3532), but absence of a large target lesion was associated with improved PFS (P = 0.0222). Grade 3 and 4 liver function abnormalities were rare and did not appear to be associated with high baseline liver tumour burden. CONCLUSIONS 177Lu-Dotatate demonstrated significant prolongation in PFS versus high-dose octreotide LAR in patients with advanced, progressive midgut NET, regardless of baseline liver tumour burden, elevated ALP, or the presence of a large target lesion. Clinicaltrials.gov NCT01578239, EudraCT 2011-005049-11.PURPOSE To evaluate the clinical benefit of positron emission tomography (PET)/computed tomography (CT) in patients with advanced melanoma, primarily not selected for surgery based on management changes and survival data using the linked evidence approach (LEA). METHODS A total of 201 18F-FDG PET/CT examinations (n = 33, stage III and n = 168, stage IV) in 119 melanoma patients, primarily not scheduled for surgery, were analysed regarding their impact on clinical management. Patients were selected from a prospective oncological PET/CT registry. The three PET/CT indication groups included unclear lesions in conventional imaging (n = 8), routine follow-up after multiple surgeries (n = 115) and therapy response evaluation of systemic therapy (n = 78). PUH71 PET/CT-induced management changes were categorized either as major (change from follow-up to surgical or systemic treatment or vice versa, change from surgery to systemic therapy or vice versa) or minor (modifications in systemic therapy). The expected benefit of c melanoma patients, primarily not considered for surgery, resulted in frequent changes of management associated with a relevant expected clinical benefit especially in patients classified by PET/CT as tumour-free or eligible for radical surgery.Social acceptability of environmental management actions, such as prescribed burning used to reduce wildfire risk, is critical to achieving positive outcomes. However, environmental managers often need to implement strategies over a long time period, and sustaining long-term community support can be challenging. Public attention to environmental issues is argued to vary over time, with acceptability of management interventions theorized to decrease with time since experiencing an environmental problem. However, it is unknown whether a person needs to personally experience the problem to maintain support, or if hearing about it in the media is sufficient. In this paper we explore whether acceptability of prescribed burning used to reduce wildfire risk declines with length of time since personally experiencing a wildfire. In a sample of 4390 Australians, acceptability of prescribed burning was not predicted by length of time since personally experiencing a wildfire, or perceptions of wildfire risk. Significant predictors included perceptions of local fuel loads, and of positive and negative impacts of prescribed burning, suggesting addressing these issues may be more effective in maintaining long-term support for wildfire management policies than investing in increasing attention to wildfire risk. This suggests environmental managers can design communication strategies to maintain support for environmental actions even in the absence of an individual personally experiencing the problem the action is designed to address.This paper reviews decentralized sanitation technologies comparing dry and wet solutions currently available, discussing their operational requirements, applicability, effluent output quality, efficiencies, environmental impacts, costs, challenges, as well as their advantages and implementation difficulties. Sanitation technologies vary from conventional centralized systems, typically used on urban areas, to decentralized systems, more common in sparse dwellings and small communities of rural areas. Compared with centralized sanitation, decentralized sanitation is being progressively considered as more sustainable solution. Most do not require energy or expensive or sophisticated operation, being easy to adapt to different geographic contexts. A general lack of consistent regulatory control over most dry rudimentary systems and primary treatment systems may compromise water quality and human health. In the future, a mix of new policies and accurate accounting of the location, performance, and degree of failure of such systems should be performed. However, forcing users and communities to face the capital, operational, or repairing costs may be challenging. Since many of the discussed technologies may be important sources of contamination with nutrients, pathogens and toxic chemicals, new opportunities are still open, which include the conversion of dry rudimentary systems into dry controlled systems.Spinal muscular atrophy (SMA) with respiratory distress type 1 (SMARD1) is an autosomal recessive motor neuron disease that is characterized by distal and proximal muscle weakness and diaphragmatic palsy that leads to respiratory distress. Without intervention, infants with the severe form of the disease die before 2 years of age. SMARD1 is caused by mutations in the IGHMBP2 gene that determine a deficiency in the encoded IGHMBP2 protein, which plays a critical role in motor neuron survival because of its functions in mRNA processing and maturation. Although it is rare, SMARD1 is the second most common motor neuron disease of infancy, and currently, treatment is primarily supportive. No effective therapy is available for this devastating disease, although multidisciplinary care has been an essential element of the improved quality of life and life span extension in these patients in recent years. The objectives of this review are to discuss the current understanding of SMARD1 through a summary of the presently known information regarding its clinical presentation and pathogenesis and to discuss emerging therapeutic approaches. Advances in clinical care management have significantly extended the lives of individuals affected by SMARD1 and research into the molecular mechanisms that lead to the disease has identified potential strategies for intervention that target the underlying causes of SMARD1. Gene therapy via gene replacement or gene correction provides the potential for transformative therapies to halt or possibly prevent neurodegenerative disease in SMARD1 patients. The recent approval of the first gene therapy approach for SMA associated with mutations in the SMN1 gene may be a turning point for the application of this strategy for SMARD1 and other genetic neurological diseases.PUH71