A community-based advanced nurse practitioner-led integrated oncology care model for adults receiving oral anticancer medication: a pilot study.

Oral anti-cancer medications (OAMs) are being used increasingly within cancer care. OAMs offer the potential to improve patient convenience and increase hospital capacity. The clinical assessment for each cycle of OAMs requires specialist patient review often performed in hospital-based oncology units. Consequently, any potential improvement in patient expediency or increased hospital capacity that OAMs can offer is not realised. This study aimed to develop and pilot the specialist assessment of patients receiving OAMs by an Advanced Nurse Practitioner (ANP) in a community-based location.The primary aim of this pilot study was to assess the feasibility of a community-based ANP-led integrated oncology care model for adults receiving OAMs in Ireland who met the pre-specified eligibility criteria. The objectives were to determine the feasibility of a definitive trial of this intervention by measuring patient safety, acceptability to patients and staff and cost of the new model of care.This single-centre pilot study provided patient care (n = 37) to those receiving OAM therapies within a community setting for a 4-month period. Consent rate was high with no attrition other than for clinical reasons. There were 151 contacts with the sample during that time.Results demonstrated that the ANP-led intervention and new model for OAM care was safe, highly acceptable to patients and staff and that related healthcare costs could be captured. Based on the success of this pilot study, the authors conclude that a community-based ANP-led integrated oncology care model for adults receiving OAMs is feasible, and a definitive trial is warranted.Trial registration ISRCTN, ISRCTN10401455 . Registered 30 November 2020.

Correction: Batch-produced, GIS-informed range maps for birds based on provenanced, crowd-sourced data inform conservation assessments.

[This corrects the article DOI: 10.1371/journal.pone.0259299.].

Local colonisations and extinctions of European birds are poorly explained by changes in climate suitability.

Climate change has been associated with both latitudinal and elevational shifts in species' ranges. The extent, however, to which climate change has driven recent range shifts alongside other putative drivers remains uncertain. Here, we use the changing distributions of 378 European breeding bird species over 30 years to explore the putative drivers of recent range dynamics, considering the effects of climate, land cover, other environmental variables, and species' traits on the probability of local colonisation and extinction. On average, species shifted their ranges by 2.4 km/year. These shifts, however, were significantly different from expectations due to changing climate and land cover. We found that local colonisation and extinction events were influenced primarily by initial climate conditions and by species' range traits. By contrast, changes in climate suitability over the period were less important. This highlights the limitations of using only climate and land cover when projecting future changes in species' ranges and emphasises the need for integrative, multi-predictor approaches for more robust forecasting.

Temperature niche composition change inside and outside protected areas under climate warming.

Conservation of biodiversity relies heavily on protected areas but their role and effectiveness under a warming climate is still debated. We estimated the climate-driven changes in the temperature niche compositions of bird communities inside and outside protected areas in southern Canada. We hypothesized that communities inside protected areas include a higher proportion of cold-dwelling species than communities outside protected areas. We also hypothesized that communities shift to warm-dwelling species more slowly inside protected areas than outside. To study community changes, we used large-scale and long-term (1997-2019) data from the Breeding Bird Survey of Canada. To describe the temperature niche compositions of bird communities, we calculated the community temperature index (CTI) annually for each community inside and outside protected areas. Generally, warm-dwelling species dominated communities with high CTI values. We modeled temporal changes in CTI as a function of protection status with linear mixed-effect models. We also determined which species contributed most to the temporal changes in CTI with a jackknife approach. As anticipated, CTI was lower inside protected areas than outside. However, contrary to our expectation, CTI increased faster over time inside than outside protected areas and warm-dwelling species contributed most to CTI change inside protected areas. These results highlight the ubiquitous impacts of climate warming. Currently, protected areas can aid cold-dwelling species by providing habitat, but as the climate warms, the communities' temperature compositions inside protected areas quickly begin to resemble those outside protected areas, suggesting that protected areas delay the impacts of climate warming on cold-dwelling species.

Cambios en la composición del nicho térmico dentro y fuera de las áreas protegidas bajo el calentamiento climático Resumen La conservación de la biodiversidad depende mucho de las áreas protegidas, aunque todavía se debate su papel y efectividad bajo el calentamiento climático. Estimamos los cambios causados por el clima en la composición de los nichos térmicos de las comunidades de aves dentro y fuera de las áreas protegidas al sur de Canadá. Supusimos que las comunidades dentro de las áreas protegidas incluyen una proporción mayor de especies de zonas frías que las comunidades fuera de las áreas protegidas. También supusimos que las comunidades cambian a especies de zonas cálidas de forma más lenta dentro de las áreas protegidas que fuera de ellas. Usamos datos de gran escala y largo plazo (1997-2019) del Censo de Aves Reproductoras de Canadá para estudiar los cambios comunitarios. Calculamos el índice anual de temperatura comunitaria (ITC) para cada comunidad dentro y fuera de las áreas protegidas para describir las composiciones del nicho térmico de las comunidades de aves. En general, las especies de zonas cálidas dominaron las comunidades con valores altos del ITC. Simulamos los cambios temporales en el ITC como función del estado de protección mediante modelos lineales de efecto mixto. También determinamos cuáles especies contribuyen más a los cambios temporales en el ITC con un enfoque jackknife. Como lo anticipamos, el ITC fue menor dentro de las áreas protegidas que afuera. Sin embargo, contrario a nuestra hipótesis, el ITC incrementó más rápido con el tiempo dentro de las áreas protegidas y las especies de zonas cálidas contribuyeron más al cambio en el ITC también dentro de las áreas protegidas. Estos resultados resaltan el impacto universal del calentamiento climático. Actualmente, las áreas protegidas pueden auxiliar a las especies de zonas frías al proporcionarles hábitats, pero conforme la temperatura aumenta, las composiciones térmicas de las comunidades dentro de las áreas protegidas se asemejan rápidamente a aquellas fuera de las áreas protegidas, lo que sugiere que las áreas protegidas retrasan el impacto del calentamiento climático sobre las especies de zonas frías.

Ecological barriers mediate spatiotemporal shifts of bird communities at a continental scale.

Species' range shifts and local extinctions caused by climate change lead to community composition changes. At large spatial scales, ecological barriers, such as biome boundaries, coastlines, and elevation, can influence a community's ability to shift in response to climate change. Yet, ecological barriers are rarely considered in climate change studies, potentially hindering predictions of biodiversity shifts. We used data from two consecutive European breeding bird atlases to calculate the geographic distance and direction between communities in the 1980s and their compositional best match in the 2010s and modeled their response to barriers. The ecological barriers affected both the distance and direction of bird community composition shifts, with coastlines and elevation having the strongest influence. Our results underscore the relevance of combining ecological barriers and community shift projections for identifying the forces hindering community adjustments under global change. Notably, due to (macro)ecological barriers, communities are not able to track their climatic niches, which may lead to drastic changes, and potential losses, in community compositions in the future.

Prophylactic cholecystectomy offers best outcomes following ERCP clearance of common bile duct stones: a meta-analysis.

BACKGROUND: Symptomatic calculus biliary disease is common with associated morbidity and occasional mortality, further confounded when there is concomitant common bile duct (CBD) stones. Choledocholithiasis and clearance of the duct reduces recurrent cholangitis, but the question is whether after clearance of the CBD if there is a need to perform a cholecystectomy. This meta-analysis evaluated outcomes in patients undergoing ERCP with or without sphincterotomy to determine if cholecystectomy post-ERCP clearance offers optimal outcomes over a wait-and-see approach. METHODS: A Prospero registered meta-analysis of the literature using PRISMA guidelines incorporating articles related to ERCP, choledocholithiasis, cholangitis and cholecystectomy was undertaken for papers published between 1st January 1991 and 31st May 2021. Existing research that demonstrates outcomes of ERCP with no cholecystectomy versus ERCP and cholecystectomy was reviewed to determine the related key events, complications and mortality of leaving the gallbladder in situ and removing it. Odds ratios (OR) were calculated using Review Manager Version 5.4 and meta-analyses performed using OR using fixed-effect (or random-effect) models, depending on the heterogeneity of studies. RESULTS: 13 studies (n = 2598), published between 2002 and 2019, were included in this meta-analysis, 6 retrospective, 2 propensity score-matched retrospective studies, 3 prospective studies and 2 randomised control trials from a total of 11 countries. There were 1433 in the no cholecystectomy cohort (55.2%) and 1165 in the prophylactic cholecystectomy (44.8%) cohort. Cholecystectomy resulted in a decreased risk of cholecystitis (OR = 0.15; CI 0.07-0.36; p < 0.0001), cholangitis (OR = 0.51; CI 0.26-1.00; p = 0.05) and mortality (OR = 0.38; CI 0.16-0.9; p = 0.03). In addition, prophylactic cholecystectomy resulted in a significant reduction in biliary events, biliary pain and pancreatitis. CONCLUSIONS: In patients undergoing CBD clearance, consideration should be given to performing prophylactic cholecystectomy to optimise outcomes.

Effects of diversity on thermal niche variation in bird communities under climate change.

Climate change alters ecological communities by affecting individual species and interactions between species. However, the impacts of climate change may be buffered by community diversity: diverse communities may be more resistant to climate-driven perturbations than simple communities. Here, we assess how diversity influences long-term thermal niche variation in communities under climate change. We use 50-year continental-scale data on bird communities during breeding and non-breeding seasons to quantify the communities' thermal variability. Thermal variability is measured as the temporal change in the community's average thermal niche and it indicates community's response to climate change. Then, we study how the thermal variability varies as a function of taxonomic, functional, and evolutionary diversity using linear models. We find that communities with low thermal niche variation have higher functional diversity, with this pattern being measurable in the non-breeding but not in the breeding season. Given the expected increase in seasonal variation in the future climate, the differences in bird communities' thermal variability between breeding and non-breeding seasons may grow wider. Importantly, our results suggest that functionally diverse wildlife communities can mitigate effects of climate change by hindering changes in thermal niche variability, which underscores the importance of addressing the climate and biodiversity crises together.

Stakeholders' perceptions of a community-based advanced nurse practitioner-led integrated oncology care model for adults receiving oral anti-cancer medication-A qualitative study.

Oral anti-cancer medications (OAMs) are increasingly prescribed in oncology, and although administered at home, ongoing monitoring generally requires the patient to attend an acute hospital. With the requirement to provide safe yet convenient care and to increase hospital capacity, the potential exists to transition this cohort of patients to the community to be assessed by oncology health care professionals (HCPs). The onset of COVID-19 facilitated this planned transition. OBJECTIVE: The primary objective was to understand stakeholders' perceptions of a community-based advanced nurse practitioner (ANP)-led integrated OAM care model for adults. METHODS: Qualitative data from interviews and focus groups were obtained from 33 individuals; either service users who attended ANP-led OAM clinics or stakeholders involved in OAM care. Data were subsequently analysed using thematic analysis. RESULTS: Four themes were identified and included reflection on pre-COVID-19 system, role of ANP in current OAM care, importance of robust communication and infrastructural requirements for transition to an integrated OAM care model. CONCLUSION: This study demonstrated that patients and HCPs perceived the proposal positively. They identified the ANP as the appropriate HCP to care for this cohort and the importance of communication and strategic planning for transitioning this model of care to the community setting. CLINICAL TRIAL REGISTRATION: ISRCTN10401455.

Decomposing the spatial and temporal effects of climate on bird populations in northern European mountains.

The relationships between species abundance or occurrence versus spatial variation in climate are commonly used in species distribution models to forecast future distributions. Under "space-for-time substitution", the effects of climate variation on species are assumed to be equivalent in both space and time. Two unresolved issues of space-for-time substitution are the time period for species' responses and also the relative contributions of rapid- versus slow reactions in shaping spatial and temporal responses to climate change. To test the assumption of equivalence, we used a new approach of climate decomposition to separate variation in temperature and precipitation in Fennoscandia into spatial, temporal, and spatiotemporal components over a 23-year period (1996-2018). We compiled information on land cover, topography, and six components of climate for 1756 fixed route surveys, and we modeled annual counts of 39 bird species breeding in the mountains of Fennoscandia. Local abundance of breeding birds was associated with the spatial components of climate as expected, but the temporal and spatiotemporal climatic variation from the current and previous breeding seasons were also important. The directions of the effects of the three climate components differed within and among species, suggesting that species can respond both rapidly and slowly to climate variation and that the responses represent different ecological processes. Thus, the assumption of equivalent species' response to spatial and temporal variation in climate was seldom met in our study system. Consequently, for the majority of our species, space-for-time substitution may only be applicable once the slow species' responses to a changing climate have occurred, whereas forecasts for the near future need to accommodate the temporal components of climate variation. However, appropriate forecast horizons for space-for-time substitution are rarely considered and may be difficult to reliably identify. Accurately predicting change is challenging because multiple ecological processes affect species distributions at different temporal scales.

Patient-reported outcome measures (PROMs) after laparoscopic cholecystectomy: systematic review.

BACKGROUND: Healthcare requires patient feedback to improve outcomes and experience. This study undertook a systematic review of the depth, variability, and digital suitability of current patient-reported outcome measures (PROMs) in patients undergoing laparoscopic cholecystectomy. METHODS: A PROSPERO-registered (registration number CRD42021261707) systematic review was undertaken for all relevant English language articles using PubMed version of MEDLINE, Scopus, and Web of Science electronic databases in June 2021. The search used Boolean operators and wildcards and included the keywords: laparoscopic cholecystectomy AND patient outcome OR patient-reported outcome OR patient-reported outcome measure OR PRO OR PROM. Medical Subjects Heading terms were used to search PubMed and Scopus. Articles published from 1 January 2011 to 2 June 2021 were included. RESULTS: A total of 4960 individual articles were reviewed in this study, of which 44 were found to evaluate PROMs in patients undergoing laparoscopic cholecystectomy and underwent methodological index for non-randomized studies (MINORS) grading. Twenty-one articles spanning 19 countries and four continents met all inclusion criteria and were included in the qualitative data synthesis. There was significant heterogeneity in PROMs identified with eight different comprehensive PROM tools used in the 21 studies. There was wide variation in the time points at which PROMs were recorded. Fourteen of 21 studies recorded PROMs before and after surgery, and 7 of 21 recorded PROMs only after surgery. Follow-up intervals ranged from 3 days to 2 years after surgery. CONCLUSIONS: This study identified that while post-laparoscopic cholecystectomy PROMs are infrequently measured currently, tools are widely available to achieve this in clinical practice. PROMs may not capture all the outcomes but should be incorporated into future cholecystectomy outcome research. The EQ-5D™ (EuroQoL Group, Rotterdam, the Netherlands) provides a simple platform for the modern digital era.

Protected areas have a mixed impact on waterbirds, but management helps.

International policy is focused on increasing the proportion of the Earth's surface that is protected for nature1,2. Although studies show that protected areas prevent habitat loss3-6, there is a lack of evidence for their effect on species' populations: existing studies are at local scale or use simple designs that lack appropriate controls7-13. Here we explore how 1,506 protected areas have affected the trajectories of 27,055 waterbird populations across the globe using a robust before-after control-intervention study design, which compares protected and unprotected populations in the years before and after protection. We show that the simpler study designs typically used to assess protected area effectiveness (before-after or control-intervention) incorrectly estimate effects for 37-50% of populations-for instance misclassifying positively impacted populations as negatively impacted, and vice versa. Using our robust study design, we find that protected areas have a mixed impact on waterbirds, with a strong signal that areas managed for waterbirds or their habitat are more likely to benefit populations, and a weak signal that larger areas are more beneficial than smaller ones. Calls to conserve 30% of the Earth's surface by 2030 are gathering pace14, but we show that protection alone does not guarantee good biodiversity outcomes. As countries gather to agree the new Global Biodiversity Framework, targets must focus on creating and supporting well-managed protected and conserved areas that measurably benefit populations.

It's time for a minimum synoptic operation template in patients undergoing laparoscopic cholecystectomy: a systematic review.

BACKGROUND: Despite the call to enhance accuracy and value of operation records few international recommended minimal standards for operative notes documentation have been described. This study undertook a systematic review of existing operative reporting systems for laparoscopic cholecystectomy (LC) to fashion a comprehensive, synoptic operative reporting template for the future. METHODS: A search for all relevant articles was conducted using PubMed version of Medline, Scopus and Web of Science databases in June 2021, for publications from January 1st 2011 to October 25th 2021, using the keywords: laparoscopic cholecystectomy AND operation notes OR operative notes OR proforma OR documentation OR report OR narrative OR audio-visual OR synoptic OR digital. Two reviewers (NOC, GMC) independently assessed each published study using a MINORS score of ≥ 16 for comparative and ≥ 10 for non-comparative for inclusion. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Synoptic operative templates from published data were assimilated into one "ideal" laparoscopic operative report template following international input from the World Society of Emergency Surgery board. RESULTS: A total of 3567 articles were reviewed. Following MINORS grading 25 studies were selected spanning 14 countries and 4 continents. Twenty-two studies were prospective. A holistic overview of the operative procedure documentation was reported in 6/25 studies and a further 19 papers dealt with selective surgical aspects of LC. A unique synoptic LC operative reporting template was developed and translated into Chinese/Mandarin, French and Arabic. CONCLUSION: This systematic review identified a paucity of publications dealing with operative reporting of LC. The proposed new template may be integrated digitally with hospitals' medical systems and include additional narrative text and audio-visual data. The template may help define new OR (operating room) recording standards and impact on care for patients undergoing LC.

Protected area characteristics that help waterbirds respond to climate warming.

Protected area networks help species respond to climate warming. However, the contribution of a site's environmental and conservation-relevant characteristics to these responses is not well understood. We investigated how composition of nonbreeding waterbird communities (97 species) in the European Union Natura 2000 (N2K) network (3018 sites) changed in response to increases in temperature over 25 years in 26 European countries. We measured community reshuffling based on abundance time series collected under the International Waterbird Census relative to N2K sites' conservation targets, funding, designation period, and management plan status. Waterbird community composition in sites explicitly designated to protect them and with management plans changed more quickly in response to climate warming than in other N2K sites. Temporal community changes were not affected by the designation period despite greater exposure to temperature increase inside late-designated N2K sites. Sites funded under the LIFE program had lower climate-driven community changes than sites that did not received LIFE funding. Our findings imply that efficient conservation policy that helps waterbird communities respond to climate warming is associated with sites specifically managed for waterbirds.

Las redes de áreas protegidas ayudan a las especies a responder al calentamiento climático. Sin embargo, se sabe muy poco sobre la contribución de las características ambientales y relevantes para la conservación de un sitio a estas respuestas. Investigamos cómo la composición de las comunidades no reproductivas de aves acuáticas (97 especies) en la red (3,018 sitios) Natura 2000 de la Unión Europea (N2K) cambió en respuesta a los incrementos de la temperatura durante más de 25 años en 26 países europeos. Medimos la reorganización comunitaria con base en series temporales de abundancia recolectadas durante el Censo Internacional de Aves Acuáticas en relación con los objetivos de conservación de los sitios N2K, el periodo de asignación de fondos y el estado del plan de manejo. La composición comunitaria de las aves acuáticas en los sitios con planes de manejo y designados explícitamente para su protección cambió más rápidamente en respuesta al calentamiento climático que en otros sitios N2K. Los cambios comunitarios temporales no se vieron afectados por el periodo de asignación a pesar de una mayor exposición al incremento de la temperatura dentro de los sitios N2K de asignación tardía. Los sitios financiados por el programa LIFE tuvieron menos cambios comunitarios causados por el clima que los sitios que no recibieron este financiamiento. Nuestros hallazgos sugieren que la política de conservación eficiente que ayuda a las comunidades de aves acuáticas a responder al calentamiento climático está asociada con sitios específicamente gestionados para las aves acuáticas.

Batch-produced, GIS-informed range maps for birds based on provenanced, crowd-sourced data inform conservation assessments.

Accurate maps of species ranges are essential to inform conservation, but time-consuming to produce and update. Given the pace of change of knowledge about species distributions and shifts in ranges under climate change and land use, a need exists for timely mapping approaches that enable batch processing employing widely available data. We develop a systematic approach of batch-processing range maps and derived Area of Habitat maps for terrestrial bird species with published ranges below 125,000 km2 in Central and South America. (Area of Habitat is the habitat available to a species within its range.) We combine existing range maps with the rapidly expanding crowd-sourced eBird data of presences and absences from frequently surveyed locations, plus readily accessible, high resolution satellite data on forest cover and elevation to map the Area of Habitat available to each species. Users can interrogate the maps produced to see details of the observations that contributed to the ranges. Previous estimates of Areas of Habitat were constrained within the published ranges and thus were, by definition, smaller-typically about 30%. This reflects how little habitat within suitable elevation ranges exists within the published ranges. Our results show that on average, Areas of Habitat are 12% larger than published ranges, reflecting the often-considerable extent that eBird records expand the known distributions of species. Interestingly, there are substantial differences between threatened and non-threatened species. Some 40% of Critically Endangered, 43% of Endangered, and 55% of Vulnerable species have Areas of Habitat larger than their published ranges, compared with 31% for Near Threatened and Least Concern species. The important finding for conservation is that threatened species are generally more widespread than previously estimated.

Regional variation in the impacts of the COVID-19 pandemic on the quantity and quality of data collected by the project eBird.

The COVID-19 pandemic has likely affected natural systems around the world; the curtailment of human activity has also affected the collection of data needed to identify the indirect effects of this pandemic on natural systems. We describe how the outbreak of COVID-19 disease, and associated stay-at-home orders in four political regions, have affected the quantity and quality of data collected by participants in one volunteer-based bird monitoring project, eBird. The four regions were selected both for their early and prolonged periods of mandated changes to human activity, and because of the high densities of observations collected. We compared the months of April 2020 with April in previous years. The most notable change was in the landscapes in which observations were made: in all but one region human-dominated landscapes were proportionally more common in the data in April 2020, and observations made near the rarer wetland habitat were less prevalent. We also found subtler changes in quantity of data collected, as well as in observer effort within observation periods. Finally, we found that these effects of COVID-19 disease varied across the political units, and thus we conclude that any analyses of eBird data will require region-specific examination of whether there have been any changes to the data collection process during the COVID-19 pandemic that would need to be taken into account.

Umbilical hernia repair and recurrence: need for a clinical trial?

INTRODUCTION: Umbilical hernia repair, despite its perceived simplicity, is associated with recurrence between 2.7 and 27%, in mesh repair and non mesh repair respectively. Many factors are recognized contributors to recurrence however multiple defects in the linea alba, known to occur in up to 30% of patients, appear to have been overlooked by surgeons. AIMS: This systematic review assessed reporting of second or multiple linea alba defects in patients undergoing umbilical hernia repair to establish if these anatomical variations could contribute to recurrence along with other potential factors. METHODS: A systematic review of all published English language articles was undertaken using databases PubMed, Embase, Web of Science and Cochrane Library from January 2014 to 2019. The search terms 'Umbilical hernia' AND 'repair' AND 'recurrence' were used across all databases. Analysis was specified in advance to avoid selection bias, was registered with PROSPERO (154173) and adhered to PRISMA statement. RESULTS: Six hundred and forty-six initial papers were refined to 10 following article review and grading. The presence of multiple linea alba defects as a contributor to recurrence was not reported in the literature. One paper mentioned the exclusion of six participants from their study due multiple defects. In all 11 factors were significantly associated with umbilical hernia recurrence. These included: large defect, primary closure without mesh, high BMI in 5/10 publications; smoking, diabetes mellitus, surgical site Infection (SSI) and concurrent hernia in 3/10. In addition, the type of mesh, advanced age, liver disease and non-closure of the defect were identified in individual papers. CONCLUSION: This study identified many factors already known to contribute to umbilical hernia recurrence in adults, but the existence of multiple defects in the linea, despite it prevalence, has evaded investigators. Surgeons need to be consider documentation of this potential confounder which may contribute to recurrence.

Reduced human activity during COVID-19 alters avian land use across North America.

The COVID-19 pandemic resulted in extraordinary declines in human mobility, which, in turn, may affect wildlife. Using records of more than 4.3 million birds observed by volunteers from March to May 2017­2020 across Canada and the United States, we found that counts of 66 (80%) of 82 focal bird species changed in pandemic-altered areas, usually increasing in comparison to prepandemic abundances in urban habitat, near major roads and airports, and in counties where lockdowns were more pronounced or occurred at the same time as peak bird migration. Our results indicate that human activity affects many of North America's birds and suggest that we could make urban spaces more attractive to birds by reducing traffic and mitigating the disturbance from human transportation after we emerge from the pandemic.

Mismatch between bird species sensitivity and the protection of intact habitats across the Americas.

Protected areas are highly heterogeneous in their effectiveness at buffering human pressure, which may hamper their ability to conserve species highly sensitive to human activities. Here, we use 60 million bird observations from eBird to estimate the sensitivity to human pressure of each bird species breeding in the Americas. Concerningly, we find that ecoregions hosting large proportions of high-sensitivity species, concentrated in tropical biomes, do not have more intact protected habitat. Moreover, 266 high-sensitivity species have little or no intact protected habitat within their distributions. Finally, we show that protected area intactness is decreasing faster where high-sensitivity species concentrate. Our results highlight a major mismatch between species conservation needs and the coverage of intact protected habitats, which likely hampers the long-term effectiveness of protected areas at retaining species. We highlight ecoregions where protection and management of intact habitats, complemented by restoration, is urgently needed.

Using the IUCN Red List to map threats to terrestrial vertebrates at global scale.

The Anthropocene is characterized by unparalleled human impact on other species, potentially ushering in the sixth mass extinction. Yet mitigation efforts remain hampered by limited information on the spatial patterns and intensity of the threats driving global biodiversity loss. Here we use expert-derived information from the International Union for Conservation of Nature Red List on threats to 23,271 species, representing all terrestrial amphibians, birds and mammals, to generate global maps of the six major threats to these groups: agriculture, hunting and trapping, logging, pollution, invasive species, and climate change. Our results show that agriculture and logging are pervasive in the tropics and that hunting and trapping is the most geographically widespread threat to mammals and birds. Additionally, current representations of human pressure underestimate the overall pressure on biodiversity, due to the exclusion of threats such as hunting and climate change. Alarmingly, this is particularly the case in areas of the highest biodiversity importance.