Translating the 10 golden rules of reforestation for coral reef restoration.

Efforts are accelerating to protect and restore ecosystems globally. With trillions of dollars in ecosystem services at stake, no clear framework exists for developing or prioritizing approaches to restore coral reefs even as efforts and investment opportunities to do so grow worldwide. Restoration may buy time for climate change mitigation, but it lacks rigorous guidance to meet objectives of scalability and effectiveness. Lessons from restoration of terrestrial ecosystems can and should be rapidly adopted for coral reef restoration. We propose how the 10 golden rules of effective forest restoration can be translated to accelerate efforts to restore coral reefs based on established principles of resilience, management, and local stewardship. We summarize steps to undertake reef restoration as a management strategy in the context of the diverse ecosystem service values that coral reefs provide. Outlining a clear blueprint is timely as more stakeholders seek to undertake restoration as the UN Decade on Ecosystem Restoration begins.

Traducción de las Diez Reglas de Oro de la Reforestación para la Restauración de los Arrecifes de Coral Resumen Cada vez son más los esfuerzos para proteger y restaurar los ecosistemas a nivel mundial. Con billones de dólares en servicios ambientales en juego, no existe un marco de trabajo para desarrollar o priorizar estrategias para la restauración de los arrecifes de coral incluso cuando en todo el mundo aumentan los esfuerzos y las oportunidades de inversión. Puede que la restauración gane tiempo para la mitigación del cambio climático, pero carece de las directrices rigurosas para cumplir los objetivos de adaptabilidad y eficacia. Las lecciones que ha brindado la restauración de los ecosistemas terrestres pueden y deben adoptarse rápidamente en la restauración de arrecifes de coral. Proponemos una traducción de las diez reglas doradas de la restauración forestal efectiva para acelerar los esfuerzos para restaurar los arrecifes de coral con base en los principios establecidos de resiliencia, gestión y administración local. Resumimos pasos para emprender la restauración de arrecifes como una estrategia de manejo en el contexto de los valores diversos de los servicios ambientales. Estamos a tiempo de delinear un proyecto conforme más actores buscan restaurar con el inicio de la Década de la ONU para la Restauración de Ecosistemas.

Wilderness forms and their implications for global environmental policy and conservation.

With the intention of securing industry-free land and seascapes, protecting wilderness entered international policy as a formal target for the first time in the zero draft of the Post-2020 Global Biodiversity Framework under the Convention on Biological Diversity. Given this increased prominence in international policy, it is timely to consider the extent to which the construct of wilderness supports global conservation objectives. We evaluated the construct by overlaying recently updated cumulative human pressure maps that offer a global-scale delineation of industry-free land as wilderness with maps of carbon stock, species richness, and ground travel time from urban centers. Wilderness areas took variable forms in relation to carbon stock, species richness, and proximity to urban centers, where 10% of wilderness areas represented high carbon and species richness, 20% low carbon and species richness, and 3% high levels of remoteness (>48 h), carbon, and species richness. Approximately 35% of all remaining wilderness in 2013 was accessible in <24 h of travel time from urban centers. Although the construct of wilderness can be used to secure benefits in specific contexts, its application in conservation must account for contextual and social implications. The diverse characterization of wilderness under a global environmental conservation lens shows that a nuanced framing and application of the construct is needed to improve understanding, communication, and retention of its variable forms as industry-free places.

Formas de las Áreas Silvestres y sus Implicaciones para las Políticas y la Conservación Mundial Resumen Con la intención de asegurar paisajes terrestres y marinos libres de la industria, la protección de las áreas silvestres entró a la política internacional por primera vez como un objetivo formal en el primer borrador del Marco de Trabajo para la Biodiversidad Mundial Post-2020 bajo el Convenio sobre la Diversidad Biológica. Con este incremento en la presencia dentro de la política internacional, es oportuno considerar el grado al que el concepto de área silvestre ayuda a los objetivos de conservación mundial. Evaluamos este concepto mediante la superposición de mapas de la presión humana acumulada recientemente actualizados que brindan una definición a escala mundial de las tierras libres de industria con mapas del stock de carbono, riqueza de especies y el tiempo de traslado terrestre desde los centros urbanos. Las áreas silvestres mostraron formas variables con respecto al stock de carbono, la riqueza de especies y la cercanía a los centros urbanos, de las cuales el 10% representó una elevada riqueza de especies y presencia de carbono, el 20% una baja riqueza de especies y presencia de carbono y el 3% una elevada lejanía (>48 horas), presencia de carbono y riqueza de especies. Aproximadamente el 35% de todas las áreas silvestres en 2013 era accesible en <24 horas de traslado desde los centros urbanos. Aunque el concepto de áreas silvestres puede usarse para garantizar beneficios en contextos específicos, su aplicación en la conservación debe considerar las implicaciones contextuales y sociales. La caracterización diversa de las áreas silvestres bajo el lente de la conservación ambiental mundial muestra que un encuadre matizado y la aplicación de este concepto son necesarios para aumentar el conocimiento, la comunicación y la retención de sus formas variables como lugares libres de industria.

A global evaluation of the effectiveness of voluntary REDD+ projects at reducing deforestation and degradation in the moist tropics.

Reducing emissions from deforestation and forest degradation (REDD+) projects aim to contribute to climate change mitigation by protecting and enhancing carbon stocks in tropical forests, but there have been no systematic global evaluations of their impact. We used a new data set for tropical humid forests and a standardized evaluation approach (based on pixel matching) to quantify the performance of a representative sample of 40 voluntary REDD+ projects in 9 countries certified under the Verified Carbon Standard (VCS). In the first 5 years of implementation, deforestation within project areas was reduced by 47% (95% confidence interval [CI]: 24-68) compared with matched counterfactual pixels, and degradation rates were 58% lower (95% CI: 49-63). Reductions were small in absolute terms but greater in sites located in high-deforestation settings and did not appear to be substantially undermined by leakage activities in forested areas within 10 km of project boundaries. At the 26th Conference of the Parties of the United Nations Framework Convention on Climate Change, the international community renewed its commitment to tackling tropical deforestation as a nature-based solution to climate change. Our results indicate that incentivizing forest conservation through voluntary site-based projects can slow tropical deforestation and highlight the particular importance of prioritizing financing for areas at greater risk of deforestation.

Evaluación Global de la Efectividad de proyectos REDD+ en la Reducción de la Deforestación y Degradación en el Trópico Húmedo Resumen Los proyectos para la reducción de emisiones derivados de la deforestación y degradación de bosques (REDD+) tienen como meta contribuir a la mitigación del cambio climático al protejer y  fomentar la disponibilidad de carbono en bosques tropicales, pero a la fecha no se han realizado evaluaciones globales sistemáticas sobre su impacto. Utilizamos bases de datos recientes sobre bosques tropicales húmedos y un método estandarizado de evaluación (basado en 'emparejamiento' [matching] de pixeles) para cuantificar el desempeño de una muestra representativa de 40 proyectos voluntarios REDD+ , localizados en 9 países y certificados bajo el estándar Verified Carbon Standard (VCS). En los primeros 5 años de implementación, la deforestación en las áreas de los proyectos disminuyó en 47% (IC 95% 24-68) en comparación con los pixeles contrafactuales correspondientes, y las tasas de degradación fueron 58% menos (IC 95% 49-63). Las reducciones fueron pequeñas en términos absolutos pero mayores en sitios con tasas de deforestación elevadas, y no parecieron ser afectadas sustancialmente por efectos de fuga (leakage) en áreas boscosas en un radio de 10 km de los límites del proyecto. En la COP26, la comunidad internacional renovó su compromiso de afrontar la deforestación tropical como una solución al cambio climático basada en la naturaleza. Nuestros resultados indican que incentivar la conservación de bosques mediante proyectos locales voluntarios puede disminuir la deforestación tropical, y resaltan la importancia de priorizar financiamiento en áreas con un mayor riesgo de deforestación.

Synergies and trade-offs among integrated conservation approaches in Mexico.

Integrated conservation approaches (ICAs) are employed by governments, communities, and nongovernmental organizations worldwide seeking to achieve outcomes with dual benefits for biodiversity conservation and poverty alleviation. Although ICAs are frequently implemented concurrently, interactions among ICAs and the synergies or trade-offs that result are rarely considered during program design, implementation, and evaluation. In support of more deliberate and effective use of ICAs, we examined interactions among four well-known strategies: biosphere reserves (BRs), voluntary protected areas (VPAs), payments for ecosystem services (PES), and community forest management (CFM). Through a comparative case study, we analyzed interactions among spatially or temporally clustered ICAs implemented on communally held and managed lands in three ecologically and socioeconomically distinct regions of Mexico. Our research methods combined policy analysis with data gathered through participant observation and semistructured interviews (n = 78) and focus groups (n = 5) with government officials, implementers, and participants involved in ICAs in 28 communities. Despite the significant differences among the regions in which they were implemented, we found that key actors at each level of involvement generally perceived interactions among ICAs as synergistic. The PES programs were perceived to strengthen protected areas by reducing forest cover loss in and around BRs, fostering proconservation attitudes, and incentivizing the establishment of VPAs. Communities that invested PES income in CFM were motivated to conserve forests beyond the duration of PES programs, and CFM in buffer zones was perceived to strengthen BRs by maintaining forest cover and generating income for communities. We also identified key social and environmental factors that can influence these interaction effects among ICAs. Based on these findings, we recommend further study of ICA interactions and intentionally complementary policy design to maximize positive environmental and social outcomes.

Las estrategias de conservación integrada (ECI) son empleadas en todo el mundo por los gobiernos, comunidades y organizaciones no gubernamentales que buscan alcanzar resultados con beneficios tanto para la conservación como para la mitigación de la pobreza. A pesar de que múltiples ECI suelen implementarse simultáneamente, es raro que se tomen en cuenta las posibles interacciones positivas (sinergías) o negativas (trade-offs) durante el diseño, la implementación y la evaluación de estos programas. En búsqueda de un uso más deliberado y efectivo de las ECI, examinamos las interacciones entre cuatro estrategias conocidas: reservas de la biósfera (RB), áreas protegidas voluntarias (APV), pagos por servicios ambientales (PSA) y el manejo comunitario de los bosques (MCB). Mediante un estudio de caso comparativo analizamos las interacciones entre las ECI agrupadas espacial o temporalmente implementadas en tierras con administración y propiedad comunal en tres regiones con diferencias ecológicas y socioeconómicas en México. Nuestros métodos de investigación combinaron el análisis de políticas con datos recopilados mediante la observación participativa, entrevistas semiestructuradas (n = 78) y grupos focales (n = 5) con funcionarios del gobierno, implementadores y participantes involucrados en las ECI de 28 comunidades. A pesar de las diferencias significativas entre las regiones en las que se implementaron estas ECI, descubrimos que los actores clave en cada nivel de participación percibieron de manera generalizada las interacciones entre las ECI como sinérgicas. Los programas de PSA fueron percibidos como algo que fortalece a las áreas protegidas mediante la reducción de la pérdida de la cobertura forestal dentro y fuera de las RB, el fomento de las actitudes a favor de la conservación y el estímulo al establecimiento de las APV. Las comunidades que invirtieron los ingresos por PSA en el MCB expresaron su motivación para conservar los bosques más allá de la duración de los programas de PSA y el MCB en zonas de amortiguamiento fue percibido como un factor de fortalecimiento de las RB mediante el mantenimiento de la cobertura forestal y la generación de ingresos para las comunidades. También identificamos los factores sociales y ambientales importantes que pueden influir sobre estos efectos de interacción entre las ECI. Con base en estos hallazgos, recomendamos un estudio más profundo de las interacciones entre las ECI y un diseño de políticas intencionalmente complementario para maximizar los resultados sociales y ambientales positivos.

Reduction in global habitat loss from fossil-fuel-dependent increases in cropland productivity.

Terrestrial biodiversity loss and climate change, driven mainly by loss of habitat to agriculture and fossil fuel (FF) use, respectively, are considered among the world's greatest environmental threats. However, FF-dependent technologies are currently essential for manufacturing synthetic nitrogen fertilizers (SNFs) and synthetic pesticides (SPs) critical to increasing agricultural productivity, which reduces habitat loss. Fossil fuel use increases CO2 levels, further enhancing agricultural productivity. Based on estimates of global increases in yields from SNFs, SPs, and atmospheric CO2 fertilization, I estimated that FF-dependent technologies are responsible for at least 62.5% of current global food production (GFP) from cropland. Thus, if FF use is eschewed in the future, maintaining current GFP means croplands would have to increase from 12.2% of global land area (GLA) excluding Antarctica to 32.7%. The additional 20.4% of GLA needed exceeds habitat lost currently to cropland (12.2% of GLA) and cumulative conservation areas globally (14.6% of GLA). Thus, although eliminating FF use could reduce climate change, its unintended consequences may be to significantly exacerbate biodiversity loss and indirectly increase food costs, reducing food security which, moreover, disproportionately affects the poor. Although it may be possible to replace SNFs and SPs with FF-free technologies, such substitutes have not yet been demonstrated to be sufficiently economical or efficient. In the interim, meeting global food demand and keeping food prices affordable would increase habitat conversion and food prices. These trade-offs should be considered in analyses of climate change policies.

Reducción de la Pérdida Mundial de Hábitat a Partir de Incrementos Dependientes de Combustibles Fósiles en la Productividad de los Terrenos de Cultivo Resumen La pérdida de la biodiversidad terrestre y el cambio climático, causados principalmente por la pérdida del hábitat debido a la agricultura y al uso de combustibles fósiles (CF) respectivamente, están consideradas entre las más grandes amenazas ambientales a nivel mundial. Sin embargo, las tecnologías dependientes de los CF son actualmente de mucha importancia para la manufactura de fertilizantes sintéticos de nitrógeno (FSN) y de pesticidas sintéticos (PS) fundamentales para el incremento de la productividad agrícola, lo cual reduce la pérdida del hábitat. El uso de los CF incrementa los niveles de CO2 , mejorando todavía más la productividad agrícola. Con base en los estimados de los incrementos mundiales de producción de FSN, PS y la fertilización por CO2 atmosférico estimé que las tecnologías dependientes de los CF son las responsables de al menos el 62.5% de la producción mundial de alimentos (PMA) en las tierras de cultivo. Por esto, si en el futuro se evita el uso de los FF, para mantener la PMA actual los terrenos de cultivo tendrían que incrementar de 12.2% del área global de suelo (AGS) (excluyendo a la Antártida) a 32.7%. El 20.4% adicional del AGS necesaria excede a los hábitats perdidos hasta ahora por terrenos de cultivo (12.2% del AGS) y a las áreas acumuladas de conservación (14.6% del AGS) en todo el mundo. Por lo tanto, mientras que la eliminación de los CF podría reducir el avance del cambio climático, las consecuencias imprevistas de esto podrían exacerbar significativamente la pérdida de la biodiversidad e indirectamente incrementar el costo de los alimentos, reduciendo así la seguridad alimentaria. Aunque puede ser posible reemplazar los FSN y los PS con tecnologías libres de CF, no se ha demostrado que dichos sustitutos sean suficientemente económicos o eficientes. Mientras tanto, cumplir la demanda mundial de alimentos y mantener costeables los precios alimentarios incrementa la conversión de los hábitats. Estas compensaciones deberían ser consideradas en los análisis de las políticas para el cambio climático.

Subjective modeling choices and the robustness of impact evaluations in conservation science.

Arbitrary modeling choices are inevitable in scientific studies. Yet, few empirical studies in conservation science report the effects these arbitrary choices have on estimated results. I explored the effects of subjective modeling choices in the context of counterfactual impact evaluations. Over 5000 candidate models based on reasonable changes in the choice of statistical matching algorithms (e.g., genetic and nearest distance mahalanobis matching), the parametrization of these algorithms (e.g., number of matches), and the inclusion of specific covariates (e.g., distance to nearest city, slope, or rainfall) were valid for studying the effect of Virunga National Park in Democratic Republic of the Congo on changes in tree cover loss and carbon storage over time. I randomly picked 2000 of the 5000 candidate models to determine how much and which subjective modeling choices affected the results the most. All valid models indicated that tree cover loss decreased and carbon storage increased in Virunga National Park from 2000 to 2019. Nonetheless, the order of magnitude of the estimates varied by a factor of 3 (from -4.78 to -13.12 percentage points decrease in tree cover loss and from 20 to 46 t Ce/ha for carbon storage). My results highlight that modeling choices, notably the choice of the matching algorithm, can have significant effects on point estimates and suggest that more structured robustness checks are a key step toward more credible findings in conservation science.

Selecciones Subjetivas de Modelos y la Contundencia de las Evaluaciones de Impacto en las Ciencias de la Conservación Resumen Las selecciones arbitrarias de modelos son inevitables en los estudios científicos. Sin embargo, pocos estudios empíricos en las ciencias de la conservación reportan los efectos de estas selecciones arbitrarias sobre los resultados estimados. Exploré los efectos de las selecciones subjetivas de modelos en el contexto de las evaluaciones de impacto contrafactuales. Más de 5000 modelos candidatos basados en cambios razonables en la elección de los algoritmos de emparejamiento estadístico (p. ej.: emparejamiento genético y de distancia más cercana mahalanobis), la parametrización de estos algoritmos (p. ej.: número de parejas) y la inclusión de covariados específicos (p. ej.: distancia a la ciudad más cercana, inclinación, precipitación) fueron válidos para estudiar el efecto del Parque Nacional Virunga en la República Democrática del Congo sobre la pérdida de cobertura arbórea y el almacenamiento de carbono a través del tiempo. Escogí al azar 2000 de los 5000 modelos candidatos para determinar cuántos y cuáles selecciones subjetivas de los modelos afectaron más al resultado. Todos los modelos válidos indicaron que la pérdida de la cobertura arbórea disminuyó y el almacenamiento de carbono incrementó en el Parque Nacional Virunga desde entre el año 2000 y el 2019. No obstante, el orden de magnitud de las estimaciones varió con un factor de 3 (una disminución de -4.78 hasta -13.12 puntos porcentuales en la pérdida de la cobertura arbórea y de 20 hasta 46 t Ce/ha para el almacenamiento de carbono). Mis resultados resaltan que la selección de los modelos, notablemente la elección del algoritmo de emparejamiento, puede tener efectos significativos sobre las estimaciones de puntos y sugieren que las revisiones más estructuradas de la contundencia son un paso importante hacia descubrimientos más creíbles en las ciencias de la conservación.

Executive summary: Updates to the dietary treatment of prediabetes and type 2 diabetes mellitus. / Resumen ejecutivo: actualización en el tratamiento dietético de la prediabetes y la diabetes mellitus tipo 2.

Adequate lifestyle changes significantly reduce the cardiovascular risk factors associated with prediabetes and type 2 diabetes mellitus. Therefore, healthy eating habits, regular physical activity, abstaining from using tobacco, and good sleep hygiene are recommended for managing these conditions. There is solid evidence that diets that are plant-based; low in saturated fatty acids, cholesterol, and sodium; and high in fiber, potassium, and unsaturated fatty acids are beneficial and reduce the expression of cardiovascular risk factors in these subjects. In view of the foregoing, the Mediterranean diet, the DASH diet, a low-carbohydrate diet, and a vegan-vegetarian diet are of note. Additionally, the relationship between nutrition and these metabolic pathologies is fundamental in targeting efforts to prevent weight gain, reducing excess weight in the case of individuals with overweight or obesity, and personalizing treatment to promote patient empowerment. This document is the executive summary of an updated review that includes the main recommendations for improving dietary nutritional quality in people with prediabetes or type 2 diabetes mellitus. The full review is available on the webpages of the Spanish Society of Arteriosclerosis, the Spanish Diabetes Society, and the Spanish Society of Internal Medicine.

Threats to intact tropical peatlands and opportunities for their conservation.

Large, intact areas of tropical peatland are highly threatened at a global scale by the expansion of commercial agriculture and other forms of economic development. Conserving peatlands on a landscape scale, with their hydrology intact, is of international conservation importance to preserve their distinctive biodiversity and ecosystem services and maintain their resilience to future environmental change. We explored threats to and opportunities for conserving remaining intact tropical peatlands; thus, we excluded peatlands of Indonesia and Malaysia, where extensive deforestation, drainage, and conversion to plantations means conservation in this region can protect only small fragments of the original ecosystem. We focused on a case study, the Pastaza-Marañón Foreland Basin (PMFB) in Peru, which is among the largest known intact tropical peatland landscapes in the world and is representative of peatland vulnerability. Maintenance of the hydrological conditions critical for carbon storage and ecosystem function of peatlands is, in the PMFB, primarily threatened by expansion of commercial agriculture linked to new transport infrastructure that is facilitating access to remote areas. There remain opportunities in the PMFB and elsewhere to develop alternative, more sustainable land-use practices. Although some of the peatlands in the PMFB fall within existing legally protected areas, this protection does not include the most carbon-dense (domed pole forest) areas. New carbon-based conservation instruments (e.g., REDD+, Green Climate Fund), developing markets for sustainable peatland products, transferring land title to local communities, and expanding protected areas offer pathways to increased protection for intact tropical peatlands in Amazonia and elsewhere, such as those in New Guinea and Central Africa which remain, for the moment, broadly beyond the frontier of commercial development.

The value of virtual conferencing for ecology and conservation.

The objectives of conservation science and dissemination of its research create a paradox: Conservation is about preserving the environment, yet scientists spread this message at conferences with heavy carbon footprints. Ecology and conservation science depend on global knowledge exchange-getting the best science to the places it is most needed. However, conference attendance from developed countries typically outweighs that from developing countries that are biodiversity and conservation hotspots. If any branch of science should be trying to maximize participation while minimizing carbon emissions, it is conservation. Virtual conferencing is common in other disciplines, such as education and humanities, but it is surprisingly underused in ecology and conservation. Adopting virtual conferencing entails a number of challenges, including logistics and unified acceptance, which we argue can be overcome through planning and technology. We examined 4 conference models: a pure-virtual model and 3 hybrid hub-and-node models, where hubs stream content to local nodes. These models collectively aim to mitigate the logistical and administrative challenges of global knowledge transfer. Embracing virtual conferencing addresses 2 essential prerequisites of modern conferences: lowering carbon emissions and increasing accessibility for remote, time- and resource-poor researchers, particularly those from developing countries.

Venous-to-arterial carbon dioxide difference in the resuscitation of patients with severe sepsis and septic shock: A systematic review. / La diferencia venoarterial de dióxido de carbono en la reanimación de pacientes con sepsis grave y shock séptico: una revisión sistemática.

INTRODUCTION: The way to assess tissue perfusion during the resuscitation of patients with severe sepsis and septic shock is a current subject of research and debate. Venous oxygen saturation and lactate concentration have been the most frequently used criteria, though they involve known limitations. The venous-to-arterial difference of carbon dioxide (pCO2 delta) is a parameter than can be used to indicate tissue perfusion, and its determination therefore may be useful in these patients. METHODS: A qualitative systematic review of the literature was made, comprising studies that assessed pCO2 delta in adult patients with severe sepsis or septic shock, and published between January 1966 and November 2016 in the Medline-PubMed, Embase-Elsevier, Cochrane Library, and LILACS databases. There was no language restriction. The PRISMA statement was followed, and methodological quality was evaluated. RESULTS: Twelve articles were included, all of an observational nature, and including 10 prospective studies (9 published since 2010). Five documented greater mortality among patients with high pCO2 delta values, in 3 cases even when achieving venous oxygen saturation targets. In 4 studies, a high pCO2 delta was related to lower venous oxygen saturation and higher lactate levels, and another 3 documented lesser percentage lactate reductions. CONCLUSION: The parameter pCO2 delta has been more frequently assessed in the management of patients with severe sepsis during the last few years. The studies demonstrate its correlation to mortality and other clinical outcomes, defining pCO2 delta as a useful tool in the management of these patients.

Effect of FiO2 in the measurement of VO2 and VCO2 using the E-COXV metabolic monitor. / Efecto de la FiO2 sobre la medición del VO2 y la VCO2 con el monitor metabólico E-COVX.

OBJECTIVE: We evaluated the effect of changes in FiO2 on the bias and accuracy of the determination of oxygen consumption (V˙O2) and carbon dioxide production (V˙CO2) using the E-COVX monitor in patients with mechanical ventilation. DESIGN: Descriptive of concordance. SETTING: Intensive Care Unit. PATIENTS OR PARTICIPANTS: Patients with mechanical ventilation. INTERVENTIONS: We measured V˙O2 and V˙CO2 using the E-COVX monitor. Values recorded were the average in 5min. Two groups of 30 patients. We analyzed: 1) the reproducibility in the measurement of V˙O2 and V˙CO2 at FiO2 0.4, and 2) the effect of the changes in FiO2 on the measurement of V˙O2 and V˙CO2. Statistical analysis was performed using Bland and Altman test. VARIABLES OF MAIN INTEREST: Bias and accuracy. RESULTS: 1) FiO2 0.4 reproducibility: The bias in the measurement of V˙O2 and V˙CO2 was 1.6 and 2.1mL/min, respectively, and accuracy was 9.7 to -8.3% and 7.2 to -5.2%, respectively, and 2) effect of FiO2 on V˙O2: The bias of V˙O2 measured at FiO2 0.4 and 0.6 was -4.0mL/min and FiO2 0.4 and 0.8 was 5.2mL/min. Accuracy between FiO2 0.4 and 0.6 was 11.9 to -14.1%, and between FiO2 0.4 and 0.8 was 43.9 to -39.7%. CONCLUSIONS: The E-COVX monitor evaluates V˙O2 and V˙CO2 in critical patients with mechanical ventilation with a clinically acceptable accuracy until FiO2 0.6.

An assessment of adherence to basic ecological principles by payments for ecosystem service projects.

Programs and projects employing payments for ecosystem service (PES) interventions achieve their objectives by linking buyers and sellers of ecosystem services. Although PES projects are popular conservation and development interventions, little is known about their adherence to basic ecological principles. We conducted a quantitative assessment of the degree to which a global set of PES projects adhered to four ecological principles that are basic scientific considerations for any project focused on ecosystem management: collection of baseline data, identification of threats to an ecosystem service, monitoring, and attention to ecosystem dynamics or the formation of an adaptive management plan. We evaluated 118 PES projects in three markets-biodiversity, carbon, and water-compiled using websites of major conservation organizations; ecology, economic, and climate-change databases; and three scholarly databases (ISI Web of Knowledge, Web of Science, and Google Scholar). To assess adherence to ecological principles, we constructed two scientific indices (one additive [ASI] and one multiplicative [MSI]) based on our four ecological criteria and analyzed index scores by relevant project characteristics (e.g., sector, buyer, seller). Carbon-sector projects had higher ASI values (P < 0.05) than water-sector projects and marginally higher ASI scores (P < 0.1) than biodiversity-sector projects, demonstrating their greater adherence to ecological principles. Projects financed by public-private partnerships had significantly higher ASI values than projects financed by governments (P < 0.05) and marginally higher ASI values than those funded by private entities (P < 0.1). We did not detect differences in adherence to ecological principles based on the inclusion of cobenefits, the spatial extent of a project, or the size of a project's budget. These findings suggest, at this critical phase in the rapid growth of PES projects, that fundamental ecological principles should be considered more carefully in PES project design and implementation in an effort to ensure PES project viability and sustainability.

Synergies and trade-offs in achieving global biodiversity targets.

After their failure to achieve a significant reduction in the global rate of biodiversity loss by 2010, world governments adopted 20 new ambitious Aichi biodiversity targets to be met by 2020. Efforts to achieve one particular target can contribute to achieving others, but different targets may sometimes require conflicting solutions. Consequently, lack of strategic thinking might result, once again, in a failure to achieve global commitments to biodiversity conservation. We illustrate this dilemma by focusing on Aichi Target 11. This target requires an expansion of terrestrial protected area coverage, which could also contribute to reducing the loss of natural habitats (Target 5), reducing human-induced species decline and extinction (Target 12), and maintaining global carbon stocks (Target 15). We considered the potential impact of expanding protected areas to mitigate global deforestation and the consequences for the distribution of suitable habitat for >10,000 species of forest vertebrates (amphibians, birds, and mammals). We first identified places where deforestation might have the highest impact on remaining forests and then identified places where deforestation might have the highest impact on forest vertebrates (considering aggregate suitable habitat for species). Expanding protected areas toward locations with the highest deforestation rates (Target 5) or the highest potential loss of aggregate species' suitable habitat (Target 12) resulted in partially different protected area network configurations (overlapping with each other by about 73%). Moreover, the latter approach contributed to safeguarding about 30% more global carbon stocks than the former. Further investigation of synergies and trade-offs between targets would shed light on these and other complex interactions, such as the interaction between reducing overexploitation of natural resources (Targets 6, 7), controlling invasive alien species (Target 9), and preventing extinctions of native species (Target 12). Synergies between targets must be identified and secured soon and trade-offs must be minimized before the options for co-benefits are reduced by human pressures.

Extracorporeal CO2 removal: Technical and physiological fundaments and principal indications.

In recent years, technological improvements have reduced the complexity of extracorporeal membrane oxygenation devices. This have enabled the development of specific devices for the extracorporeal removal of CO2. These devices have a simpler configuration than extracorporeal membrane oxygenation devices and uses lower blood flows which could reduce the potential complications. Experimental studies have demonstrated the feasibility, efficacy and safety of extracorporeal removal of CO2 and some of its effects in humans. This technique was initially conceived as an adjunct therapy in patients with severe acute respiratory distress syndrome, as a tool to optimize protective ventilation. More recently, the use of this technique has allowed the emergence of a relatively new concept called "tra-protective ventilation"whose effects are still to be determined. In addition, the extracorporeal removal of CO2 has been used in patients with exacerbated hypercapnic respiratory failure with promising results. In this review we will describe the physiological and technical fundamentals of this therapy and its variants as well as an overview of the available clinical evidence, focused on its current potential.

Examining the uncertain origin and management role of martens on Prince of Wales Island, Alaska.

Conservation biologists are generally united in efforts to curtail the spread of non-native species globally. However, the colonization history of a species is not always certain, and whether a species is considered non-native or native depends on the conservation benchmark. Such ambiguities have led to inconsistent management. Within the Tongass National Forest of Alaska, the status of American marten (Martes americana) on the largest, most biologically diverse and deforested island, Prince of Wales (POW), is unclear. Ten martens were released to POW in the early 1930s, and it was generally believed to be the founding event, although this has been questioned. The uncertainty surrounding when and how martens colonized POW complicates management, especially because martens were selected as a design species for the Tongass. To explore the history of martens of POW we reviewed other plausible routes of colonization; genetically and isotopically analyzed putative marten fossils deposited in the late Pleistocene and early Holocene to verify marten occupancy of POW; and used contemporary genetic data from martens on POW and the mainland in coalescent simulations to identify the probable source of the present-day marten population on POW. We found evidence for multiple routes of colonization by forest-associated mammals beginning in the Holocene, which were likely used by American martens to naturally colonize POW. Although we cannot rule out human-assisted movement of martens by Alaskan Natives or fur trappers, we suggest that martens be managed for persistence on POW. More generally, our findings illustrate the difficulty of labeling species as non-native or native, even when genetic and paleo-ecological data are available, and support the notion that community resilience or species invasiveness should be prioritized when making management decisions rather than more subjective and less certain conservation benchmarks.

Selecting cost-effective areas for restoration of ecosystem services.

Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services.

[The diet low in fermentable carbohydrates short chain and polyols improves symptoms in patients with functional gastrointestinal disorders in Spain]. / La dieta con bajo contenido en hidratos de carbono de cadena corta y polioles fermentables mejora los síntomas en pacientes con trastornos funcionales gastrointestinales en España.

BACKGROUND AND AIMS: Successful treatment of patients with irritable bowel syndrome (IBS) often remains elusive. Recent studies in Australia, the United Kingdom and New Zealand have suggested the efficacy of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) in the management of these patients. The aims of this study were to determine whether a diet low in FODMAPs improves symptoms in patients with functional gastrointestinal disorders (FGID) in Spain and to analyze the predictors of a good response. PATIENTS AND METHODS: A prospective study was carried out in consecutive patients with FGID type IBS and functioanl abdominal bloating. At inclusion all patients underwent an assessment through a baseline demographic questionnaire of symptoms of anxiety and depression and quality of life. A hydrogen breath test with lactose and fructose was performed and a low FODMAPs diet was indicated for 2 months by expert dietitians. These tests were taken as a reference. A positive response was defined as an improvement of at least 5 points out of a possible 10 in the symptom questionnaire. RESULTS: We included 30 patients (24 women, 39 [12] years). The response to the low FODMAPs diet was positive in controlling overall symptoms and specific symptoms such as functioanl abdominal bloating, abdominal pain, diarrhea, flatulence, nausea and fatigue in more than 70% of patients (P<.05). By contrast, constipation was controlled in only 48% of patients (P>.05). Adherence to the diet was good in 87% of patients and was a predictor of positive response in the univariate analysis. CONCLUSIONS: A diet low in FODMAPs is associated with symptom improvement in patients with IBS and functioanl abdominal bloating. Adherence to the diet was a determining factor.

Effects of invasive cordgrass on presence of Marsh Grassbird in an area where it is not native.

The threatened Marsh Grassbird (Locustella pryeri) first appeared in the salt marsh in east China after the salt marsh was invaded by cordgrass (Spartina alterniflora), a non-native invasive species. To understand the dependence of non-native Marsh Grassbird on the non-native cordgrass, we quantified habitat use, food source, and reproductive success of the Marsh Grassbird at the Chongming Dongtan (CMDT) salt marsh. In the breeding season, we used point counts and radio-tracking to determine habitat use by Marsh Grassbirds. We analyzed basal food sources of the Marsh Grassbirds by comparing the δ(13) C isotope signatures of feather and fecal samples of birds with those of local plants. We monitored the nests through the breeding season and determined the breeding success of the Marsh Grassbirds at CMDT. Density of Marsh Grassbirds was higher where cordgrass occurred than in areas of native reed (Phragmites australis) monoculture. The breeding territory of the Marsh Grassbird was composed mainly of cordgrass stands, and nests were built exclusively against cordgrass stems. Cordgrass was the major primary producer at the base of the Marsh Grassbird food chain. Breeding success of the Marsh Grassbird at CMDT was similar to breeding success within its native range. Our results suggest non-native cordgrass provides essential habitat and food for breeding Marsh Grassbirds at CMDT and that the increase in Marsh Grassbird abundance may reflect the rapid spread of cordgrass in the coastal regions of east China. Our study provides an example of how a primary invader (i.e., cordgrass) can alter an ecosystem and thus facilitate colonization by a second non-native species.

Avoiding re-inventing the wheel in a people-centered approach to REDD+.

One important debate regarding Reducing Emissions from Deforestation and Forest Degradation (REDD+) in developing countries concerns the manner in which its implementation might affect local and indigenous communities. New ways to implement this mechanism without harming the interests of local communities are emerging. To inform this debate, we conducted a qualitative research synthesis to identify best practices (BPs) from people-centered approaches to conservation and rural development, developed indicators of BPs, and invited development practitioners and researchers in the field to assess how the identified BPs are being adopted by community-level REDD+ projects in Latin America. BPs included: local participation in all phases of the project; project supported by a decentralized forest governance framework; project objectives matching community livelihood priorities; project addressing community development needs and expectations; project enhancing stakeholder collaboration and consensus building; project applying an adaptive management approach; and project developing national and local capacities. Most of the BPs were part of the evaluated projects. However, limitations of some of the projects related to decentralized forest governance, matching project objectives with community livelihood priorities, and addressing community development needs. Adaptive management and free and prior informed consent have been largely overlooked. These limitations could be addressed by integrating conservation outcomes and alternative livelihoods into longer-term community development goals, testing nested forest governance approaches in which national policies support local institutions for forest management, gaining a better understanding of the factors that will make REDD+ more acceptable to local communities, and applying an adaptive management approach that allows for social learning and capacity building of relevant stakeholders. Our study provides a framework of BPs and indicators that could be used by stakeholders to improve REDD+ project design, monitoring, and evaluation, which may help reconcile national initiatives and local interests without reinventing the wheel.

Dietary intake in individuals with phenylketonuria: an integrative review.

Introduction: Introduction: the dietary intake of individuals with phenylketonuria (PKU) may vary widely according to different cultural eating habits, lifestyle, access to multidisciplinary team, and metabolic formulas available. Thus, knowing the dietary intake of this population makes it possible to tailor nutritional treatment strategies to impact their health. Objective: to analyze the evidence on the dietary intake of individuals with PKU. Methods: an integrative literature review was conducted on the dietary intake of individuals with PKU in the databases PUBMED, BIREME and Science Direct. Original articles that addressed the energy and macronutrient food intake of children, adolescents and/or adults with PKU were included in the study, without time restriction, in any language. A total of 384 articles were found and 27 articles were selected and analyzed. Results: evidence about the nutritional composition of their diet showed that individuals with PKU consume between 1160-2721 kcal of energy -7.2-17.4 % (32.4-76.9 g) of energy as protein, 45.9-69.2 % of energy as carbohydrates, 16.6-39 % of energy as lipids- and between 7.6 and 20 g of fiber. Conclusion: most individuals with PKU have low energy, protein and fiber intake, adequate lipid intake, and high carbohydrate intake. Metabolic control of the disease is still a challenge in all countries. Nutritional strategies to improve dietary nutritional composition and phenylalanine blood levels in individuals with PKU remain an urgent issue.

Introducción: Introducción: la ingesta dietética de los individuos con fenilcetonuria (PKU) puede variar ampliamente debido a los diferentes hábitos culturales de alimentación, el estilo de vida, el acceso al equipo multidisciplinar y las fórmulas metabólicas disponibles. Por ello, conocer la ingesta dietética de esta población permite adaptar las estrategias de tratamiento nutricional para incidir en su salud. Objetivo: analizar la evidencia sobre la ingesta dietética de individuos con PKU. Métodos: se realizó una revisión bibliográfica integradora sobre la ingesta dietética de las personas con PKU en las bases de datos PUBMED, BIREME y Science Direct. El estudio incluyó artículos originales que abordaran la ingesta alimentaria de energía y macronutrientes de niños, adolescentes y/o adultos con PKU, sin restricción de tiempo, en cualquier idioma. Se encontraron 384 artículos y se seleccionaron y analizaron 27. Resultados: la evidencia de la composición nutricional de la dieta mostró que los individuos con PKU consumen entre 1160 y 2721 kcal de energía ­7,2-17,4 % (32,4-76,9 g) de la energía en forma de proteínas, 45,9-69,2 % de la energía en carbohidratos, 16,6-39 % de la energía en lípidos­ y entre 7,6 y 20 g de fibra. Conclusiones: la mayoría de los individuos con PKU tienen una ingesta baja de energía, proteínas y fibra, una ingesta adecuada de lípidos y una ingesta alta de hidratos de carbono. El control metabólico de la enfermedad sigue siendo un reto en todos los países. Siguen siendo urgentes las estrategias nutricionales para mejorar la composición nutricional de la dieta y los niveles de fenilalanina en sangre de los individuos con PKU.