Twenty actions for a “good Anthropocene”—perspectives from early-career conservation professionals

Humans are now recognized as the main drivers of environmental change, leaving the future of our planet dependent on human action or inaction. Although the outlook of our planet is often depicted in a “doom and gloom” manner due to recent troubling environmental trends, we suggest that a “good Anthropocene” (in which human quality of life may be maintained or improved without cost to the environment) is attainable if we engage in adaptive, multi-disciplinary actions capable of addressing the socio-ecological issues of today and tomorrow. Early-career conservation scientists and practitioners have an unmatched understanding of novel technologies and social connectivity and, as those left with the ever-growing responsibility to be the problem solvers of the attributed increasing environmental consequences of living in the Anthropocene, their perspectives on steps towards a good Anthropocene are valuable. Here we present a list of 20 actions derived by early-career conservation scientists and practitioners for conservationists to help achieve a good Anthropocene that utilize the social connectivity and technology of today. Central to these actions are the notions that multi-, inter-, and trans-disciplinary collaboratives that embrace diverse world views need to be integrated into decision-making processes; training and outreach platforms need to communicate both environmental challenges and solutions broadly; and conservation successes need to be acknowledged and disseminated in a forward-looking, adaptive capacity. Together the 20 actions identified here reinforce the underlying paradigm shift that must accompany living in the Anthropocene, given that biodiversity and healthy ecosystems are requisite for sustained human life. By sharing this list of actions, we look to promote positive socio-environmental changes towards the collective goal of achieving a good Anthropocene.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Twenty actions for a “good anthropocene”—perspectives from early-career conservation professionals

Humans are now recognized as the main drivers of environmental change, leaving the future of our planet dependent on human action or inaction. Although the outlook of our planet is often depicted in a “doom and gloom” manner due to recent troubling environmental trends, we suggest that a “good Anthropocene” (in which human quality of life may be maintained or improved without cost to the environment) is attainable if we engage in adaptive, multi-disciplinary actions capable of addressing the socio-ecological issues of today and tomorrow. Early-career conservation scientists and practitioners have an unmatched understanding of novel technologies and social connectivity and, as those left with the ever-growing responsibility to be the problem solvers of the attributed increasing environmental consequences of living in the Anthropocene, their perspectives on steps towards a good Anthropocene are valuable. Here we present a list of 20 actions derived by early-career conservation scientists and practitioners for conservationists to help achieve a good Anthropocene that utilize the social connectivity and technology of today. Central to these actions are the notions that multi-, inter-, and trans-disciplinary collaboratives that embrace diverse world views need to be integrated into decision-making processes; training and outreach platforms need to communicate both environmental challenges and solutions broadly; and conservation successes need to be acknowledged and disseminated in a forward-looking, adaptive capacity. Together the 20 actions identified here reinforce the underlying paradigm shift that must accompany living in the Anthropocene, given that biodiversity and healthy ecosystems are requisite for sustained human life. By sharing this list of actions, we look to promote positive socio-environmental changes towards the collective goal of achieving a good Anthropocene

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo