Management of Patients With Refractory Reflux-Like Symptoms Despite Proton Pump Inhibitor Therapy: Evidence-Based Consensus Statements.

Background: Many patients diagnosed with gastro-oesophageal reflux disease (GERD) have persistent symptoms despite proton pump inhibitor (PPI) therapy.

Aims: The aim of this consensus is to provide evidence-based statements to guide clinicians caring for patients with refractory reflux-like symptoms (rRLS) or refractory GERD.

Methods: This consensus was developed by the International Working Group for the Classification of Oesophagitis.

Inequalities in the geographic access to delivery services in Brazil.

Background: Despite Brazil's recent social progress, access to health services is still unequal. This article analyzes the inter-municipal distances traveled by pregnant women to access delivery services, documenting their magnitude and relationship to socioeconomic and risk factors for over a decade in Brazil.

Methods: Using data between 2007 and 2017 from the Brazilian Information System of Live Births and a matrix of inter-municipal distances, we describe the evolution of (i) the share of pregnant women that traveled across municipalities and (ii) the average distance they traveled.

The role of lag phases between real-term marine heatwaves in the trait responses of two macrophyte species.

Coastal marine macrophytes are critical ecosystem engineers providing valuable ecosystem services. However, they experience detrimental impacts from climate change-induced stresses such as marine heatwaves (MHW), which are becoming more intense and frequent. This study investigated trait responses in real-term heatwaves, Continuous (1MHW) and Consecutive (with a 4-day lag phase, 2MHW), on two key macrophytes, the seaweed Fucus vesiculosus and seagrass Zostera marina.

Metabolic Dysfunction-Associated Steatotic Liver Disease in Chronic Hepatitis C Virus Infection: From Basics to Clinical and Nutritional Management.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with obesity and other cardiometabolic risk factors. MASLD has rapidly become the most common cause of liver disease worldwide, currently affecting 38% of the global population. Excess weight causes chronic inflammation and the activation of different pathways involved in liver damage.