Barrett’s Esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia. Barrett’s Esophagus strongly predisposes to esophageal adenocarcinoma (EAC), a tumour with a very poor prognosis. We have undertaken the first genome-wide association study on Barrett’s Esophagus, comprising 1,852 UK cases and 5,172 UK controls in discovery and 5,986 cases and 12,825 controls in the replication. Two regions were associated with disease risk: chromosome 6p21, rs9257809 (Pcombined=4.09×10−9, OR(95%CI) =1.21(1.13-1.28)) and chromosome 16q24, rs9936833 (Pcombined=2.74×10−10, OR(95%CI) =1.14(1.10-1.19)). The top SNP on chromosome 6p21 is within the major histocompatibility complex, and the closest protein-coding gene to rs9936833 on chromosome 16q24 is FOXF1, which is implicated in esophageal development and structure. We found evidence that the genetic component of Barrett’s Esophagus is mediated by many common variants of small effect and that SNP alleles predisposing to obesity also increase risk for Barrett’s Esophagus.

Background & AimsBarrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations.MethodsWe performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls.ResultsWe identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09–1.18; P = 1.8 × 10−11) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86–0.93; P = 7.5 × 10−9). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87–0.93; P = 3.72 × 10−9).ConclusionsWe identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response.

Since the 1980s, within the broader context of studies on smart cities, there has been a growing body of academic research on networked cities and "computable cities" by authors including Manuel Castells (Castells, 1989;Castells & Cardoso, 2005), William Mitchell (1995), Michael Batty (2005), and Rob Kitchin (2011. Over the last decade, governments in Asia have displayed an appetite and commitment to construct large scale city developments from scratch-one of the most infamous being the smart entrepreneurial city of Songdo, South Korea. Using Songdo as a case study, this paper will examine, from an urban systems perspective, some of the challenges of using a green-city model led by networked technology. More specifically, this study intends to add to the growing body of smart city literature by using an external global eventthe global financial crisis in 2008-to reveal what is missing from the smart city narrative in Songdo. The paper will use the definition of an urban system and internal subsystems by Bertuglia et al. (1987) and Bertuglia, Clarke and Wilson (1994) to reveal the sensitivity and resilience of a predetermined smart city narrative. For instance, what happens if the vision moves from the originally intended international-orientated population towards remarketing the city to attract a domestic middle-class population. The lens of the financial crisis in 2008 revealed that the inherent inflexibility of a closed-system approach in Songdo was not sufficiently resilient to external shocks. The shift towards a domestic middle-class population revealed the inequality in accessing the city services in a system designed with formalized and rigid inputs and outputs. By focusing predominantly on technology, the social dimensions of the city were not part of Songdo's smart city vocabulary. Therefore, in adopting a technologically deterministic approach (Mullins & Shwayri, 2016) to achieving efficiency and combating environmental issues, Songdo's green city model was found insufficient in its ability to cope with the complexity and dissonance that occurs in relation to "glocal" challenges facing cities today.

Post-partum clinical presentation with seizures and focal neurological deficit has a wide differential diagnosis. Two cases of the rare condition Posterior Reversible Encephalopathy Syndrome (PRES) associated with pregnancy are presented with complete recovery following multidisciplinary care. One of the cases was associated with Factor VII deficiency in pregnancy and the other with twin gestation and psoas abcess.