Explore the vast range of titles available.

Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD). Design PubMed and Embase were screened for new references using the original search strings. Studies were required to be population-based, to include ≥200 individuals, to have response rates ≥50% and recall periods <12 months. GERD was defined as heartburn and/or regurgitation on at least 1 day a week, or according to the Montreal definition, or diagnosed by a clinician. Temporal and geographic trends in disease prevalence were examined using a Poisson regression model. Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%–27.8% in North America, 8.8%–25.9% in Europe, 2.5%–7.8% in East Asia, 8.7%–33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 1–17 years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p<0.0001), particularly in North America and East Asia. Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.

Concerns on the timing and processes associated with petroleum degradation were raised after the use of Corexit during the Deepwater Horizon oil spill. There is a lack of understanding of the removal of oil associated with flocculate materials to the sediment. Mesocosm studies employing coastal and open-ocean seawater from the Gulf of Mexico were undertaken to examine changes in oil concentration and composition with time. The water accommodated fractions (WAF) and chemically enhanced WAF (CEWAF) produced using Macondo surrogate oil and Corexit were followed over 3-4 days in controlled environmental conditions. Environmental half-lives of estimated oil equivalents (EOE), polycyclic aromatic hydrocarbons (PAH), n-alkanes (C10-C35), isoprenoids pristane and phytane, and total petroleum hydrocarbons (TPH) were determined. EOE and PAH concentrations decreased exponentially following first-order decay rate kinetics. WAF, CEWAF and DCEWAF (a 10X CEWAF dilution) treatments half-lives ranged from 0.9 to 3.2 days for EOE and 0.5 to 3.3 days for PAH, agreeing with estimates from previous mesocosm and field studies. The aliphatic half-lives for CEWAF and DECWAF treatments ranged from 0.8 to 2.0 days, but no half-life for WAF could be calculated as concentrations were below the detection limits. Biodegradation occurred in all treatments based on the temporal decrease of the nC17/pristane and nC18/phytane ratios. The heterogeneity observed in all treatments was likely due to the hydrophobicity of oil and weathering processes occurring at different rates and times. The presence of dispersant did not dramatically change the half-lives of oil. Comparing degradation of oil alone as well as with dispersant present is critical to determine the fate and transport of these materials in the ocean.

Desmoid tumours are locally aggressive tumours associated with substantial morbidity. No systemic treatments are approved for this disease, with methotrexate–vinblastine the only chemotherapy regimen assessed in a clinical trial setting to date. VEGF overexpression is a common feature in aggressive desmoid tumours. Pazopanib is an oral antiangiogenic agent targeting VEGF receptors 1, 2, and 3, platelet-derived growth factor receptor-like protein (PDGFR) α and β, and c-KIT tyrosine kinases. We aimed to assess antitumour activity and safety of targeted therapy or combination chemotherapy in progressive desmoid tumours. DESMOPAZ was a non-comparative, randomised, open-label, phase 2 trial conducted at 12 centres from the French Sarcoma Group. We enrolled adults (≥18 years) with progressive desmoid tumours, normal organ function and centrally documented progressive disease according to Response Evaluation Criteria in Solid Tumors version 1.1 based on two imaging assessments obtained within less than a 6-month interval. Participants were randomly assigned (2:1) to oral pazopanib 800 mg per day for up to 1 year or to an intravenous regimen combining vinblastine (5 mg/m2 per dose) and methotrexate (30 mg/m2 per dose), administered weekly for 6 months and then every other week for 6 months. Randomisation was stratified according to inclusion centre and tumour location. The primary endpoint was the proportion of patients who had not progressed at 6 months in the first 43 patients who had received one complete or two incomplete cycles of pazopanib. This endpoint was also assessed as a prespecified exploratory endpoint in all patients who had received one complete or two incomplete cycles of methotrexate–vinblastane. Safety analyses were done for all patients who received at least one dose of allocated treatment. This trial was registered with ClinicalTrials.gov, number NCT01876082. From Dec 4, 2012, to Aug 18, 2017, 72 patients were enrolled and randomly assigned (n=48 in the pazopanib group; n=24 in the methotrexate–vinblastine group). Median follow-up was 23·4 months (IQR 17·1–25·5). 46 patients in the pazopanib group and 20 patients in the methotrexate–vinblastine group were assessable for activity. In the first 43 patients assessable for the primary endpoint in the pazopanib group, the proportion of patients who had not progressed at 6 months was 83·7% (95% CI 69·3–93·2). The proportion of patients treated with methotrexate–vinblastine who had not progressed at 6 months was 45·0% (95% CI 23·1–68·5). The most common grade 3 or 4 adverse events in the pazopanib group were hypertension (n=10, 21%) and diarrhoea (n=7, 15%) and in the methotrexate–vinblastine group were neutropenia (n=10, 45%) and liver transaminitis (n=4, 18%). 11 patients (23%) had at least one serious adverse event related to study treatment in the pazopanib group, as did and six patients (27%) in the methotrexate–vinblastine group. Pazopanib has clinical activity in patients with progressive desmoid tumours and could be a valid treatment option in this rare and disabling disease. GlaxoSmithKline and Novartis.

The Mississippian limestone is a prolific hydrocarbon play in the northern region of Oklahoma and the southern part of Kansas. The Mississippian reservoirs feature variations in produced fluid chemistry usually explained by different possible source rocks. Such chemical variations are regularly obtained from bulk, molecular, and isotopic characteristics. In this study, we present a new geochemical investigation of gasoline range hydrocarbons, biomarkers, phenols, and diamondoids in crude oils produced from Mississippian carbonate and Woodford Shale formations. A set of oil samples was examined for composition using high-performance gas-chromatography and mass-spectrometry techniques. The result shows a distinct geochemical fingerprint reflected in biomarkers such as the abundance of extended tricyclic terpanes, together with heptane star diagrams, and diamantane isomeric distributions. Such compounds are indicative of the organic matter sources and stages of thermal maturity. Phenolic compounds varied dramatically based on geographic location, with some oil samples being depleted of phenols, while others are intact. Based on crude oil compositions, two possible source rocks were identified including the Woodford Shale and Mississippian mudrocks, with a variable degree of mixing reported. Variations in phenol concentrations reflect reservoir fluid dynamic and water interactions, in which oils with intact phenols are least affected by water-washing conversely and crude oils depleted in phenols attributed to reservoir water-washing. These geochemical parameters shed light into petroleum migration within Devonian-Mississippian petroleum systems and mitigate geological risk in exploring and developing petroleum reservoirs.

Localized contamination from research-related activities and its effects on macrofauna communities in the marine environment were investigated at Palmer Station, a medium-sized Antarctic research station. Relatively low concentrations of polycyclic aromatic hydrocarbons (PAHs; 32–302 ng g-1) and total petroleum hydrocarbons (TPHs; 0.9–8.9 μg g-1) were detected in sediments adjacent to the sewage outfall and pier, where most human activities were expected to have occurred, and at even lower concentrations at two seemingly reference areas (PAHs 6–30 ng g-1, TPHs 0.03–5.1 μg g-1). Elevated concentrations of PAHs in one sample taken in one reference area (816 ng g-1) and polychlorinated biphenyls (353 ng g-1) and dichloro-diphenyl-trichloroethane (3.2 and 25.3 ng g-1) in two samples taken adjacent to the sewage outfall indicate spatial heterogeneity of localized sediment contamination. Limpet (Nacella concinna) tissues collected adjacent to Palmer Station had high concentrations of PAHs, copper, lead, zinc and several other metals relative to outlying islands. Sediment and limpet tissue contaminant concentrations have decreased since the early 1990s following the Bahía Paraíso spill. Natural sediment characteristics affected macrofaunal community composition more than contamination adjacent to Palmer Station, presumably because of the low overall contamination levels.

A suite of trace metals was determined in twenty surface sediments collected from Lake Qaroun, which is designated as a natural reserve in 1989 to examine their spatial distribution and their potential environmental impact on the lake. Contamination factor ( C f ), enrichment factor (EF), geoaccumulation index ( I geo ), and pollution load index (PLI) are applied to evaluate the quality of the lake. The highest concentrations were detected in the eastern portion of the lake near Al-Bats drain. The levels of Ba exceeded the toxicity reference value (TRV) (20 ng/g dw) set by US EPA for all sediments, while sediments collected from Al-Bats region exceeded the TRV for Zn (68 ng/g dw). Arsenic, Ba, Sn, Co, Cu, and Hg are poorly correlated with background value of Fe suggesting anthropogenic activities over the entire lake. The values of C f and I geo confirmed that the eastern portion of the lake has been found moderately to considerably contaminated by As, Sn, and Zn. Sediments collected from the eastern location (S1) were very highly enriched of Sn (22.47); however, the other eastern locations were highly enriched of Sn, As, Cd, Co, and Ba. It is clear that sites near Al-Bats and El-Wadi drains are hot spots, which got immense amounts of domestic, agricultural, and industrial wastes. Behind the influence of these discharges, concentrations are decreased. The PLI over the entire lake ranged from 0.247 to 0.801 for all sites, which reflect unpolluted status.

This brief and accessible title integrates contemporary scholarly research with compelling vignettes to make it appealing to both instructors and undergraduate audiences. While focused on the United States in respect to its target audience and emphasis, it contains considerable international data that compares and contrasts social policies adopted in Europe and elsewhere.

Sediment and fish ( Oreochromis niloticus ) samples collected from Lake Manzala were analyzed to assess the spatial distribution of OCPs and 96 PCBs. Relatively higher concentrations of chlorpyrifos, ∑DDT, and HCB were found, particularly at the Bahr Al-Baqar drain station, which has uncontrolled inputs of untreated domestic, agricultural, and industrial wastes. The concentrations of ∑PCBs ranged from 19 to 69 ng/g dw and from 7.4 to 29 ng/g dw for sediment and fish samples, respectively. Ratios of DDT to its metabolites suggest that the source of ∑DDT is from past usage of technical DDT in the regions surrounding the lake. Sediment quality guidelines were exceeded in 88, 75, and 42% of sediments for the Effects Range Low (ERL) for ∑PCBs, ∑DDT, and 4,4′ -DDE, respectively. Sediment from the Bahr Al-Baqar drain exceeded the Probable Effects Level (PEL) for DDT isomers 2,4′ and 4,4′ . All fish samples from Lake Manzala were well below action and tolerance levels set by US EPA for ∑DDT, chlordane, dieldrin, heptachlor, mirex, and PCBs. Highlights Distributions of OCPs and PCBs in sediment and tilapia from Lake Manzala were investigated. Chlorpyrifos, ∑DDT, and HCB sediment concentrations were spatially variable and relatively elevated. ∑96PCBs, ∑DDT, and 4,4′ -DDE exceeded the Effects Range Low in 88, 75, and 42% of the sediments, respectively. The major input from Cairo, the Bahr Al-Baqar drain, exceeded the Probable Effects Level for DDT isomers in sediments. OCP and PCB concentrations in tilapia were below action and tolerance levels set by the US-EPA.

To analyse the treatment and control of dyslipidaemia in patients at high and very high cardiovascular risk being treated for the primary prevention of cardiovascular disease (CVD) in Europe. Data were assessed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov identifier: NCT00882336), which included a randomly sampled population of primary CVD prevention patients from 12 European countries (n = 7641). Patients' 10-year risk of CVD-related mortality was calculated using the Systematic Coronary Risk Evaluation (SCORE) algorithm, identifying 5019 patients at high cardiovascular risk (SCORE ≥5% and/or receiving lipid-lowering therapy), and 2970 patients at very high cardiovascular risk (SCORE ≥10% or with diabetes mellitus). Among high-risk individuals, 65.3% were receiving lipid-lowering therapy, and 61.3% of treated patients had uncontrolled low-density lipoprotein cholesterol (LDL-C) levels (≥2.5 mmol/L). For very-high-risk patients (uncontrolled LDL-C levels defined as ≥1.8 mmol/L) these figures were 49.5% and 82.9%, respectively. Excess 10-year risk of CVD-related mortality (according to SCORE) attributable to lack of control of dyslipidaemia was estimated to be 0.72% and 1.61% among high-risk and very-high-risk patients, respectively. Among high-risk individuals with uncontrolled LDL-C levels, only 8.7% were receiving a high-intensity statin (atorvastatin ≥40 mg/day or rosuvastatin ≥20 mg/day). Among very-high-risk patients, this figure was 8.4%. There is a considerable opportunity for improvement in rates of lipid-lowering therapy use and achievement of lipid-level targets in high-risk and very-high-risk patients being treated for primary CVD prevention in Europe.