Spatial and temporal deforestation dynamics in protected and unprotected dry forests: a case study from Myanmar (Burma)

Tropical dry forests are more threatened, less protected and especially susceptible to deforestation. However, most deforestation research focuses on tropical rain forests. We analyzed spatial and temporal changes in land cover from 1972 through 2005 at Chatthin Wildlife Sanctuary (CWS), a tropical dry forest in Myanmar (Burma). CWS is one of the largest protected patches of tropical dry forest in Southeast Asia and supports over half the remaining wild population of the endangered Eld’s deer. Between 1973 and 2005, 62% of forest was lost at an annual rate of 1.86% in the area, while forest loss inside CWS was only 16% (0.45% annually). Based on trends found during our study period, dry forests outside CWS would not persist beyond 2019, while forests inside CWS would persist for at least another 100 years. Analysis of temporal deforestation patterns indicates the highest rate of loss occurred between 1992 and 2001. Conversion to agriculture, shifting agriculture, and flooding from a hydro-electric development were the main deforestation drivers. Fragmentation was also severe, halving the area of suitable Eld’s deer habitat between 1973 and 2001, and increasing its isolation. CWS protection efforts were effective in reducing deforestation rates, although deforestation effects extended up to 2 km into the sanctuary. Establishing new protected areas for dry forests and finding ways to mitigate human impacts on existing forests are both needed to protect remaining dry forests and the species they support.     

Multifactorial approach and superior treatment efficacy in renal patients with the aid of nurse practitioners. Design of The MASTERPLAN Study [ISRCTN73187232]

Background

Patients with chronic kidney disease (CKD) are at a greatly increased risk of developing cardiovascular disease. Recently developed guidelines address multiple risk factors and life-style interventions. However, in current practice few patients reach their targets. A multifactorial approach with the aid of nurse practitioners was effective in achieving treatment goals and reducing vascular events in patients with diabetes mellitus and in patients with heart failure. We propose that this also holds for the CKD population.

Design

MASTERPLAN is a multicenter randomized controlled clinical trial designed to evaluate whether a multifactorial approach with the aid of nurse-practicioners reduces cardiovascular risk in patients with CKD. Approximately 800 patients with a creatinine clearance (estimated by Cockcroft-Gault) between 20 to 70 ml/min, will be included. To all patients the same set of guidelines will be applied and specific cardioprotective medication will be prescribed. In the intervention group the nurse practitioner will provide lifestyle advice and actively address treatment goals. Follow-up will be five years. Primary endpoint is the composite of myocardial infarction, stroke and cardiovascular mortality. Secondary endpoints are cardiovascular morbidity, overall mortality, decline of renal function, change in markers of vascular damage and change in quality of life. Enrollment has started in April 2004 and the study is on track with 700 patients included on October 15th, 2005. This article describes the design of the MASTERPLAN study.     

Guidelines for indications for coronary revascularization in The Netherlands

In 1996 the Minister of Public Health, Welfare and Sports in The Netherlands published a 'Planning Decree Special Interventions in the Heart'. She requested from the professional organizations guidelines for the indications for interventions in the heart. A working group was formed with representatives from the Dutch professional organizations for cardiology and thoracic surgery, to address this issue for patients with coronary artery disease. The working group confirmed the need to discuss all patients who are considered for either elective or emergency revascularization during a multidisciplinary consultation in (or with) one of the specialized Dutch hospitals. During this meeting of the 'heart team', at least one interventional cardiologist and one thoracic surgeon should be present. There are three possible outcomes of the heart team's consultations for each patient: drug therapy only ('conservative management'), coronary surgery or catheter intervention. For each case, the team should indicate the expected benefit, the risk of the intervention, the urgency and the estimated waiting time. The guidelines presented in this paper address these issues for three patient categories: stable angina pectoris, unstable angina pectoris and acute myocardial infarction.     

Bacterial swimming strategies and turbulence

Most bacteria in the ocean can be motile. Chemotaxis allows bacteria to detect nutrient gradients, and hence motility is believed to serve as a method of approaching sources of food. This picture is well established in a stagnant environment. In the ocean a shear microenvironment is associated with turbulence. This shear flow prevents clustering of bacteria around local nutrient sources if they swim in the commonly assumed "run-and-tumble" strategy. Recent observations, however, indicate a "back-and-forth" swimming behavior for marine bacteria. In a theoretical study we compare the two bacterial swimming strategies in a realistic ocean environment. The "back-and-forth" strategy is found to enable the bacteria to stay close to a nutrient source even under high shear. Furthermore, rotational diffusion driven by thermal noise can significantly enhance the efficiency of this strategy. The superiority of the "back-and-forth" strategy suggests that bacterial motility has a control function rather than an approach function under turbulent conditions.     

Non-toxigenic Clostridium sordellii: clinical and microbiological features of a case of cholangitis-associated bacteremia

Toxigenic Clostridium sordellii strains are increasingly recognized to cause highly lethal infections in humans that are typified by a toxic shock syndrome (TSS). Two glucosylating toxins, lethal toxin (TcsL) and hemorrhagic toxin (TcsH) are believed to be important in the pathogenesis of TSS. While non-toxigenic strains of C. sordellii demonstrate reduced cytotoxicity in vitro and lower virulence in animal models of infection, there are few data regarding their behavior in humans. Here we report a non-TSS C. sordellii infection in the context of a polymicrobial bacterial cholangitis. The C. sordellii strain associated with this infection did not carry either the TcsL-encoding tcsL gene or the tcsH gene for TcsH. In addition, the strain was neither cytotoxic in vitro nor lethal in a murine sepsis model. These results provide additional correlative evidence that TcsL and TcsH increase the risk of mortality during C. sordellii infections.     

Conservation status of Asian elephants: the influence of habitat and governance

Understanding the drivers of Asian elephant (Elephas maximus) abundance and distribution is critical for effective elephant conservation, yet no such analysis exists despite decades of assessments and planning. We explored the influence of habitat- and governance-related drivers on elephant abundance across the 13 Asian elephant range countries. We tested competing statistical models by integrating a binary index of elephant abundance (IEA) derived from expert knowledge with different predictor variables including habitat, human population, socioeconomics, and governance data. We employed logistic regression and model-averaging techniques based on Akaike’s Information Criterion to identify the best-performing subset among our 12 candidate models and used the model-averaged results to predict IEA in other areas in Asia where elephant population status is currently unknown. Forest area was our strongest single predictor variable. The best performing model, however, featured a combination of habitat and governance variables including forest area, level of corruption, proportional mix of forest and agriculture, and total agricultural area. Our predictive model identified five areas with medium–high to high probability to have populations with >150 elephants, which we believe should be surveyed to assess their status. Asian elephants persist in areas that are dominated by forest but also seem to benefit from a mix of agricultural activities. A relatively low level of corruption is also important and we conclude that effective governance is essential for maintaining Asian elephant populations. Asian elephant populations cannot be maintained solely in protected areas but need well-managed, mixed-use landscapes where people and elephants coexist.