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BackgroundDespite unprecedented benefit from immune checkpoint inhibitors (ICIs) in patients with mismatch repair deficient (dMMR)/microsatellite instability high (MSI-H) advanced gastrointestinal cancers, a relevant proportion of patients shows primary resistance or short-term disease control. Since malignant effusions represent an immune-suppressed niche, we investigated whether peritoneal involvement with or without ascites is a poor prognostic factor in patients with dMMR/MSI-H metastatic colorectal cancer (mCRC) and gastric cancer (mGC) receiving ICIs.MethodsWe conducted a global multicohort study at Tertiary Cancer Centers and collected clinic-pathological data from a cohort of patients with dMMR/MSI-H mCRC treated with anti-PD-(L)1 ±anti-CTLA-4 agents at 12 institutions (developing set). A cohort of patients with dMMR/MSI-high mGC treated with anti-PD-1 agents±chemotherapy at five institutions was used as validating dataset.ResultsThe mCRC cohort included 502 patients. After a median follow-up of 31.2 months, patients without peritoneal metastases and those with peritoneal metastases and no ascites had similar outcomes (adjusted HR (aHR) 1.15, 95% CI 0.85 to 1.56 for progression-free survival (PFS); aHR 0.96, 95% CI 0.65 to 1.42 for overall survival (OS)), whereas inferior outcomes were observed in patients with peritoneal metastases and ascites (aHR 2.90, 95% CI 1.70 to 4.94; aHR 3.33, 95% CI 1.88 to 5.91) compared with patients without peritoneal involvement. The mGC cohort included 59 patients. After a median follow-up of 17.4 months, inferior PFS and OS were reported in patients with peritoneal metastases and ascites (aHR 3.83, 95% CI 1.68 to 8.72; aHR 3.44, 95% CI 1.39 to 8.53, respectively), but not in patients with only peritoneal metastases (aHR 1.87, 95% CI 0.64 to 5.46; aHR 2.15, 95% CI 0.64 to 7.27) when compared with patients without peritoneal involvement.ConclusionsPatients with dMMR/MSI-H gastrointestinal cancers with peritoneal metastases and ascites should be considered as a peculiar subgroup with highly unfavorable outcomes to current ICI-based therapies. Novel strategies to target the immune-suppressive niche in malignant effusions should be investigated, as well as next-generation ICIs or intraperitoneal approaches.

The Madrid Land Use project (MLUP) is an aerial photographic interpretation-based mapping program for the Madrid region, Spain, now available for five time periods: 2000, 2006, 2009, 2014 and 2020. In this paper we showcase the most recent updates for 2014 and 2020, using examples from the municipalities of Arganda del Rey, Campo Real and Rivas-Vaciamadrid. The updated geodatabase enhances our understanding of urban development trends and land use patterns. Broadly, development followed a simplistic template initiated by the construction of road infrastructure, later infilling with multi-family housing, retail and facilities. This pattern is highly dispersed, increasingly car dependent and energy and resource inefficient, and thus not aligned with environmental, climate or sustainability goals. The results of the MLUP show the continuing importance of large detail scale mapping from aerial orthophoto interpretation as an essential tool for understanding urban land use dynamics.

Large-scale and long-term restoration efforts are urgently needed to reverse historical global trends of deforestation and forest degradation in the tropics. Restoration of forests within landscapes offers multiple social, economic, and environmental benefits that enhance lives of local people, mitigate effects of climate change, increase food security, and safeguard soil and water resources. Despite rapidly growing knowledge regarding the extent and feasibility of natural regeneration and the environmental and economic benefits of naturally regenerating forests in the tropics, tree planting remains the major focus of restoration programs. Natural regeneration is often ignored as a viable land-use option. Here, we assemble a set of 16 original papers that provide an overview of the ecological, economic, and social dimensions of forest and landscape restoration (FLR), a relatively new approach to forest restoration that aims to regain ecological integrity and enhance human well-being in deforested or degraded forest landscapes. The papers describe how spontaneous (passive) and assisted natural regeneration can contribute to achieving multiple social and ecological benefits. Forest and landscape restoration is centered on the people who live and work in the landscape and whose livelihoods will benefit and diversify through restoration activities inside and outside of farms. Given the scale of degraded forestland and the need to mitigate climate change and meet human development needs in the tropics, harnessing the potential of natural regeneration will play an essential role in achieving the ambitious goals that motivate global restoration initiatives.

Carnivores face important anthropogenic threats in agricultural areas from habitat loss and fragmentation, disturbance by domestic free-roaming dogs and cats, and direct hunting by humans. Anthropogenic disturbances are shifting the activity patterns of wild animals, likely modifying species interactions. We estimated changes in the activity patterns of the mesocarnivore guild of agricultural landscapes of the La Araucanía region in southern Chile in response to land-use intensification, comparing intra- and interspecific activity patterns at low and high levels of forest cover, fragmentation, and land ownership subdivision. Our focal species comprise the güiña or kod-kod (Leopardus guigna), two fox species (Lycalopex culpaeus and L. griseus), a skunk (Conepatus chinga), and one native mustelid (Galictis cuja), in addition to free-roaming dogs (Canis lupus familiaris) and cats (Felis catus) and their main mammalian prey species (i.e., Rodentia and Lagomorpha). In 23,373 trap nights, we totaled 21,729 independent records of our focal species. Our results show tendencies toward nocturnality at high land-use intensification, with potential impacts on species fitness. Nocturnal mesocarnivores decreased their diurnal/ crepuscular activity, while cathemeral activity shifted to nocturnal activity at high land-use intensification, but only when in sympatry with a competitor. High land-use intensification decreased the activity overlap between native and domestic mesocarnivores but increased the overlap between native mesocarnivores. High intensification also reduced overlap with prey species. Notably, foxes displayed peaks of activity opposing those of dogs, and plasticity in activity pattern when in sympatry with dogs, such as strategies to avoid encounters. We stress the need to suppress the free-roaming and unsupervised activity of dogs to mitigate impacts of high land-use intensification on mesocarnivores.

Objective of the study: The objective is to identify factors that influence student’s acceptance of Learning Management System (LMS) using the Unified Theory of Acceptance and Use of Technology (UTAUT) model.  This study investigates how UTAUT factors affect students’ intention and attitudes to use Blackboard as a LMS at King Abdulaziz University in Saudi Arabia.Methodology/approach: This study proposes a research model based on UTAUT factors ‘Effort Expectancy (EE), Performance Expectancy (PE), Perceived Functionality (PF), Facilitating Condition (FC), Social Influence (SI)’, Behavioural Intention to use (BI) and Usage Behaviour.   The survey research methodology was adopted using questionnaire to identifying factors that influencing the students’ intention and attitudes towards LMS. Originality/relevance: The study relates corporate LMS to support educational institutions to enhance the students’ acceptance and attitudes to use in Saudi Arabia.Main result: The results indicate that PE, PF, FC and SI factors were significant and directly influence on students' BI Blackboard. Both PE and FC are second factors that affect students’ intention and EE factor does not impact the student's BI.Theoretical/methodological contributions: The study contributes to the body of knowledge in developing the research model using UTAUT model by showing the factors affecting the students’ intention in using LMS and usage behavior in Saudi Arabia. Social/management contributions: This study contributes in understanding the critical factors affecting the Saudi Arabia students’ intentions in using Blackboard. Another study should be extended to other universities by using different methods to test the model and incorporate different moderating factors to accept and use the Blackboard. 

Objective. To assess the effectiveness of a brief intervention and motivational interviewing in reducing the use of different tobacco-related products in adults Methods. For this systematic review, PubMed, Web of Science, and PsychINFO databases were electronically searched for randomized controlled trials on the effect of a brief intervention and / or motivational interview on tobacco reduction among healthy adults published between January 1, 2011 to January 1, 2021. Data from eligible studies were extracted and analyzed. CONSORT guidelines were used to assess the quality of the studies by two reviewers for the included studies. The titles and abstracts of the search results were screened and reviewed by two independent reviewers for eligibility criteria per the inclusion and exclusion criteria. Cochrane review criteria were used to assess the risk of bias in included studies. Results. A total of 12 studies were included in the final data extraction of 1406 studies. The brief intervention and motivational interviewing showed varied effects on tobacco use reduction among adults at different follow-ups. Seven of the 12 studies (58.3%) reported a beneficial impact on reducing tobacco use. Pieces of evidence on biochemical estimation on tobacco reduction are limited compared to self-reports, and varied results on quitting and tobacco cessation with different follow-ups. Conclusion. The current evidence supports the effectiveness of a brief intervention and motivational interviewing to quit tobacco use. Still, it suggests using more biochemical markers as outcome measures to reach an intervention-specific decision. While more initiatives to train nurses in providing non-pharmacological nursing interventions, including brief interventions, are recommended to help people quit smoking.

Global land-use and land-cover change (LUCC) data are crucial for modeling a wide range of environmental conditions. So far, access to high-resolution LUCC products at a global scale for public use is difficult because of data and technical issues. This article presents a Future Land-Use Simulation (FLUS) system to simulate global LUCC in relation to human-environment interactions, which is built and verified by using remote sensing data. IMAGE has been widely used in environmental studies despite its relatively coarse spatial resolution of 30 arc-min, which is about 55 km at the equator. Recently, an improved model has been developed to simulate global LUCC with a 5-min resolution (about 10 km at the equator). We found that even the 10-km resolution, however, still produced major distortions in land-use patterns, leading urban land areas to be underestimated by 19.77 percent at the global scale and global land change relating to urban growth to be underestimated by 60 to 97 percent, compared with the 1-km resolution model proposed through this article. These distortions occurred because a large percentage of small areas of urban land was merged into other land-use classes. During land-use change simulation, a majority of small urban clusters were also lost using the IMAGE product. Responding to these deficiencies, the 1-km FLUS product developed in this study is able to provide the spatial detail necessary to identify spatial heterogeneous land-use patterns at a global scale. We argue that this new global land-use product has strong potential in radically reducing uncertainty in global environmental modeling.

Background Ulnar shortening osteotomy (USO) is a common surgical procedure for the treatment of ulnar impaction syndrome (UIS). The purpose of this study was to compare the results of metaphyseal and diaphyseal USO.  Methods This retrospective study compared the clinical outcomes and complications of 32 patients who underwent diaphyseal step-cut USO ( n  = 10), diaphyseal oblique USO ( n  = 12), or metaphyseal USO ( n  = 10). Results Patient characteristics, ulnar variance, wrist range of motion, preoperative pain, grip strength, and functional scores (quick disability of the arm, shoulder, and hand and patient-rated wrist evaluation) were comparable. Both operation time (79.5 vs. 138/139 min) and incision length (7.80 vs. 9.67/13.00 cm) were shorter in the metaphyseal USO than in the diaphyseal oblique/step-cut USO. Compared with diaphyseal oblique/step-cut USO, metaphyseal osteotomies were associated with greater improvement in the pain on postoperative day 3 and shorter bone healing time. The requirements for implant removal were the same among the three groups. No complications were observed in any group. Conclusion Compared with diaphyseal USO, metaphyseal USO has advantages for operation time and incision length, early postoperative pain, bone healing in UIS management. The results suggested that metaphyseal USO could be widely applied to the surgical treatment of UIS. However, the long-term outcomes of these techniques still require further evaluation using more large-scale, randomized clinical trials.

En los últimos años el sistema educativo español ha experimentado la introducción masiva del ordenador e Internet en las aulas. En este contexto, el objetivo del trabajo es conocer la incidencia de estas Tecnologías de la Información y la Comunicación (TIC) en la adquisición de determinadas competencias y teniendo en cuenta la titularidad del centro (público o privado). Para ello se emplea una base de datos novedosa que incorpora información desglosada sobre la tenencia y el consumo de TIC elaborada a partir de una evaluación por ordenador de PISA-2012. Los principales resultados corroboran la existencia de efectos diferenciales según sea la variable TIC considerada, con un impacto mayor de las mismas en el aprendizaje de las matemáticas. Sin embargo, no se detectan diferencias significativas según tipología de centro. Asimismo, destaca la importancia de un contacto temprano de los alumnos con las TIC y una buena predisposición a su uso. In recent years the Spanish education system has undergone massive introduction of computers and the Internet in classrooms. In this context, the aim of the study is to determine the incidence of these Information and Communications Technology (ICT) in the acquisition of certain skills. We take into consideration if there are different effects by type of school (public or private). To this end we employ a data base that contains disaggregated data on the possession and consumption of ICT in the PISA-2012 computer-based evaluation of competences. The main results corroborate the existence of differential effects depending on the ICT variable considered, with a greater impact on the learning of mathematics. However, no significant differences were detected by type of school. We emphasize the importance of early contact of students with ICT and their willingness to use this kind of tool.

En la actualidad, mejorar la calidad del aprendizaje constituye uno de los grandes retos de las instituciones universitarias en Europa. Desde un punto de vista académico, responder con eficacia a este propósito requiere de un conocimiento básico sobre el modo en que los estudiantes conciben su propio proceso formativo. Para enriquecer la investigación en este ámbito, el presente trabajo explora la percepción de los universitarios sobre el nivel de aprendizaje competencial alcanzado al finalizar sus estudios de Grado y en relación con sus expectativas de entrada a la Universidad. La metodología adoptada es de carácter cuantitativo y se ha desarrollado en dos momentos distintos del proceso formativo: durante la fase de inicio de los estudios de Grado y al finalizar los mismos. Entre los resultados obtenidos, destaca una sobreestimación del nivel de competencias interpersonales adquirido con respecto a sus expectativas de entrada a la Universidad. Se concluye resaltando la conveniencia de seguir profundizando en este campo para la mejora de la calidad educativa universitaria. Currently, one of the greatest challenges for university institutions in Europe is to improve the quality of learning. From an academic point of view, effectively addressing this purpose requires basic knowledge on how students understand their formative process. With the aim of enriching this field of research, the present article explores the perception that university students have regarding their level of achievement in their developments of competencies by the end of their university degree if compared to their expectations when they started their university education. The methodology adopted here is quantitative and it was developed in two specific moments of their educational process: during the initial and the final phases of their university degree. Among the results there is a noteworthy underestimation of the level of interpersonal competencies obtained as compared to the students' expectations upon starting their university degree. The present research concludes by emphasising the need to keep exploring this field in order to improve the quality of university education.