Levetiracetam in a broad population of patients with refractory epilepsy: interim results of the international SKATE trial

OBJECTIVE: To prospectively assess the safety and efficacy of levetiracetam in patients with uncontrolled focal epilepsy, in a common practice-based setting. PATIENTS AND METHODS: In this phase IV, open-label, 16-week community-based study, adult patients with focal seizures initially received levetiracetam 1,000 mg/day. Throughout the study, the dose was adjusted in increments of 1,000 mg (maximum 3,000 mg/day) to achieve seizure control and maintain tolerability. The outcome parameters were the percentage reduction in partial and total seizure frequency per week from historical baseline, global evaluation scale (GES), and adverse events (AE). RESULTS: Seven hundred and thirty-one patients were included in this analysis and 84.4% completed the study. The median percent reduction in all seizures was 47.8%, and 49.3% for all partial seizures. The 50% responder rate was 49%, and the seizure-free rate was 17.2% for all partial seizures. Approximately 60% of patients showed moderate to marked improvement on the GES. The majority of AE were of mild to moderate severity; the most commonly reported being asthenia, somnolence, headache, and dizziness. CONCLUSION: Levetiracetam is both efficacious and safe as an add-on therapy in patients with refractory epilepsy treated by clinicians in their daily practice.status: publishe

Ecosystem services assessment tools for African Biosphere Reserves: A review and user-informed classification

While the concept of ecosystem services which links biodiversity to human wellbeing, is by now well-known, its translation into actual management decisions is still uneven. African Biosphere Reserves, which are to be living labs for sustainable development, embody the idea of synergies between people and nature. Gaining knowledge about the provision, the use and the trends of ecosystem services in these reserves is essential to ensure their global change-proof management. The diversity of rapidly evolving ecosystem services assessment tools requires a systematic and informed selection, in order to ensure that prospective tool users select the most adequate tool, aligned to their needs and context. Based on a Delphi survey of future tool users, and on a review of ecosystem services assessment tools, we propose guidance to users to select the most suited tool based on the context of African Biosphere Reserves, and on tool requirements regarding data input, necessary skills, outputs and types of ecosystem services addressed. The use of the Delphi survey and the focus on African Biosphere Reserves are new elements that contribute to the theory and practice of ecosystem services assessment

Levetiracetam in a broad population of patients with refractory epilepsy: interim results of the international SKATE trial

OBJECTIVE: To prospectively assess the safety and efficacy of levetiracetam in patients with uncontrolled focal epilepsy, in a common practice-based setting. PATIENTS AND METHODS: In this phase IV, open-label, 16-week community-based study, adult patients with focal seizures initially received levetiracetam 1,000 mg/day. Throughout the study, the dose was adjusted in increments of 1,000 mg (maximum 3,000 mg/day) to achieve seizure control and maintain tolerability. The outcome parameters were the percentage reduction in partial and total seizure frequency per week from historical baseline, global evaluation scale (GES), and adverse events (AE). RESULTS: Seven hundred and thirty-one patients were included in this analysis and 84.4% completed the study. The median percent reduction in all seizures was 47.8%, and 49.3% for all partial seizures. The 50% responder rate was 49%, and the seizure-free rate was 17.2% for all partial seizures. Approximately 60% of patients showed moderate to marked improvement on the GES. The majority of AE were of mild to moderate severity; the most commonly reported being asthenia, somnolence, headache, and dizziness. CONCLUSION: Levetiracetam is both efficacious and safe as an add-on therapy in patients with refractory epilepsy treated by clinicians in their daily practice

Ecosystem services assessment tools for African Biosphere Reserves: A review and user-informed classification

While the concept of ecosystem services which links biodiversity to human wellbeing, is by now well-known, its translation into actual management decisions is still uneven. African Biosphere Reserves, which are to be living labs for sustainable development, embody the idea of synergies between people and nature. Gaining knowledge about the provision, the use and the trends of ecosystem services in these reserves is essential to ensure their global change-proof management. The diversity of rapidly evolving ecosystem services assessment tools requires a systematic and informed selection, in order to ensure that prospective tool users select the most adequate tool, aligned to their needs and context. Based on a Delphi survey of future tool users, and on a review of ecosystem services assessment tools, we propose guidance to users to select the most suited tool based on the context of African Biosphere Reserves, and on tool requirements regarding data input, necessary skills, outputs and types of ecosystem services addressed. The use of the Delphi survey and the focus on African Biosphere Reserves are new elements that contribute to the theory and practice of ecosystem services assessment