Long term evolution of tree growth, understorey vegetation and soil properties in a silvopastoral system of northern Greece

Tree growth, understorey characteristics and soil parameters were evaluated in a silvopastoral system in northern Greece at seven and twelve years after its establishment. The experiment was laid out in 1992 and included three understorey treatments (grass, legume and control- unsown), two tree species - sycamore (Acer pseudoplatanus L.) and Scots pine (Pinus sylvestris L.) and two tree spacings (2.5 x 2.5 m and 3.5 x 3.5 m). Tree height was taller in the control and in the dense stands while Scots pine had better growth but, higher mortality than sycamore in the both periods. In 2004, understorey vegetation was uniform under the three understorey treatments and a significant decrease in sward above ground biomass was recorded under the dense treatment, compared with the open stand. In the same year, organic C and N, Mg and K concentrations as well as arbuscular mycorrhizal fungi spore numbers were found significantly higher under sycamore than Scots pine plots in the 0-20 cm soil depth. The results show that, although understorey vegetation became uniform over time, the initial plant composition of the understorey treatments continued to affect tree growth, indicating the importance of the understorey vegetation at the establishment stage of silvopastoral systems. However, as time passed initial tree spacing started to affect tree growth and tree species, particularly sycamore to improve soil properties. These results indicate an evolution of the initial silvopastoral system to a forest.</p

Alternating Cystoscopy with Bladder EpiCheck®in the Surveillance of Low-Grade Intermediate-Risk NMIBC: A Cost Comparison Model

BACKGROUND: Bladder cancer surveillance is invasive, intensive and costly. Patients with low grade intermediate risk non-muscle invasive bladder cancer (NMIBC) are at high risk of recurrence. OBJECTIVE: The objective of this model is to compare the cost of a strategy to alternate surveillance with cystoscopy and a urine marker, Bladder EpiCheck, to standard surveillance. METHODS: A decision tree model was built using TreeAge Pro Healthcare to compare standard surveillance (Standard) with a modified surveillance incorporating Bladder EpiCheck. The model was based on 2 years of surveillance. Outcomes were obtained from literature. Costs were obtained from US and 9 European countries. Sensitivity analyses were performed. RESULTS: The efficacy of the model was equivalent in terms of recurrence for each arm with median recurrence rate of 22%. When setting marker price at 200 local currency, the marker arm was less expensive in the USA, Netherlands, Switzerland, Belgium, Italy, Austria and UK by 154€ to 329£ per patient, for a 2-year period. Cost was higher in France, Spain, and Germany by 33-103€. Cost parity was achieved with marker price between 148€ and $421. Marker cost and specificity have the greatest impact on the overall model cost. CONCLUSIONS: A strategy alternating the urine marker Bladder EpiCheck with cystoscopy in the surveillance of patients with low grade intermediate risk bladder cancer is cost equivalent in the US and European countries when the marker is priced 148€ -$421, as a result of the marker's high specificity (86%). Prospective studies will be necessary to validate these findings.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Corrigendum to ‘EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer—An International Collaborative Multistakeholder Effort Under the Auspices of the EAU-ESMO Guidelines Committees’ [European Urology 77 (2020) 223–250](S0302283819307638)(10.1016/j.eururo.2019.09.035)

The authors regret that a co-author was mistakenly missed from the authorship. The following co-author should have been included in the authorship: Peter-Paul M. Willemse Department of Oncological Urology, University Medical Center, Utrecht Cancer Center, Utrecht, The Netherlands © 2019 European Society of Medical Oncology and European Association of Urolog

EAU–ESMO consensus statements on the management of advanced and variant bladder cancer—an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees

Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. Design: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. Setting: Online Delphi survey and consensus conference. Participants: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. Outcome measurements and statistical analysis: Statements were ranked by experts according to their level of agreement: 1–3 (disagree), 4–6 (equivocal), 7–9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). Results and limitations: Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. Conclusions: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach. © 2019 European Society for Medical Oncolog