A Global Strategy for Ecologically Sustainable Transport and other Linear Infrastructure

The current Global Strategy for Ecologically Sustainable Transport and other Linear Infrastructure primarily sets up the objectives and principles for governments and organizations for mainstreaming biodiversity and ecological connectivity on transport infrastructure development. Additionally, it addresses the overall framework of stakeholders who must be engaged as key players in: • launching proactive policies, • establishing appropriate legal frameworks, • supporting better planning, • promoting multi-sector cooperation, and • encouraging innovative science-based solutions. We consider this as a living document as future versions may integrate additional elements with regards to governance, policy, and financing, in the attempt to develop a common comprehensive language and grounds for cooperation. This “Global Strategy” has been developed by an international working group coordinated by IENE and supported by an international coalition formed from the international conferences on transport and ecology and conservation organisations as IENE, ICOET, ANET, ACLIE, WWF and IUCN. The working group is drawn from global experts in transport and ecology and aims to work towards finding a ‘win-win’ solution for securing mainstreaming biodiversity and ecological connectivity and avoiding, mitigating, or compensating ecosystems’ fragmentation during transport infrastructure development or adaptation. This Strategy builds upon five years of development of the guidelines “International Guidance for Ecologically - Friendly Linear Infrastructure (IGELI)” initiated at the ICOET 2015 conference in North Carolina, USA. IGELI was an international debate with experts from all over the world continued during workshops held at the international conferences of IENE (Lyon, France, 2016 and Eindhoven, Holland, 2018), ICOET (Salt Lake City, USA, 2017 and Sacramento, USA, 2019), IUCN (Hawaii, USA, 2016) and ACLIE (Kruger National Park, South Africa, 2019). Summarising the Decision 14/3 on mainstreaming of biodiversity in the energy and mining, infrastructure, manufacturing, and processing sectors (CBD/ COP/DEC/14/3/30 November 2018) of 14th COP CBD (Sharm El Sheikh, Egypt, Nov 2018) (Convention on Biological Diversity 2018), the international coalition of the working group, initiated to promote the Strategy at the CBD COP 15 in China. We hope, this Strategy provides a useful tool and roadmap for promoting the urgent need of supporting biodiversity conservation and securing ecological connectivity at all scales of governance, policies, planning and implementation of transport projects internationally. The creation of an International Observatory for monitoring the fragmentation status globally as an important threat for biodiversity loss is proposed as a common ambition of the working group members and their organizations.IENE, ICOET, ANET, ACLIE, WWF, IUCN, WWF, WCPA, Connectivity Conservation Specialist Grou

Findings from an in-depth annual tree-ring radiocarbon intercomparison

The radiocarbon (¹⁴C) calibration curve so far contains annually resolved data only for a short period of time. With accelerator mass spectrometry (AMS) matching the precision of decay counting, it is now possible to efficiently produce large datasets of annual resolution for calibration purposes using small amounts of wood. The radiocarbon intercomparison on single-year tree-ring samples presented here is the first to investigate specifically possible offsets between AMS laboratories at high precision. The results show that AMS laboratories are capable of measuring samples of Holocene age with an accuracy and precision that is comparable or even goes beyond what is possible with decay counting, even though they require a thousand times less wood. It also shows that not all AMS laboratories always produce results that are consistent with their stated uncertainties. The long-term benefits of studies of this kind are more accurate radiocarbon measurements with, in the future, better quantified uncertainties

Tackling antibiotic resistance: the environmental framework

Antibiotic resistance is a threat to human and animal health worldwide, and key measures are required to reduce the risks posed by antibiotic resistance genes that occur in the environment. These measures include the identification of critical points of control, the development of reliable surveillance and risk assessment procedures, and the implementation of technological solutions that can prevent environmental contamination with antibiotic resistant bacteria and genes. In this Opinion article, we discuss the main knowledge gaps, the future research needs and the policy and management options that should be prioritized to tackle antibiotic resistance in the environment

Removal of Limited Nodal Disease in Patients Undergoing Radical Prostatectomy: Long-Term Results Confirm a Chance for Cure

Abstract PURPOSE: In 2003 we reported on the outcomes of 88 patients with node positive disease who underwent radical prostatectomy and pelvic lymph node dissection (median 21 nodes) between 1989 and 1999. Patients with limited nodal disease appeared to have a good chance of long-term survival, even without immediate adjuvant therapy (androgen deprivation therapy and/or radiotherapy). In this study we update the followup in these patients and verify the reported projected probability of survival. MATERIALS AND METHODS: The projected 10-year cancer specific survival probability after the initially reported followup of 3.2 years was 60% for these patients with node positive disease. The outcome has been updated after a median followup of 15.6 years. RESULTS: Of the 39 patients with 1 positive node 7 (18%) remained biochemically relapse-free, 11 (28%) showed biochemical relapse only and 21 (54%) experienced clinical progression. Of these 39 patients 22 (57%) never required deferred androgen deprivation therapy and 12 (31%) died of prostate cancer. All patients with 2 (20) or more than 2 (29) positive nodes experienced biochemical relapse and only 5 (10%) of these 49 experienced no clinical progression. Of these 49 patients 39 (80%) received deferred androgen deprivation therapy. CONCLUSIONS: Biochemical relapse is likely in patients with limited nodal disease after radical prostatectomy and pelvic lymph node dissection, but for 47% of patients this does not imply death from prostate cancer. Patients with 1 positive node have a good (75%) 10-year cancer specific survival probability and a 20% chance of remaining biochemical relapse-free even without immediate adjuvant therapy

Nutzen der Urinzytologie mit forcierter Diurese zum follow-up des Urothelkarzinoms im oberen Harntrakt?

Einleitung: Nach radikaler Zystektomie (RC) besteht ein 0,8–6,4 % Rezidivrisiko im oberen Harntrakt (oH). Bei der Urinzytologieanalyse nach forcierter Diurese (UAFD) werden Zellen aus dem oH untersucht. Ziel der Studie war die UAFD als Follow-up (FU) Methode nach RC zu untersuchen. Material und Methoden: Patienten nach RC wurde prospektiv mittels Ultraschall, CT, MRI oder i. v. Pyelographien nach 6, 12, 18 und 24 Monaten nachkontrolliert. UAFD wurde nach 6 Monaten, anschliessend jährlich bei Tumoren nahe oder im Ureter, multifokalem Carcinoma in situ oder bei auffälliger Bildgebung durchgeführt. Ergebnisse: Eine UAFD wurde in 598/1005 (60 %) Patienten durchgeführt. Während einem medianen FU von 7,8 Jahre, wurden 1560 UAFD analysiert. 35/1560 (2,2 %) waren positiv. 13/35 (37 %) Patienten zeigten ein Rezidiv im oberen Harntrakt. Die übrigen 22/35 (63 %) Patienten hatten ein Rezidiv in der Urethra bei orthotopem Blasenersatz. Insgesamt hatten 33/598 (5 %) Patienten ein gesichertes Rezidiv im oberen Harntrakt. Bei 26/33 Patienten erfolgte die UAFD und 13/26 (50 %) waren positiv. In 3/33 (9 %) wurde das Rezidiv mittels UAFD bei negativer Bildgebung detektiert. Die UAFD zeigt eine Sensitivität, Spezifität, positiv prädiktiven Wert und negativ prädiktiven Wert von 50 %, 100 %, 100 % und 99,1 %. Schlussfolgerung: Die UAFD ist eine nicht invasive Methode für das FU des oH. Eine positive Zytologie ist diagnostisch und kann Harnröhrenrezidive bei orthotopem Blasenersatz und Rezidive im oH detektieren. Eine negative UAFD kann ein Rezidiv jedoch nicht ausschliessen. Die Hälfte der Rezidive wären mit UAFD alleine verpasst worden, jedoch vermag die UAFD auch Rezidive zu entdecken, welche mit der Bildgebung alleine verpasst worden wären

Seminal Vesical Sparing Cystectomy in Bladder Cancer Patients is Feasible with Good Functional Results without Impairing Oncological Outcomes: A Longitudinal Long-Term Propensity-Matched Single Center Study.

PURPOSE Seminal-vesicle-sparing radical-cystectomy has been reported to improve short-term functional-results without compromising oncological outcomes. However, there is still a lack of data on long-term outcomes after seminal-vesicle-sparing radical-cystectomy. The aim of this study was to compare oncological and functional outcomes in patients after seminal-vesicle-sparing vs nonseminal-vesicle-sparing radical-cystectomy. MATERIAL AND METHODS Oncological and functional outcomes of 470 consecutive patients after radical-cystectomy and orthotopic ileal reservoir from 2000 to 2017 were evaluated. They were stratified into 6 groups according to nerve-sparing and seminal-vesicle-sparing status as attempted during surgery: no-sparing at all (n=55), unilateral-nerve-sparing (n=159), bilateral-nerve-sparing (n=132), unilateral-seminal-vesicle-sparing and unilateral-nerve-sparing (n=30), unilateral-seminal-vesicle-sparing and bilateral-nerve-sparing (n=45), and bilateral seminal-vesicle-sparing (n=49) and used propensity modelling to adjust for preoperative differences. RESULTS Median follow-up among the entire cohort was 64months. Among the 6 groups, our analysis showed no difference in local recurrence-free survival (p=0.173). However, progression free, cancer-specific and overall survival were more favourable in patients with seminal-vesicle-sparing radical-cystectomy (p <0.001, p=0.006 and p <0.001, respectively). Proportions of patients with erectile function recovery were higher in the seminal-vesicle-sparing groups at all time points in all analyses, respectively, with pronounced earlier recovery in patients with bilateral-SVS. Importantly, patients with seminal-vesicle-sparing were significantly less in need of erectile aids to achieve erection and intercourse. Over the whole period, daytime urinary-continence was significantly better in the seminal-vesicle-sparing groups (OR 2.64 to 5.21). CONCLUSIONS In a highly selected group of patients, seminal-vesicle-sparing radical-cystectomy is oncologically safe and results in excellent functional outcomes that are reached at an earlier timepoint after surgery and remain superior over a longer period of time

Diagnostic Value of Urine Cytology in Pharmacologically Forced Diuresis for Upper Tract Urothelial Carcinoma Diagnosis and Follow-Up

We performed a urine cytology analysis of a pharmacologically induced diuresis for the diagnosis of upper tract urothelial carcinoma. To evaluate the diagnostic value of cytology of pharmacologically forced diuresis, an initial cohort of 77 consecutive patients with primary upper tract urothelial carcinoma treated via radical surgery was enrolled. To evaluate pharmacologically forced diuresis cytology as a follow-up procedure, a second cohort of 1250 patients who underwent a radical cystectomy for bladder cancer was selected. In the first cohort, the sensitivity of cytology of pharmacologically forced diuresis in patients with invasive, high-grade, low-grade, and concomitant carcinoma in situ was 8%, 9%, 0%, and 14%, respectively. In the second cohort, cytology of pharmacologically forced diuresis was positive in 30/689 (4.3%) patients, in whom upper urinary tract recurrence was present in 21/30 (70%) of cases, and urethral recurrence was present in 8/30 (26%) of cases. As a follow-up tool, cytology of pharmacologically forced diuresis showed a sensitivity, specificity, and positive and negative predictive values of 60%, 99%, 70%, and 98%, respectively. Overall, as a diagnostic tool, the sensitivity of cytology of pharmacologically forced diuresis is slightly better in patients with invasive upper tract urothelial carcinoma and concomitant carcinoma in situ. As a follow-up method, positive cytology of pharmacologically forced diuresis is strongly related to cancer recurrence and can reveal urethral recurrence. Cytology of pharmacologically forced diuresis might be useful in cases with contraindications for imaging or when achieving endoscopic access to the upper urinary tract is difficult