•This paper synthesized evidence of elderly people’s preferences for nature-based recreation and landscape characteristics.•A systematic literature review based on the PRISMA method was conducted, ...including an in-depth analysis of 44 peer-reviewed articles.•It found that elderly people seem to have some common preferences, but interactions between people and nature can affect them.•It suggests that planners consider scientific evidence of preferences, local conditions, and different landscape design options.•It suggests that further research is needed to explore elderly people’s emotional ties with nature and the urban-rural differences in preferences.
As demographic changes abound, landscape planners should increase their understanding of both elderly people’s preferences concerning nature-based recreation and approaches to consider those preferences in planning. This study aims to synthesize existing knowledge about elderly people’s preferences, namely, how they interact with green spaces, what landscape characteristics they prefer or dislike, and how practitioners can improve planning to better meet elderly people’s needs. A systematic literature review based on the PRISMA method was conducted, including an in-depth analysis of 44 peer-reviewed journal articles. We find that published studies focus primarily on elderly people’s recreational activities in urban parks. Across different contexts, elderly people seem to have common preferences: landscape features that are natural, aesthetic, comprehensible, and diverse, with accessible and well-maintained infrastructure and facilities. Moreover, interactions between people and nature may affect the relative importance levels of the preferences. We recommend that landscape planning practitioners consider both scientific evidence and local conditions that could affect elderly people’s preferences, and explore the degree to which design options may fulfill these preferences. Further research is needed to explore differences in preferences between urban and rural dwellers, to quantify preferences, and to enhance understanding of elderly people’s emotional ties with nature.
Cases of coronavirus disease 2019 (COVID-19) have been reported worldwide. However, one epidemiological report has claimed a lower incidence of the disease in people living at high altitude ...(>2,500 m), proposing the hypothesis that adaptation to hypoxia may prove to be advantageous with respect to SARS-CoV-2 infection. This publication was initially greeted with skepticism, because social, genetic, or environmental parametric variables could underlie a difference in susceptibility to the virus for people living in chronic hypobaric hypoxia atmospheres. Moreover, in some patients positive for SARS-CoV-2, early post-infection 'happy hypoxia" requires immediate ventilation, since it is associated with poor clinical outcome. If, however, we accept to consider the hypothesis according to which the adaptation to hypoxia may prove to be advantageous with respect to SARS-CoV-2 infection, identification of the molecular rational behind it is needed. Among several possibilities, HIF-1 regulation appears to be a molecular hub from which different signaling pathways linking hypoxia and COVID-19 are controlled. Interestingly, HIF-1α was reported to inhibit the infection of lung cells by SARS-CoV-2 by reducing ACE2 viral receptor expression. Moreover, an association of the rs11549465 variant of HIF-1α with COVID-19 susceptibility was recently discovered. Here, we review the evidence for a link between HIF-1α, ACE2 and AT1R expression, and the incidence/severity of COVID-19. We highlight the central role played by the HIF-1α signaling pathway in the pathophysiology of COVID-19.
•Paper focuses on nature-based measures (NBM) in flood risk management plans (FRMPs).•Actual uptake of NBM in three German states is assessed via document analysis.•NBM uptake in FRMPs is generally ...low, with divergence across states.•Uptake relates positively to stream order, low flood risks and expected benefits.•Uptake could be enhanced by use of best available data and participatory methods.
Nature-based measures (NBMs), understood here as measures such as floodplain restoration that use ecosystem processes to meet societal challenges, are increasingly advocated as promising solutions for managing flood risks. A suitable instrument to implement NBMs are flood risk management plans (FRMPs) stipulated by the EU Floods Directive. While prior research suggests several governance challenges for NBM uptake in FRMPs, little is known so far regarding the actual extent of NBM uptake and its role in decision-making of flood risk management. Germany, with a coherent water policy framework but state-specific implementation conditions, provides a suitable case study for exploring the decision-making practices that are used in the planning process for FRMPs by German federal states with different water governance characteristics. The aim of this study is to analyze the actual uptake of NBMs in German FRMPs, and to explore potential factors of the FRMP preparation and decision-making practices explaining this uptake. Our explorative research design is based on a document analysis method which assesses the contents of FRMPs of three German federal states.
The results offer the first empirical evidence of the uptake of NBMs in Germany and insights into how NBMs and other measure types are chosen for FRMPs. Our findings confirm an overall low uptake of NBMs, with diverging preferences for particular NBM types between the three states. Looking across the states, the level of NBM uptake is likely to be higher if rivers with higher stream order are considered in the FRMP's spatial scope, the potential flood risk in a river basin is low, and positive flood impacts and positive cost-benefit ratios are expected. We conclude that FRMPs still hold substantial potential to enhance the NBM uptake in flood risk management planning. To make use of this potential, we suggest three key strategies to increase the change for a better NBM uptake including applying FRMPs at different spatial levels and degrees of details.
Sense of place is increasingly advocated to support the management of social-ecological systems. Given the concept’s complexity, we suggest that an indicator for sense of place is needed to ...facilitate its application in practical planning. We propose such an indicator called “meaningful places,” defined as geographic locations to which (i) immediately perceived as well as socially constructed meanings are ascribed and (ii) evaluative attachments are tied. We applied the indicator in two independent case studies, Lübeck and Lahn, both of which aimed to integrate sense of place in an actual planning process. The case studies differed in the spatial scale of the meaningful places, the indicator’s operationalization, and the specific assessment methods. In the Lübeck case, semi-structured interviews and a simple mapping method were used to analyze participants’ “home-regions.” The results revealed diverse but overlapping locations characterized as aesthetic, different from others, close to nature, and quiet (place meanings). In the Lahn case, a public participation GIS (public participation geographic information system PPGIS) survey was conducted and yielded insights into the spatial distribution of meaningful places. The results reflect a wide range of place meanings linked to, for example, activities, aesthetic qualities, or well-being. Furthermore, participants expressed different intensities of place attachments. Although the indicator is still in an exploratory stage, it allows for reflection on potential benefits for planning practitioners. The resulting data can be combined with spatial information usually used in planning processes, e.g., about the state of the underlying physical environment and/or foreseeable drivers of change. This offers new opportunities for managers regarding the determination of priorities to conserve meaningful places, the anticipation of conflicts, and the utilization of the communicative power of meaningful places. We argue that the benefits for planning justify a new direction of research devoted to the development and further advancement of the indicator.
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•Nature-based solutions (NBS) can alleviate societal challenges.•A concise definition for application of NBS in planning research is given.•Landscape planning provides spatial ...information for effective design of NBS.•Governance research may identify barriers and opportunities for NBS implementation.•Research needs concern effectiveness, co-design approaches, and implementation.
Nature-based solutions (NBS) in river landscapes, such as restoring floodplains, can not only decrease flood risks for downstream communities but also provide co-benefits in terms of habitat creation for numerous species and enhanced delivery of diverse ecosystem services. This paper aims to explore how landscape planning and governance research can contribute to the identification, design and implementation of NBS, using the example of water-related challenges in the landscape of the Lahn river in Germany. The objectives are (i) to introduce the NBS concept and to provide a concise definition for application in planning research, (ii) to explore how landscape planning and governance research might support a targeted use and implementation of NBS, and (iii) to propose an agenda for further research and practical experimentation. Our methods include a focused literature review and conceptual framework development. We define NBS as actions that alleviate a well-defined societal challenge (challenge-orientation), employ ecosystem processes of spatial, blue and green infrastructure networks (ecosystem processes utilization), and are embedded within viable governance or business models for implementation (practical viability). Our conceptual framework illustrates the functions of NBS in social-ecological landscape systems, and highlights the complementary contributions of landscape planning and governance research in developing and implementing NBS. Finally, a research and experimentation agenda is proposed, focusing on knowledge gaps in the effectiveness of NBS, useful approaches for informed co-design of NBS, and options for implementation. Insights from this paper can guide further studies and support testing of the NBS concept in practice.
This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery–asoociated acute kidney injury (AKI) identified by standard criteria and/or ...urinary kidney biomarkers.
Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI. Primary end point was acute renal replacement therapy or in-hospital mortality. Long-term end points among others included 5-year mortality. Patients with single-biomarker-positive subclinical AKI (RIFLE negative) were identified. We controlled for systemic inflammation using C-reactive protein test.
Urinary biomarkers (neutrophil gelatinase-associated lipocalin, midkine, and interleukin 6) were identified as independent predictors of the primary end point. Neutrophil gelatinase-associated lipocalin, midkine, or interleukin 6 positivity or de novo/worsening proteinuria identified 21.1%, 16.9%, 30.5%, and 48.0% more cases, respectively, with likely subclinical AKI (biomarker positive/RIFLE negative) additionally to cases with RIFLE positivity alone. Patients with likely subclinical AKI (neutrophil gelatinase-associated lipocalin or interleukin 6 positive) had increased risk of primary end point (adjusted hazard ratio, 7.18; 95% confidence interval, 1.52-33.93 P = .013 and hazard ratio, 6.27; 95% confidence interval, 1.12-35.21 P = .037), respectively. Compared with biomarker-negative/RIFLE-positive patients, neutrophil gelatinase-associated lipocalin positive/RIFLE-positive or midkine-positive/RIFLE-positive patients had increased risk of primary end point (odds ratio, 9.6; 95% confidence interval, 1.4-67.3 P = .033 and odds ratio, 14.7; 95% confidence interval, 2.0-109.2 P = .011, respectively). Three percent to 11% of patients appear to be influenced by single-biomarker-positive subclinical AKI. During follow-up, kidney biomarker-defined short-term outcomes appeared to translate into long-term outcomes.
Urinary kidney biomarkers identified RIFLE-negative patients with high-risk subclinical AKI as well as a higher risk subgroup of patients among RIFLE-AKI-positive patients. These findings support the concept that urinary biomarkers define subclinical AKI and higher risk subpopulations with worse long-term prognosis among standard patients with AKI.
•Proposes a framework for integrating ecosystem services (ES) in planning.•ES integration achieved via analysis of state changes in DPSIR-based planning.•ES indicators for different pressures, ...states, and impacts are suggested.•A case study explores scenario impacts on different ES indicators.•The added value lies in improved implementation of policy and practice.
Applying ecosystem services (ES) concepts and indicators in landscape planning requires them to be linked with models for decision-making by practitioners. The objective of this paper is to introduce an ES-in-Planning framework, which combines ES assessment and valuation indicators with the widely used Driving Forces, Pressures, State, Impacts and Responses (DPSIR) model. Within this framework, ES indicators become part of landscape planning as a means of assessing the current state of the environment and for determining how it might change in the future. The implementation and added value of the framework is illustrated in a case study of planning issues in the Mardorf community bordering the Steinhuder Meer Lake, Northern Germany. Two scenarios of potential landscape changes and possible response measures are considered in terms of alterations in a set of ES indicators. The ES examined are food production (a provisioning ES), climate mitigation (a regulation ES), landscape esthetics (as the basis for many cultural ES), and biodiversity. The ES indicators employed distinguish between services valued by humans and those which are actually utilized. Valuation of changes in ES has shown to reflect societal objectives (as institutionalized in legal requirements) and expert-based estimates. However, these valuations could be further validated by including economic and social valuation of impacts. The added value of applying ES in the planning process lies in improved opportunities for developing targeted response measures, for communicating trade-offs between planning options, and for facilitating joint implementation by partners.
Graft versus host disease (GVHD) is a post-transplant pathology in which donor-derived T cells present in the Peyer's patches target the cell-surface alloantigens of the recipient, causing host ...tissue damages. Therefore, the GVHD has long been considered only a purely immunological process whose prevention requires an immunosuppressive treatment. However, since the early 2010s, the impact of gut microbiota on GVHD has received increased attention. Both a surprising fall in gut microbiota diversity and a shift toward Enterobacteriaceae were described in this disease. Recently, unexpected results were reported that further link GVHD with changes in bacterial composition in the gut and disruption of intestinal epithelial tight junctions leading to abnormal intestinal barrier permeability. Patients receiving allogenic hematopoietic stem cell transplant (allo-HCT) as treatment of hematologic malignancies showed a decrease of the overall diversity of the gut microbiota that affects
and
spp. and a predominance of lactic acid bacteria (LAB) of the
genus, in particular the lactose auxotroph
. The reduced microbiota diversity (likely including Actinobacteria, such as
that cross feed butyrogenic bacteria) deprives the butyrogenic bacteria (such as
or
) of their capacity to metabolize acetate to butyrate. Indeed, administration of butyrate protects against the GVHD. Here, we review the data highlighting the possible link between GVHD and lactase defect, accumulation of lactose in the gut lumen, reduction of Reg3 antimicrobial peptides, narrower enzyme equipment of bacteria that predominate post-transplant, proliferation of
that use lactose as metabolic fuels, induction of innate and adaptive immune response against these bacteria which maintains an inflammatory process, elevated expression of myosin light chain kinase 210 (MLCK210) and subsequent disruption of intestinal barrier, and translocation of microbial products (lactate) or transmigration of LAB within the liver. The analysis of data from the literature confirms that the gut microbiota plays a major role in the GVHD. Moreover, the most recent publications uncover that the LAB, butyrogenic bacteria and bacterial cross feeding were the missing pieces in the puzzle. This opens new bacteria-based strategies in the treatment of GVHD.
Boundary work, defined as effort to mediate between knowledge and action, is a promising approach for facilitating knowledge co-production for sustainable development. Here, we investigate a case ...study of knowledge co-production, to assess the applicability of boundary work as a conceptual framework to support implementing adaptive management in the water sector. We refer to a boundary work classification recently proposed by Clark et al., (2016), based on three types of knowledge uses, i.e. enlightenment, decision-, and negotiation-support, and three types of sources, i.e. personal expertise, single, and multiple communities of expertise. Our empirical results confirm boundary work has been crucial for the three types of knowledge use. For enlightenment and decision-support, effective interaction among knowledge producers and users was achieved through diverse boundary work practices, including joint agenda setting, and sharing of data and expertise. This initial boundary work eased subsequent knowledge co-production for decision-support and negotiations, in combination with stepping up of cooperation between relevant actors, suitable legislation and pressure for problem solving. Our analysis highlighted the temporal dimension matters - building trust around enlightenment first, and then using this as a basis for managing knowledge co-production for decision-, and negotiation support. We reconfirmed that boundary work is not a single time achievement, rather is a dynamic process, and we emphasized the importance of key actors driving the process, such as water utilities. Our results provide a rich case study of how strategic boundary work can facilitate knowledge co-production for adaptive management in the water sector. The boundary work practices employed here could also be transferred to other cases. Water utilities, as intermediaries between providers and beneficiaries of the important water-related ecosystem service of clean water provision, can indeed serve as key actors for initiating such boundary work practices.
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•We assess boundary work as conceptual framework to support adaptive management.•Case study is knowledge cogeneration and application in watershed management.•Evidence found of boundary work for enlightenment, decision, and negotiation support•Guidance provided for identifying barriers and implementing adaptive management
A key challenge of environmental planning is to craft recommendations for future sustainable spatial development amid ubiquitous uncertainties. This paper aims to explore how different data ...uncertainties, usually unknown to the planner, may influence environmental planning recommendations. We apply a case study-based approach, in which we provide three illustrative examples of how data with different kinds and levels of uncertainty affect environmental assessments and, by that, the decision-support provided by environmental planning. The cases stem from different spatial levels in Germany and consider 'Regional soil-based climate change mitigation' in the region of Hannover, 'State-wide habitat conservation siting' in the federal state of Saxony-Anhalt, and 'National renewable energy planning'. Based on the three examples, we discuss implications for planning practice and derive recommendations for further research. The three cases studies illustrate the substantial effects of data uncertainty on environmental assessments and planning recommendations derived from those results. We identify four problem constellations of dealing with data uncertainty in environmental planning that relate to the severeness of uncertainty impacts, the responsibility of the decision-maker, and the kinds of impacts that wrong decisions may have. We close with recommendations for further research, among others to develop robust and pragmatic methods for identifying the uncertainty levels in environmental data and assessment results.
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