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Background: Despite guidelines recommending diagnostic laparoscopy in patients with gastric cancer, implementation is low. We aimed to explore trends in the use of laparoscopy for staging of gastric cancer in Alberta, Canada, determine the rate of positive findings and identify factors predictive of positive staging laparoscopy (SL) findings in this patient population. Methods: In August 2018, we sent a survey to all general surgeons in Alberta who were members of the Alberta Association of General Surgeons to identify those treating gastric cancer. The survey inquired about type of practice (academic or community), gastric cancer case volume, routine versus selective use of SL and, if selective use of SL, criteria used to select cases. Participants were also asked to provide data from their SL cases from July 2007 to February 2019. We double-checked surgeon records with chart review. The primary outcome was evidence of metastatic disease on SL or cytologic examination or both. We performed logistic regression analysis to identify factors predictive of positive laparoscopy findings. Results: The survey was completed by 41 of 127 surgeons (response rate 32.3%). We reviewed 116 cases from 5 surgeons at 4 centres. Gross metastatic disease or positive findings on cytologic examination or both were identified in 37 patients (31.9%). On univariate analysis, the following were associated with an increased risk of identification of metastatic disease at laparoscopy: visualization of the primary tumour on computed tomography (CT) (odds ratio [OR] 9.8, 95% confidence interval [CI] 1.2-76.5), presence of abdominal lymphadenopathy greater than 1 cm (OR 2.4, 95% CI 1.1-5.4) and presence of ascites (OR 19.1, 95% CI 2.2-161.8). Visualization of the primary tumour on CT (OR 8.4, 95% CI 1.0-68.3) and the presence of ascites (OR 15.9, 95% CI 1.8-137.0) remained statistically significant predictors on multivariate analysis. Conclusion: Metastatic disease was identified at SL in almost one-third of cases, which suggests that SL should still be used routinely in gastric cancer staging in Canadian centres. Our study identified several preoperative imaging findings associated with evidence of metastatic disease on laparoscopy; however, further studies are needed to establish robust predictors of positive findings before advocating for a selective SL approach. Contexte : Bien que les directives recommandent une laparoscopie diagnostique chez les patients atteints d'un cancer de l'estomac, cette intervention est peu utilisee. Nous avons voulu explorer les tendances du recours a la laparoscopie pour la stadification du cancer de l'estomac en Alberta, au Canada, etablir le taux de resultats positifs et cibler les facteurs predictifs de resultats positifs de la laparoscopie de stadification dans cette population de patients. Methodes : En aout 2018, nous avons envoye un sondage a tous les chirurgiens generaux de l'Alberta membres de l'Alberta Association of General Surgeons pour savoir lesquels traitaient le cancer de l'estomac. L'enquete portait sur le type de pratique (universitaire ou communautaire), le volume de cas de cancer de l'estomac, le recours systematique ou selectif de la laparoscopie de stadification et, en cas de recours selectif, les criteres de selection. Les participants ont egalement ete invites a fournir des donnees sur les cas ou la laparoscopie de stadification avait ete utilisee de juillet 2007 a fevrier 2019. Nous avons reverifie les dossiers des medecins. Le principal indicateur etait la presence d'une maladie metastatique lors de la laparoscopie de stadification ou de l'examen cytologique (ou les deux). Nous avons procede a une analyse de regression logistique pour cerner les facteurs predictifs de resultats positifs a la laparoscopie. Resultats : Sur 127 chirurgiens 41 ont repondu au sondage (taux de reponse de 32,3 %). Nous avons examine 116 cas traites par 5 chirurgiens dans 4 centres. Une maladie metastatique brute ou des resultats positifs a l'examen cytologique ou les deux ont ete identifies chez 37 patients (31,9 %). Une analyse univariee a revele que les elements suivants etaient associes a un risque accru d'identification de maladie metastatique lors de la laparoscopie : visualisation de la tumeur primaire a la tomodensito-metrie (TDM) (rapport des cotes [RC] 9,8, intervalle de confiance [IC] de 95 % 1,2-76,5), presence d'une lymphadenopathie abdominale superieure a 1cm (RC 2,4, IC de 95 % 1,1-5,4) et presence d'ascite (RC 19,1, IC de 95 % 2,2-161,8). La visualisation de la tumeur primaire a la TDM (RC 8,4, RC de 95 % 1,0-68,3) et la presence d'ascite (RC 15,9, RC de 95 % 1,8-137,0) sont demeurees des facteurs predictifs statistiquement significatifs dans l'analyse multivariee. Conclusion : Une maladie metastatique a ete identifiee a la laparoscopie de stadification dans pres d'un tiers des cas, ce qui suggere que la laparoscopie de stadification devrait con inuer d'etre utilisee de facon systematique dans la stadification du cancer de l'estomac dans les centres canadiens. Notre etude a montre plusieurs resultats d'imagerie preoperatoire associes a des signes de maladie metastatique a la laparoscopie; cependant, d'autres etudes sont necessaires pour etablir des predicteurs solides de resultats positifs avant de preconiser une approche selective de la laparoscopie de stadification., Gastric cancer remains the fifth most common cancer diagnosed worldwide and the third most common cause of cancer-related death. (1) In Canada, the incidence of gastric adenocarcinoma is estimated to [...]

ABSTRACT This article contributes to the literature at the intersection of migration and global production networks (GPNs) by examining the role of labour market intermediaries (LMIs) for migrant workers. It demonstrates mediation processes by LMIs and elaborates on migration networks in the global labour market through qualitative and quantitative data. It examines the role of LMIs in responding to mechanisms in GPN, including zero inventory and just‐in‐time production, and the impact of private employment agents on migrant workers, particularly on their career paths. The article found that LMIs play an active role in the mediation and cooperation between migrant labour and firms and in shaping structural conditions for migrant workers in response to global competitive pressures. However, LMIs play a controversial role in social upgrading. Private LMIs are identified as having a negative impact on career paths of migrant workers. [ABSTRACT FROM AUTHOR]

The promotion of R&D carries the risk that economically strong regions will benefit to a greater extent and that regional disparities will increase by focusing the economy on high technology. However, this is expected to depend on the specific sectoral and technological composition of R&D funding. R&D funding for a bio-based economy in Germany is particularly illustrative for a shift in funding focus from a narrow concept of biotechnology to a broader concept of bioeconomy. Along with this shift, an impact on the spatial distribution of R&D funding is assumed. Against the background of inclusive innovation policy, this study examines the potential of the bioeconomy for a reduction of regional disparities in public R&D funding. Based on a database containing publicly-funded R&D projects in Germany and further regional data, comparative regressions are conducted in order to identify spatial patterns. The results demonstrate distinct funding mechanisms in the different areas of the bioeconomy. The broadening of R&D funding for bio-based activities from the biotechnology vision towards bioresources and bioecology leads to a greater participation of rural and lagging regions which is expected to be the result of the inclusion of more traditional industries as recipients of R&D funding. [ABSTRACT FROM AUTHOR]

Non-flow periods in fluvial ecosystems are a global phenomenon. Streambed drying and rewetting by sporadic rainfalls could drive considerable changes in the microbial communities that govern stream nitrogen (N) availability at different temporal and spatial scales. We performed a microcosm-based experiment to investigate how dry period duration (DPD) (0, 3, 6, and 9 weeks) and magnitude of sporadic rewetting by rainfall (0, 4, and 21 mm applied at end of dry period) affected stocks of N in riverbed sediments, ammonia-oxidizing bacteria (AOB) and archaea (AOA) and rates of ammonia oxidation (AO), and emissions of nitrous oxide (N2O) to the atmosphere. While ammonium (NH4 +) pool size decreased, nitrate (NO3 -) pool size increased in sediments with progressive drying. Concomitantly, the relative and absolute abundance of AOB and, especially, AOA (assessed by 16S rRNA gene sequencing and quantitative PCR of ammonia monooxygenase genes) increased, despite an apparent decrease of AO rates with drying. An increase of N2O emissions occurred at early drying before substantially dropping until the end of the experiment. Strong rainfall of 21 mm increased AO rates and NH4 + in sediments, whereas modest rainfall of 4 mm triggered a notable increase of N2O fluxes. Interestingly, such responses were detected only after 6 and 9 weeks of drying. Our results demonstrate that progressive drying drives considerable changes in in-stream N cycling and the associated nitrifying microbial communities, and that sporadic rainfall can modulate these effects. Our findings are particularly relevant for N processing and transport in rivers with alternating dry and wet phases - a hydrological scenario expected to become more important in the future.

Streams are significant contributors of greenhouse gases (GHG) to the atmosphere, and the increasing number of stressors degrading freshwaters may exacerbate this process, posing a threat to climatic stability. However, it is unclear whether the influence of multiple stressors on GHG concentrations in streams results from increases of in‐situ metabolism (i.e., local processes) or from changes in upstream and terrestrial GHG production (i.e., distal processes). Here, we hypothesize that the mechanisms controlling multiple stressor effects vary between carbon dioxide (CO2) and methane (CH4), with the latter being more influenced by changes in local stream metabolism, and the former mainly responding to distal processes. To test this hypothesis, we measured stream metabolism and the concentrations of CO2 (pCO2) and CH4 (pCH4) in 50 stream sites that encompass gradients of nutrient enrichment, oxygen depletion, thermal stress, riparian degradation and discharge. Our results indicate that these stressors had additive effects on stream metabolism and GHG concentrations, with stressor interactions explaining limited variance. Nutrient enrichment was associated with higher stream heterotrophy and pCO2, whereas pCH4 increased with oxygen depletion and water temperature. Discharge was positively linked to primary production, respiration and heterotrophy but correlated negatively with pCO2. Our models indicate that CO2‐equivalent concentrations can more than double in streams that experience high nutrient enrichment and oxygen depletion, compared to those with oligotrophic and oxic conditions. Structural equation models revealed that the effects of nutrient enrichment and discharge on pCO2 were related to distal processes rather than local metabolism. In contrast, pCH4 responses to nutrient enrichment, discharge and temperature were related to both local metabolism and distal processes. Collectively, our study illustrates potential climatic feedbacks resulting from freshwater degradation and provides insight into the processes mediating stressor impacts on the production of GHG in streams. [ABSTRACT FROM AUTHOR]

Trait‐based approaches have received increasing interest among freshwater scientists given their capacity to predict community structure and biodiversity effects on ecosystem functioning. However, the inconsistent development and use of trait concepts and terms across freshwater scientific disciplines may have limited realisation of the potential of traits.Here, we reviewed trait definitions and terms use to provide recommendations for their consistent application in freshwater science. To do so, we first reviewed literature to identify established trait definitions, historical and current use of trait terms and challenges restricting the application of trait‐based approaches in freshwater science. Next, we surveyed 414 freshwater researchers from 54 countries to assess variability in the current use of trait terminology in relation to respondent characteristics (i.e., professional experience, geographical region, research discipline, and focal freshwater ecosystem, biotic group, and ecosystem function).Our literature review identified two well‐established trait definitions, which emphasise individual phenotypic characteristics that influence either eco‐evolutionary aspects (i.e., organism performance and fitness) or ecosystem dynamics and processes (i.e., responses to the environment and/or effects on ecosystem functioning). Publications used a range of trait‐related terms and their frequency of use varied among scientific fields. The term functional trait dominated fields such as biodiversity conservation, environmental sciences and ecology, plant sciences and microbiology. In contrast, the terms biological trait, functional trait, and species trait were used with similar frequencies in fields such as entomology, fisheries, marine and freshwater biology, and zoology. We also found that well‐established trait definitions are difficult to apply to freshwater unicellular organisms, colonial multicellular organisms, genomic information, and cultural traits.Our survey revealed highly inconsistent use of trait terms among freshwater researchers. Terms including biological trait, functional trait, structural measure, and ecosystem function were commonly used to describe the same traits or functions. Variability in the use of terms was generally explained by research discipline, geographical region, and focal biotic group and ecosystem functions.We propose making the trait concept flexible enough to be applicable to all freshwater biota and their characteristics, while keeping and integrating links to eco‐evolutionary and ecosystem aspects. Specifically, our new definition expands the established functional trait definition by considering also supra‐individual scales of trait measurement (colonial‐ or community‐mean traits), genotypic traits (e.g., functional gene markers of enzymes) and cultural traits (e.g., feeding behaviours, communication skills). To reduce terminological ambiguity, we also recommend that researchers define trait terms, prioritising the use of functional trait as an overarching term over alternative terms (e.g., biological trait), and restricting specific terms (e.g., morphological trait) to situations in which such precision is desirable. The findings of our integrative study could help to improve terminological consistency across freshwater disciplines and to better recognise the potential of traits to elucidate the mechanisms behind ecological patterns. [ABSTRACT FROM AUTHOR]

Background: International guidelines recommend routine computed tomography (CT) of the chest for gastric cancer staging. In Asian countries, where the incidence of pulmonary metastases is less than 1%, some guidelines recommend chest CT only for gastroesophageal junction cancers. If the incidence of pulmonary metastases is also low in Canada, routine chest CT may not be beneficial. Methods: We performed a retrospective review of patients in northern Alberta with newly diagnosed gastric cancer from January 2010 to July 2016. The primary aim of the study was to determine the incidence of pulmonary metastases at the time of diagnosis in this population. A secondary aim was to identify potential predictors of pulmonary metastases. We reviewed CT reports for pulmonary metastases. Imaging data also included liver metastases, abdominal lymphadenopathy (> 1 cm), ascites and omental or peritoneal nodules. Other data recorded were age, sex, primary tumour location, histologic type and tumour grade. Results: Four hundred and sixty-two patients (311 men, 151 women) were included in the analysis. Pulmonary metastases were identified in 25 patients (5.4%) overall and in 11 of 299 patients (3.7%) whose primary cancer was not in the cardia. On univariate analysis the presence of liver metastases (odds ratio [OR] 7.72, 95% confidence interval [CI] 3.24-18.37, p < 0.001) and abdominal lymphadenopathy (OR 3.30, 95% CI 1.29-8.48, p = 0.01) was associated with an increased risk of pulmonary metastases. Liver metastases retained statistical significance on multivariate analysis (OR 6.17, 95% CI 2.53-15.03, p < 0.001). Conclusion: The incidence of pulmonary metastases at the time of gastric cancer diagnosis is higher in northern Alberta than previously reported in Asian studies. Abdominal lymphadenopathy and liver metastases confer an elevated risk of pulmonary metastases. Contexte : Les lignes directrices internationales recommandent une tomodensitometrie (TDM) thoracique de routine pour la stadification du cancer de l'estomac. Dans les pays asiatiques, ou l'incidence des metastases pulmonaires est inferieure a 1 %, certaines lignes directrices recommandent la TMD thoracique seulement dans les cancers de la jonction gastro-oesophagienne. Si l'incidence des metastases pulmonaires est egalement faible au Canada, la TDM thoracique de routine pourrait ne pas etre benefique. Methodes : Nous avons procede a une analyse retrospective des patients du Nord de l'Alberta ayant recu un diagnostic de cancer de l'estomac entre janvier 2010 et juillet 2016. L'objectif principal de l'etude etait de determiner l'incidence des metastases pulmonaires au moment du diagnostic chez cette population. Un objectif secondaire consistait a identifier les predicteurs potentiels des metastases pulmonaires. Les rapports de TDM ont ete passes en revue pour ce qui est des metastases pulmonaires. Les donnees provenant des epreuves d'imagerie incluaient aussi les metastases hepatiques, la lymphadenopathie abdominale (> 1 cm), l'ascite et les nodules epiploiques ou peritoneaux. Parmi les autres donnees consignees, mentionnons l'age, le sexe, de meme que la localisation, le type histologique et le grade de la tumeur principale. Resultats : Quatre cent soixante-deux patients (311 hommes, 151 femmes) ont ete inclus dans l'analyse. Globalement, des metastases pulmonaires ont ete observees chez 25 patients (5,4 %), et chez 11 patients sur 299 (3,7 %) dont le cancer principal ne se situait pas dans le cardia. A l'analyse univariee, la presence de metastases hepatiques (rapport des cotes [RC] 7,72, intervalle de confiance [IC] de 95 % de 3,24 a 18,37, p < 0,001) et de lymphadenopathie abdominale (RC 3,30, IC de 95 %, de 1,29 a 8,48, p = 0,01) a ete associee a un risque accru de metastases pulmonaires. Les metastases hepatiques ont conserve leur portee statistique lors de l'analyse multivariee (RC 6,17, IC de 95 % de 2,53 a 15,03, p < 0,001). Conclusion : L'incidence des metastases pulmonaires au moment ou un diagnostic de cancer de l'estomac est pose s'est revelee plus elevee dans le Nord de l'Alberta que dans les rapports d'etudes asiatiques precedentes. La lymphadenopathie abdominale et les metastases hepatiques conferent un risque eleve de metastases pulmonaires., The incidence of gastric adenocarcinoma in Canada is estimated at 8.6 per 100 000 population. (1) It is rare relative to other cancers in the Canadian population, and the majority [...]