Assessing Future Flood Hazards for Adaptation Planning in a Northern European Coastal Community

From a transdisciplinary approach in the town of Thyboron, Denmark, we investigate couplings between sea state (i.e. mean and extreme) and flooding hazards today and ahead. This includes analyses of change and variability in the groundwater table, precipitation, land motion, geotechnical ground properties, sewerage systems and other infrastructure to outline a more complete platform for the integration of knowledge into climate adaptation schemes at this highly vulnerable coastal location. It involves the engagement of the main stakeholders who, although having different responsibilities, interests, needs of knowledge and data, and different timeframes for investment and planning, must join in a common appraisal of the challenges faced ahead to provide for better adaptation measures. Apart from obvious adverse effects from future storm surge events, knowledge about the coupled effects of the abovementioned parameters needs to be taken into account to reach optimal mitigation and adaptation measures. Through stakeholder interviews it becomes clear that an enhanced focus on transdisciplinary research is a viable way forward to develop such measures: it will bring in more knowledge, a broader scope, and it will provide for more holistic solutions that both serve to protect the town and allow for business development and better municipal planning ahead

Can phylogeny predict chemical diversity and potential medicinal activity of plants? A case study of amaryllidaceae

Background During evolution, plants and other organisms have developed a diversity of chemical defences, leading to the evolution of various groups of specialized metabolites selected for their endogenous biological function. A correlation between phylogeny and biosynthetic pathways could offer a predictive approach enabling more efficient selection of plants for the development of traditional medicine and lead discovery. However, this relationship has rarely been rigorously tested and the potential predictive power is consequently unknown.Results We produced a phylogenetic hypothesis for the medicinally important plant subfamily Amaryllidoideae (Amaryllidaceae) based on parsimony and Bayesian analysis of nuclear, plastid, and mitochondrial DNA sequences of over 100 species. We tested if alkaloid diversity and activity in bioassays related to the central nervous system are significantly correlated with phylogeny and found evidence for a significant phylogenetic signal in these traits, although the effect is not strong.Conclusions Several genera are non-monophyletic emphasizing the importance of using phylogeny for interpretation of character distribution. Alkaloid diversity and in vitro inhibition of acetylcholinesterase (AChE) and binding to the serotonin reuptake transporter (SERT) are significantly correlated with phylogeny. This has implications for the use of phylogenies to interpret chemical evolution and biosynthetic pathways, to select candidate taxa for lead discovery, and to make recommendations for policies regarding traditional use and conservation priorities.<br /

The prevalence of moderate mitral regurgitation in patients undergoing CABG

Objective. The aim of this study was to determine the prevalence of moderate ischemic mitral regurgitation (IMR) in the contemporary CABG population. We also aimed to correlate the effective regurgitant orifice area (ERO) of any regurgitant mitral valve in patients with coronary artery disease with the semiquantitative integrated scale of IMR. Design. From March 15 through June 15, 2006, 510 consecutive CABG patients in three tertiary centres were included in the study. All patients showing any sign of mitral regurgitation (MR) at the referring hospital underwent a preoperative transthoracic echocardiographic estimation of the degree of MR using the integrated scale (1-4) and ERO. Results. IMR was found in 141 patients (28%). The prevalence of moderate 2+ or worse IMR was 4% (95% CI; 2.5-6.1%) and the ERO corresponding to 2+ IMR or more ranged from 5 to 30 mm2. Fourteen patients had an ERO between 15-30 mm2. Conclusions. According to our study, patients with moderate IMR, defined as an ERO between 15-30 mm2, account for only 2.7% (95% CI; 1.5-4.7%) of a non-emergency CABG population

Moderate mitral regurgitation in patients undergoing CABG - the MoMIC trial

Background. The presence of mild to moderate ischemic mitral regurgitation (IMR) marks a significantly reduced long-term survival and increased hospitalizations due to heart-failure. However, it is common practice in many institutions to refrain from repairing the mitral valve in these patients. There are no available conclusive data to support this practice, and thus there is a need for an adequately powered randomized trial. Study design. The Moderate Mitral Regurgitation In Patients Undergoing CABG (MoMIC) trial is the first international multi-center, large-scale study to clarify whether moderate IMR in CABG patients should be corrected. A total of 550 CABG patients with moderate IMR are to be randomized to treatment of either CABG alone or CABG plus mitral valve correction. The primary end point is a composite end point of mortality and rehospitalization for heart failure at five years. The inclusion and randomization of patients started in February 2008. Implication. If correction of moderate IMR in CABG patients proves to be the superior strategy, most patients should be treated accordingly