The importance of peatlands for conservation and provision of public services has been well evidenced in the last years, especially in relation to their contribution to the net zero carbon emission ...agenda. However, little is known about the importance of recreation relative to conservation and their trade-offs. In this paper we address this knowledge gap by exploring the trade-offs between natural properties of peatlands and recreational infrastructures for different categories of recreationists (walkers, cyclists, anglers, and birdwatchers) of an open heather moors and peatlands landscape. We do so building on a series of management scenarios formulated through participatory methods and applying choice experiment related to an Area of Outstanding Natural Beauty and UNESCO Global Geopark in the UK. Results show a high degree of heterogeneity in landscape preferences across different user groups. Recreationists had a higher appreciation for semi-natural habitats compared to pristine or restored peatland (e.g., land rewetting). Walkers and cyclists were more sensitive to changes in the availability of recreational facilities than to environmental quality, while anglers’ and birdwatchers’ preferences were more aligned with values promoted by restoration policies. Overall, our results point to a potential value conflict between benefits generated by conservation and the benefits valued most by some groups of recreationists. To maximise success conflicts like the one revealed here need to be considered in strategies that provide a central role for peatlands in net zero climate mitigation strategies.
•Recreational values are explored in the peatlands landscapes of the North Pennines AONB, UK.•Participatory scenarios were developed to discuss with stakeholders the future management strategies in the AONB.•Recreationists show higher appreciation for semi-natural habitats vs. pristine or restored peatlands.•Walkers and cyclists were more sensitive to changes in recreational facilities than environmental quality.•Anglers and birdwatchers’ preferences were more aligned with values promoted by conservation.•Value conflicts between conservation and recreational benefits are possible
The aim of this multicenter study was to investigate the feasibility and negative predictive value of sentinel lymph node detection with blue dye in vulvar carcinoma patients.
In patients with ...squamous cell carcinoma of the vulva without suspicious groin lymph nodes, patent blue V was injected intradermally shortly before surgery. Routine groin lymph node dissection and radical vulvectomy were performed. During the surgery, blue lymph vessels and lymph nodes were identified, and the blue lymph nodes were sent separately for histologic examination. The negative predictive value of the blue lymph nodes for the absence of metastases was assessed by histologic examination of the groin lymph node specimens.
Fifty-one patients in whom 93 groin lymph node dissections were performed were entered. One or more blue lymph nodes were detected in only 52 groins (56%). Nine (17%) of these were tumor positive, and 6 blue lymph nodes were the only tumor positive lymph nodes in the specimen in which they were found. There were two false-negative blue lymph nodes. The negative predictive value was 0.953.
It was shown in this multicenter study that sentinel lymph node detection in vulvar carcinoma patients with blue dye only is not feasible because its negative predictive value is too low. Further studies involving the use of a combination of radioactive labeled technetium and blue dye are warranted.
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