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Internationally coordinated expansion of the global protected area network to 17% could triple the average protection of species ranges and ecoregions; if projected land-use changes and consequent habitat loss until 2040 occur, currently feasible protection levels will not be achievable, and more than 1,000 threatened species face reductions in the range of over 50%. Conservation without frontiers Protected areas are intended to mitigate pressures on biodiversity caused by anthropogenic factors such as habitat loss. To that end, an internationally agreed target aims to extend the protected area network to cover 17% of the world's land area by 2020. But biodiversity is unevenly distributed between countries and habitats, raising the question of which areas should be protected to maximize the effectiveness. Federico Montesino Pouzols et al . show that internationally coordinated expansion of the protected area network to the 17% target could triple the average protection of species ranges and ecoregions. However, within-country prioritization is considerably less efficient. Moreover, taking into account projected land-use changes and consequent habitat loss until 2040, current levels of protection will not be feasible to maintain, and over 1,000 threatened species face reductions in their range of over 50%. Thus, the authors suggest that for effective biodiversity conservation, land-use policy and protected area decisions must be coordinated at an international level. Protected areas are one of the main tools for halting the continuing global biodiversity crisis 1 , 2 , 3 , 4 caused by habitat loss, fragmentation and other anthropogenic pressures 5 , 6 , 7 , 8 . According to the Aichi Biodiversity Target 11 adopted by the Convention on Biological Diversity, the protected area network should be expanded to at least 17% of the terrestrial world by 2020 ( http://www.cbd.int/sp/targets ). To maximize conservation outcomes, it is crucial to identify the best expansion areas. Here we show that there is a very high potential to increase protection of ecoregions and vertebrate species by expanding the protected area network, but also identify considerable risk of ineffective outcomes due to land-use change and uncoordinated actions between countries. We use distribution data for 24,757 terrestrial vertebrates assessed under the International Union for the Conservation of Nature (IUCN) ‘red list of threatened species’ 9 , and terrestrial ecoregions 10 (827), modified by land-use models for the present and 2040, and introduce techniques for global and balanced spatial conservation prioritization. First, we show that with a coordinated global protected area network expansion to 17% of terrestrial land, average protection of species ranges and ecoregions could triple. Second, if projected land-use change by 2040 (ref. 11 ) takes place, it becomes infeasible to reach the currently possible protection levels, and over 1,000 threatened species would lose more than 50% of their present effective ranges worldwide. Third, we demonstrate a major efficiency gap between national and global conservation priorities. Strong evidence is shown that further biodiversity loss is unavoidable unless international action is quickly taken to balance land-use and biodiversity conservation. The approach used here can serve as a framework for repeatable and quantitative assessment of efficiency, gaps and expansion of the global protected area network globally, regionally and nationally, considering current and projected land-use pressures.

Complementarity and cost-efficiency are widely used principles for protected area network design. Despite the wide use and robust theoretical underpinnings, their effects on the performance and patterns of priority areas are rarely studied in detail. Here we compare two approaches for identifying the management priority areas inside the global protected area network: 1) a scoring-based approach, used in recently published analysis and 2) a spatial prioritization method, which accounts for complementarity and area-efficiency. Using the same IUCN species distribution data the complementarity method found an equal-area set of priority areas with double the mean species ranges covered compared to the scoring-based approach. The complementarity set also had 72% more species with full ranges covered, and lacked any coverage only for half of the species compared to the scoring approach. Protected areas in our complementarity-based solution were on average smaller and geographically more scattered. The large difference between the two solutions highlights the need for critical thinking about the selected prioritization method. According to our analysis, accounting for complementarity and area-efficiency can lead to considerable improvements when setting management priorities for the global protected area network.

The rates of ecosystem degradation and biodiversity loss are alarming and current conservation efforts are not sufficient to stop them. The need for new tools is urgent. One approach is biodiversity offsetting: a developer causing habitat degradation provides an improvement in biodiversity so that the lost ecological value is compensated for. Accurate and ecologically meaningful measurement of losses and estimation of gains are essential in reaching the no net loss goal or any other desired outcome of biodiversity offsetting. The chosen calculation method strongly influences biodiversity outcomes. We compare a multiplicative method, which is based on a habitat condition index developed for measuring the state of ecosystems in Finland to two alternative approaches for building a calculation method: an additive function and a simpler matrix tool. We examine the different logic of each method by comparing the resulting trade ratios and examine the costs of offsetting for developers, which allows us to compare the cost-effectiveness of different types of offsets. The results show that the outcomes of the calculation methods differ in many aspects. The matrix approach is not able to consider small changes in the ecological state. The additive method gives always higher biodiversity values compared to the multiplicative method. The multiplicative method tends to require larger trade ratios than the additive method when trade ratios are larger than one. Using scoring intervals instead of using continuous components may increase the difference between the methods. In addition, the calculation methods have differences in dealing with the issue of substitutability.

The rate and extent of global biodiversity change is surpassing our ability to measure, monitor and forecast trends. We propose an interconnected worldwide system of observation networks — a global biodiversity observing system (GBiOS) — to coordinate monitoring worldwide and inform action to reach international biodiversity targets.

Author’s accepted manuscript (postprint)

Complementarity and cost-efficiency are widely used principles for protected area network design. Despite the wide use and robust theoretical underpinnings, their effects on the performance and patterns of priority areas are rarely studied in detail. Here we compare two approaches for identifying the management priority areas inside the global protected area network: 1) a scoring-based approach, used in recently published analysis and 2) a spatial prioritization method, which accounts for complementarity and area-efficiency. Using the same IUCN species distribution data the complementarity method found an equal-area set of priority areas with double the mean species ranges covered compared to the scoring-based approach. The complementarity set also had 72% more species with full ranges covered, and lacked any coverage only for half of the species compared to the scoring approach. Protected areas in our complementarity-based solution were on average smaller and geographically more scattered. The large difference between the two solutions highlights the need for critical thinking about the selected prioritization method. According to our analysis, accounting for complementarity and area-efficiency can lead to considerable improvements when setting management priorities for the global protected area network.

Guidelines for the management of patients with invasive candidiasis and mucosal candidiasis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous guidelines published in the 15 January 2004 issue of Clinical Infectious Diseases and are intended for use by health care providers who care for patients who either have or are at risk of these infections. Since 2004, several new antifungal agents have become available, and several new studies have been published relating to the treatment of candidemia, other forms of invasive candidiasis, and mucosal disease, including oropharyngeal and esophageal candidiasis. There are also recent prospective data on the prevention of invasive candidiasis in high-risk neonates and adults and on the empiric treatment of suspected invasive candidiasis in adults. This new information is incorporated into this revised document.

Background. Invasive candidiasis (IC) is an important healthcare-related infection, with increasing incidence and a crude mortality exceeding 50%. Numerous treatment options are available yet comparative studies have not identified optimal therapy. Methods. We conducted an individual patient-level quantitative review of randomized trials for treatment of IC and to assess the impact of host-, organism-, and treatment-related factors on mortality and clinical cure. Studies were identified by searching computerized databases and queries of experts in the field for randomized trials comparing the effect of ≥2 antifungals for treatment of IC. Univariate and multivariable analyses were performed to determine factors associated with patient outcomes. Results. Data from 1915 patients were obtained from 7 trials. Overall mortality among patients in the entire data set was 31.4%, and the rate of treatment success was 67.4%. Logistic regression analysis for the aggregate data set identified increasing age (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.00—1.02; P = .02), the Acute Physiology and Chronic Health Evaluation II score (OR, 1.11; 95% CI, 1.08—1.14; P = .0001), use of immunosuppressive therapy (OR, 1.69; 95% CI, 1.18—2.44; P = .001), and infection with Candida tropicalis (OR, 1.64; 95% CI, 1.11—2.39; P = .01) as predictors of mortality. Conversely, removal of a central venous catheter (CVC) (OR, 0.50; 95% CI, .35—.72; P = .0001) and treatment with an echinocandin antifungal (OR, 0.65; 95% CI, .45—.94; P = .02) were associated with decreased mortality. Similar findings were observed for the clinical success end point. Conclusions. Two treatment-related factors were associated with improved survival and greater clinical success: use of an echinocandin and removal of the CVC.