A standard lexicon of terms for area-based conservation version 1.0.

Target 3 in the Kunming-Montreal Global Biodiversity Framework (GBF) calls for protecting at least 30% of the world's lands and waters in area-based conservation approaches by 2030. This ambitious 30×30 target has spurred great interest among policy makers, practitioners, and researchers in defining and measuring the effectiveness of these types of approaches. But along with this broad interest, there has also been a proliferation of terms and their accompanying abbreviations used to describe different types of conservation areas and their governance, planning, management, and monitoring. The lack of standard terms is hindering the use and assessment of area-based approaches to conserve the world's biodiversity. It is difficult to track progress toward GBF Target 3 or to share learning with other practitioners if different groups of people are using different words to describe the same concept or similar words to talk about different concepts. To address this problem, the International Union for Conservation of Nature's World Commission on Protected Areas commissioned a task force to review existing terms and recommend a standard English-language lexicon for this field based on key criteria. The results were definitions of 37 terms across 6 categories, including types of protected and additional conservation areas (e.g., protected area, additional conservation area), sets of these areas (protected area network, protected area system), their governance and management (governance, rightsholders), assessment (effectiveness, equitability), spatial planning (key biodiversity area), and action planning (value, outcome, objective). Our standard lexicon can provide a common language for people who want to use it and a shared reference point that can be used to translate various terms used by different groups. The common understanding provided by the lexicon can serve as a foundation for collaborative efforts to improve the policies, implementation, assessments, research, and learning about this important set of conservation approaches.

Un léxico estandarizado de términos para la conservación basada en áreas versión 10 Resumen El objetivo 3 del Marco Global para la Biodiversidad de Kunming­Montreal (GBF) establece la protección de al menos el 30% de los suelos y aguas del planeta con estrategias de conservación basada en áreas para el 2030. Este objetivo ambicioso de 30x30 ha provocado un gran interés por definir y medir la eficiencia de este tipo de estrategias entre quienes hacen las políticas, los practicantes y los investigadores. Junto con este interés generalizado también ha habido una proliferación de términos y abreviaciones usados para describir los diferentes tipos de áreas de conservación y su gestión, planeación, manejo y monitoreo. La falta de términos estandarizados dificulta el uso y la evaluación de las estrategias basadas en áreas para conservar la biodiversidad mundial. Es difícil registrar los avances hacia el Objetivo 3 del GBF o compartir el aprendizaje con otros practicantes si diferentes grupos de personas usan diferentes palabras para describir el mismo concepto o palabras similares para hablar de conceptos distintos. Para abordar este problema, la Comisión Mundial de Áreas Protegidas de la Unión Internacional para la Conservación de la Naturaleza comisionó un grupo de trabajo para que revise los términos existentes y recomiende un léxico estandarizado en inglés para este campo con base en criterios clave. Como resultado obtuvieron la definición para 37 términos de seis categorías, incluyendo los tipos de área protegida y las áreas adicionales de conservación (p. ej.: área protegida, área adicional de conservación), los conjuntos de estas áreas (p. ej.: red de áreas protegidas, sistema de áreas protegidas), su gestión y manejo (gobernanza, derechohabientes), evaluación (efectividad, equidad), planeación espacial (área clave de biodiversidad) y plan de acción (valor, resultado, objetivo). Nuestro léxico estandarizado puede proporcionar un lenguaje común para la gente que quiera usarlo y una referencia compartida que puede usarse para traducir varios términos que usan los diferentes grupos. El conocimiento común proporcionado por el léxico puede fungir como una base para que los esfuerzos colaborativos mejoren las políticas, implementación, evaluación, investigación y aprendizaje sobre este conjunto importante de estrategias de conservación.

Species conservation in the era of genomic science.

The exponential increase in the availability of genomic data, derived from sequencing thousands of loci or whole genomes, provides exciting new insights into the diversity of life. However, it can also challenge established species concepts and existing management regimes derived from these concepts. Genomic data can help inform decisions about how to manage genetic diversity, but policies that protect identified taxonomic entities can generate conflicting recommendations that create challenges for practitioners. We outline three dimensions of management concern that arise when facing new and potentially conflicting interpretations of genomic data: defining conservation entities, deciding how to manage diversity, and evaluating the risks and benefits of management actions. We highlight the often-underappreciated role of values in influencing management choices made by individuals, scientists, practitioners, the public, and other stakeholders. Such values influence choices through mechanisms such as the Rashomon effect, whereby management decisions are complicated by conflicting perceptions of the causes and consequences of the conservation problem. To illustrate how this might operate, we offer a hypothetical example of this effect for the interpretation of genomic data and its implications for conservation management. Such value-based decisions can be challenged by the rigidity of existing management regimes, making it difficult to achieve the necessary flexibility to match the changing biological understanding. We finish by recommending that both conservation geneticists and practitioners reflect on their respective values, responsibilities, and roles in building a more robust system of species management. This includes embracing the inclusion of stakeholders in decision-making because, as in many cases, there are not objectively defensible right or wrong decisions.

Captive and urban environments are associated with distinct gut microbiota in deer mice (Peromyscus maniculatus).

Animals in captive and urban environments encounter evolutionarily novel conditions shaped by humans, such as altered diets, exposure to human-associated bacteria, and, potentially, medical interventions. Captive and urban environments have been demonstrated to affect gut microbial composition and diversity independently but have not yet been studied together. By sequencing the gut microbiota of deer mice living in laboratory, zoo, urban and natural settings, we sought to identify (i) whether captive deer mouse gut microbiota have similar composition regardless of husbandry conditions and (ii) whether captive and urban deer mice have similar gut microbial composition. We found that the gut microbiota of captive deer mice were distinct from those of free-living deer mice, indicating captivity has a consistent effect on the deer mouse microbiota regardless of location, lineage or husbandry conditions for a population. Additionally, the gut microbial composition, diversity and bacterial load of free-living urban mice were distinct from those of all other environment types. Together, these results indicate that gut microbiota associated with captivity and urbanization are likely not a shared response to increased exposure to humans but rather are shaped by environmental features intrinsic to captive and urban conditions.

Safety and feasibility of transesophageal echocardiography in patients with prior esophageal surgery.

BACKGROUND: Transesophageal echocardiography (TEE) is a specialized form of cardiac ultrasound and has been associated with rare but serious complications. In patients with prior esophageal surgery, the risk of esophageal damage or the inability to perform a comprehensive and successful TEE warrants further evaluation. METHODS: Retrospective study of patients with prior esophageal surgery who underwent TEE between June 21, 2002 and October 15, 2019. Medical and echocardiographic records were reviewed for image quality and procedural complications. Post-procedure complications and 30-day all-cause mortality were collected. Evaluation by gastroenterology (GI), otolaryngology/ear, nose, throat (ENT), or thoracic surgery (TS) within 30 days of TEE was reviewed in detail. RESULTS: Ninety-five patients with prior esophageal surgery underwent 145 TEEs. The most commonly performed esophageal procedures were anti-reflux operations (89%). TEE image quality was degraded in 16% while transgastric imaging was not completed in 37% of cases. A comprehensive TEE was completed in 57% of patients with diagnostic study goals achieved in 96% of cases. Comments describing procedural difficulty were reported in 6% while comments on procedural complications occurred in 1% of cases. Post-procedure complications occurred in 1% of patients including hypotension and unplanned hospital/ICU admission. CONCLUSIONS: Concern for esophageal damage and the inability to perform a comprehensive and diagnostic TEE may limit the usefulness of TEE in patients with prior esophageal surgery. While TEE-associated complications were rare in this series, a conservative approach with a thorough pre-procedure assessment, including multi-disciplinary evaluation when appropriate, is prudent in this complex cohort of patients.

The Safety and Feasibility of Transesophageal Echocardiography in Patients With Esophageal Stricture.

OBJECTIVES: Expert guidelines consistently list esophageal stricture (ES) as a contraindication to the performance of transesophageal echocardiography (TEE), although anecdotally the authors are aware of patients with ES undergoing TEE without apparent complication. Therefore the authors sought to determine the outcomes of patients with ES who had undergone TEE at their institution. DESIGN: Single-center, retrospective review. SETTING: Academic medical center (clinic and affiliated hospital). PARTICIPANTS: Patients with documented ES who also underwent TEE. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In a 10-year period, 1,083 TEE reports were generated for 823 patients who had a diagnosis of ES. One case of esophageal perforation occurred (1/1,083 examination reports [0.09%]) in an 85-year-old male with gastroesophageal reflux disease-related ES who had undergone esophageal dilation the same day as the TEE. In 17.2% of the TEE reports reviewed, changes to the conduct of the examination occurred, such as use of a pediatric probe or avoidance of transgastric imaging. In 8% of reviewed examinations, procedural difficulty was recorded. CONCLUSIONS: Patients with nonmalignant ES commonly present for TEE (>100 per year, on average, at the authors' institution). Severe TEE-related esophageal injury rarely occurred in patients with ES. However, changes to the conduct of the TEE examination and procedural difficulty were not infrequent in this group. Clinicians contemplating TEE in patients with ES should prepare for the possibility of altered examination conduct and possible procedural difficulty.

Assessment of the Conservation Measures Partnership's effort to improve conservation outcomes through adaptive management.

Conservation practice has demonstrated an increasing desire for accountability of actions, particularly with respect to effectiveness, efficiency, and impact to clearly identified objectives. This has been accompanied by increased attention to achieving adaptive management. In 2002, practitioners representing several prominent conservation nongovernmental organizations (NGOs) launched a community of practice called the Conservation Measures Partnership (CMP). The partnership CMP has worked to establish standards of conservation practice to improve accountability of conservation actions through adaptive management. The focal organizing framework for CMP has been the Open Standards for the Practice of Conservation (OS). We evaluated, through an online survey and personal interviews, the first decade of CMP and the OS. The CMP has garnered a positive reputation among agencies, NGOs, and funders and has succeeded in developing a large user base of the OS. However, CMP has not fully achieved its goal of making the OS standard operating procedure for the largest NGOs (e.g., The Nature Conservancy, World Wildlife Fund), despite it being widely used within these organizations. This lack of institutionalization is attributable to multiple causes, including an increase in the number of partially overlapping decision-support frameworks and challenges achieving full-cycle adaptive management. Users strongly believed the OS fosters better conservation practice and highly valued the OS for improving their practice. A primary objective of the OS is to assist practitioners to achieve full-cycle adaptive management to better integrate learning into improving the effectiveness and efficiency of actions. However, most practitioners had not yet achieved cycle completion for their projects. To improve the effectiveness of CMP, OS, and conservation practice in general, we recommend collaborative efforts among the proponents of multiple decision-support frameworks to foster strong institutional adoption of a common set of adaptive-management standards for conservation accountability.

Object-based verification of a prototype Warn-on-Forecast system.

An object-based verification methodology for the NSSL Experimental Warn-on-Forecast System for ensembles (NEWS-e) has been developed and applied to 32 cases between December 2015 and June 2017. NEWS-e forecast objects of composite reflectivity and 30-minute rotation tracks of updraft helicity are matched to corresponding objects in Multi-Radar Multi-Sensor data on space and time scales typical of a National Weather Service warning. Object matching allows contingency table-based verification statistics to be used to establish baseline performance metrics for NEWS-e thunderstorm and mesocyclone forecasts. NEWS-e critical Success Index (CSI) scores of reflectivity (updraft helicity) forecasts decrease from approximately 0.7 (0.4) to 0.4 (0.2) over 3 hours of forecast time. CSI scores decrease through the forecast period, indicating that errors have not saturated and skill is retained at 3 hours of forecast time. Lower verification scores for rotation track forecasts are primarily a result of a high frequency bias. Comparison of different system configurations used in 2016 and 2017 show an increase in skill for 2017 reflectivity forecasts, attributable mainly to improvements in the forecast initial condition. A small decrease in skill in 2017 rotation track forecasts is likely a result of sample differences between 2016 and 2017. Although large case-to-case variation is present, evidence is found that NEWS-e forecast skill improves with increasing object size and intensity, as well as in mesoscale environments in which an enhanced or higher risk of severe thunderstorms was forecast.

Synthetic biology and conservation of nature: wicked problems and wicked solutions.

So far, conservation scientists have paid little attention to synthetic biology; this is unfortunate as the technology is likely to transform the operating space within which conservation functions, and therefore the prospects for maintaining biodiversity into the future.

Human health impacts of ecosystem alteration.

Human activity is rapidly transforming most of Earth's natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms.

The complementary niches of anthropocentric and biocentric conservationists.

A divergence of values has become apparent in recent debates between conservationists who focus on ecosystem services that can improve human well-being and those who focus on avoiding the extinction of species. These divergent points of view fall along a continuum from anthropocentric to biocentric values, but most conservationists are relatively closer to each other than to the ends of the spectrum. We have some concerns with both positions but emphasize that conservation for both people and all other species will be most effective if conservationists focus on articulating the values they all share, being respectful of divergent values, and collaborating on common interests. The conservation arena is large enough to accommodate many people and organizations whose diverse values lead them to different niches that can, with good will and foresight, be far more complementary than competitive.

Optimism and challenge for science-based conservation of migratory species in and out of U.S. National Parks.

Public agencies sometimes seek outside guidance when capacity to achieve their mission is limited. Through a cooperative agreement and collaborations with the U.S. National Park Service (NPS), we developed recommendations for a conservation program for migratory species. Although NPS manages ∼ 36 million hectares of land and water in 401 units, there is no centralized program to conserve wild animals reliant on NPS units that also migrate hundreds to thousands of kilometers beyond parks. Migrations are imperiled by habitat destruction, unsustainable harvest, climate change, and other impediments. A successful program to counter these challenges requires public support, national and international outreach, and flourishing migrant populations. We recommended two initial steps. First, in the short term, launch or build on a suite of projects for high-profile migratory species that can serve as proof to demonstrate the centrality of NPS units to conservation at different scales. Second, over the longer term, build new capacity to conserve migratory species. Capacity building will entail increasing the limited knowledge among park staff about how and where species or populations migrate, conditions that enable migration, and identifying species' needs and resolving them both within and beyond parks. Building capacity will also require ensuring that park superintendents and staff at all levels support conservation beyond statutory borders. Until additional diverse stakeholders and a broader American public realize what can be lost and do more to protect it and engage more with land management agencies to implement actions that facilitate conservation, long distance migrations are increasingly likely to become phenomena of the past.

Robotic mitral valve repair: a review of anesthetic management of the first 200 patients.

OBJECTIVE: The aim of this study was to describe the evolution in anesthetic technique used for the first 200 patients undergoing robotic mitral valve surgery. DESIGN: A retrospective review. SETTING: A single tertiary referral academic hospital. PARTICIPANTS: Two hundred consecutive patients undergoing robotic mitral valve surgery using the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) at Mayo Clinic Rochester. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After obtaining institutional review board approval, surgical and anesthetic data were recorded. For analysis, patients were placed in 4 groups, each containing 50 consecutive patients, labeled Quartiles 1 to 4. Over time, there were statistically significant decreases in cardiopulmonary bypass and aortic cross-clamp times. Significant differences in the anesthetic management were shown, with a reduction of intraoperative fentanyl and midazolam doses, and the introduction of paravertebral blockade in Quartile 2. There was a reduction of time between incision closure and extubation, and nearly 90% of patients were extubated in the operating room in Quartiles 3 and 4. Despite changes to the intraoperative analgesic management, and focus on earlier extubation, there were no differences seen in visual analog scale (VAS) pain scores over the 4 quartiles. Reductions were seen in total intensive care unit and hospital length of stay during the study period. CONCLUSIONS: Changes to the practice, including efforts to limit intraoperative opioid administration and the addition of preoperative paravertebral blockade, helped facilitate earlier extubation. In the second half of the study period, close to 90% of patients were extubated in the operating room safely and without delaying patient transition to the intensive care unit.

Military Family Physicians' Readiness to Provide Gender-Affirming Care: A Serial Cross-Sectional Study.

PURPOSE: Family physicians are increasingly more likely to encounter transgender and gender-diverse (TGD) patients requesting gender-affirming care. Given the significant health inequities faced by the TGD community, this study aimed to assess changes in military-affiliated clinicians' perspectives toward gender-affirming care over time. METHODS: Using a serial cross-sectional survey design of physicians at the 2016 and 2023 Uniformed Services Academy of Family Physicians conferences, we studied participants' perception of, comfort with, and education on gender-affirming care using Fisher's Exact tests and logistic regression. RESULTS: Response rates were 68% (n = 180) and 69% (n = 386) in 2016 and 2023, respectively. Compared to 2016, clinicians in 2023 were significantly more likely to report receiving relevant education during training, providing care to >1 patient with gender dysphoria, and being able to provide nonjudgmental care. In 2023, 26% reported an unwillingness to prescribe gender-affirming hormones (GAH) to adults due to ethical concerns. In univariable analysis, female-identifying participants were more likely to report willingness to prescribe GAH (OR = 2.6, 95%CI = 1.7-4.1) than male-identifying participants. Willingness to prescribe was also associated with ≥4 h of education (OR = 2.2, 95%CI = 1.1-4.2) compared to those with fewer than 4 h, and those who reported the ability to provide nonjudgmental care compared to those who were neutral (OR = 0.09, 95%CI = 0.04-0.2) or disagreed (OR = 0.11, 95%CI = 0.03-0.39). Female-identifying clinicians were more likely to agree additional training would benefit their practice (OR = 5.3, 95%CI = 3.3-8.5). CONCLUSIONS: Although military-affiliated family physicians endorsed more experience with and willingness to provide nonjudgmental gender-affirming care in 2023 than 2016, profound gaps in patient experience may remain based on the assigned clinician. Additional training opportunities should be available, and clinicians unable to provide gender-affirming care should ensure timely referrals. Future research should explore trends across clinical specialties.