Over the past three decades, interacting with wildlife as a tourism activity has grown significantly and has transformed from a relatively rare experience into a mainstream tourism product. Tourism opportunities to watch, photograph and otherwise interact with animals in their natural environment have grown to include a range of species and settings, including in the sea. Close encounters with marine wildlife are facilitated by a wide range of commercial operators, and many include and promote a strong adventure component. This paper provides a consideration of the issues of risk and the emerging role of the use of social media in marine wildlife tourism experiences. While the concept of ecotourism has been widely explored in wildlife tourism research, the inherited risk involved in these activities has received little attention. This is particularly the case regarding interactions with potentially dangerous wildlife in open-water environments. This aspect warrants exploration in the context of the growth of wildlife photography/videography and sharing via social media platforms, which frequently display close encounters with animals in dangerous scenarios for both people and wildlife involved.

In summary, SERCA2a-overexpression improved contractility in a frequency-dependent way due to increased SR Ca2+ loading whereas transsarcolemmal Ca2+ fluxes were decreased.

No abstract

No abstract

Background/Introduction Arterial lactate is an established risk marker in patients with acute pulmonary embolism (PE). However, its clinical application is limited by the need for an arterial puncture, a procedure not routinely performed in haemodynamically stable PE patients. In contrast, information on venous lactate can be easily obtained via peripheral venepuncture and might thus be more suitable for risk assessment in normotensive PE. Purpose To investigate the prognostic value of peripheral venous lactate for outcome prediction in normotensive patients with acute PE. Methods Consecutive normotensive PE patients enrolled in a prospective single-centre registry between 09/2008 and 03/2018 were studied. Study outcomes included in-hospital adverse outcome (PE-related death, cardiopulmonary resuscitation or vasopressor treatment) and all-cause mortality. An optimised venous lactate cut-off concentration was identified using receiver operating curve analysis and its prognostic value compared to the established cut-off value for arterial lactate (2.0 mmol/l) and the upper limit of normal for venous lactate (2.3 mmol/l). Furthermore, we tested if addition of venous lactate to the 2019 European Society of Cardiology (ESC) risk stratification algorithm improves risk prediction. Results We analysed data from 419 (age 70 [interquartile range (IQR) 57–79] years; 53% female) patients. Patients with an in-hospital adverse outcome had higher venous lactate concentrations than those with a favourable clinical course (3.1 [IQR 1.3–4.9] vs. 1.6 [IQR 1.2–2.3] mmol/l, p=0.001). An optimized cut-off value of 3.3 mmol/l predicted both, adverse outcome (OR 11.0 [95% CI 4.6–26.3]) and all-cause mortality (OR 3.8 [95% CI 1.3–11.3]). Venous lactate ≥2.0 mmol/l and ≥2.3 mmol/l had lower predictive value for an adverse outcome (OR 3.6 [95% CI 1.5–8.7] and OR 5.7 [95% CI 2.4–13.6], respectively) and did not predict all-cause mortality. If venous lactate was added to the 2019 ESC algorithm (Figure), a cut-off concentration of 2.3 mmol/l had high negative predictive value (0.99 [95% CI 0.97–1.00]) for an adverse outcome in intermediate-low-risk patients, whereas levels ≥3.3 mmol/l predicted adverse outcomes in the intermediate-high-risk group (OR 5.2 (95% CI 1.8–15.0). Conclusions Even modest venous lactate elevations above the upper limit of normal (2.3 mmol/l) were associated with increased risk for an in-hospital adverse outcome and a cut-off value of 3.3 mmol/l provided optimal prognostic performance predicting both, an adverse outcome and all-cause mortality. Adding venous lactate to the 2019 ESC algorithm seems to further improve risk stratification. Importantly, the established cut-off value for arterial lactate (2.0 mmol/l) has limited specificity in venous samples and should not be used. Venous lactate for risk stratification Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1503). The authors are responsible for the contents of this publication. BRAHMS GmbH, part of Thermo Fisher Scientific, Hennigsdorf/Berlin, Germany provided financial support for biomarker measurements. The sponsor was neither involved in biomarker measurements, statistical analyses, writing of the abstract nor had any influence on the scientific contents.

No abstract

Einfluss der AntiarrhythmikaFlecainid und Amiodaron auf die kontraktile Funktion und die Kraft-Frequenz-Beziehung des Herzens Untersuchungen am isolierten insuffizienten menschlichen Myokard und gesunden Kaninchenmyokard INAUGURAL -DISSERTATION zur Erlangung des Doktorgrades der Medizinischen Fakultät der Georg-August-Universität zu Göttingen vorgelegt von Christian Pagel aus Goslar Göttingen 2009

Swim-with-whales tourism has become a growing aspect of the marine mammal tourism scene. Several remote island destinations allow for these in-water experiences. Understanding swim-with-whales tourists’ motivations is an important aspect to effectively promoting and managing these interactions. This paper focuses on tourist motivations for swimming with humpback whales (Megaptera novaeangliae) in Niue. A qualitative research approach using 21 semi-structured in-depth interviews was used to gain these. A thematic approach to understanding the data identified eight themes that describe intrinsic and extrinsic motivations in these whale-swim participants. Of particular interest was the emotional component of engaging in the activity. In contrast to other research on marine wildlife tourism motivations, the importance of learning was absent in this study. These findings highlight the personal and variable nature of individual motivations for participating in commercial whale-swims.