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Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes

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World Journal of gastroenterology 2018年第43期24卷 4846-4861页

作者： Andrew Mcguigan Paul Kelly Richard C Turkington Claire Jones helen g coleman R Stephen McCain Centre for Cancer Research and Cell Biology Queen’s University Belfast Department of Pathology Royal Victoria HospitalBelfast Department of Hepatobiliary Surgery Mater Hospital Centre for Public Health Queen’s University Belfast

This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to

关键词： Pancreatic cancer Pancreatic adenocarcinoma Pancreatic cancer risk factors Pancreatic cancer treatment

Achalasia: A review of clinical diagnosis, epidemiology,treatment and outcomes

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World Journal of gastroenterology 2013年第35期19卷 5806-5812页

作者： Orla M O'Neill Brian T Johnston helen g coleman Centre for Public Health Queen’s University Belfast Department of gastroenterology Belfast Health and Social Care Trust

Achalasia is a neurodegenerative motility disorder of the oesophagus resulting in deranged oesophageal peristalsis and loss of lower oesophageal sphincter ***,annual achalasia incidence rates were believed to be low,approximately 0.5-1.2 per *** recent reports suggest that annual incidence rates have risen to 1.6 per 100000 in some *** aetiology of achalasia is still unclear but is likely to be *** causes include environmental or viral exposures resulting in inflammation of the oesophageal myenteric plexus,which elicits an autoimmune *** of achalasia may be elevated in a sub-group of genetically susceptible *** in the diagnosis of achalasia,through the introduction of high resolution manometry with pressure topography plotting,has resulted in the development of a novel classification system for *** classification system can evaluate patient prognosis and predict responsiveness to *** is currently much debate over whether pneumatic dilatation is a superior method compared to the Heller’s myotomy procedure in the treatment of achalasia.A recent com-parative study found equal efficacy,suggesting that patient preference and local expertise should guide the *** achalasia is a relatively rare condition,it carries a risk of complications,including aspiration pneumonia and oesophageal *** risk of both squamous cell carcinoma and adenocarcinoma of the oesophagus is believed to be significantly increased in patients with achalasia,however the absolute excess risk is ***,it is currently unknown whether a surveillance programme in achalasia patients would be effective or cost-effective.

关键词： Epidemiology Achalasia Incidence Treatment Oesophageal cancer risk

Socio-economic status and lifestyle factors are associated with achalasia risk: A population-based case-control study

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World Journal of gastroenterology 2016年第15期22卷 4002-4008页

作者： helen g coleman Ronan T gray Kar W Lau Conall Mc Caughey Peter V Coyle Liam J Murray Brian T Johnston Cancer Epidemiology and Health Services Research group Centre for Public Health Queen’s University Belfast Regional Virus Laboratory Royal Victoria Hospital Belfast Department of gastroenterology Royal Victoria HospitalBelfast

AIM: To evaluate the association between various lifestyle factors and achalasia ***: A population-based case-control study was conducted in Northern Ireland, including n = 151 achalasia cases and n = 117 age- and sexmatched controls. Lifestyle factors were assessed via a face-to-face structured interview. The association between achalasia and lifestyle factors was assessed by unconditional logistic regression, to produce odds ratios(OR) and 95% confidence interval(CI).RESULTS: Individuals who had low-class occupations were at the highest risk of achalasia(OR = 1.88, 95%CI: 1.02-3.45), inferring that high-class occupation holders have a reduced risk of achalasia. A history of foreign travel, a lifestyle factor linked to upper socioeconomic class, was also associated with a reduced risk of achalasia(OR = 0.59, 95%CI: 0.35-0.99). Smoking and alcohol consumption carried significantly reduced risks of achalasia, even after adjustment for socio-economic status. The presence of pets in the house was associated with a two-fold increased risk of achalasia(OR = 2.00, 95%CI: 1.17-3.42). Nochildhood household factors were associated with achalasia ***: Achalasia is a disease of inequality, and individuals from low socio-economic backgrounds are at highest risk. This does not appear to be due to corresponding alcohol and smoking behaviours. An observed positive association between pet ownership and achalasia risk suggests an interaction between endotoxin and viral infection exposure in achalasia aetiology.

关键词： Achalasia Risk factors Epidemiology Lifestyle Socio-economic status

REVIEW OF RECENT PROgRESS IN TROPICAL CYCLONE TRACK FORECASTINg AND EXPRESSION OF UNCERTAINTIES

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Tropical Cyclone Research and Review 2019年第4期8卷 181-218页

作者： Julian T.Heming Fernando Prates Morris A.Bender Rebecca Bowyer John Cangialosi Phillippe Caroff Thomas coleman James D.Doyle Anumeha Dube ghislain Faure Jim Fraser Brian C.Howell Yohko Igarashi Ron McTaggart-Cowan M.Mohapatra Jonathan R.Moskaitis Jim Murtha Rabi Rivett M.Sharma Chris J.Short Amit A.Singh Vijay Tallapragada helen A.Titley Yi Xiao 不详

The Ninth International Workshop on Tropical Cyclones(IWTC-9) took place in Hawaii, USA in December 2018. This review paper was presented at the Workshop under the Tropical Cyclone Track *** forecasting of tropical cyclone(TC) track has seen significant improvements in recent decades both by numerical weather prediction models and by regional warning centres who issue forecasts having made use of these models and other forecasting techniques. Heming and goerss(2010) gave an overview of forecasting techniques and models available for TC forecasting, including evidence of the improvement in performance over the years. However, the models and techniques used for TC forecasting have continued to develop in the last decade. This presentation gives an updated overview of many of the numerical weather prediction models and other techniques used for TC track prediction. It includes recent performance statistics both by the models and the regional warning centres.

关键词： Tropical Cyclone World Meteorological Organization Workshop Numerical Models Track Forecasting