of 315 enrolled patients (detection rate, 85%). Center experience, lymphovascular invasion, body mass index (BMI), and learning curve were positively associated with the detection rate. The false-negative rate to identify pN+ patients by SLNB was 46% (38 of 82). BMI showed a significant association to the false-negative rate (P 22 patients enrolled), the sensitivity increased to 88% (14 of 16). Moreover, 21% (30 of 141) of the patients, classified as pN0 by routine histopathology, revealed micrometastases or isolated tumor cells (MM/ITC) in the SLN. CONCLUSIONS:: The contribution of SLNB to conventional nodal staging of colon cancer patients is still unspecified. Technical problems have to be resolved before a definite conclusion can be drawn in this regard. However, SLNB identifies about one fourth of stage II patients to reveal MM/ITC in lymph nodes. Further studies must clarify the clinical impact of these findings in terms of prognosis and the indication of adjuvant therapy.

BackgroundThe different treatment strategies for bone cysts in children are often associated with persistence and high recurrence rates of the lesions. The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated.MethodsFrom 02/07 to 01/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss®) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS®) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration.ResultsA cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS®and Orthoss®to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary.ConclusionsThe combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS®) enhances the treatment of bone cysts in children, with no resulting complications.

There is disclosed a bass fiddle of the violin family of instruments having a sound box made from blown fiberglass reinforced resins and wood top plate. An integrating tonal arm is located in the upper chamber of the sound box and eliminates overtones in the upper chamber and produces uniform tonal retention of all strings in all positions.