Identifying governance strategies that effectively support ecosystem services, resource sustainability, and biodiversity.

Conservation scientists, national governments, and international conservation groups seek to devise, and implement, governance strategies that mitigate human impact on the environment. However, few studies to date have systematically investigated the performance of different systems of governance in achieving successful conservation outcomes. Here, we use a newly-developed analytic framework to conduct analyses of a suite of case studies, linking different governance strategies to standardized scores for delivering ecosystem services, achieving sustainable use of natural resources, and conserving biodiversity, at both local and international levels. Our results: (i) confirm the benefits of adaptive management; and (ii) reveal strong associations for the role of leadership. Our work provides a critical step toward implementing empirically justified governance strategies that are capable of improving the management of human-altered environments, with benefits for both biodiversity and people.

[Pulmonary hypertension in left heart disease: how to define it and how to manage it in 2013?]. / Hypertension pulmonaire associée aux maladies du coeur gauche: quelle définition et quelle prise en charge en 2013?

Pulmonary hypertension is a frequent complication of left heart disease arising from a wide range of cardiac disorders and is associated with poor prognosis. Its pathophysiology is complex with both passive mechanisms of elevated filling pressures in left cavities and occasionally reactive mechanisms of arterial vasoconstriction and remodelling to interplay. This stage, called <> pulmonary hypertension, further worsens the heart failure patients' prognosis but is still a matter of debate concerning the criteria to apply for its diagnosis and concerning the best way to manage it. This article gives an overview of the importance and pathophysiology of pulmonary hypertension associated with left heart disease, and discusses the challenges associated with its diagnosis and treatment.

Comparison of single and split-dose flubendazole treatment for the nematode parasite Trichostrongylus tenuis in experimentally infected grey partridges Perdix perdix.

Different therapeutic regimes using flubendazole for the treatment of Trichostrongylus tenuis infection in experimentally infected grey partridges Perdix perdix were examined. Flubendazole dosages of 4, 8 and 20 mg/kg were administered orally as a single dose or split into 3 or 9 parts given over 9 days. The efficacy against adult worms in the caeca improved with dose rate. Split doses were at least as effective as single doses, which removed up to 83% of adult T. tenuis. A dose of 20 mg/kg administered on a daily basis over 3 or 9 days gave the best clearance of T. tenuis, resulting in a reduction of at least 95% in worm burden.

[Preoperative cardiac assessment before non-cardiac surgery: cardiac risk stratification]. / Evaluation cardiologique préopératoire avant chirurgie non cardiaque: stratification du risque cardiovasculaire.

Perioperative cardiac events occurring in patients undergoing non-cardiac surgery are a common cause of morbidity and mortality. Current guidelines recommend an individualized approach to preoperative cardiac risk stratification prior to non-cardiac surgery, integrating risk factors both for the patient (active cardiac conditions, clinical risk factors, functional capacity) and for the planned surgery. Preoperative cardiac investigations are currently limited to high-risk patients in whom they may contribute to modify the perioperative management. A multidisciplinary approach to such patients, integrating the general practitioner, is recommended in order to define an individualized peri-operative strategy.

[Pulmonary hypertension: difficult diagnosis and role of echocardiography]. / Hypertension pulmonaire: difficulté diagnostique et intérêt de l'échocardiographie.

Pulmonary hypertension (PH) is a complex disease leading, in its advance form, to a decreased quality of life and early mortality. In the early stage, non specific signs and symptoms are the rule. The diagnosis is often missed, leaving the patient alone to face the disease and its repercussion on his daily life. This article reviews the main PH causes and predisposing conditions. Signs and symptoms suggesting the diagnosis are reviewed as well as conditions recognised at high risk for the disease. The key role of echocardiography in establishing the diagnosis, assessing PH severity, cardiac repercussions and/or potential aetiologies, is addressed. Finally the importance of a multidisciplinary approach is recommended.

Stroke recurrence in patients with patent foramen ovale: the Lausanne Study. Lausanne Stroke with Paradoxal Embolism Study Group.

Patent foramen ovale (PFO) is more common in patients with stroke than in matched controls, but the stroke mechanism and late prognosis are not well known. We studied features, coexisting causes, and recurrences of stroke in 140 consecutive patients (mean age 44 +/- 14 years) with stroke and PFO admitted to a population-based primary-care center. We selected the patients from 340 patients (41%) aged < or = 60 years with acute stroke. The initial event was brain infarction in 118 patients (84%) and TIA in 22 (16%). Intracranial embolic occlusions were present on angiography or transcranial Doppler in most patients admitted within 12 hours of onset, whereas a venous source was clinically apparent in only six patients (5.5%). Pulmonary embolism, Valsalva maneuver at onset, and coagulation abnormalities were rare, but one-fourth of the patients had an interatrial septum aneurysm (ISA) that coexisted with PFO. An alternative cause of stroke was present in only 22 patients (16%), usually cardiac (atrial fibrillation, severe mitral valve prolapse, akinetic left ventricular segment). During a mean follow-up of 3 years, the stroke or death rate was 2.4% per year, but only eight patients had a recurrent infarct (1.9% per year). This low rate of recurrence contrasted with the severity of initial stroke, which left disabling sequelae in one-half the patients. Multivariate analysis showed that interatrial communication, a history of recent migraine, posterior cerebral artery territory infarct, and a coexisting cause of stroke were associated with recurrence, whereas ISA and treatment type (coagulant or antiaggregant therapy, surgical closure of PFO) were not. However, given the low number of events, these findings must be taken with caution. In conclusion, our study shows that stroke associated with PFO with or without ISA is not commonly due to a coexisting cause of stroke. It is usually embolic, although a definite source cannot often be demonstrated. The presenting stroke is often severe, but recurrence is uncommon. The demonstration of factors associated with a higher risk of recurrence in subgroups of patients is critical for the long-term management of these patients.

Prognosis after stroke followed by surgical closure of patent foramen ovale: a prospective follow-up study with brain MRI and simultaneous transesophageal and transcranial Doppler ultrasound.

BACKGROUND: The risk of stroke and the long-term prognosis of recurrent strokes in young patients with patent foramen ovale (PFO) are not well known. For this reason, the treatment of these patients remains empirical. An alternative treatment to prolonged antithrombotic therapy may be surgical closure of the PFO. METHODS: Thirty patients (20 men and 10 women) with stroke and PFO were prospectively selected among 138 patients with stroke and PFO for a study of surgical closure of PFO at our center. Eligible patients were < 60 years old, had negative results of a systematic search for another cause of stroke (first criterion), and met two of the four following criteria: (1) recurrent clinical cerebrovascular events or multiple ischemic lesions on brain MR, (2) PFO associated with an atrial septal aneurysm, (3) > 50 microbubbles counted in the left atrium on contrast transesophageal echocardiography (TEE), and (4) Valsalva maneuver or cough preceding the stroke. Patients selected in this manner for surgery were considered to be a subgroup with a higher risk of stroke recurrence. RESULTS: All patients had a direct suture of PFO while under cardiopulmonary bypass without recorded early or delayed significant complication. All patients underwent a new brain MRI and TEE simultaneous with transcranial Doppler ultrasonography after contrast injection at 8 +/- 3 months after surgery. After a mean follow-up of 2 years without antithrombotic treatment, no recurrent cerebrovascular event (stroke or transient ischemic attack [TIA]) and no new lesion on MRI had developed. Postoperative contrast TEE and transcranial Doppler ultrasonography showed that two patients had residual interatrial right-to-left shunting, although much smaller than before surgery, associated with single versus double continuous suture. CONCLUSIONS: Our study of 30 selected stroke patients with surgical suture of PFO showed a stroke recurrence rate of 0% and no significant complication. Residual right-to-left shunting may be avoided by double continuous suture of the PFO. In the absence of controlled studies to guide individual therapeutic decisions, our findings show that PFO closure can be done safely and may be considered to avoid recurrence in selected patients with long life expectancy and presumed paradoxic embolism.

Usefulness of the echocardiographic velocity ratio for detection of significant aortic stenosis.

In this study, which included 56 patients with aortic stenosis, the predictive value of the fractional shortening velocity ratio was evaluated. This Doppler index allowed detection of significant aortic stenosis (0.53 cm2/m2), with a positive predictive value of 93% and a negative predictive value of 92% for a cutoff value of 0.8.

Determination of right ventricular volume by two-dimensional echocardiography with a crescentic model.

Right ventricular volume in 14 fixed hearts from dogs was determined by echocardiography with an algorithm that takes into consideration the crescentic shape of the right ventricular (RV) cross-sectional area. To validate this model the volumes obtained by echocardiography were compared with volumes obtained by water displacement of silicone casts of the same 14 hearts. A strong linear correlation was demonstrated between the echocardiographic volumes and the volumes obtained by water displacement of RV casts (r = 0.96). The results also showed that the echocardiographic volume determination underestimated the RV volume obtained from cast with an almost constant ratio averaging 0.755 as a result of the exclusion of the RV outflow tract volume from the echocardiographic model. We conclude that a crescentic model allows accurate echocardiographic determination of RV volume.

Ventricular interdependence during Valsalva maneuver as seen by two-dimensional echocardiography: new insights about an old method.

Two-dimensional echocardiography was used in 15 normal volunteers to assess left (LV) and right ventricular (RV) responses, as well as their interdependence, during the Valsalva maneuver. During the strain phase, LV and RV areas decreased progressively, the RV area decreasing more than the LV area. Immediately after strain release, the RV end-diastolic area increased suddenly and dramatically to 143.3% +/- 9.4% of its baseline value, whereas the LV end-diastolic area decreased further. This transiently overloaded right ventricle and associated septal shift changed LV shape and further reduced the LV cross-sectional area. Thus the resulting momentary drop in the stroke LV area may contribute, along with pulmonary blood pooling, to the abrupt systemic blood pressure drop characteristic of phase III seen in normal subjects. Real-time imaging with echocardiography during respiratory maneuvers is feasible for clinical use. Its application in patients with congestive heart failure might bring further understanding of LV and RV interrelationships in the failing heart.

The estimation of density dependence using census data from several sites.

The discussion of density dependence in the ecological literature has tended to concentrate on significance testing, whereas estimation is often of more importance. In this paper we use simulation to investigate the bias and precision of a number of methods for estimating density dependence using census data from several sites. The estimation methods examined were a modification of an existing maximum likelihood approach, a regression method, and a new approach using restricted (or residual) maximum likelihood (REML). Simulations indicated that the REML method produced the most accurate estimates, with negligible bias for most parameter combinations. A further advantage of the REML method is that it can be easily implemented using standard statistical software. Using a second series of simulations we investigated the relationship between accuracy of estimation and sample size for the REML method. The results indicated that using more than one site gave substantial improvement in accuracy, but that using more than five sites gave little further improvement unless in excess of 10 years of data were available for each site. Where a standard error is required for the density dependence estimate we suggest using bootstrapping at the site level. Where this is not possible, a parametric bootstrap or a randomisation test may be used instead. The REML method is demonstrated using bag totals of red-legged partridges Alectoris rufa and grey partridges Perdix perdix for shoots on estates in East Anglia in the United Kingdom. This paper shows that combining information from several sites can give improved estimation of density dependence, particularly if REML estimation is adopted.

[Echocardiographic discoveries in 102 patients with vascular cerebral accidents]. / Découvertes échocardiographiques chez 102 patients atteints d'accident vasculaire.

The causes of vascular ischaemic accidents are numerous, and when the brain is involved management is limited to the prevention of similar events. Since cardiac sources of embolism potentially curable, we have prospectively analyzed the results of cardiovascular examinations (including ECG and radiography of the chest) and of echocardiography in 102 patients with cerebral or peripheral vascular ischaemic event in order to determine the impact of echocardiography and the influence of different diagnoses on the need for anticoagulant therapy. Intracardiac thrombi, mitral stenosis, dilated cardiomyopathy, severe left ventricular dysfunction with or without aneurysm and cardiac valve vegetations were regarded as diseases carrying a high risk of embolism, the low risk diseases being mitral valve prolapse, mitral annulus calcification and isolated left atrial dilatation. Atrial fibrillation was treated separately, as it may be associated with several of the diseases listed above. We found 14 diseases with a high risk of embolism (14 p. 100) and 35 diseases with a low risk of embolism (34 p. 100). 10/91 patients with cerebral vascular accident (11 p. 100) and 4/11 patients with peripheral vascular accident presented with a heart disease carrying a high risk of embolism. The most common heart disease with a high risk of embolism (10/14, 71 p. 100) was severe left ventricular dysfunction secondary to a coronary disease or a dilated cardiomyopathy. We did not find more cases of mitral valve prolapse or mitral annulus calcification than in the normal population. 20/29 patients with normal cardiac examination had a normal echocardiogram. The anticoagulant treatment was modified after echocardiography in only one case.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute pulmonary edema in the post partum and cor triatriatum sinistrum.

A case is described of an apparently healthy young woman in her first pregnancy who presented with acute pulmonary edema in the early postpartum period in the context of mild pregnancy-induced hypertension. After quick improvement in her condition, a Doppler followed by a transesophageal study revealed a left atrial septation with a small atrial septal defect secundum type and moderate mitral regurgitation strongly suggestive of a cor triatriatum sinistrum.

Infectious agents associated with respiratory disease in pheasants.

In a case-control study of the infectious agents associated with natural outbreaks of respiratory disease in pheasants, 28 batches of birds from sites affected by disease and eight batches of birds from unaffected sites were examined by six veterinary laboratories in England, Wales and Scotland, and tested for mycoplasmas, other bacteria and viruses. Sinusitis was the commonest sign of disease and was associated with Mycoplasma gallisepticum as detected by PCR in the trachea (P < 0.05) and conjunctiva (P < 0.01). Sinusitis was also associated with pasteurella cultured from the sinus (P < 0.05), antibody to avian pneumovirus (APV) (P < 0.01) and avian coronaviruses as detected by reverse-transcriptase PCR (P < 0.05); there was no association between disease and APV as detected by PCR. Avian coronaviruses were the most common infectious agents detected. They were genetically close to infectious bronchitis virus (IBV) but differed in their gene sequence from all the serotypes of IBV previously identified in domestic fowl, and serological tests with six known IBV types showed little cross reactivity. Mycoplasma species other than M gallisepticum were cultured in 18 batches of pheasants but, with the exception of Mycoplasma gallinaceum, were not associated with disease.

[Cardiac pacing in obstructive hypertrophic cardiomyopathies]. / L'apport de la stimulation cardiaque dans les cardiomyopathies hypertrophiques obstructives.

Up until recently, the first-line treatment of obstructive hypertrophic cardiomyopathy was pharmacological and surgical in refractory cases. However, the immediate beneficial effect of a cardiac pacing on infra-aortic obstruction has been known for many years. The development of sophisticated two-chamber pacemakers and their use in patients with obstructive hypertrophic cardiomyopathy has confirmed their beneficial effect both in terms of haemodynamic and clinical parameters. There appears to be many reasons for this advantageous effect and only some of them have been elucidated, including alteration of the activation sequence of the left ventricle secondary to apical ectopic electrical activation and reduction of the contact time of the mitral valve with the proximal septum and, in the long term, ventricular remodelling secondary to release of the outflow obstruction. The increasing number of publications reporting a beneficial effect of two-chamber pacemakers in these patients justifies consideration of this approach in all patients refractory to drug therapy.

Complete Carbonylation of fac-

The rate constant of ligand exchange on the complex fac-[(99)Tc(H(2)O)(3)(CO)(3)](+) was determined by means of (13)C, (17)O, and (99)Tc NMR spectroscopy under pressurized conditions in aqueous media. After keeping the sample under CO pressure for an extended period, the formation of [(99)Tc(CO)(6)](+) could unambiguously be detected in the (13)C and (99)Tc NMR spectra.

Estimating the proportion of uncatchable animals in a population by double-sampling.

Estimates of population size obtained by capture-recapture methods refer solely to the catchable portion of a population. Given a population containing marked animals, two closed-form maximum likelihood estimators of the proportion of uncatchable animals are presented. They are based on twice sampling the proportion of marked animals in the population: the first sample is drawn from catchable animals only, the second from mixed catchable and uncatchable animals. If the individuals in the first sample are not available to the second sample, both samples must be taken from a representative subpopulation of known size. The quantities required may be obtained during a standard capture-recapture session, provided the sampling methods meet the relevant assumptions; the ensuing estimate of population size can then be corrected for uncatchability. The technique is illustrated for eider ducks, using data from Coulson (1984, Ibis 126, 525-543).

[Cardiac pacemaker for the treatment of obstructive hypertrophic cardiomyopathy, a concept which is gaining ground]. / Le stimulateur cardiaque pour le traitement de la cardiomyopathie hypertrophique obstructive, un concept qui avance.

Pacing reduces the sub-aortic pressure gradient in hypertrophic obstructive cardiomyopathy. This phenomenon was described long ago but only recently, with the development of sophisticated pacemakers, has it become possible to use pacemakers for the long term treatment of this disease. The acute hemodynamic improvement with pacemaker treatment is well documented. The reason for this acute and chronic improvement is of multiple origin. Pacing modulates the activation sequence of the left ventricle, reduces contractility, reduces subaortic flow velocities, influences mitral valve movement and leads to remodeling of the ventricle in the long term. All these factors together explain the clinical and hemodynamic improvement in patients suffering from hypertrophic obstructive cardiomyopathy.

A mathematical model of the right ventricular muscle geometry and mass.

An understanding of the geometry of the right ventricular (RV) free wall is imperative for both modelling its mechanics and assessing its mass by imaging techniques such as echocardiography. In this paper, a new model of the RV free wall geometry is discussed in which the wall is assumed to have a parabolic long-axis and a circular short-axis curvature respectively. By use of analytic geometry, mathematical expressions for RV surface area, volume and mass were derived. In vitro model validation was carried out in the following manner: (1) echocardiographic images of 16 isolated calf hearts were obtained; (2) measurements were made from the images to determine the parameters required by the model; (3) wall mass was determined by use of these parameters; and (4) the calculated wall mass was then compared with actual RV wall mass (determined by weighting). The model was found to be very accurate for determination of RV free wall mass (R = 0.92); it should prove useful in the study of the stress-strain relationships for the RV and for precise quantitative assessment of RV free wall mass.

Recurrent cardioembolic stroke related to late dislodgement of a right atrial pacing lead into the left atrium.

A 76-year-old woman had a permanent transvenous DDDR pacemaker implanted for complete atrioventricular block. She was hospitalized 4 years later for recurrent transient ischaemic attacks related to dislodgment of the atrial lead into the left atrium through a patent foramen ovale. The patient was successfuly treated by transvenous extraction of the atrial lead. The follow-up has been uneventful 12 months after the procedure. Left atrially dislodged pacemaker leads have to be retracted under full anticoagulation.