Planeamiento territorial sostenible: un reto para el futuro de nuestras sociedades; criterios aplicados

In a large part of the 17 sustainable development objectives set as goals for humanity by the UN, sustainability can be glimpsed. As a result of the dominant socio-productive model, the only way to head towards more sustainable territories that allow achieving and maintaining the well-being of the world's population is to bear in mind the need to properly plan territorial development. This work reflects on this need and takes a step forward in the definition of the main criteria to achieve territorial sustainability at regional and local scales

Sustainable Development, Ecological Complexity, and Environmental Values

Sustainable Development, Ecological Complexity, and Environmental Values contributes to expanding the idea of sustainability by integrating different thematic issues related to sustainable development in its threefold consideration (economic, social, and environmental) with regard to the case of the Basque Country. On the global scale, changes have clearly accelerated; ecological and social sustainability are two facets of the same changing reality. First, social sustainability depends on ecological sustainability. If we continue degrading nature's capacity to produce the ecosystems' services (water filtration, climate stabilization, etc) and resources (food, materials), both individuals and nations will be affected by growing pressures and increasing conflicts, as well as by threats to public health and personal safety. Second, ecological sustainability depends on social sustainability, a socially unjust and unfair system wiht an ever-increasing population that is not able to have its needs met will necessarily lead to environmental collapse. In addition, human behavior and the social dynamic often lie at the heart of social and ecological problems. It must be, therefore, assumed that there will not be sustainable development if sustainable societies do not first exist. A sustainable society has the challenge of developing human capital. In this book, these global questions are treated as they relate to specific place and context, the Basque Country and its modern institutions.This book was published with generous financial support from the Basque Government.Introduction—Ignacio Ayestarán and Miren Onaindia ? 1. An Evaluation of Ecosystem Services as a Base for the Sustainable Management of a Region by Miren Onaindia and Gloria Rodríguez-Loinaz ? 2. An Evaluation of Millennium Ecosystems from the Basque Country by Igone Palacios, Izaskun Casada-Arzuaga, Iosu Madariaga, and Xabier Arana ? 3. Climate Change: Activities of the EOLO Group at the University of the Basque Country by Agustín Ezcurra, Jon Sáenz, and Gabriel Ibarra-Berastegi ? 4. The Environmental Value of the Karstic Landscape of the Urdaibai Biosphere Reserve: The Asnarre Promontory (Bizkaia) by Arantza Aranburu, Laura Damas-Mollá, Patxi García-Garmilla, Iñaki Yusta, M. Arriolabengoa, Peru Iridoy, and Eneko Iriarte ? 5. Recent Environmental Transformation of the Bilbao Estuary: Natural and Anthropogenic Processes by Alejandro Cearreta, Maria Jesús Irabien, and Eduardo Leorri ? 6. The Landscape of the Autonomous Community of the Basque Country: The Evolution of Forest Systems by Lorena Peña and Ibone Amezaga ? 7. Critical Theories of Sustainable Development by Eguzki Urteaga ? 8. Bases for the Transition toward a Sustainable Economy by Roberto Bermejo, David Hoyos, and Eneko Garmendia ? 9. Environmental Values, the Epistemology of Complex Problems, and Postnormal Science in the Face of Global Change by Ignacio Ayestáran ? 10. Science, Gender, and Sustainable Development by Teresa Nuño Angós ? 11. Environmental Education as Training: A Case Study at the University of the Basque Country by Araitz Uskola Ibarluzea ? 12. Social Values and Sustainable Practices among Basque Inshore Fishermen by Pío Pérez Aldasoro ? 13. Sustainable Development and the Values of Well-Being and Globalization by Eduardo Rubio Ardanaz, Juan Antonio Rubio-Ardanaz, and Xiao Fang ? Index ? List of Contributor

The Evolving Role of Consensus Molecular Subtypes: a Step Beyond Inpatient Selection for Treatment of Colorectal Cancer

The heterogenous nature of colorectal cancer (CRC) renders it a major clinical challenge. Increasing genomic understanding of CRC has improved our knowledge of this heterogeneity and the main cancer drivers, with significant improvements in clinical outcomes. Comprehensive molecular characterization has allowed clinicians a more precise range of treatment options based on biomarker selection. Furthermore, this deep molecular understanding likely extends therapeutic options to a larger number of patients. The biological associations of consensus molecular subtypes (CMS) with clinical outcomes in localized CRC have been validated in retrospective clinical trials. The prognostic role of CMS has also been confirmed in the metastatic setting, with CMS2 having the best prognosis, whereas CMS1 tumors are associated with a higher risk of progression and death after chemotherapy. Similarly, according to mesenchymal features and immunosuppressive molecules, CMS1 responds to immunotherapy, whereas CMS4 has a poorer prognosis, suggesting that a CMS1 signature could identify patients who may benefit from immune checkpoint inhibitors regardless of microsatellite instability (MSI) status. The main goal of these comprehensive analyses is to switch from “one marker-one drug” to “multi-marker drug combinations” allowing oncologists to give “the right drug to the right patient.” Despite the revealing data from transcriptomic analyses, the high rate of intra-tumoral heterogeneity across the different CMS subgroups limits its incorporation as a predictive biomarker. In clinical practice, when feasible, comprehensive genomic tests should be performed to identify potentially targetable alterations, particularly in RAS/BRAF wild-type, MSI, and right-sided tumors. Furthermore, CMS has not only been associated with clinical outcomes and specific tumor and patient phenotypes but also with specific microbiome patterns. Future steps will include the integration of clinical features, genomics, transcriptomics, and microbiota to select the most accurate biomarkers to identify optimal treatments, improving individual clinical outcomes. In summary, CMS is context specific, identifies a level of heterogeneity beyond standard genomic biomarkers, and offers a means of maximizing personalized therapy

Molecular subtypes and the evolution of treatment management in metastatic colorectal cancer

Colorectal cancer (CRC) is a heterogeneous disease representing a therapeutic challenge, which is further complicated by the common occurrence of several molecular alterations that confer resistance to standard chemotherapy and targeted agents. Mechanisms of resistance have been identified at multiple levels in the epidermal growth factor receptor (EGFR) pathway, including mutations in KRAS, NRAS, and BRAFV600E, and in the HER2 and MET receptors. These alterations represent oncogenic drivers that may co-exist in the same tumor with other primary and acquired alterations via a clonal selection process. Other molecular alterations include DNA damage repair mechanisms and rare kinase fusions, potentially offering a rationale for new therapeutic strategies. In recent years, genomic analysis has been expanded by a more complex study of epigenomic, transcriptomic, and microenvironment features. The Consensus Molecular Subtype (CMS) classification describes four CRC subtypes with distinct biological characteristics that show prognostic and potential predictive value in the clinical setting. Here, we review the panorama of actionable targets in CRC, and the developments in more recent molecular tests, such as liquid biopsy analysis, which are increasingly offering clinicians a means of ensuring optimal tailored treatments for patients with metastatic CRC according to their evolving molecular profile and treatment history