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\"Director Robert Luketic and screenwriters Jason Dean Hall and Barry Levy team up to adapt author Joseph Finder's novel centering on a tech-savvy twentysomething who becomes a corporate spy for a scheming businessman. Determined to make the most of his new job at Wyatt Telecom, Adam Cassidy (Liam Hemsworth) is horrified when a felonious mistake earns him the wrath of unforgiving CEO Nicholas Wyatt (Gary Oldman). Typically, Wyatt's first response would be to throw a lawbreaking employee under the bus. But this time he's willing to cut a deal: Should Adam agree to infiltrate Wyatt Telecom's chief rival, the CEO will turn a blind eye to his employee's error. In no time Adam is climbing the corporate ladder straight to the top. No one suspects a thing, and Wyatt is gaining a distinct advantage over the competition. Later, upon realizing that his success is a mere illusion and he's become a simple pawn in a much bigger game, Adam hatches an ingenious plan to get out of his situation before it's too late\"--Allmovie.com, viewed August 17, 2018.

The past decade has seen substantial policy effort directed at promoting the reclamation and reuse of urban brownfield or potentially contaminated land. This paper is based on the results of a survey regarding the role of stakeholder attitudes in managing contaminated sites at the Romanian level. Findings indicate that effective policies and programmes need to be framed within an understanding of the different needs of national development. While different perceptions were identified in regard to the meanings of several concepts and terms used in this field, important aspects related to the need for developing a correctly ranked and coordinated decision-making process were also identified. Additional findings indicate gaps in the legal mechanisms intended to promote brownfield rehabilitation in the course of redevelopment. At the same time, the survey respondents suggested several recommendations such as the necessity of developing a risk assessment to establish the level and extent of contamination that can endanger human health and the environmental integrity on a site and also the need for greater compatibility between land-use planning processes and environmental legislation related to contaminated site management. The paper presents general conclusions engaging all the recommendations drawn from the survey questionnaire as well as from the general current situation in Romania.

Disasters, both natural and man-made, not only present a major threat to national security, they can also significantly impede the stable development of national economies. Dealing with them safely and efficiently is dependent on a well structured policy in emergency preparedness, something which can also go some way towards mitigating the inevitable burden they represent in financial terms. In the Caucasian region alone, natural and man-made disasters are estimated to have cost hundreds of millions of US dollars in the period 2003 to 2010. This book presents 34 papers, arising from the NATO Advanced Research Workshop (ARW) held in Yerevan, Armenia, in October 2010. The aim of this ARW was to further supplement the common efforts of scientists from NATO and partner countries to transfer technology and knowledge with the objective of decreasing the vulnerability of the population from both natural and man-made disasters. The ARW's aim was achieved, not least, by evaluating accumulated European theoretical knowledge and practical experience in the relevant fields so that recommendations could be developed for the prevention and mitigation of disasters. The book is divided into four main sections covering the themes of: public risk perception and communication, seismic risk assessment and consequent reduction, hazard monitoring and management, and assessment and management of industrial risks, and will be of interest to all those involved in the prevention and management of disasters, both natural and man-made.

Outcomes for children and adults with advanced soft tissue sarcoma are poor with traditional therapy. We investigated whether the addition of pazopanib to preoperative chemoradiotherapy would improve pathological near complete response rate compared with chemoradiotherapy alone. In this joint Children's Oncology Group and NRG Oncology multicentre, randomised, open-label, phase 2 trial, we enrolled eligible adults (aged ≥18 years) and children (aged between 2 and <18 years) from 57 hospitals in the USA and Canada with unresected, newly diagnosed trunk or extremity chemotherapy-sensitive soft tissue sarcoma, which were larger than 5 cm in diameter and of intermediate or high grade. Eligible patients had Lansky (if aged ≤16 years) or Karnofsky (if aged >16 years) performance status score of at least 70. Patients received ifosfamide (2·5 g/m2 per dose intravenously on days 1–3 with mesna) and doxorubicin (37·5 mg/m2 per dose intravenously on days 1–2) with 45 Gy preoperative radiotherapy, followed by surgical resection at week 13. Patients were randomly assigned (1:1) using a web-based system, in an unmasked manner, to receive oral pazopanib (if patients <18 years 350 mg/m2 once daily; if patients ≥18 years 600 mg once daily) or not (control group), with pazopanib not given immediately before or after surgery at week 13. The study projected 100 randomly assigned patients were needed to show an improvement in the number of participants with a 90% or higher pathological response at week 13 from 40% to 60%. Analysis was done per protocol. This study has completed accrual and is registered with ClinicalTrials.gov, NCT02180867. Between July 7, 2014, and Oct 1, 2018, 81 eligible patients were enrolled and randomly assigned to the pazopanib group (n=42) or the control group (n=39). At the planned second interim analysis with 42 evaluable patients and a median follow-up of 0·8 years (IQR 0·3–1·6) in the pazopanib group and 1 year (0·3–1·6) in the control group, the number of patients with a 90% pathological response or higher was 14 (58%) of 24 patients in the pazopanib group and four (22%) of 18 patients in the control group, with a between-group difference in the number of 90% or higher pathological response of 36·1% (83·8% CI 16·5–55·8). On the basis of an interim analysis significance level of 0·081 (overall one-sided significance level of 0·20, power of 0·80, and O'Brien-Fleming-type cumulative error spending function), the 83·8% CI for response difference was between 16·5% and 55·8% and thus excluded 0. The improvement in pathological response rate with the addition of pazopanib crossed the predetermined boundary and enrolment was stopped. The most common grade 3–4 adverse events were leukopenia (16 [43%] of 37 patients), neutropenia (15 [41%]), and febrile neutropenia (15 [41%]) in the pazopanib group, and neutropenia (three [9%] of 35 patients) and febrile neutropenia (three [9%]) in the control group. 22 (59%) of 37 patients in the pazopanib group had a pazopanib-related serious adverse event. Paediatric and adult patients had a similar number of grade 3 and 4 toxicity. There were seven deaths (three in the pazopanib group and four in the control group), none of which were treatment related. In this presumed first prospective trial of soft tissue sarcoma spanning nearly the entire age spectrum, adding pazopanib to neoadjuvant chemoradiotherapy improved the rate of pathological near complete response, suggesting that this is a highly active and feasible combination in children and adults with advanced soft tissue sarcoma. The comparison of survival outcomes requires longer follow-up. National Institutes of Health, St Baldrick's Foundation, Seattle Children's Foundation.

Gout is characterized by painful joint inflammation, most commonly in the first metatarsophalangeal joint, resulting from precipitation of monosodium urate crystals in a joint space. Gout is typically diagnosed using clinical criteria from the American College of Rheumatology. Diagnosis may be confirmed by identification of monosodium urate crystals in synovial fluid of the affected joint. Acute gout may be treated with nonsteroidal anti-inflammatory drugs, corticosteroids, or colchicine. To reduce the likelihood of recurrent flares, patients should limit their consumption of certain purine-rich foods (e.g., organ meats, shellfish) and avoid alcoholic drinks (especially beer) and beverages sweetened with high-fructose corn syrup. Consumption of vegetables and low-fat or nonfat dairy products should be encouraged. The use of loop and thiazide diuretics can increase uric acid levels, whereas the use of the angiotensin receptor blocker losartan increases urinary excretion of uric acid. Reduction of uric acid levels is key to avoiding gout flares. Allopurinol and febuxostat are first-line medications for the prevention of recurrent gout, and colchicine and/or probenecid are reserved for patients who cannot tolerate first-line agents or in whom first-line agents are ineffective. Patients receiving urate-lowering medications should be treated concurrently with nonsteroidal anti-inflammatory drugs, colchicine, or low-dose corticosteroids to prevent flares. Treatment should continue for at least three months after uric acid levels fall below the target goal in those without tophi, and for six months in those with a history of tophi. ( Am Fam Physician. 2014;90(12):831-836. Copyright © 2014 American Academy of Family Physicians.)

Pheochromocytomas and paragangliomas are chromaffin cell tumors arising from neuroendocrine cells. At least 1/3 of paragangliomas are related to germline mutations in 1 of 17 genes. Although these tumors can occur throughout the body, cardiac paragangliomas are very rare, accounting for <0.3% of mediastinal tumors. The purpose of this study was to determine the clinical characteristics of patients with cardiac paragangliomas, particularly focusing on their genetic backgrounds. A retrospective chart analysis of 15 patients with cardiac paragangliomas was performed to determine clinical presentation, genetic background, diagnostic workup, and outcomes. The average age at diagnosis was 41.9 years. Typical symptoms of paraganglioma (e.g., hypertension, sweating, palpitations, headache) were reported at initial presentation in 13 patients (86.7%); the remaining 2, as well as 4 symptomatic patients, initially presented with cardiac-specific symptoms (e.g., chest pain, dyspnea). Genetic testing was done in 13 patients (86.7%); 10 (76.9%) were positive for mutations in succinate dehydrogenase (SDHx) subunits B, C, or D. Thirteen patients (86.7%) underwent surgery to remove the paraganglioma with no intraoperative morbidity or mortality; 1 additional patient underwent surgical resection but experienced intraoperative complications after removal of the tumor due to co-morbidities and did not survive. SDHx mutations are known to be associated with mediastinal locations and malignant behavior of paragangliomas. In this report, the investigators extend the locations of predominantly SDHx-related paragangliomas to cardiac tumors. In conclusion, cardiac paragangliomas are frequently associated with underlying SDHx germline mutations, suggesting a need for genetic testing of all patients with this rare tumor.

Approximately one-half of the adult population worldwide is affected by a headache disorder. The International Headache Society classification and diagnostic criteria can help physicians differentiate primary headaches (e.g., tension, migraine, cluster) from secondary headaches (e.g., those caused by infection or vascular disease). A thorough history and physical examination, and an understanding of the typical features of primary headaches, can reduce the need for neuroimaging, lumbar puncture, or other studies. Some red flag signs and symptoms identified in the history or during a physical examination can indicate serious underlying pathology and will require neuroimaging or other testing to evaluate the cause of headache. Red flag signs and symptoms include focal neurologic signs, papilledema, neck stiffness, an immunocompromised state, sudden onset of the worst headache in the patient's life, personality changes, headache after trauma, and headache that is worse with exercise. If an intracranial hemorrhage is suspected, head computed tomography without contrast media is recommended. For most other dangerous causes of headache, magnetic resonance imaging or computed tomography is acceptable.

The nuclear disaster at the Chernobyl power plant, devastating floods, landslides, droughts, the erosion of tailings dams and desertification are just some of the natural and manmade disasters which have afflicted the Ukraine and neighboring countries in recent years. It is therefore entirely appropriate that the NATO Advanced Research Workshop (ARW), Correlation between Human Factors and the Prevention of Catastrophes, was held in Dnipropetrovsk, Ukraine in September 2011. This book presents the proceedings of the ARW, which analyzed accumulated European theoretical knowledge and practical experience in the field of disaster prevention, addressing a wide range of correlations between human factors and the prevention of catastrophes. Subjects covered include land-use planning and management procedures; risk assessment in emergency situations; control of polluted water; socio economic impacts from desertification; health impacts arising from nuclear facilities, flooding and tailings dam accidents; risk management systems and measures; and the protection of water resources. The presentations reflected the extensive experience of workshop participants and will be of great interest, especially to countries that are developing their legal frameworks in civil emergency planning, most particularly those who are aligning to EU directives and other international standards.

Increasing frequency and severity of natural disasters during the last fifteen years in the Republic of Moldova, limited resources for prevention and mitigation of their impact, has increased the level of vulnerability of the population. Considered efforts are to be made to decrease vulnerability of population through a dipper study of human and societal dynamics, different methodologies of disaster forecast and prevention, transfer of technology and knowledge. In this publication theoretical knowledge and practical experiences in the area of natural and anthropogenic disasters are discussed. Practical recommendations are developed for the prevention of negative effects on the environment and society. It is demonstrated that international security policy is not limited just to regional security - it means 'Global Security' - and efficient international cooperation is needed to ensure it.