Shared decision-making in healthcare: development and assessment of the translated Finnish version of the SDM-Q-9.

AIMS: The aim of this study was to assess the cultural validity and reliability of a Finnish version of the nine-item Shared Decision-Making Questionnaire (SDM-Q-9) in a sample of patients with different sociodemographic characteristics. METHOD: The original SDM-Q-9 was translated into Finnish with the agreement of the developers of the original scale. The standardised translation procedure was followed by a pilot test of the questionnaire. The data were collected from an online questionnaire. Reliability was estimated by Cronbach's alpha. Structural validity of the questionnaire was assessed by confirmatory factor analysis. RESULTS: The pilot study assessing the cultural validity of the scale was a success, as it did not find any expressions needing to be revised. The Finnish version of the SDM-Q-9 - the SDM-Q-9-FIN - was tested in the study where a total of 736 patients responded to the questionnaire. The questionnaire yielded high reliability with a Cronbach's alpha of 0.92. Confirmatory factor analysis confirmed the unidimensional factor structure with Item 1 excluded. CONCLUSIONS: The SDM-Q-9-FIN was shown to be a reliable instrument for evaluating shared decision-making among Finnish patients. Further testing and research are recommended among a greater diversity of patient groups.

Establishing the distribution of Carpophilus truncatus in Australia using an integrative approach for an emerging global pest.

The nitidulid beetle Carpophilus truncatus is rapidly becoming a major pest of nut crops around the world. This insect first infested Australian almonds in 2013 and has since escalated to be the preeminent insect pest for the industry. Data pertaining to C. truncatus distribution are scant, but without awareness of its origin, distribution, and ecological factors that influence distribution, efforts to understand and manage the insect as a pest are stymied. Here, we employ an integrative approach to gain a multifaceted understanding of the distribution of C. truncatus in Australia. Methods employed were (1) reviewing historical records in insect collections to establish the presence of C. truncatus prior to commercial almond horticulture, (2) field trapping of insects to establish presence in regions of interest, (3) laboratory trials to determine the thermal limits of the organism, and (4) correlative species distribution modelling to describe its current distribution. We find that C. truncatus is more widespread across Australia than was previously known, with historical records preceding commercial almond production in Australia by a century. The methods developed in this study can be applied elsewhere in the world where C. truncatus is an emerging pest, or to novel pest species as they arise with increasing frequency in a globalised and warming world.

The role of shared decision-making in enhancing patient experience: Insights from a cohort of curative head and neck cancer patients.

INTRODUCTION: Shared decision-making (SDM) is on the NHS policy agenda, and the preferred model for preference-sensitive decisions. This study establishes baseline patient-perceived SDM in a radical head and neck cohort, and explores patients' views on SDM in a large, specialist trust. METHODS: An SDM questionnaire was distributed to all radical head and neck radiotherapy patients (N = 165), June-December 2023. This combined a well-validated instrument for measuring SDM from the patient perspective, SDM-Q-9, with additional questions exploring patient views. Thematic analysis was used to construct and interpret themes. RESULTS: 65/165 (39%) questionnaires were returned. SDM-Q-9 mean standardised score was 78.6 (SD 26.3). There was a moderate ceiling effect (26%). Scores were not sensitive to sex (p = 0.64) or age (ρ = 0.1). Higher levels of SDM were perceived by participants who stated SDM was very important (51/65, 79%) than somewhat or not at all important (82.4 vs. 62.7; p = 0.02; Cohen d = 0.75). Individuals who discussed their personal priorities with the clinician (46/65, 70.8%), were more likely to be very satisfied with their involvement in SDM (89.1% vs. 52.9%). Thematic analysis generated three themes: Control, Desire for Transparency and Understanding, and Doctor as the Expert. CONCLUSION: Patient-perceived SDM levels are high for head and neck patients. Participants who value SDM also perceive higher levels of SDM. Patient satisfaction increases when individuals discuss their personal priorities. The modest response rate and self-selection bias affect the generalisability of the results. Only radiotherapy patients were included; those who chose alternative treatment may perceive different levels of SDM. The moderate ceiling effect may limit the use of SDM-Q-9 to measure impact of future interventions to improve SDM. IMPLICATIONS FOR PRACTICE: SDM-Q-9 should be combined with an objective, observer measure of SDM.

The Ethical Complexity of Medical Decision Making in the Adolescent Oncology Patient.

Adolescent Medical Decision Making (aMDM) is frequently discussed but presents a significant challenge in practice, especially in cases of adolescents with life threatening or life limiting illnesses. In this paper, we present a case that explores the importance of aMDM, the difficulties for providers when engaging adolescents in these discussions, and how certain skills may be incorporated into pediatric practice. Literature suggests that patients of this age group, while being legally without capacity, have meaningful insights into their care. However, unless physicians feel comfortable and competent engaging adolescents in a manner that honors their developmentally appropriate understanding of their illness, these insights can be lost.

Spontaneous Brain Activity Abnormalities in Patients With Temporal Lobe Epilepsy: A Meta-Analysis of 1474 Patients.

BACKGROUND: Abnormalities in resting-state functional brain activity have been detected in patients with temporal lobe epilepsy (TLE). The results of individual neuroimaging studies of TLE, however, are frequently inconsistent due to small and heterogeneous samples, analytical flexibility, and publication bias toward positive findings. PURPOSE: To investigate the most consistent regions of resting-state functional brain activity abnormality in patients with TLE through a quantitative meta-analysis of published neuroimaging data. STUDY TYPE: Meta-analysis. SUBJECTS: Exactly 1474 TLE patients (716 males and 758 females) from 31 studies on resting-state functional brain activity were included in this study. FIELD STRENGTH/SEQUENCE: Studies utilizing 1.5 T or 3 T MR scanners were included for meta-analysis. Resting-state functional MRI using gradient echo-planar imaging, T1-weighted imaging. ASSESSMENT: PubMed, Web of Science, Chinese National Knowledge Infrastructure, and WanFang databases were searched to identify studies investigating amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) at the whole-brain level between patients with TLE and healthy controls (HCs). STATISTICAL TESTS: Seed-based d Mapping with Permutation of Subject Images, standard randomization tests and meta-regression analysis were used. Results were significant if P < 0.05 with family-wise error corrected. RESULTS: Patients with TLE displayed resting-state functional brain activity which was a significant increase in the right hippocampus, and significant decrease in the right angular gurus and right precuneus. Additionally, the meta-regression analysis demonstrated that age (P = 0.231), sex distribution (P = 0.376), and illness duration (P = 0.184), did not show significant associations with resting state functional brain activity in patients with TLE. DATA CONCLUSION: Common alteration patterns of spontaneous brain activity were identified in the right hippocampus and default-model network regions in patients with TLE. These findings may contribute to understanding of the underlying mechanism for potentially effective intervention of TLE. TECHNICAL EFFICACY STAGE: Stage 2.

The role of the purposeful shared decision making model in vascularized composite allotransplantation.

For some patients who have lost the lower part of an arm, hand transplant offers the possibility of receiving a new limb with varying degrees of sensation and function. This procedure, Vascularized Composite Allotransplantation (VCA), is demanding for patients and their care community and comes with significant risks. As a high-stakes decision, patients interested in VCA are subject to extensive clinical evaluation and eligibility decision making. Patients and their care community must also decide if hand transplant (versus other approaches including rehabilitative therapies with or without prosthesis) is right for them. This decision making is often confusing and practically and emotionally fraught. It is complicated in four ways: by the numerous beneficial and harmful potential effects of hand transplant or other options, the number of people affected by VCA and the diverse or conflicting positions that they may hold, the practical demands and limitations of the patient's life situation, and the existential significance of limb loss and transplant for the patient's being. Patients need support in working through these treatment determining issues. Evaluation does not provide this support. Shared decision making (SDM) is a method of care that helps patients think, talk, and feel their way through to the right course of action for them. However, traditional models of SDM that focus on weighing possible beneficial and harmful effects of treatments are ill-equipped to tackle the heterogeneous issues of VCA. A recent model, Purposeful SDM extends the range of troubling issues that SDM can help support beyond opposing effects, to include conflicting positions, life situations, and existential being. In this paper we explore the pertinence of these issues in VCA, methods of SDM that each require of clinicians, the benefits of supporting patients with the breadth of issues in their unique problematic situations, implications for outcomes and practice, and extend the theory of the Purposeful SDM model itself based on the issues present in hand transplant decision making.

Alteration of fractional anisotropy in preterm-born individuals: a systematic review and meta-analysis.

BACKGROUD: Neurological disorders are common in preterm (PT) born individuals. Diffusion tensor imaging (DTI) studies using tract-based spatial statistics (TBSS) effectively detect microstructural white matter (WM) abnormalities in the brain. We conducted this systematic review to integrate the findings of TBSS studies to determine the most consistent WM alterations in PT born individuals. METHODS: PubMed, Embase, Web of Science and Science Direct were searched. DTI studies using TBSS in PT born individuals were screened up to October 2022. The systematic review included studies reporting alterations in FA values for the entire brain in a stereotactic space, with three coordinates (x, y, z), according to the seed-based d mapping method. RESULTS: The search strategy identified seventeen studies that fulfilled our inclusion criteria, with a total of 911 PT-born individuals and 563 matched controls were analysed. Of the seventeen studies, eight were dedicated to 650 adults, five to 411 children and four to 413 infants. Ten studies recruited 812 individuals born very prematurely (GA <29 weeks), six studies recruited 386 moderately premature individuals (GA = 29-32 weeks) and one study recruited 276 individuals born late prematurely (GA >32 weeks). This meta-analysis of six studies including 388 individuals highlighted four brain regions in which fractional anisotropy (FA) was lower in PT group than in people born at term. The quantitative meta-analysis found that the most robust WM alterations were located in the corpus callosum (CC), the bilateral thalamus and the left superior longitudinal fasciculus (SLF) II. Significant changes in FA reflect WM abnormalities in PT born individuals from infant to young adulthood. CONCLUSIONS: Significant changes in FA reflect WM abnormalities in individuals born PT from infancy to young adulthood. The abnormal development of the CC, bilateral thalamus and left SLF may play a vital role in the neurodevelopment of PT individuals.

Neurological disorders are prevalent in preterm (PT) born individuals. The use of tract-based spatial statistics (TBSS) in diffusion tensor imaging (DTI) studies has proven effective in detecting microstructural abnormalities of the white matter (WM) of the brain. In order to determine the most consistent alterations in WM among those born prematurely, we have screened DTI studies using TBSS in this PT born population up until October 2022. The meta-analysis identified four brain regions where fractional anisotropy (FA) was lower in the PT group than in those born at term. The quantitative meta-analysis identified the corpus callosum, the bilateral thalamus and the left superior longitudinal fasciculus II. As the most robust WM alterations. Various studies have demonstrated the links between PT birth, intelligence quotient, gestational age and subject age.

The future of plant diversity within a Mediterranean endemism centre: Modelling the synergistic effects of climate and land-use change in Peloponnese, Greece.

Climate- and land-use change stand as primary threats to terrestrial biodiversity. Yet, their synergistic impacts on species distributions remain poorly understood. To address this knowledge gap, we conducted the first-ever comprehensive species distribution analysis on an entire regional endemism centre within an eastern Mediterranean country, incorporating dynamic land-use/land-cover change data together with climate change scenarios. Specifically, we apply species distribution modelling and spatial data analysis techniques to compare the individual and synergistic effects of these environmental drivers on the endemic vascular flora of Peloponnese, focusing on potential range contractions, altitudinal shifts, and habitat fragmentation levels. Moreover, we identify fine-scale present and potential future endemism hotspots within our study area, incorporating taxonomic and phylogenetic information. Overall, we aim to enhance our current understanding of endemism patterns and contribute to the development of future-proof conservation strategies for safeguarding Greece's endangered endemic flora. The integration of land-use change projections with climate change yielded less severe impacts compared to the effects anticipated when considering climatic variables alone. Most taxa are expected to undergo significant range declines and nearly half might experience increased habitat fragmentation, due to the synergistic effects of climate- and land-use change. We identified endemism hotspots, which are concentrated in or along the main Peloponnesian mountain massifs. However, our predictions indicate that areas presently recognized as endemism hotspots will undergo a concerning area decline, across all future scenarios considered in this study. Our findings highlight the importance of including dynamic land-use variables alongside climatic predictors when projecting species distributions under global change. Moreover, we showed that endemism hotspots are not static and considering their potential geographic shifts is paramount to delineate effective forward-looking conservation strategies.

Medical Complexity of Children with Special Healthcare Needs and Healthcare Experiences.

The rising prevalence of CSHCN has led to significant challenges for caregivers, particularly mothers, who face difficulties from caregiving demands and managing complex healthcare interactions. The objective of this study was to examine the association between the medical complexity of CSHCN and the healthcare experiences of their mothers while exploring the influence of sociodemographic factors on these associations. The study utilized data from the 2016-2020 National Survey of Children's Health (NSCH), involving 17,434 mothers of CSHCN. Mothers provided information on the medical complexity of CSHCN, healthcare experiences (care coordination, family-centered care, and shared decision-making), and sociodemographic information (race, community, insurance, child sex, age, and federal poverty level). Results from multiple regressions revealed that greater medical complexity was associated with more negative healthcare experiences. Minoritized mothers, those in rural areas, and families with lower income reported lower levels of family-centered care, indicating significant disparities. Additionally, the negative association between medical complexity and healthcare experiences was pronounced for White families and those with private insurance compared to minoritized families and those with public insurance. This study highlights the necessity for targeted interventions to improve care coordination, family-centered care, and shared decision-making, emphasizing the need for a comprehensive, family-centered approach to address healthcare disparities and promote health equity for CSHCN and their families.

Habitat suitability modelling to predict the distribution of deep coral ecosystems: The case of Linosa Island (southern Mediterranean Sea, Italy).

In areas with limited field data, predictive habitat mapping is a valuable method for elucidating species-environment relationships and enhancing our knowledge of the spatial distribution and complexity of benthic habitats. Species distribution models (SDMs) can be an important tool to support in science-based ecosystem management. The availability of direct observations of mesophotic species, including gorgonians and black corals, during costly surveys is generally limited. Therefore, predicting the distribution of mesophotic species in relation to key physical parameters of the seafloor would help improving conservation strategies in existing and new Marine Protected Areas (MPAs). This study aims to assess the distribution of gorgonians and black corals off Linosa Island, in the Strait of Sicily, a biogeographic boundary area between the western and eastern Mediterranean. The volcanic island of Linosa represents a small, naturally preserved area, with very limited human pressure, hosting rich marine benthic biodiversity on its wide submarine portions. Distribution of the most common coral species off Linosa Island was modelled under an SDM framework, relying on direct observations collected during two research cruises in 2016 and 2017 and a series of terrain parameters acquired through geophysical techniques. We used the so-called "ensemble of small models" approach to calibrate SDMs, which achieved fair-to-excellent results (AUC >0.7). In addition to identifying depth as the primary factor influencing coral distribution, our study also highlighted ruggedness as a significant terrain variable. Specifically, the depth range of 110-230 m emerged as the critical parameter determining habitat suitability for all modelled species, also highlighting peculiar and specie-specific habitat requirements.

Common and separable neural alterations in adult and adolescent depression - Evidence from neuroimaging meta-analyses.

Depression is a highly prevalent and debilitating mental disorder that often begins in adolescence. However, it remains unclear whether adults and adolescents with depression exhibit common or distinct brain dysfunctions during reward processing. We aimed to identify common and separable neurofunctional alterations during receipt of rewards and brain structure in adolescents and adults with depression. A coordinate-based meta-analysis was employed using Seed-based d mapping with permutation of subject images (SDM-PSI). Compared with healthy controls, both age groups exhibited common activity decreases in the right striatum (putamen, caudate) and subgenual ACC. Adults with depression showed decreased reactivity in the right putamen and subgenual ACC, while adolescents with depression showed decreased activity in the left mid cingulate, right caudate but increased reactivity in the right postcentral gyrus. This meta-analysis revealed shared (caudate) and separable (putamen and mid cingulate cortex) reward-related alterations in adults and adolescents with depression. The findings suggest age-specific neurofunctional alterations and stress the importance of adolescent-specific interventions that target social functions.

Intrinsic disruption of white matter microarchitecture in major depressive disorder: A voxel-based meta analysis of diffusion tensor imaging.

BACKGROUND: Major depressive disorder (MDD) is a prevalent and disabling mood disorder, thought to be linked with brain white matter (WM) alterations. Prior diffusion tensor imaging (DTI) studies have reported inconsistent changes in fractional anisotropy (FA) across different brain regions in MDD patients. However, none of these studies utilized raw t-map data for WM meta-analysis in MDD. Our study aims to address this gap by conducting a whole-brain-based meta-analysis of FA in MDD using Seed-based d mapping via permutation of subject images (SDM-PSI), combining reported peak coordinates and raw statistical parametric maps. OBJECTIVES: Following PRISMA guidelines, we performed a systematic search and meta-analysis to compare FA in MDD patients with healthy controls (HC). Our goal was to identify WM abnormalities in MDD, using SDM, which could shed light on the disorder's pathogenesis. RESULTS: The meta-analysis included 39 studies with 3696 participants (2094 with MDD, 1602HC). It revealed that MDD patients, in comparison to HC, have lower FA in the corpus callosum (CC) and anterior thalamic projections (ATP). Subgroup analyses indicated that the CC is a more stable pathogenic factor in MDD. Meta-regression analyses showed no linear correlation between the mean age, percentage of female patients, duration of depression, and FA abnormalities. This suggests that WM impairments in interhemispheric connections and anterior thalamocortical circuits are significant in the pathogenesis of MDD.

Study on the bioactive components of Banxia Xiexin Decoction with different decocting methods and its effects on ulcerative colitis rats from the perspective of phase states.

ETHNOPHARMACOLOGICAL RELEVANCE: Banxia Xiexin Decoction (BXD) is one of the seven classic prescriptions of the special decoction method (SDM) of "removing dregs and decocting again", which has been widely used in inflammatory bowel diseases such as ulcerative colitis (UC). However, the impacts of SDM have not been fully investigated, either on the components or on the biological effects. AIM OF THE STUDY: This study aimed to investigate the rational of SDM traditionally recorded about BXD, re-decoction after dreg-removal, by comparing with the contemporary general decoction method (GDM) from the perspective of phase states, in the bioactive components from the perspective of phase states, and their corresponding pharmacodynamic effects on a particular UC rat model. METHODS: The BXD decoctions were respectively obtained by SDM and GDM, together with the different samples with different decocting time. The phase state samples (true solution, colloidal phase, and precipitated phase), were also obtained after a series of separation process and characterized. The multi-components in the in-process decoctions, original decoctions and phase state samples were quantitatively determined. HPLC fingerprint spectrum of the samples were also detected and compared with chemometrics analysis. A rat model of ulcerative colitis with cold-heat complex syndrome was established, on which the pharmacodynamic effects of different phases of SDM-made BXD were investigated. RESULTS: The results showed that the contents of eight marker components in SDM-made decoction were significantly higher than those in GDM-made decoction. Compared with the precipitated phases and true solutions, the colloidal phase was confirmed to obtain absolutely higher contents of the components (except berberine). The analysis on HPLC fingerprints also revealed that the profiles of colloidal phase showed the majority of the characteristics of original decoctions, when compared with the other phases. The results showed the BXD group, precipitated phase group and colloidal phase group had certain therapeutic effects on the ulcerative colitis rats with cold-heat complex syndrome, among which the original decoction group showed optimal effects, followed by the colloidal phase. CONCLUSION: The study has provided the experimental evidence of the bioactive components and pharmacodynamic effects on the rational of SDM, as originally recorded about the classic prescription, which might provide useful idea for the interpretation on medicinal properties of TCM compound prescriptions, and contemporary TCM innovative drug developments.

Predicting the potential risk of Caragana shrub encroachment in the Eurasian steppe under anthropogenic climate change.

Climate change and human activities drive widespread shrub encroachment in global grassland ecosystems, particularly in the Eurasian steppe. Caragana shrubs, the primary contributors to shrub encroachment in this region, play a crucial role in shaping the ecosystem's structure and function. Future changes in the suitable distribution range of Caragana species will directly affect the ecological security and sustainable socio-economic development of the Eurasian steppe ecosystem. We used an ensemble modeling approach to predict Caragana shrub-dominated plant communities' current and future distribution in three major steppe subregions: the Black Sea-Kazakhstan steppe, the Tibetan Plateau steppe, and the Central Asian steppe. We assessed the potential risk of Caragana shrub encroachment by predicting changes in the suitable distribution area of 19 Caragana shrub species under future climate changes. Our research findings suggest that the expansion of Caragana species in different subregions of the Eurasian steppe is influenced by the effects of climate change in various ways. The distribution of Caragana species is primarily influenced by precipitation and temperature, and the global human modification (ghm) has a significant impact on the Central Asian and Tibetan Plateau subregions. Minimal changes are expected in the Black Sea-Kazakhstan subregion, a slight increase on the Tibetan Plateau, and a substantial rise in the Central Asian subregion, which suggests a higher potential risk of Caragana species shrub encroachment in that area. Our research provides valuable insights into the response of Caragana shrub encroachment to changing climates and human activities. It also has implications for the sustainable management of different areas of the vast Eurasian steppe ecosystem.

Exploring ways to improve China's ecological well-being amidst air pollution challenges using mixed methods.

Ecological well-being performance (EWP), a novel concept in sustainable development research, diverges from traditional ecological efficiency in terms of perspectives, core content, and driving factors. However, research on EWP remains insufficiently comprehensive, particularly the corresponding theoretical and methodological investigations into driving pathways. To address this gap, this study develops an "economy-environment-health" framework, incorporating air pollution and associated health losses into the evaluation system, and employs a two-stage Super-NSBM and Window DEA model for reevaluating EWP. The study further investigates the primary pathways of EWP, focusing on environmental regulations, technological innovation, and structural adjustments through both quantitative and qualitative methods. Quantitative spatial econometric analysis reveals that factors such as market-driven environmental regulations, green invention patents, and industrial and energy consumption structures significantly enhance EWP. While examining the "net effects" contributions of individual variables using spatial econometric models, the fsQCA method is employed to identify four effective driving paths for EWP from a configurational perspective. These paths are 1) technological innovation and structural adjustment under environmental regulations with public participation; 2) a combination of environmental regulation, technological innovation, and structural adjustment; 3) structural adjustment with minimal influence from environmental regulations and technological innovation; and 4) structural adjustment directed by market-incentive environmental regulations.

Model-based individual life-spanning documentation in visceral surgery: a proof of concept.

INTRODUCTION: Surgical documentation has many implications. However, its primary function is to transfer information about surgical procedures to other medical professionals. Thereby, written reports describing procedures in detail are the current standard, impeding comprehensive understanding of patient-individual life-spanning surgical course, especially if surgeries are performed at a timely distance and in diverse facilities. Therefore, we developed a novel model-based approach for documentation of visceral surgeries, denoted as 'Surgical Documentation Markup-Modeling' (SDM-M). MATERIAL AND METHODS: For scientific evaluation, we developed a web-based prototype software allowing for creating hierarchical anatomical models that can be modified by individual surgery-related markup information. Thus, a patient's cumulated 'surgical load' can be displayed on a timeline deploying interactive anatomical 3D models. To evaluate the possible impact on daily clinical routine, we performed an evaluation study with 24 surgeons and advanced medical students, elaborating on simulated complex surgical cases, once with classic written reports and once with our prototypical SDM-M software. RESULTS: Leveraging SDM-M in an experimental environment reduced the time needed for elaborating simulated complex surgical cases from 354 ± 85 s with the classic approach to 277 ± 128 s. (p = 0.00109) The perceived task load measured by the Raw NASA-TLX was reduced significantly (p = 0.00003) with decreased mental (p = 0.00004) and physical (p = 0.01403) demand. Also, time demand (p = 0.00041), performance (p = 0.00161), effort (p = 0.00024), and frustration (p = 0.00031) were improved significantly. DISCUSSION: Model-based approaches for life-spanning surgical documentation could improve the daily clinical elaboration and understanding of complex cases in visceral surgery. Besides reduced workload and time sparing, even a more structured assessment of individual surgical cases could foster improved planning of further surgeries, information transfer, and even scientific evaluation, considering the cumulative 'surgical load.' CONCLUSION: Life-spanning model-based documentation of visceral surgical cases could significantly improve surgery and workload.

Some bats are here: Reducing the Wallacean shortfall of bats in the amazon.

The Amazon rainforest has approximately 23% of its sampled area dedicated to bats, making it one of the least sampled and most diverse regions for bats in Brazil. The lack of sampling results in a lack of knowledge regarding the accurate geographical distribution of bat species. This lack is referred to as the Wallacean shortfall, which should be addressed with primary data obtained from in situ collections. However, the use of Species Distribution Models (SDMs) can help alleviate this gap. The states of Pará and Acre are located in the Brazilian Amazon. So, our objective is to decrease the Wallacean shortfall concerning Amazonian bat species. To achieve this, we provide (i) a list of bat species sampled in the states of Pará and Acre in the last 5 years (2017 to 2022); (ii) the potential distribution of species considered as new occurrences for the region; and (iii) the potential distribution of species classified as Data Deficient (DD) and Near Threatened (NT) according to the IUCN classification. With 96 nights of collection and 129,600 m2h of mist netting, we obtained 75 bat species, with an estimated total of 94.78 species. Additionally, 21 species were considered as range extensions. The Brazilian Amazon region has a vast geographic expanse and few established research centers, resulting in a limited sampling of bats and other biological groups. Furthermore, we draw attention to the significant number of bat species with expanded geographical distributions, with 21 out of the 75 sampled species. This should be a reminder that primary biogeographic data is still necessary for the neotropical region.

The potential range of west Asian apple species Malus orientalis Uglitzk. under climate change.

The wild relatives of cultivated apples would be an ideal source of diversity for breeding new varieties, which could potentially grow in diverse habitats shaped by climate change. However, there is still a lack of knowledge about the potential distribution of these species. The aim of the presented work was the understand the impacts of climate change on the potential distribution and habitat fragmentation of Caucasian crab apple (Malus orientalis Uglitzk.) and the designation of areas of high interest according to climatic conditions. We used the MaxEnt models and Morphological-Spatial Analysis (MSPA) to evaluate the potential distribution, suitability changes, habitat fragmentation, and connectivity throughout the species range in Turkey, Armenia, Georgia, Russia, and Iran. The results revealed that the potentially suitable range of M. orientalis encompasses 858,877 km², 635,279 km² and 456,795 km² under the present, RCP4.5 and RCP8.5 scenario, respectively. The range fragmentation analysis demonstrated a notable shift in the edge/core ratio, which increased from 50.95% in the current scenario to even 67.70% in the future. The northern part of the range (Armenia, northern Georgia, southern Russia), as well as the central and western parts of Hyrcania will be a core of the species range with suitable habitats and a high connectivity between M. orientalis populations and could work as major refugia for the studied species. However, in the Zagros and central Turkey, the potential range will shrink due to the lack of suitable climatic conditions, and the edge/core ratio will grow. In the southern part of the range, a decline of M. orientalis habitats is expected due to changing climatic conditions. The future outlook suggests that the Hyrcanian forest and the Caucasus region could serve as important refuges for M. orientalis. This study helps to understand spatial changes in species' range in response to climate change and can help develop conservation strategies. This is all the more important given the species' potential use in future breeding programs aimed at enriching the gene pool of cultivated apple varieties.

"They must get to know the individual very well": relationship-building of family and volunteer supporters in supported decision-making schemes.

PURPOSE: Supported decision-making (SDM) is an emerging and innovative alternative to substitute decision-making practices. While relationships are pivotal in establishing proper and effective SDM, scant research has examined these relationships in-depth. This study explores how decision-making supporters perceive relationships embedded in SDM for adults with disabilities. Furthermore, it compares the points of view of family and volunteer supporters on these relationships. MATERIALS AND METHODS: Using a semi-structured interview guide, in-depth interviews were held with 16 family and 16 volunteer supporters of Israeli decision-makers with disabilities. RESULTS: Both family and volunteer supporters addressed the centrality of the support relationship. However, they differed in their perspectives on the ways such relationships should be formed and on their boundaries. We distinguish between families' continuing relationships vs. volunteers' emerging relationships to emphasize the identified differences. CONCLUSIONS: The findings highlighted the importance of relationships to SDM processes, highlighting the need to examine in greater depth whether and how "typical" family relationships differ from SDM relationships. Based on these findings, we recommend training and guidance for both family and volunteer supporters in developing and strengthening these relationships.

Supported decision-making enhances quality of life as it helps persons with disabilities make and implement decisions.With proper supported decision-making, people with disabilities feel their wishes are recognized and respected.Focus on and awareness of relationship building is crucial and thus its various dimensions should explicitly be incorporated in any training program or policy for supported decision-makersGiven adequate training, both family and volunteers can develop positive relationships in supported decision-making schemes.

Predicting suitable habitat for the endangered tree Ormosia microphylla in China.

Climate change has significantly influenced the growth and distribution of plant species, particularly those with a narrow ecological niche. Understanding climate change impacts on the distribution and spatial pattern of endangered species can improve conservation strategies. The MaxEnt model is widely applied to predict species distribution and environmental tolerance based on occurrence data. This study investigated the suitable habitats of the endangered Ormosia microphylla in China and evaluated the importance of bioclimatic factors in shaping its distribution. Occurrence data and environmental variables were gleaned to construct the MaxEnt model, and the resulting suitable habitat maps were evaluated for accuracy. The results showed that the MaxEnt model had an excellent simulation quality (AUC = 0.962). The major environmental factors predicting the current distribution of O. microphylla were the mean diurnal range (bio2) and precipitation of the driest month (bio14). The current core potential distribution areas were concentrated in Guangxi, Fujian, Guizhou, Guangdong, and Hunan provinces in south China, demonstrating significant differences in their distribution areas. Our findings contribute to developing effective conservation and management measures for O. microphylla, addressing the critical need for reliable prediction of unfavorable impacts on the potential suitable habitats of the endangered species.