Global protected areas seem insufficient to safeguard half of the world's mammals from human-induced extinction.

Protected areas (PAs) are a cornerstone of global conservation and central to international plans to minimize global extinctions. During the coming century, global ecosystem destruction and fragmentation associated with increased human population and economic activity could make the long-term survival of most terrestrial vertebrates even more dependent on PAs. However, the capacity of the current global PA network to sustain species for the long term is unknown. Here, we explore this question for all nonvolant terrestrial mammals for which we found sufficient data, ∼4,000 species. We first estimate the potential population size of each such mammal species in each PA and then use three different criteria to estimate if solely the current global network of PAs might be sufficient for their long-term survival. Our analyses suggest that current PAs may fail to provide robust protection for about half the species analyzed, including most species currently listed as threatened with extinction and a third of species not currently listed as threatened. Hundreds of mammal species appear to have no viable protected populations. Underprotected species were found across all body sizes, taxonomic groups, and geographic regions. Large-bodied mammals, endemic species, and those in high-biodiversity tropical regions were particularly poorly protected by existing PAs. As new international biodiversity targets are formulated, our results suggest that the global network of PAs must be greatly expanded and most importantly that PAs must be located in diverse regions that encompass species not currently protected and must be large enough to ensure that protected species can persist for the long term.

Incidence of RSV in Adults: A Comprehensive Review of Observational Studies and Critical Gaps in Information.

BACKGROUND: We conducted a global comprehensive literature review of observational studies reporting RSV incidence in adults and determined current evidence gaps. METHODS: PubMed and Embase were searched for English-language publications (2000-2022) and congress abstracts (2019-2021) reporting RSV incidence rates/cumulative incidence. Cross-sectional studies, case series, and other designs estimating only RSV frequency were excluded. The search included all geographic areas; data were extracted by age group and underlying condition where available. RESULTS: 528 potentially relevant records were identified, of which 37 primary studies were relevant to this review. Most evidence was from high-income regions. Approximately two-thirds of the studies reported RSV incidence in the hospital setting. Fifteen studies included or focused exclusively on RSV incidence in adult populations with underlying conditions. Studies varied in their measurement and presentation of incidence. RSV incidence estimates were highly variable within and between geographic regions. Overall, RSV incidence tended to increase with age and was highest in adults with underlying conditions. CONCLUSION: Estimates of RSV incidence are highly variable across populations and geographies. Further population-based studies with well-defined consistent case definitions and surveillance strategies are needed for accurate and comparable estimates of RSV incidence, particularly in the geographic regions identified by the gap analysis.

A framework for integrating evidence to assess hazards and risk.

To accurately characterize human health hazards, human, animal, and mechanistic data must be integrated and the relevance to the research question of all three lines of evidence must be considered. Mechanistic data are often critical to the full integration of animal and human data and to characterizing relevance and uncertainty. This novel evidence integration framework (EIF) provides a method for synthesizing data from comprehensive, systematic, quality-based assessments of the epidemiological and toxicological literature, including in vivo and in vitro mechanistic studies. It organizes data according to both the observed human health effects and the mechanism of action of the chemical, providing a method to support evidence synthesis. The disease-based component uses the evidence of human health outcomes studied in the best quality epidemiological literature to organize the toxicological data according to authors' stated purpose, with the pathophysiology of the disease determining the potential relevance of the toxicological data. The mechanism-based component organizes the data based on the proposed mechanisms of effect and data supporting events leading to each endpoint, with the epidemiological data potentially providing corroborating information. The EIF includes a method to cross-classify and describe the concordance of the data, and to characterize its uncertainty. At times, the two methods of organizing the data may lead to different conclusions. This facilitates identification of knowledge gaps and shows the impact of uncertainties on the strength of causal inference.

Diversification of refugia types needed to secure the future of coral reefs subject to climate change.

Identifying locations of refugia from the thermal stresses of climate change for coral reefs and better managing them is one of the key recommendations for climate change adaptation. We review and summarize approximately 30 years of applied research focused on identifying climate refugia to prioritize the conservation actions for coral reefs under rapid climate change. We found that currently proposed climate refugia and the locations predicted to avoid future coral losses are highly reliant on  excess heat metrics, such as degree heating weeks. However, many existing alternative environmental, ecological, and life-history variables could be used to identify other types of refugia that lead to the desired diversified portfolio for coral reef conservation. To improve conservation priorities for coral reefs, there is a need to evaluate and validate the predictions of climate refugia with long-term field data on coral abundance, diversity, and functioning. There is also the need to identify and safeguard locations displaying resistance toprolonged exposure to heat waves and the ability to recover quickly after thermal exposure. We recommend using more metrics to identify a portfolio of potential refugia sites for coral reefs that can avoid, resist, and recover from exposure to high ocean temperatures and the consequences of climate change, thereby shifting past efforts focused on avoidance to a diversified risk-spreading portfolio that can be used to improve strategic coral reef conservation in a rapidly warming climate.

Diversificación de los tipos de refugio necesarios para asegurar el futuro de los arrecifes de coral sujetos al cambio climático Resumen Una de las principales recomendaciones para la adaptación al cambio climático es identificar los refugios de los arrecifes de coral frente al estrés térmico del cambio climático y mejorar su gestión. Revisamos y resumimos ∼30 años de investigación aplicada centrada en la identificación de refugios climáticos para priorizar las acciones de conservación de los arrecifes de coral bajo un rápido cambio climático. Descubrimos que los refugios climáticos propuestos actualmente y las ubicaciones que pueden evitarlos dependen en gran medida de métricas de exceso de calor, como las semanas de calentamiento en grados (SCG). Sin embargo, existen muchas variables alternativas de historia vital, ambientales y ecológicas que podrían utilizarse para identificar otros tipos de refugios que resulten en el acervo diversificado que se desea para la conservación de los arrecifes de coral. Para mejorar las prioridades de conservación de los arrecifes de coral, es necesario evaluar y validar las predicciones sobre refugios climáticos con datos de campo a largo plazo sobre abundancia, diversidad y funcionamiento de los corales. También es necesario identificar y salvaguardar lugares que muestren resistencia a la exposición climática prolongada a olas de calor y la capacidad de recuperarse rápidamente tras la exposición térmica. Recomendamos utilizar más métricas para identificar un acervo de posibles lugares de refugio para los arrecifes de coral que puedan evitar, resistir y recuperarse de la exposición a las altas temperaturas oceánicas y las consecuencias del cambio climático, para así desplazar los esfuerzos pasados centrados en la evitación hacia un acervo diversificado de riesgos que pueda utilizarse para mejorar la conservación estratégica de los arrecifes de coral en un clima que se calienta rápidamente.

Online Core Curriculum and Mastery (OCCAM): A Behavioral Neurology & Neuropsychiatry (BNNP) Curricular Needs Assessment.

Behavioral neurology & neuropsychiatry (BNNP) fellowships are accredited by the United Council for Neurologic Subspecialties (UCNS). Programs cover the UCNS-recommended topics differently. A curriculum accessible to all fellowships would standardize education and identify gaps in topics that are less well covered across programs. The purpose of the present needs assessment was to inform the development of the Online Core Curriculum and Mastery: BNNP (OCCAM-BNNP), a website for all UCNS-accredited BNNP programs. Program directors and fellows were surveyed to learn how well topics are covered and identify educational gaps, or specific topics on the UCNS website that are less well represented among programs. Thirty-seven fellowship program directors listed on the UCNS website were invited to take the survey and forward it to both current fellows (graduating in 2021) and recent graduates (graduated from 2015 to 2020). There were 29 responses from 37 programs. Of the 34 topics that respondents rated on a 1-5 Likert scale (from "not covered" to "completely covered"), 15 of 34 (44%) were identified as having >40% of responses as mostly "not covered," "incompletely covered," or "partially covered." Ninety-seven percent of respondents affirmed that it would be useful to have a free web-based resource for BNNP education. Slightly under one-half of all BNNP topics were not well covered. A survey was undertaken to identify and fill the educational gaps indicated by fellowship directors and fellows, and the OCCAM-BNNP website was developed as a repository for relevant content, providing a resource that many BNNP clinicians would find useful.

Patient experiences in ulcerative colitis: conceptual model and review of patient-reported outcome measures.

PURPOSE: To identify symptoms and their impacts on daily functioning and health-related quality of life (HRQoL) experienced by adult patients with ulcerative colitis (UC) and evaluate patient-reported outcome (PRO) measures for UC clinical studies. METHODS: A conceptual model of symptoms and impacts of UC were developed from a literature review. PRO measures were identified from the literature, clinical trials databases, health technology assessment submissions, and regulatory label claims, and were selected for conceptual analysis based on disease specificity and use across information sources. PRO measures covering the most concepts when mapped against the conceptual model were assessed for gaps in psychometric properties using Food and Drug Administration (FDA) guidance and consensus-based standards for the selection of health measurement instruments (COSMIN) criteria. RESULTS: The conceptual model grouped the 52 symptom concepts and 72 proximal and distal impacts into eight, two, and five dimensions, respectively. Of 65 PRO measures identified, eight underwent conceptual analysis. Measures covering the most concepts and assessed for psychometric properties were the Inflammatory Bowel Disease Questionnaire, Symptoms and Impacts Questionnaire for UC, UC-PRO symptoms modules, UC-PRO impact modules, and Crohn's and UC Questionnaire; all had good or excellent support for content validity. The UC-PRO Signs and Symptoms fully met FDA guidance and COSMIN criteria for content validity and most psychometric properties. CONCLUSION: Existing PRO measures assess concepts relevant to patients with UC, but all PRO measures reviewed require further psychometric evaluation to demonstrate they are fit for purpose.

Gap analysis between trainees' subjective competencies and the competencies expected by instructors in urology: A need assessment survey in Japan.

OBJECTIVE: According to the rapid progress in surgical techniques, a growing number of procedures should be learned during postgraduate training periods. This study aimed to clarify the current situation regarding urological surgical training and identify the perception gap between trainees' competency and the competency expected by instructors in Japan. METHODS: Regarding the 40 urological surgical procedures selected via the Delphi method, we collected data on previous caseloads, current subjective autonomy, and confidence for future skill acquisition from trainees (<15 post-graduate years [PGY]), and the competencies when trainees became attending doctors expected by instructors (>15 PGY), according to a 5-point Likert scale. In total, 174 urologists in Hokkaido Prefecture, Japan were enrolled in this study. RESULTS: The response rate was 96% (165/174). In a large proportion of the procedures, caseloads grew with accumulation of years of clinical practice. However, trainees had limited caseloads of robotic and reconstructive surgeries even after 15 PGY. Trainees showed low subjective competencies at present and low confidence for future skill acquisition in several procedures, such as open cystectomy, ureteroureterostomy, and ureterocystostomy, while instructors expected trainees to be able to perform these procedures independently when they became attending doctors. CONCLUSION: Trainees showed low subjective competencies and low confidence for future skill acquisition in several open and reconstructive procedures, while instructors considered that these procedures should be independently performable by attending doctors. We believe that knowledge of these perception gaps is helpful to develop a practical training program.

Gaps in mammal conservation in China: An analysis with a framework based on minimum area requirements.

Climate change, habitat loss, and human disturbance are major threats to biodiversity. Protecting habitats plays a pivotal role in biodiversity conservation, and there is a global imperative to establish an effective system of protected areas (PAs) to implement habitat conservation and halt biodiversity decline. However, the protected patch size of habitat for a species is just as important for biodiversity conservation as the expansion of areas already under protection. In China, conservation management is often carried out based on administrative divisions. Therefore, here, an analytical conservation management framework was developed based on administrative divisions to assess whether the current network of PAs can effectively meet species' conservation needs using the minimum area requirements (MARs) of species as criteria for medium and large-sized mammals in China. This study found that the MAR of medium and large-sized mammals was larger in the northwest and smaller in the southeast, while taking the Hu line as the dividing line. Precipitation seasonality, elevation, annual mean temperature, and annual precipitation are the main environmental factors driving the distribution of a species MAR. Compared with MAR for each species, the maximum protected patch size of habitat is severely undersized in most provinces where those species primarily distribute, and this is particularly true for large carnivores and threatened species. The densely populated provinces of eastern China are particularly affected by this. The present study's framework can identify the provinces needing to expand PAs or implement other effective area-based conservation measures and habitat restoration. This analytical framework is also relevant for biodiversity conservation in different taxa and regions around the globe.

Use of Structured Template and Reporting Tool for Real-World Evidence for Critical Appraisal of the Quality of Reporting of Real-World Evidence Studies: A Systematic Review.

OBJECTIVES: Real-world evidence (RWE) studies are increasingly being used to support healthcare decisions. Various frameworks, tools, and checklists exist for ensuring quality of real-world data, designing robust studies, and assessing potential for bias. In January 2021, Structured Template and Reporting Tool for RWE (STaRT-RWE) was released to further reduce ambiguity, assumptions, and misinterpretation while planning, implementing, and reporting RWE studies of the safety and effectiveness of treatments. The objective of this study was to identify gaps in the reporting quality of published RWE studies by using this template for critical appraisal. METHODS: Two reviewers conducted a keyword search on PubMed for free-full-text research articles using real-world data, RWE design, and safety with or without effectiveness outcomes of a medicinal product or intervention in humans of any age or gender, published in English between January 13, 2021, and January 13, 2022. Assessment of risk of bias was done using Assessment of Real-World Observational Studies critical appraisal tool. Deficiencies in methods and findings as per STaRT-RWE template were reported as frequencies. RESULTS: A total of 54 of 2374 retrieved studies were included in the review. Based on the STaRT-RWE template, the studies inadequately reported empirically defined covariates, power and sample size calculation, attrition, sensitivity analyses, index date (day 0) defining criterion, predefined covariates, outcome, metadata about data source and software, objective, inclusion and exclusion criteria, analysis specifications, and follow-up. CONCLUSIONS: The use of STaRT-RWE template along with its tables, design diagram, and library of published studies has a potential of improving robustness of RWE studies.

Application of the multiple dependent state sampling strategy to late adolescent suicide rates.

A multiple dependent state sampling plan (MDSSP) is designed when the lifetimes of the variables follow New Lomax Rayleigh Distribution (NLRD). The decision to accept or reject a lot in the proposed methodology is based on the quality of the given present or previous lots. A binomial model-based operating characteristic curve (OC curve) for continuous lots of variables under similar settings in healthcare is used in finding the probability of acceptance, acceptance number, rejection number, and the number of preceding (succeeding) lots to consider. Time truncated life test based on the specified median of the NLRD is used in designing the current acceptance sampling plan. For specified values of the parameters of NLRD, quantile ratios, consumer's risk and producer's risk, average sampling number (ASN) and probability of acceptance of a lot are reported in tables. Real data on worldwide suicide rates of 15-19 years in the year 2019 from the World Health Organization (WHO) website is considered to illustrate this methodology. The minimum sample size required from the selected data to comment on worldwide suicide rates in late adolescents is explained with MDSSP. The results of the proposed acceptance sampling method are compared with the single-stage sampling plan.

Considering science needs to deliver actionable science.

Conservation practitioners, natural resource managers, and environmental stewards often seek out scientific contributions to inform decision-making. This body of science only becomes actionable when motivated by decision makers considering alternative courses of action. Many in the science community equate addressing stakeholder science needs with delivering actionable science. However, not all efforts to address science needs deliver actionable science, suggesting that the synonymous use of these two constructs (delivering actionable science and addressing science needs) is not trivial. This can be the case when such needs are conveyed by people who neglect decision makers responsible for articulating a priority management concern and for specifying how the anticipated scientific information will aid the decision-making process. We argue that the actors responsible for articulating these science needs and the process used to identify them are decisive factors in the ability to deliver actionable science, stressing the importance of examining the provenance and the determination of science needs. Guided by a desire to enhance communication and cross-literacy between scientists and decision makers, we identified categories of actors who may inappropriately declare science needs (e.g., applied scientists with and without regulatory affiliation, external influencers, reluctant decision makers, agents in place of decision makers, and boundary organization representatives). We also emphasize the importance of, and general approach to, undertaking needs assessments or gap analyses as a means to identify priority science needs. We conclude that basic stipulations to legitimize actionable science, such as the declaration of decisions of interest that motivate science needs and using a robust process to identify priority information gaps, are not always satisfied and require verification. To alleviate these shortcomings, we formulated practical suggestions for consideration by applied scientists, decision makers, research funding entities, and boundary organizations to help foster conditions that lead to science output being truly actionable.

Los administradores ambientales y de los recursos y los practicantes de la conservación buscan frecuentemente contribuciones científicas para informar sus decisiones. Este sector de la ciencia sólo se vuelve práctico cuando lo incentivan los órganos decisorios que consideran vías alternas de acción. Muchos dentro de la comunidad científica equiparan abordar las necesidades científicas de los actores con la ciencia práctica como resultado. Sin embargo, no son todos los esfuerzos por abordar las necesidades científicas los que resultan en ciencia práctica, lo que sugiere que el uso sinónimo de estos dos constructos (ciencia práctica como resultado y abordar las necesidades científicas) no es trivial. Esto puede ocurrir cuando personas que dejan de lado a los órganos decisorios responsables de articular un problema prioritario de manejo y de especificar cómo la información científica anticipada servirá durante el proceso de decisión transmiten dichas necesidades. Sostenemos que los actores responsables de articular estas necesidades científicas y el proceso utilizado para identificarlos son factores decisivos en la capacidad de tener ciencia práctica como resultado, con un hincapié en la importancia que tiene examinar el origen y determinación de dichas necesidades. Con el deseo de mejorar la comunicación y la alfabetización transversal entre los científicos y los órganos decisorios, identificamos las categorías de actores que pueden declarar indebidamente las necesidades científicas (p. ej.: científicos aplicados con y sin afiliación regulatoria, personas influyentes externas, órganos decisorios renuentes, agentes suplentes de los órganos decisorios y representantes de organizaciones fronterizas). También destacamos la importancia de, y el acercamiento general a, realizar análisis de las necesidades o análisis de las brechas como método para identificar las necesidades científicas prioritarias. Concluimos que las estipulaciones básicas para legitimar la ciencia práctica, como la declaración de las decisiones de interés que impulsan a las necesidades científicas y el uso de un proceso firme para identificar las brechas informativas prioritarias, no siempre se cumplen y requieren una verificación. Para mitigar estas deficiencias, formulamos algunas propuestas prácticas a consideración de los científicos aplicados, órganos decisorios, entidades de financiamiento para la investigación y organizaciones fronterizas para propiciar las condiciones que resultan en una producción científica realmente práctica.

Illicit cigarette market in Georgia: potential impacts on smoking prevalence and tax revenues.

OBJECTIVES: This study aims to examine the impact of taxation measures implemented between 2017 and 2019 on the illicit cigarette market in Georgia and to assess the potential effects of its full elimination on smoking rates and tax revenues. STUDY DESIGN: This was a cross-sectional and observational study. METHODS: The study uses the gap analysis method to estimate the size of the illicit market by comparing self-reported cigarette consumption with tax-paid cigarette sales. Potential changes in cigarette consumption are calculated using estimates of price demand elasticity and the price difference between licit and illicit cigarettes. The applicable excise tax is then applied to the estimated change in licit cigarette consumption to determine the potential change in tax revenues. RESULTS: In 2020, illicit cigarettes accounted for 6.4% of the market, which decreased to 0.6% in 2021. Eliminating the illicit cigarette market could potentially reduce the number of smokers by 0.5% in 2020 and 0.1% in 2021. It could also lead to a 2.8% increase in excise tax revenues in 2020 and a 0.2% increase in 2021. The study highlights a notable shift in consumer behavior since 2019 toward smoking roll-your-own (RYO) cigarettes. CONCLUSIONS: Tax increases did not have a significant impact on the size of the illicit market in Georgia. The shift in consumer preference toward RYO cigarettes may explain why the illicit cigarette market did not expand after the tax hikes. However, this shift diminishes the effectiveness of taxation policies in reducing smoking rates and leads to a decline in excise tax collection.

Gaps in humanitarian WASH response: perspectives from people affected by crises, practitioners, global responders, and the literature.

Water, sanitation, and hygiene (WASH) interventions prevent and control disease in humanitarian response. To inform future funding and policy priorities, WASH 'gaps' were identified via 220 focus-group discussions with people affected by crises and WASH practitioners, 246 global survey respondents, and 614 documents. After extraction, 2,888 (48 per cent) gaps from direct feedback and 3,151 (52 per cent) from literature were categorised. People affected by crises primarily listed 'services gaps', including a need for water, sanitation, solid waste disposal, and hygiene items. Global survey respondents principally cited 'mechanism gaps' in providing services, including collaboration, WASH staffing expertise, and community engagement. Literature highlighted gaps in health (but not other) WASH intervention impacts. Overall, people affected by crises wanted the 'what' (services), responders wanted the 'how' (to supply), and researchers wanted the 'why' (health consequences). This study suggests a need for a renewed focus on basic WASH services, collaboration across stakeholders, and research on WASH outcomes beyond health.

Utilizing a top predator to prioritize site protection for biodiversity conservation.

Ongoing global change makes it ever more urgent to find creative solutions for biodiversity preservation, but prioritizing sites for protection can be challenging. One shortcut lies in mapping the habitat requirements of well-established biodiversity indicators, such as top predators, to identify high-biodiversity sites. Here, we planned site protection for biodiversity conservation by developing a multi-scale species distribution model (SDM) for the raptorial Northern Goshawk (Accipiter gentilis; goshawk) breeding in an extensive megacity region of Japan. Specifically, we: (1) examined the determinants of top predator occurrence and thus of high-biodiversity value in this megacity setting, (2) identified the biodiversity hotspots, (3) validated whether they actually held higher biodiversity through an independent dataset, and (4) evaluated their current protection by environmental laws. The SDM revealed that goshawks preferred secluded sites far from roads, with abundant forest within a 100 m radius and extensive forest ecotones suitable for hunting within a 900 m radius. This multi-scale landscape configuration was independently confirmed to hold higher biodiversity, yet covered only 3.2% of the study area, with only 44.0% of these sites legally protected. Thus, a rapid biodiversity assessment mediated by a top predator quickly highlighted: (1) the poor development of biodiversity-friendly urban planning in this megacity complex, an aspect overlooked for decades of rapid urban sprawl, and (2) the extreme urgency of extending legal protection to the sites missed by the current protected area network. Exigent biodiversity indicators, such as top predators, could be employed in the early or late stages of anthropogenic impacts in order to proactively incorporate biodiversity protection into planning or flag key biodiversity relics. Our results confirm and validate the applied reliability of top predatory species as biodiversity conservation tools.

Limited co-benefits of protected areas in southwest China under current climate change and human modification.

An ambitious new Post-2020 Global Biodiversity Framework "Kunming-Montreal Global Biodiversity Framework" has been developed. However, the combined effects of climate change and human modification can undermine the potential benefits of the global post-2020 conservation efforts. The co-benefits of stabilizing the climate, conserving biodiversity, and maintaining intact wilderness areas may help to persuade the general public of the need to quickly expand existing protected areas (PAs). To maximize the co-benefits after 2020, the careful optimization of existing (PAs) network and scientific identification of conservation targets are both essential. Here, we mapped hotspots of biodiversity, climate vulnerability, and wilderness in Southwest China (SWC). By analyzing the representativeness and gaps of the existing PAs network in SWC, we devised post-2020 conservation targets and highlighted their implications for decision-makers. Our results showed that the incongruence between hotspots of different species exists, indicating that habitats suitable for one taxon may not fully harbor other taxa. According to our assessment, the five jurisdictions of SWC have warmed on average by 0.4°C-1.1 °C over the past 60 years alone. In particular, biodiversity hotspots in SWC are undergoing stark climatic changes. We uncovered prominent conservation gaps in SWC's network of PAs, especially in terms of climate vulnerability and biodiversity. Due to their insufficient number and unreasonable spatial distribution, the PAs network in SWC may be not capable of meeting its biodiversity, climate vulnerability, and wilderness conservation objectives. To rectify this, we proposed a 3-step mission: milestone 2025, milestone 2030, and goal 2050, which aims to protect 23%, 28%, and 60% of the terrestrial area in SWC, respectively. Taken together, our study derived conservation priority areas with relatively clear spatial boundaries and importance levels, thus providing detailed, timely information for decision-makers to expand the PAs network and implement conservation measures varying in strictness in post-2020 conservation practice.

Mapping the biodiversity conservation gaps in the East China sea.

Being one of the most productive China seas, the East China Sea is facing the challenge of unprecedented biodiversity loss and habitat degradation under the dual pressure of anthropogenic disturbance and climate change. Although marine protected areas (MPAs) are considered an effective conservation tool, it remains unclear whether existing MPAs adequately protect marine biodiversity. To investigate this issue, we first constructed a maximum entropy model to predict the distributions of 359 threatened species and identified its species richness hotspots in the East China Sea. Then we identified priority conservation areas (PCAs1) under different protection scenarios. Since the actual conservation in the East China Sea is far from the goals proposed by Convention on Biological Diversity, we calculated a more realistic conservation goal by quantifying the relationship between the percentage of protected areas in the East China Sea and the average proportion of habitats covered for all species. Finally, we mapped conservation gaps by comparing the PCAs under the proposed goal and existing MPAs. Our results showed that these threatened species were very heterogeneously distributed, and their abundance was highest at low latitudes and in nearshore areas. The identified PCAs were distributed mainly in nearshore areas, especially in the Yangtze River estuary and along the Taiwan Strait. Based on the current distribution of threatened species, we suggest a minimum conservation goal of 20.4% of the total area of the East China Sea. Only 8.8% of the recommended PCAs are currently within the existing MPAs. We recommend expanding the MPAs in six areas to achieve the minimum conservation target. Our findings provide a solid scientific reference and a reasonable short-term target for China to realize the vision of protecting 30% of its oceans by 2030.

A general approach for evaluating of the coverage, resolution, and representation of streamflow monitoring networks.

Streamflow monitoring networks provide information for a wide range of public interests in river and streams. A general approach to evaluate monitoring for different interests is developed to support network planning and design. The approach defines three theoretically distinct information metrics (coverage, resolution, and representation) based on the spatial distribution of a variable of interest. Coverage is the fraction of information that a network can provide about a variable when some areas are not monitored. Resolution is the information available from the network relative to the maximum information possible given the number of sites in the network. Representation is the information that a network provides about a benchmark distribution of a variable. Information is defined using Shannon entropy where the spatial discretization of a variable among spatial elements of a landscape or sites in a network indicates the uncertainty in the spatial distribution of the variable. This approach supports the design of networks for monitoring of variables with heterogeneous spatial distributions ("hot spots" and patches) that might otherwise be unmonitored because they occupy insignificant portions of the landscape. Areas where monitoring will maintain or improve the metrics serve as objective priorities for public interests in network design. The approach is demonstrated for the streamflow monitoring network operated by the United States Geological Survey during water year 2020 indicating gaps in the coverage of coastal rivers and the resolution of low flows.

Expectation versus Reality on Basic Research Topics in Plastic Surgery Conferences: Gap Analysis.

The idea of attending conferences in our specialty is defeated if the demands are not met. Hence, the authors have tried to sum up the feedback after attending such conferences to give future organizers an insight into the same and ways to rectify the pitfalls by giving guidelines to amend them.

Assessing the status of existing and tentative marine World Heritage areas reveals opportunities to better achieve World Heritage Convention goals.

The 1972 World Heritage Convention (WHC) and 1994 Global Strategy aim to preserve the outstanding universal value of internationally important cultural and natural sites within a "representative, balanced and credible" network of highly-protected areas. Increasing human pressures and shortfalls in representation have been documented across the World Heritage network, particularly in terrestrial and cultural sites, threatening the integrity and primary goals of the WHC. However, the conservation status of current and tentative (i.e., proposed) marine natural World Heritage areas (mnWHA) remains relatively unknown. We assessed the extent of recent (2013) and historical (2008-2013) cumulative human impacts and several metrics of representation (country, continent, ecoregion, wilderness, and 'at-risk' species) within existing and tentative mnWHAs. We found moderate yet increasing cumulative human impacts across most existing sites, and high or very high impacts across the majority of tentative sites. Climate change impacts comprised nearly 75% of impact scores, on average, and differences between land- and marine-based impacts across sites could help prioritise management decisions. Over 75% of marine ecoregions and 80% of 'at-risk' species considered in this study have no representation within the existing sites. We outline how prioritizing representation across tentative sites for future World Heritage listing could greatly increase these metrics. We urge the WHC to adopt quantitative, systematic and transparent evaluations of how current and tentative sites contribute to the overarching goals of maintaining a representative World Heritage network and preserving outstanding universal value for future generations.

Clinical use of Convalescent Plasma in the COVID-19 pandemic: a transfusion-focussed gap analysis with recommendations for future research priorities.

BACKGROUND AND OBJECTIVES: Use of convalescent plasma for coronavirus disease 2019 (COVID-19) treatment has gained interest worldwide. However, there is lack of evidence on its dosing, safety and effectiveness. Until data from clinical studies are available to provide solid evidence for worldwide applicable guidelines, there is a need to provide guidance to the transfusion community and researchers on this emergent therapeutic option. This paper aims to identify existing key gaps in current knowledge in the clinical application of COVID-19 convalescent plasma (CCP). MATERIALS AND METHODS: The International Society of Blood Transfusion (ISBT) initiated a multidisciplinary working group with worldwide representation from all six continents with the aim of reviewing existing practices on CCP use from donor, product and patient perspectives. A subgroup of clinical transfusion professionals was formed to draft a document for CCP clinical application to identify the gaps in knowledge in existing literature. RESULTS: Gaps in knowledge were identified in the following main domains: study design, patient eligibility, CCP dose, frequency and timing of CCP administration, parameters to assess response to CCP treatment and long-term outcome, adverse events and CCP application in less-resourced countries as well as in paediatrics and neonates. CONCLUSION: This paper outlines a framework of gaps in the knowledge of clinical deployment of CPP that were identified as being most relevant. Studies to address the identified gaps are required to provide better evidence on the effectiveness and safety of CCP use.