Relating characteristics of global biodiversity targets to reported progress.

To inform governmental discussions on the nature of a revised Strategic Plan for Biodiversity of the Convention on Biological Diversity (CBD), we reviewed the relevant literature and assessed the framing of the 20 Aichi Biodiversity Targets in the current strategic plan. We asked international experts from nongovernmental organizations, academia, government agencies, international organizations, research institutes, and the CBD to score the Aichi Targets and their constituent elements against a set of specific, measurable, ambitious, realistic, unambiguous, scalable, and comprehensive criteria (SMART based, excluding time bound because all targets are bound to 2015 or 2020). We then investigated the relationship between these expert scores and reported progress toward the target elements by using the findings from 2 global progress assessments (Global Biodiversity Outlook and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services). We analyzed the data with ordinal logistic regressions. We found significant positive relationships (p < 0.05) between progress and the extent to which the target elements were perceived to be measurable, realistic, unambiguous, and scalable. There was some evidence of a relationship between progress and specificity of the target elements, but no relationship between progress and ambition. We are the first to show associations between progress and the extent to which the Aichi Targets meet certain SMART criteria. As negotiations around the post-2020 biodiversity framework proceed, decision makers should strive to ensure that new or revised targets are effectively structured and clearly worded to allow the translation of targets into actionable policies that can be successfully implemented nationally, regionally, and globally.

Relación de las Características de los Objetivos Mundiales de Biodiversidad con el Progreso Reportado Resumen Para informar las discusiones gubernamentales sobre la naturaleza de una revisión del Plan Estratégico para la Biodiversidad del Convenio sobre la Diversidad Biológica (CBD, en inglés), revisamos la literatura relevante y evaluamos el marco de 20 Objetivos de Biodiversidad de Aichi en el plan estratégico actual. Le pedimos a expertos internacionales de organizaciones no gubernamentales, de la academia, de agencias gubernamentales, organizaciones internacionales, de institutos de investigación y de la CBD que puntuaran los Objetivos de Aichi y sus elementos constituyentes frente a un conjunto de criterios específicos, medibles, ambiciosos, realistas (basados en SMART [las iniciales en inglés] y excluyendo aquellos limitados por el tiempo, pues todos los objetivos están limitados al 2015 o al 2020), inequívocos, expansibles y completos (excluyendo aquellos limitados por el tiempo). Después investigamos la relación entre los puntajes de estos expertos y el progreso reportado hacia los elementos objetivo usando los resultados de dos valoraciones mundiales del progreso (el Pronóstico Mundial de la Biodiversidad y la Plataforma Intergubernamental de Ciencia y Política sobre la Biodiversidad y los Servicios Ambientales). Analizamos los datos con regresiones logísticas ordinales. Encontramos relaciones positivas significativas (p < 0.05) entre el progreso y el alcance al que fueron percibidos como medibles, realistas, inequívocos y expansibles los elementos objetivo. Hubo algo de evidencia de la relación entre el progreso y la ambición. Somos los primeros en mostrar las asociaciones entre el progreso y la extensión hasta la que los Objetivos de Aichi cumplen con ciertos criterios SMART. Conforme proceden las negociaciones en torno al marco de trabajo de biodiversidad post-2020, quienes toman las decisiones deberían esforzarse por asegurar que los objetivos nuevos o revisados estén estructurados efectivamente y redactados claramente para permitir la traducción de los objetivos hacia políticas factibles que puedan implementarse exitosamente a nivel nacional, regional y mundial.

Erythropoietin treatment in the neuropsychiatric porphyrias.

BACKGROUND: In a previous report, 31 patients with neuropsychiatric porphyria were studied and nine of these patients were anaemic in association with inappropriately low serum erythropoietin levels. We were also able to demonstrate that treatment with erythropoietin in non-porphyric patients (mainly diabetic patients with autonomic neuropathy) significantly reduced urinary delta-aminolaevulinic acid levels. METHODS: We treated six porphyric patients, five of whom were anaemic, with recombinant human erythropoietin (1000-2000 IU thrice weekly). They were all in clinical but not biochemical remission. Full blood count, including reticulocytes and platelets, urinary delta-aminolaevulinic acid, porphobilinogen and total porphyrins were measured monthly. Baseline serum ferritin, vitamin B(12), folate and C-reactive protein levels were all within the normal range and serum creatinine did not exceed 126 micromol/l. RESULTS: After 3 months of treatment, the average baseline haemoglobin increased significantly (p=0.01). When treatment was stopped, the haemoglobin decreased and after 3 months pre-treatment, haemoglobin levels were reached. Urinary delta-aminolaevulinic acid, porphobilinogen and porphyrin levels all tended to decrease during treatment with erythropoietin, but the difference between baseline and 3 months of erythropoietin was statistically significant only for porphobilinogen (p=0.03). The severity of porphyria attacks was reduced and the quality of life increased during treatment with erythropoietin. CONCLUSION: We conclude that in some porphyric patients treatment with erythropoietin reduces urinary delta-aminolaevulinic acid, porphobilinogen and porphyrin levels with an increase in well-being and a reduction in the severity of porphyria attacks.

Serum erythropoietin levels may be inappropriately low in the acute neuropsychiatric porphyrias.

BACKGROUND: Patients with the acute porphyrias may develop renal failure and autonomic dysfunction. Renal damage and sympathetic failure may both cause erythropoietin (EPO) deficiency. In this study, we have investigated serum erythropoietin levels and autonomic function in patients with acute porphyria in clinical remission. METHODS: Serum erythropoietin levels and the corresponding haemoglobin (Hb) were assayed in 31 patients with acute porphyria and were compared to 15 type 1 diabetic patients with autonomic neuropathy, 23 patients with iron-deficiency anaemia and 18 healthy individuals. RESULTS: 9 out of 31 porphyric patients showed a normochromic normocytic anaemia with normal ferritin levels. Three patients had borderline-raised serum creatinine levels, and one of them was anaemic. Autonomic function was investigated in seven patients, six of them being anaemic, and the results were normal. Patients with iron-deficiency anaemia showed the expected increase in serum erythropoietin levels in response to a decreasing haemoglobin (r=-0.86, p<0.001). Patients with porphyria had inappropriately low serum erythropoietin levels for the degree of anaemia compared to iron-deficiency patients (p<0.001) although there was still a significant increase in serum erythropoietin with decreasing haemoglobin levels (r=-0.46, p=0.01). In contrast, diabetic autonomic neuropathy patients demonstrated a significant decrease in serum erythropoietin with decreasing Hb levels (r=+0.53, p=0.05). CONCLUSIONS: Patients with acute porphyria may have inappropriately low levels of EPO. In contrast to the diabetic patients, this does not appear to be due to autonomic neuropathy but it may reflect mild renal tubular impairment.