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Striving for an integrated semi-natural stream-floodplain system as restoration target would optimally serve biodiversity and the provisioning of ecosystem services. This pursuit is currently limited by multiple pressures and constraints that come with, amongst others, a high human population density and intensive land-use. To be able to weigh the ecological and societal needs in lowland-stream watersheds, we analysed the developments in lowland-stream restoration in relation to the actual and potential state of ecosystems services these systems provide. To reach an ecological-societal balance in stream restoration, we pose five steps: (i) Choose a clear and realistic restoration target, (ii) Map and quantify environmental stressors at local to watershed scale, (iii) Map and quantify biological indicators at local to regional scale, (iv) List potential restoration measures to remove or mitigate stressors, and (v) Build scenarios, composed of combinations of measures fitting the societal context of the watershed. The most promising scenarios make use of watershed processes and involve establishing a transverse landscape zonation, from the streams' riparian zone to the uplands. Such landscape transition poses a challenge for policy makers and implies a strong societal change. Therefore, a framework is provided with building blocks that help to find a suitable balance in practice. [ABSTRACT FROM AUTHOR]

Introduction: Clinical prediction models (CPMs) for coronavirus disease 2019 (COVID-19) may support clinical decision making, treatment, and communication. However, attitudes about using CPMs for COVID-19 decision making are unknown. Methods: Online focus groups and interviews were conducted among health care providers, survivors of COVID-19, and surrogates (i.e., loved ones/surrogate decision makers) in the United States and the Netherlands. Semistructured questions explored experiences about clinical decision making in COVID-19 care and facilitators and barriers for implementing CPMs. Results: In the United States, we conducted 4 online focus groups with 1) providers and 2) surrogates and survivors of COVID-19 between January 2021 and July 2021. In the Netherlands, we conducted 3 focus groups and 4 individual interviews with 1) providers and 2) surrogates and survivors of COVID-19 between May 2021 and July 2021. Providers expressed concern about CPM validity and the belief that patients may interpret CPM predictions as absolute. They described CPMs as potentially useful for resource allocation, triaging, education, and research. Several surrogates and people who had COVID-19 were not given prognostic estimates but believed this information would have supported and influenced their decision making. A limited number of participants felt the data would not have applied to them and that they or their loved ones may not have survived, as poor prognosis may have suggested withdrawal of treatment. Conclusions: Many providers had reservations about using CPMs for people with COVID-19 due to concerns about CPM validity and patient-level interpretation of the outcome predictions. However, several people who survived COVID-19 and their surrogates indicated that they would have found this information useful for decision making. Therefore, information provision may be needed to improve provider-level comfort and patient and surrogate understanding of CPMs. Highlights: While clinical prediction models (CPMs) may provide an objective means of assessing COVID-19 prognosis, provider concerns about CPM validity and the interpretation of CPM predictions may limit their clinical use. Providers felt that CPMs may be most useful for resource allocation, triage, research, or educational purposes for COVID-19. Several survivors of COVID-19 and their surrogates felt that CPMs would have been informative and may have aided them in making COVID-19 treatment decisions, while others felt the data would not have applied to them. [ABSTRACT FROM AUTHOR]

Understanding the trait adaptations associated with mobility in Trichoptera larvae under different flow conditions would enhance the understanding of survival mechanisms under flow stress induced by spates. In stream mesocosms, we mimicked a lowland stream spate by suddenly increasing current velocity above an organic habitat patch from 10 to 30 or 50 cm/s. Subsequently, we investigated whether short-term, small-scale movements in six Trichoptera species were not random but directional and whether the type of movement was related to the magnitude of flow increase. Main types of response distinguished were as follows: (1) resistance, in which the species remained in the habitat patch, (2) upstream or downstream crawling, and (3) being dislodged from the streambed and drift downstream (vulnerability). The type of response observed was related to the species' ecological preferences and morphological traits. The experiment showed that movement in Trichoptera larvae was directional and flow-dependent. Drift was the main mechanism observed with an increase in current velocity, but upstream crawling and aggregation in the habitat patch were observed as well. The type and magnitude of the response were highly species specific. It appeared that each combination of morphological and behavioral adaptations developed individually for each species under niche-specific conditions. [ABSTRACT FROM AUTHOR]