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Great progress has been made in addressing global undernutrition over the past several decades, in part because of large increases in food production from agricultural expansion and intensification. Food systems, however, face continued increases in demand and growing environmental pressures. Most prominently, human-caused climate change will influence the quality and quantity of food we produce and our ability to distribute it equitably. Our capacity to ensure food security and nutritional adequacy in the face of rapidly changing biophysical conditions will be a major determinant of the next century's global burden of disease. In this article, we review the main pathways by which climate change may affect our food production systems-agriculture, fisheries, and livestock-as well as the socioeconomic forces that may influence equitable distribution. Expected final online publication date for the Annual Review of Public Health Volume 38 is March 20, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH), but also other significant subgroups of pulmonary hypertension (PH). In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany to discuss open and controversial issues surrounding the practical implementation of the European Guidelines. Several working groups were initiated, one of which was dedicated to the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (CTEPH). In every patient with PH of unknown cause CTEPH should be excluded. The primary treatment option is surgical pulmonary endarterectomy (PEA) in a specialized multidisciplinary CTEPH center. Inoperable patients or patients with persistent or recurrent CTEPH after PEA are candidates for targeted drug therapy. For balloon pulmonary angioplasty (BPA), there is currently only limited experience. This option - as PEA - is reserved to specialized centers with expertise for this treatment method. In addition, a brief overview is given on pulmonary artery sarcoma, since its surgical treatment is often analogous to PEA. The recommendations of this working group are summarized in the present paper.

Objective: Pulmonary artery sarcoma is a rare malignancy which is often mistaken for pulmonary thromboembolism. The presentation is one of central pulmonary artery obstruction and progressive right-heart failure. Methods: A 43-year-old woman presented to her general practitioner with chronic cough[for full text, please go to the a.m. URL], Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie

While language educators are being encouraged to exploit the Web for authentic intercultural communication, research is showing that rather than bringing people from different backgrounds together, the Internet is offering a platform for people to express their opinions with those who share similar ideas. When intercultural contact does occur, it often appears to be highly conflictual. This paper begins with a brief discussion of the open Web and intercultural dialogue, followed by an overview of attitudes to conflict in education and foreign language teaching and learning. We then turn to our preliminary study of the perspectives of educators from European universities on disagreement and the discussion of sensitive topics in online intercultural exchange. Our data indicate a considerable divergence of views and a great need for dialogue amongst educators and further research into this topic., Journal of e-Learning and Knowledge Society, Vol 8, No 3 (2012): Journal of e-Learning and Knowledge Society: Focus on: Computer-mediated Communication and Language Learning

Le présent ouvrage propose la traduction française d'écrits de William Isaac Thomas, l'un des fondateurs de la sociologie américaine appartenant à la tradition de l'école de Chicago. Les morceaux choisis illustrent les thèmes de l'immigration, de l'intégration sociale et de la déviance.

BACKGROUND AND PURPOSE: Spinal osteoid osteomas are rare; when they occur, they are usually treated by surgical or percutaneous excision. The aim of percutaneous interstitial laser photocoagulation (ILP) of osteoid osteomas under CT guidance is thermal destruction of the nidus using low-power laser energy, thus precluding bone resection and open surgery. METHODS: Three cases of spinal osteoid osteomas were treated with percutaneous ILP of the nidus. Under CT guidance, the needle was positioned in the center of the nidus, at least 8 mm from neurologic structures. Using a high-power semiconductor diode laser (805 nm) with a 400-microm optical fiber, we delivered 600 to 800 joules to the nidus, depending on its size. The procedure was performed with the patient under neuroleptanalgesia and required overnight hospitalization. RESULTS: Complete pain relief was obtained in all three patients within 24 hours of the procedure, and no major complications were incurred. Follow-up ranged from 20 months to 60 months. CONCLUSION: Percutaneous ILP of spinal osteoid osteoma is a promising, simple, precise, and minimally invasive technique and may be an alternative to traditional surgical and percutaneous ablations.

Background: Pulmonary arterial compliance (PAC) is a prognostic parameter in pulmonary arterial hypertension (PAH) reflecting the elasticity of the pulmonary vessels. Objectives: The objective of this post hoc analysis of a prospective randomized controlled trial (RCT) was to assess the effect of exercise training on PAC and stroke volume (SV) in patients with PAH and persistent/inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Method: From the previous RCT, 43 out of 87 patients with severe PAH (n = 29) and CTEPH (n = 14) had complete haemodynamic examinations at baseline and after 15 weeks by right heart catheterization and were analysed (53% female, 79% World Health Organization functional class III/IV, 58% combination therapy, 42% on supplemental oxygen therapy, training group n = 24, and control group n = 19). Medication remained unchanged for all patients. Results: Low-dose exercise training at 4–7 days/week significantly improved PAC (training group 0.33 ± 0.65 mL/mm Hg vs. control group −0.06 ± 1.10 mL/mm Hg; mean difference 0.39 mL/mm Hg, 95% confidence interval [CI] 0.15–0.94 mL/mm Hg; p = 0.004) and SV (training group 9.9 ± 13.4 mL/min vs. control group −4.2 ± 11.0 mL/min; mean difference 14.2 mL, 95% CI 6.5–21.8 mL; p < 0.001) in the training versus control group. Furthermore, exercise training significantly improved cardiac output and pulmonary vascular resistance at rest, peak oxygen consumption, and oxygen pulse. Conclusions: Our findings suggest that supervised exercise training may improve right ventricular function and PAC at the same time. Further prospective studies are needed to evaluate these findings.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease which is often caused by recurrent emboli. These are also frequently found in patients with myeloproliferative diseases. While myeloproliferative diseases can be caused by gene defects, the genetic predisposition to CTEPH is largely unexplored. Therefore, the objective of this study was to analyse these genes and further genes involved in pulmonary hypertension in CTEPH patients. A systematic screening was conducted for pathogenic variants using a gene panel based on next generation sequencing. CTEPH was diagnosed according to current guidelines. In this study, out of 40 CTEPH patients 4 (10%) carried pathogenic variants. One patient had a nonsense variant (c.2071A&gt, T p.Lys691*) in the BMPR2 gene and three further patients carried the same pathogenic variant (missense variant, c.1849G&gt, T p.Val617Phe) in the Janus kinase 2 (JAK2) gene. The latter led to a myeloproliferative disease in each patient. The prevalence of this JAK2 variant was significantly higher than expected (p &lt, 0.0001). CTEPH patients may have a genetic predisposition more often than previously thought. The predisposition for myeloproliferative diseases could be an additional risk factor for CTEPH development. Thus, clinical screening for myeloproliferative diseases and genetic testing may be considered also for CTEPH patients.

De l'infrastructure de transport à la plate-forme de commerce mondial: Avec la mondialisation, la fonction transport s'intègre dans le procès de circulation. Cette activité considérée comme secondaire à l'ère industrielle, largement régulée par l'État pour le simple déplacement d'une production massifiée à l'échelle nationale, se trouve désormais incluse au centre d'un processus de commerce, de marchandisation de productions mondiales au sein de marchés spécifiques. Toutes les grandes infrastructures de transport se transforment en plateforme de commerce, d'échanges et de logistique, au cœur de ce processus de circulation de biens liés à des informations. Les divers agencements de biens et d'informations visent des marchandisations just in time & in place. Ces plates-formes logistiques de commerce sont au cœur des processus de captation et de redistribution à l'échelle continentale de la circulation globale, au cœur des processus de reterritorialisation, et deviennent une opportunité majeure de développement pour les métropoles qui les accueillent. Des relations fortes s'instituent en effet entre les plates-formes et leur territoire : d'une part la plate-forme a besoin de relations avec les producteurs de valeurs ajoutées dans la métropole, d'autre part cette dernière découvre les branchements, matériels et immatériels, que procurent la plate-forme.

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