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The updated edition of the German, Austrian and Swiss Guidelines for Systemic Treatment of Gastric Cancer was completed in August 2023, incorporating new evidence that emerged after publication of the previous edition. It consists of a text-based “Diagnosis” part and a “Therapy” part including recommendations and treatment algorithms. The treatment part includes a comprehensive description regarding perioperative and palliative systemic therapy for gastric cancer and summarizes recommended standard of care for surgery and endoscopic resection. The guidelines are based on a literature search and evaluation by a multidisciplinary panel of experts nominated by the hematology and oncology scientific societies of the three involved countries.

Large-herbivore migrations occur across gradients of food quality or food abundance that are generally determined by underlying geographic patterns in rainfall, elevation, or latitude, in turn causing variation in the degree of interspecific competition and the exposure to predators. However, the role of top-down effects of predation as opposed to the bottom-up effects of competition for resources in shaping migrations is not well understood. We studied 30 GPS radio-collared wildebeest and zebra migrating seasonally in the Serengeti-Mara ecosystem to ask how predation and food availability differentially affect the individual movement patterns of these co-migrating species. A hierarchical analysis of movement trajectories (directions and distances) in relation to grass biomass, high-quality food patches, and predation risk show that wildebeest tend to move in response to food quality, with little attention to predation risk. In contrast, individual zebra movements reflect a balance between the risk of predation and the access to high-quality food of sufficient biomass. Our analysis shows how two migratory species move in response to different attributes of the same landscape. Counterintuitively and in contrast to most other animal movement studies, we find that both species move farther each day when resources are locally abundant than when they are scarce. During the wet season when the quality of grazing is at its peak, both wildebeest and zebra move the greatest distances and do not settle in localized areas to graze for extended periods. We propose that this punctuated movement in high-quality patches is explained by density dependency, whereby large groups of competing individuals (up to 1.65 million grazers) rapidly deplete the localized grazing opportunities. These findings capture the roles of predation and competition in shaping animal migrations, which are often claimed but rarely measured.

Accurate and on-demand animal population counts are the holy grail for wildlife conservation organizations throughout the world because they enable fast and responsive adaptive management policies. While the collection of image data from camera traps, satellites, and manned or unmanned aircraft has advanced significantly, the detection and identification of animals within images remains a major bottleneck since counting is primarily conducted by dedicated enumerators or citizen scientists. Recent developments in the field of computer vision suggest a potential resolution to this issue through the use of rotation-invariant object descriptors combined with machine learning algorithms. Here we implement an algorithm to detect and count wildebeest from aerial images collected in the Serengeti National Park in 2009 as part of the biennial wildebeest count. We find that the per image error rates are greater than, but comparable to, two separate human counts. For the total count, the algorithm is more accurate than both manual counts, suggesting that human counters have a tendency to systematically over or under count images. While the accuracy of the algorithm is not yet at an acceptable level for fully automatic counts, our results show this method is a promising avenue for further research and we highlight specific areas where future research should focus in order to develop fast and accurate enumeration of aerial count data. If combined with a bespoke image collection protocol, this approach may yield a fully automated wildebeest count in the near future.

Wildlife within protected areas is under increasing threat from bushmeat and illegal trophy trades, and many argue that enforcement within protected areas is not sufficient to protect wildlife. We examined 50 years of records from Serengeti National Park in Tanzania and calculated the history of illegal harvest and enforcement by park authorities. We show that a precipitous decline in enforcement in 1977 resulted in a large increase in poaching and decline of many species. Conversely, expanded budgets and antipoaching patrols since the mid-1980s have greatly reduced poaching and allowed populations of buffalo, elephants, and rhinoceros to rebuild.

Developing countries often have rich natural resources but poor infrastructure to capitalize on them, which leads to significant challenges in terms of balancing poverty alleviation with conservation. The underlying premise in development strategies is to increase the socio-economic welfare of the people while simultaneously ensuring environmental sustainability, however these objectives are often in direct conflict. National progress is dependent on developing infrastructure such as effective transportation networks, however roads can be ecologically catastrophic in terms of disrupting habitat connectivity and facilitating illegal activity. How can national development and conservation be balanced? The proposed Serengeti road epitomizes the conflict between poverty alleviation on one hand, and the conservation of a critical ecosystem on the other. We use the Serengeti as an exemplar case-study in which the relative economic and social benefits of a road can be assessed against the ecological impacts. Specifically, we compare three possible transportation routes and ask which route maximizes the socio-economic returns for the people while minimizing the ecological costs. The findings suggest that one route in particular that circumnavigates the Serengeti links the greatest number of small and medium sized entrepreneurial businesses to the largest labour force in the region. Furthermore, this route connects the most children to schools, provisions the greatest access to hospitals, and opens the most fertile crop and livestock production areas, and does not compromise the ecology and tourism revenue of the Serengeti. This route would improve Tanzania's food security and self-reliance and would facilitate future infrastructure development which would not be possible if the road were to pass through the Serengeti. This case study provides a compelling example of how a detailed spatial analysis can balance the national objectives of poverty alleviation while maintaining ecological integrity.

PurposeThe study aimed to investigate strategies to prevent and treat cetuximab-induced skin reactions and their perceived effectiveness in patients with metastatic colorectal cancer (mCRC) and recurrent/metastatic squamous cell cancer of the head and neck (SCCHN).MethodsThis open-label, prospective observational study was conducted in Switzerland.ResultsA total of 125 patients were included (n = 91 mCRC, n = 34 SCCHN; mean age 63.3 years; 73.6% males). The frequency of acneiform rash grade ≥ 2 increased from 12.6% at week 2 to 21.7% at week 16. The proportion of patients who reported no skin reaction decreased from 75.6% at week 2 to 43.3% at week 16. The most frequently used skin products at any time of observation were moisturizing (77.6%), lipid-regenerating (56.8%) or urea-containing products (52%), systemic antibiotics (49.6%), and vitamin K1 cream (43.2%). There was no clear effectiveness pattern for all product classes: in given patients, either the product showed no effect at all or a moderate/strong effect, consistently over time.ConclusionsA great variety of low-cost general skin care products were commonly used. According to physician’s preference, systemic antibiotics and vitamin K1 cream are an appropriate approach to prevent or treat cetuximab-related skin toxicity.

Background To evaluate the effect of Recurrence Score® results (RS; Onco type DX® multigene assay ODX) on treatment recommendations by Swiss multidisciplinary tumor boards (TB). Methods SAKK 26/10 is a multicenter, prospective cohort study of early breast cancer patients: Eligibility: R0-resection, ≥10% ER+ malignant cells, HER2 – , pN0/pN1a. Patients were stratified into low-risk (LR) and non-low-risk (NLR) groups based on involved nodes (0 vs 1–3) and five additional predefined risk factors. Recommendations were classified as hormonal therapy (HT) or chemotherapy plus HT (CT + HT). Investigators were blinded to the statistical analysis plan. A 5%/10% rate of recommendation change in LR/NLR groups, respectively, was assumed independently of RS (null hypotheses). Results Two hundred twenty two evaluable patients from 18 centers had TB recommendations before and after consideration of the RS result. A recommendation change occurred in 45 patients (23/154 (15%, 95% CI 10–22%) in the LR group and 22/68 (32%, 95% CI 22–45%) in the NLR group). In both groups the null hypothesis could be rejected (both p  < 0.001). Specifically, in the LR group, only 5/113 (4%, 95% CI 1–10%) with HT had a recommendation change to CT + HT after consideration of the RS, while 18/41 (44%, 95% CI 28–60%) of patients initially recommended CT + HT were subsequently recommended only HT. In the NLR group, 3/19 (16%, 95% CI 3–40%) patients were changed from HT to CT + HT, while 19/48 (40%, 95% CI 26–55%) were changed from CT + HT to HT. Conclusion There was a significant impact of using the RS in the LR and the NLR group but only 4% of LR patients initially considered for HT had a recommendation change (RC); therefore these patients could forgo ODX testing. A RC was more likely for NLR patients considered for HT. Patients considered for HT + CT have the highest likelihood of a RC based on RS.

The production of positive electrodes for lithium ion batteries typically involves the use of the environmentally harmful solvent N‐methyl‐2‐pyrrolidone to process the binder polyvinylidene difluoride. An alternative approach is aqueous processing with more environmentally friendly binding agents (BAs) like sodium carboxymethyl cellulose (CMC). This article investigates the influence of the degree of substitution (DS) of CMC, indicating the average number of hydroxy groups substituted with carboxymethyl groups, on the microstructure, as well as on the physical properties of LiNi0.6Mn0.2Co0.2O2‐based positive electrodes. The results indicate a higher DS to be associated with enhanced electronic conductivity and improved adhesion of/within the composite electrode. Battery cells containing aqueously processed electrodes with CMC, with a DS of 1.2, displayed enhanced cycling stability and rate capability in comparison to cells based on CMCs with a lower DS of 0.9 and 0.7. This is attributed to stabilizing effects that occurred during the process of electrode drying. These became more prominent with increasing DS and resulted in the formation of electrodes with higher initial porosity and a favorable distribution of the carbon binder domain comprised of BA and conductive additive. Aqueous processing of positive electrodes is a crucial step toward sustainable production of lithium ion batteries. Therein, the individual properties of the binding agent can largely influence processing, the physical electrode properties, and thus, the electrochemical performance and cycle life. Therefore, a detailed analysis of the influence of the degree of substitution within sodium carboxymethyl cellulose is conducted.

The sustainability of lithium‐ion battery (LIB) production can be improved by implementing aqueous processing for positive electrodes, as already practiced for negative electrodes. This approach enables the use of water as a solvent with environmentally benign polymers as a binder instead of a standard solvent/binder combination of N‐methyl‐2‐pyrrolidone (NMP) and fluorinated polyvinylidene difluoride (PVdF), which have been the subject of concerns regarding their environmental and health implications. Aqueous processing is less complex to implement for olivine‐type LiFePO4 (LFP) positive electrodes compared to layered oxide materials due to the minimal Li+ leaching caused by H+ exchange with water in LFP. Hence, this study evaluated LFP‐based electrodes formulated with various water‐compatible binders, including carboxymethyl cellulose (CMC), styrene butadiene rubber (SBR), Xanthan Gum (XG), and Poly 3,4‐ethylenedioxythiophene:polystyrene sulfonate (PEDOT:PSS), and their combinations, comparing their performance against the NMP/PVdF reference system. The impact of all binder systems was assessed with regard to physical and electrochemical electrode properties. Each binder uniquely enhanced specific electrode properties: CMC and XG improved Li+ diffusion coefficient, PEDOT:PSS enhanced electronic and ionic conductivity, and SBR increased adhesion and flexibility. Notably, aqueously processed LFP electrodes exhibited lower polarization and enhanced charge transfer kinetics relative to PVdF‐containing electrodes, resulting in superior electrochemical performance. Aqueous processing of positive electrodes based on noncritical active materials like LiFePO4 is considered inevitable to enable overall sustainable lithium‐ion batteries. Therein, the various binder candidates can largely influence processing, electrode properties, as well as electrochemical performance and cycle life. Therefore, a detailed analysis was performed to decipher which aqueous binder systems lead to the best‐performing LiFePO4‐based batteries.

Tumor necrosis factor-related apoptosis-inducing ligand (Apo2L/TRAIL) belongs to the family of programmed cell death-inducing cytokines. Apo2L/TRAIL induces apoptosis in a wide variety of tumor cells. Tumor cells that are resistant to Apo2L/TRAIL-induced apoptosis can be sensitized by chemotherapeutic drugs and other agents via an unknown mechanism. Here we report that PG490 (triptolide), a diterpene triepoxide extracted from the Chinese herb Tripterygium wilfordii and used in traditional Chinese medicine, sensitizes lung cancer but not normal human bronchial epithelial cells to Apo2L/TRAIL-induced apoptosis. Sensitization was accompanied by caspase-3 and caspase-8 activation, whereas no cleavage of caspase-9 was observed. Determination of cell surface receptors by flow cytometry demonstrated no difference in Apo2L/TRAIL-R1 and -R2 expression, the two receptors with functional death domains, between resistant and sensitized cells. In cells treated with the combination of Apo2L/TRAIL and PG490, we observed activation of ERK2, a member of the mitogen-activated protein kinase family. Furthermore, sensitization could be blocked by the ERK inhibitor U0126 but not the p38 inhibitor SB203580, suggesting that activation of ERK2 is required for this effect. In addition, sensitization of lung cancer cells was also seen in ex vivo culture of lung cancer tissue from four patients who underwent surgery. Immunohistochemical staining showed a clear reduction in proliferation cell nuclear antigen (PCNA) in tissue treated with Apo2L/TRAIL and PG490. In conclusion, apoptosis induced by the combination of Apo2L/TRAIL and PG490 warrants further evaluation as a potential new strategy for the treatment of lung cancer.