People depend on functioning ecosystems, which provide benefits that support human existence and wellbeing. The relationship between people and nature has been experienced and conceptualized in multiple ways. Recently, ecosystem services (ES) concepts have permeated science, government policies, multinational environmental agreements, and science-policy interfaces. In 2017, the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) introduced a new and closely related concept-Nature's Contributions to People (NCP). The introduction of NCP has sparked some lively discussion and confusion about the distinguishing characteristics between ES and NCP. In order to clarify their conceptual relation, we identify eleven specific claims about novel elements from the latest NCP literature and analyze how far ES research has already contributed to these corresponding conceptual claims in the existing ES literature. We find a mixed-picture, where on six specific conceptual claims (culture, social sciences and humanities, indigenous and local knowledge, negative contributions of nature, generalizing perspective, non-instrumental values and valuation) NCP does not differ greatly from past ES research, but we also find five conceptual claims (diverse worldviews, context-specific perspective, relational values, fuzzy and fluid reporting categories and groups, inclusive language and framing) where NCP provides novel conceptualizations of people and nature relations.

The unpredictable Anthropocene poses the challenge of imagining a radically different, equitable and sustainable world. Looking 100 years ahead is not easy, and especially as millennials, it appears quite bleak. This paper is the outcome of a visioning exercise carried out in a 2-day workshop, attended by 33 young early career professionals under the auspices of IPBES. The process used Nature Futures Framework in an adapted visioning method from the Seeds of Good Anthropocene project. Four groups envisioned more desirable future worlds; where humanity has organised itself, the economy, politics and technology, to achieve improved nature-human well-being. The four visions had differing conceptualisations of this future. However, there were interesting commonalities in their leverage points for transformative change, including an emphasis on community, fundamentally different economic systems based on sharing and technological solutions to foster sustainability and human-nature connectedness. Debates included questioning the possibility of maintaining local biocultural diversity with increased connectivity globally and the prominence of technology for sustainability outcomes. These visions are the first step towards a wider galvanisation of youth visions for a brighter future, which is often missing in the arena where it can be taken seriously, to trigger more transformative pathways towards meeting global goals ARTICLE HISTORY

Purpose The entire world is currently facing a devastating crisis due to growing coronavirus pandemic, which was declared as a public health emergency by the World Health Organization on March 11, 2020. Management of cancer patients at this time is an overwhelming task. This study highlights our experience in the management of patients of gynecological malignancies over a period of 2 months during the COVID-19 pandemic. Methods Patients of confirmed gynecological malignancies who visited our outpatient clinic and those who received radiotherapy/chemotherapy in March and April 2020 were included for analysis. Guidelines issued by the National Institute of Health and Care Excellence, National Health Service, MD Anderson Cancer Centre and those by young oncologists in Italy were followed with minor modifications while managing the logistics and health worker safety. Results A total of 160 patients were treated in our department during this time period. In total, 44.4% of patients on treatment had associated comorbidities that imposed an additional risk. One hundred twenty-three patients continued treatment with their initial plan of radiotherapy or chemotherapy. New patients were prioritized based on the severity of clinical symptoms and whether the expected outcome would significantly affect their survival and quality of life. Patients were monitored for the development of treatment-related toxicities and COVID-19-related symptoms. Conclusions All oncology personnel need to identify the correct balance between risks and benefit and then proceed with further management. Thus, it is essential to cautiously select patients for treatment, minimizing the risk of exposure but adequately addressing the underlying disease.

No abstract

Background Polish and Australian randomized studies compared short-course radiotherapy (RT) with immediate surgery and long-course chemoradiotherapy (CRT) with delayed surgery. In these studies, similar long-term survival and local control have been reported for both these approaches, but pathological complete response (pCR) is not better with short-course RT. Moreover, studies have shown better tumor downstaging with delayed surgery. In this context, the use of short-course RT with delayed surgery may have some advantages and needs to be tested in clinical trials. Patients and Methods This was a two-arm, prospective, observational study, in which preoperative short-course RT followed by two cycles of chemotherapy was compared with the conventional neoadjuvant CRT in locally advanced rectal cancer. The primary end points were the rate of complete response and toxicity profile. The secondary end points were the rate of R0 resection, overall survival, and progression-free survival. The data obtained from the two arms were analyzed using Pearson’s chi-square test to determine the statistical significance between the two treatment arms. Results The pCR rate was 6.7% in the study arm and 0 in the control arm (p = 0.343). The RO resection rates were 92.8 and 92.3% in the study and control arms, respectively. The rates of grade 3and 4 acute toxicity in the study and control arms were 14.2 and 61.5%, respectively (p = 0.011). The rates of grade 3 and 4 late toxicity in the study and control arms were 21.4 and 15.3%, respectively (p = 0.686). Conclusions The pCR rates and the late toxicities in both arms are comparable. The major advantages of the 5 × 5 Gy regimen with chemotherapy in a neoadjuvant setting are a significant reduction in acute toxicities and better patient compliance along with similar efficacy as that of the standard regimen.

No abstract

Orbital metastasis, as the initial clinical presentation in hepatocellular carcinoma (HCC), is a rare manifestation. A 66-year-old male patient presented with a history of protrusion of the eyeballs, double vision, and swelling over the left side of the head for 8 months. Magnetic resonance imaging of the brain with orbit revealed a heterogeneous lesion in the left frontal lobe causing its destruction with intraorbital and intracranial extension. Triphasic contrast-enhanced computed tomography was suggestive of multiple hypodense areas in both lobes of the liver. Tissue diagnosis from the liver was suggestive of HCC. A diagnosis of multifocal HCC with orbital metastasis was made. The patient was treated with palliative radiotherapy and sorafenib. Orbital metastasis in HCC is rare. Prognosis is somber in such cases. The treatment should focus on providing palliation from symptoms.

No abstract