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Medical student knowledge and opinions of clinical research have important ramifications for how likely they will be to refer patients into clinical trials as practicing physicians. This study examined students understanding, knowledge, and attitudes about clinical trials at the start of medical school and after completion of a multi-faceted intervention designed to increase medical students' confidence in understanding and explaining clinical trials during the pre-clinical and clinical years. Medical students were surveyed about their knowledge of and attitudes toward clinical trials in their first (N = 724) and third (N = 191) years of medical school. During the intervening years, students attend a lecture delivered by University of Hawai 'i Cancer Center faculty, were provided a resource manual from National Cancer Institute, participated in two problem-based learning clinical scenarios, and completed an optional practicum. After completing the comprehensive clinical trials education, there were significant increases in student understanding and knowledge and a decrease in student perception that clinical trials exploit participants. Most students agreed or strongly agreed that inclusion of clinical trials in the curriculum was important and would influence their future practice. Integration of clinical trials education into the medical school curriculum improved students' understanding of clinical research, their ability to communicate the clinical trials process, and confidence in conducting, referring to, and locating clinical trials. Medical students appreciate the importance of clinical trials in advancing medicine and medical education. Further integration of clinical trials education and opportunities to engage in research during medical school are warranted to address students' uncertainty about the benefits of participation for patients., (© 2023. The Author(s).)

This study assessed the impact of altitude, precipitation, and soil conditions on species richness (SR), phylogenetic diversity (PD), and functional diversity (FD) standardized effect sizes in subtropical Brazilian Atlantic Forest tree communities. We considered specific trait information (FDs) for FD, reflecting recent adaptive evolution, contrasting with deeper phylogenetic constraints in FD. Three functional traits (leaf area-LA, wood density-WD, and seed mass-SM) were examined for their response to these gradients. Generalized least squares models with environmental variables as predictors and diversity metrics as response variables were used, and a fourth-corner correlation test explored trait-environmental relationships. SR decreased with altitude, while PD increased, indicating niche convergence at higher altitudes. Leaf area and seed mass diversity also decreased with altitude. For LA, both FD and FDs were significant, reflecting filtering processes influenced by phylogenetic inheritance and recent trait evolution. For SM, only the specific trait structure responded to altitude. LA and SM showed significant trait-environmental relationships, with smaller-leaved and lighter-seeded species dominant at higher altitudes. Soil gradients affect diversity. Fertile soils have a wider range of LA, indicating coexistence of species with different nutrient acquisition strategies. WD variation is lower for FDs. SM diversity has different relationships with soil fertility for FDs and FD, suggesting phylogeny influences trait variation. Soil pH influences WD and LA under acidic soils, with deeper phylogenetic constraints (FD). Environmental factors impact tree communities, with evidence of trait variation constraints driven by conditions and resources. Subtropical Atlantic forests' tree assemblies are mainly influenced by altitude, pH, and soil fertility, selecting fewer species and narrower trait spectra under specific conditions (e.g., higher altitudes, pH). Functional diversity patterns reflect both phylogenetic and recent evolution constraints, with varying strength across traits and conditions. These findings highlight the intricate processes shaping long-lived species assembly across diverse environments in the Southern Brazilian Atlantic Forest., (© 2023 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Here we provide the 'Global Spectrum of Plant Form and Function Dataset', containing species mean values for six vascular plant traits. Together, these traits -plant height, stem specific density, leaf area, leaf mass per area, leaf nitrogen content per dry mass, and diaspore (seed or spore) mass - define the primary axes of variation in plant form and function. The dataset is based on ca. 1 million trait records received via the TRY database (representing ca. 2,500 original publications) and additional unpublished data. It provides 92,159 species mean values for the six traits, covering 46,047 species. The data are complemented by higher-level taxonomic classification and six categorical traits (woodiness, growth form, succulence, adaptation to terrestrial or aquatic habitats, nutrition type and leaf type). Data quality management is based on a probabilistic approach combined with comprehensive validation against expert knowledge and external information. Intense data acquisition and thorough quality control produced the largest and, to our knowledge, most accurate compilation of empirically observed vascular plant species mean traits to date., (© 2022. The Author(s).)

Plant functional traits can predict community assembly and ecosystem functioning and are thus widely used in global models of vegetation dynamics and land-climate feedbacks. Still, we lack a global understanding of how land and climate affect plant traits. A previous global analysis of six traits observed two main axes of variation: (1) size variation at the organ and plant level and (2) leaf economics balancing leaf persistence against plant growth potential. The orthogonality of these two axes suggests they are differently influenced by environmental drivers. We find that these axes persist in a global dataset of 17 traits across more than 20,000 species. We find a dominant joint effect of climate and soil on trait variation. Additional independent climate effects are also observed across most traits, whereas independent soil effects are almost exclusively observed for economics traits. Variation in size traits correlates well with a latitudinal gradient related to water or energy limitation. In contrast, variation in economics traits is better explained by interactions of climate with soil fertility. These findings have the potential to improve our understanding of biodiversity patterns and our predictions of climate change impacts on biogeochemical cycles., (© 2021. The Author(s).)

The aims of this study were to identify floristic assemblages for alluvial forests in the Atlantic Forest and Pampa regions in Brazil, assess the level of floristic similarity between assemblages, and determine environmental gradients and indicator species for these assemblages. Surveys carried out in alluvial forests in the Atlantic Forest and Pampa regions were selected, based on which a presence/absence matrix was built for tree species. A cluster analysis was performed to verify the existence of species assemblages. Floristic similarity was determined by means of the Sorensen Distance measure, from which a dendrogram was developed. The floristic matrix was ordinated by means of NMDS. A PCA was performed with climatic data from areas to determine environmental gradients. An assessment of indicator species was carried out afterwards. Two groups of areas not related to the separation of the regions became visible from the dendrogram and were corroborated by NMDS. Temperature, rainfall and altitude gradients were synthesized by the PCA. Gymnanthes klotzschiana and Andira fraxinifolia were the most relevant species, respectively, in the Paraná-Uruguay and Atlantic assemblages. Alluvial forests were gradually separated in two floristic assemblages associated with river basins and migration routes, while especially influenced by tropicality and altitude gradients.

Biological invasion is a major threat to global biodiversity and ecosystem services. We examined the functional traits similarity between a set of native and non-native invasive tree species from the Southern Brazilian subtropical mixed forest, part of an important global hotspot for biodiversity conservation. We hypothesized that invasive species occupy marginal niche spaces. We ordered the species using the Principal Component Analysis based on their wood density, leaf area, and specific leaf area. These are all important traits that summarize essential ecological strategies associated with resource acquisition and conservation. Functional overlaps between non-native and native species were analyzed through kernel density estimation of continuous traits data. While native and non-native invasive species were distributed along the same functional gradients, the position of non-native species in the functional space is species and traits specific. We concluded that within Brazilian subtropical mixed forests, the functional dissimilarity as a key factor in invasion success could not be generalized for all species and traits.

Aim: Predictions of plant traits over space and time are increasingly used to improve our understanding of plant community responses to global environmental change. A necessary step forward is to assess the reliability of global trait predictions. In this study, we predict community mean plant traits at the global scale and present a systematic evaluation of their reliability in terms of the accuracy of the models, ecological realism and various sources of uncertainty., Location: Global., Time Period: Present., Major Taxa Studied: Vascular plants., Methods: We predicted global distributions of community mean specific leaf area, leaf nitrogen concentration, plant height and wood density with an ensemble modelling approach based on georeferenced, locally measured trait data representative of the plant community. We assessed the predictive performance of the models, the plausibility of predicted trait combinations, the influence of data quality, and the uncertainty across geographical space attributed to spatial extrapolation and diverging model predictions., Results: Ensemble predictions of community mean plant height, specific leaf area and wood density resulted in ecologically plausible trait-environment relationships and trait-trait combinations. Leaf nitrogen concentration, however, could not be predicted reliably. The ensemble approach was better at predicting community trait means than any of the individual modelling techniques, which varied greatly in predictive performance and led to divergent predictions, mostly in African deserts and the Arctic, where predictions were also extrapolated. High data quality (i.e., including intraspecific variability and a representative species sample) increased model performance by 28%., Main Conclusions: Plant community traits can be predicted reliably at the global scale when using an ensemble approach and high-quality data for traits that mostly respond to large-scale environmental factors. We recommend applying ensemble forecasting to account for model uncertainty, using representative trait data, and more routinely assessing the reliability of trait predictions., (© 2020 The Authors. Global Ecology and Biogeography published by John Wiley & Sons Ltd.)

Analysis of the structure, diversity, and demographic dynamics of tree assemblages in tropical forests is especially important in order to evaluate local and regional successional trajectories.We conducted a long-term study to investigate how the structure, species richness, and diversity of secondary tropical forests change over time. Trees (DBH ≥ 5 cm) in the Atlantic Forest of southern Brazil were sampled twice during a 10-year period (2007 and 2017) in six stands (1 ha each) that varied in age from their last disturbance (25, 60, 75, 90, and more than 100 years). We compared forest structure (abundance and basal area), species richness, alpha diversity, demographic rates (mortality, recruitment, and loss or gain in basal area), species composition, spatial beta diversity, and temporal beta diversity (based on turnover and nestedness indices) among stand ages and study years.Demographic rates recorded in a 10-year interval indicate a rapid and dynamic process of species substitution and structural changes. Structural recovery occurred faster than beta diversity and species composition recovery. The successional gradient showed a pattern of species trade-off over time, with less spatial dissimilarity and faster demographic rates in younger stands. As stands grow older, they show larger spatial turnover of species than younger stands, making them more stochastic in relation to species composition. Stands appear to split chronologically to some extent, but not across a straightforward linear axis, reflecting stochastic changes, providing evidence for the formation of a nonequilibrium community. Policy implications . These results reiterate the complexity and variability in forest succession and serve as a reference for the evaluation and monitoring of local management and conservation actions and for defining regional strategies that consider the diversity of local successional trajectories to evaluate the effectiveness of restoration measures in secondary forests of the Atlantic Forest biome., Competing Interests: We declare we have no conflict of interests., (© 2019 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

In Hawai'i, Native Hawaiian men (kāne) have the highest death rate from colon cancer among all ethnic groups. While screening can prevent 90% of these cancers, data show that >58% of kāne over age 50 have never been screened. Prior research has demonstrated that community-based social networks may help kāne adopt healthy behaviors such as cancer screening, however, few studies have activated such an approach. A cross-sectional study entitled No Ke Ola Pono o Nā Kāne (for the good health of men) was conducted statewide in Hawai'i from 2014 to 2018. The study strived to perpetuate the Native Hawaiian traditional practice of "hale mua" (men's house) to promote healthy behaviors among kāne including the adoption of colon cancer prevention strategies such as fecal immunochemical testing (FIT). The study applied a peer-led intervention model using kāne volunteers to deliver the program's educational components, including standardized materials to help the volunteers confidently conduct the sessions. Of the 378 kāne who were recruited into the study, 232 participated in the colorectal session of which 64% ( n = 149) were over age 50. Survey data from the 149 kāne indicated that 31% had not discussed colon health or screening with their doctors but 92% had improved their knowledge about colon health from the session. In addition, 76% ( n = 113) agreed to complete a FIT. Session evaluations indicated that >91% of kāne liked the hale mua approach and benefited from talking with other kāne about their health.

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives., (© 2019 The Authors. Global Change Biology published by John Wiley & Sons Ltd.)

Biological invasions are a major threat to global biodiversity. Ligustrum lucidum, native to temperate Asia, is one of the most invasive plant species in the world. Climate is an important ecological factor influencing species distribution. Therefore, we investigated the climatic niche of L. lucidum in various regions of the world to determine whether it uses different climatic conditions in its invasive ranges than in its native range. The geographical coordinates of its occurrence were extracted from the Global Biodiversity Information Facility and Southern African Plant Invaders Atlas databases. Climatic variables and altitude data were obtained from WorldClim. We evaluated niche overlap and performed niche similarity tests, and estimated niche shift parameters. L. lucidum occurs mostly in warm temperate climates. Niche overlap between native and invaded areas was low. Niche similarity tests indicated that the species could expand its occurrence into regions with climates similar to and different from that of its native range. We concluded that L. lucidum uses different realized climatic niches in its invasive ranges than in its native range. Warmer and wetter climatic conditions may not necessarily constrain this species from establishing populations outside of its native range.

Plant functional traits directly affect ecosystem functions. At the species level, trait combinations depend on trade-offs representing different ecological strategies, but at the community level trait combinations are expected to be decoupled from these trade-offs because different strategies can facilitate co-existence within communities. A key question is to what extent community-level trait composition is globally filtered and how well it is related to global versus local environmental drivers. Here, we perform a global, plot-level analysis of trait-environment relationships, using a database with more than 1.1 million vegetation plots and 26,632 plant species with trait information. Although we found a strong filtering of 17 functional traits, similar climate and soil conditions support communities differing greatly in mean trait values. The two main community trait axes that capture half of the global trait variation (plant stature and resource acquisitiveness) reflect the trade-offs at the species level but are weakly associated with climate and soil conditions at the global scale. Similarly, within-plot trait variation does not vary systematically with macro-environment. Our results indicate that, at fine spatial grain, macro-environmental drivers are much less important for functional trait composition than has been assumed from floristic analyses restricted to co-occurrence in large grid cells. Instead, trait combinations seem to be predominantly filtered by local-scale factors such as disturbance, fine-scale soil conditions, niche partitioning and biotic interactions.

Motivation: The BioTIME database contains raw data on species identities and abundances in ecological assemblages through time. These data enable users to calculate temporal trends in biodiversity within and amongst assemblages using a broad range of metrics. BioTIME is being developed as a community-led open-source database of biodiversity time series. Our goal is to accelerate and facilitate quantitative analysis of temporal patterns of biodiversity in the Anthropocene., Main Types of Variables Included: The database contains 8,777,413 species abundance records, from assemblages consistently sampled for a minimum of 2 years, which need not necessarily be consecutive. In addition, the database contains metadata relating to sampling methodology and contextual information about each record., Spatial Location and Grain: BioTIME is a global database of 547,161 unique sampling locations spanning the marine, freshwater and terrestrial realms. Grain size varies across datasets from 0.0000000158 km 2 (158 cm 2 ) to 100 km 2 (1,000,000,000,000 cm 2 )., Time Period and Grain: BioTIME records span from 1874 to 2016. The minimal temporal grain across all datasets in BioTIME is a year., Major Taxa and Level of Measurement: BioTIME includes data from 44,440 species across the plant and animal kingdoms, ranging from plants, plankton and terrestrial invertebrates to small and large vertebrates., Software Format: .csv and .SQL.

We aimed to investigate the taxonomic and functional variations of tree component of Araucaria Forest (AF) areas located along an altitudinal gradient (700, 900 and 1,600 m asl), in the southern region of Brazil. The functional traits determined were leaf area, specific leaf area, wood density, maximum potential height and dispersal syndromes and deciduousness. The data were analyzed through a functional and taxonomic dissimilarity dendrograms, community-weighted mean trait values, parametric and nonparametric tests, and Principal Component Analysis. The largest floristic-structural similarity was observed between the lower altitude areas (700 and 900 m asl), whose Bray-Curtis distance was 0.63. The area at 700 m asl was characterized by a predominance of deciduous and semi-deciduous species, with a high number of self- and wind-dispersed species, whereas the area at 1,600 m asl exhibited a predominance of animal-dispersed and evergreen species. It was also observed that there were significant variations for leaf traits, basic wood density and maximum potential height. Over all altitudinal gradient, the ordinations indicated that there was no evidence of functional differentiation among dispersal and deciduousness groups. In conclusion, the evaluated Araucaria Forest areas presented high floristic-functional variation of the tree component along the altitudinal gradient.

Native Hawaiians, the indigenous people of Hawai’i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai’i. Six listening meetings were conducted, involving 41 community-dwelling kūpuna (Native Hawaiian elders) and ‘ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories—life course perspective, minority stress theory, and historical trauma—that guided the design of this study and provided the study’s context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers.

In order to determine the influence of soil water table fluctuation on tree species richness and structure of alluvial forest fragments, 24 plots were allocated in a point bar forest and 30 plots in five forest fragments located in a floodplain, in the municipality of São Sebastião da Bela Vista, Southeast Brazil, totalizing 54, 10 X 20 m, plots. The information recorded in each plot were the soil water table level, diameter at breast height (dbh), total height and botanical identity off all trees with dbh > 5 cm. The water table fluctuation was assessed through 1 m deep observation wells in each plot. Correlations analysis indicated that sites with shallower water table in the flooding plains had a low number of tree species and high tree density. Although the water table in the point bar remained below the wells during the study period, low tree species richness was observed. There are other events taking place within the point bar forest that assume a high ecological importance, such as the intensive water velocity during flooding and sedimentation processes.

The objectives of this study were to evaluate the influence of propagules source and the implication of tree size class on the spatial pattern of Xylopia brasiliensis Spreng. individuals growing under the canopy of an experimental plantation of eucalyptus. To this end, all individuals of Xylopia brasiliensis with diameter at soil height (dsh) > 1 cm were mapped in the understory of a 3.16 ha Eucalyptus spp. and Corymbia spp. plantation, located in the municipality of Lavras, SE Brazil. The largest nearby mature tree of X. brasiliensis was considered as the propagules source. Linear regressions were used to assess the influence of the distance of propagules source on the population parameters (density, basal area and height). The spatial pattern of trees was assessed through the Ripley K function. The overall pattern showed that the propagules source distance had strong influence over spatial distribution of trees, mainly the small ones, indicating that the closer the distance from the propagules source, the higher the tree density and the lower the mean tree height. The population showed different spatial distribution patterns according to the spatial scale and diameter class considered. While small trees tended to be aggregated up to around 80 m, the largest individuals were randomly distributed in the area. A plausible explanation for observed patterns might be limited seed rain and intra-population competition.

Native Hawaiian women have high cancer rates and low survival rates. As with other women, a major source of support for Native Hawaiian women is their families. This pilot study reports on the feasibility of providing and measuring a culturally appropriate intervention designed to help Native Hawaiian women and their families deal with cancer. The feasibility evaluation indicated that a major strength of the intervention was its incorporation of Hawaiian values and practices, and a major limitation reflected the difficulties in recruiting Native Hawaiians for research studies. Despite the small sample size, the six Native Hawaiian women and their 10 family members in the intervention group showed improved self-efficacy and coping when compared with the four Native Hawaiian women and their eight family members in the control group. Pilot study data established the feasibility and potential effectiveness of this culturally tailored intervention for Native Hawaiians, and feasibility findings will be useful in designing follow-up studies. Steps taken to incorporate cultural values into an intervention also provide a model for other social workers in developing culturally appropriate interventions for minority populations.

Cancer clinical trials are essential to advancing the prevention and treatment of cancer, yet adult participation rates in clinical trials remain abysmal. Despite the essential contributions of clinical trials to science and medicine, adult participation in clinical trials remains exceedingly low, with only 2%-4% of all adult patients with cancer in the U.S. participating in clinical trials. Clinical trials accrual rates in Hawai'i follow this national trend of less than 3% of eligible patients participating in trials. Recognizing the need to increase awareness about clinical trials, the National Cancer Institute's Cancer Information Service-Pacific Region, through the Hawai'i Clinical Trials Education Coalition, has employed strategic dissemination plans to train and educate key target audiences, including registered nurses, nursing students, and community outreach workers about the availability of over 90 cancer clinical trials in Hawai'i. Previous research suggests that nurses often play a vital role in increasing a patient's understanding of clinical trials and may also act as a patient advocate in regards to participation in a clinical trial. A train-the-trainer model curriculum was developed using the Clinical Trials Education Series (CTES), a collection of multi-level resources designed by the National Cancer Institute, to educate various constituents about clinical trials. The training curriculum and workshop format is adapted based on both formal and informal needs assessments conducted with audiences prior to the planned training, yet key elements remain central to the training model. In addition, an interactive, internet-based case study was developed using local place names and cultural cues to allow training participants to engage in realistic and practical methods for locating and sharing information about clinical trials with patients and the public. This training model has been implemented in a variety of settings including three statewide nursing conferences, two college campuses, and a community-based workshop. Evaluation results consistently indicate statistically significant increases in participants' knowledge and awareness related to clinical trials, and a cadre of trained clinical trials advocates is developing. Health professional advocacy towards adult participation in clinical trials is gaining momentum, with plans to expand the training model throughout the Pacific region.

Native Hawaiian women in Hawai'i suffer the highest breast cancer incidence and death rates among women from Hawai'i's five major ethnic groups. Native Hawaiian women have the third highest breast cancer mortality rate in the nation, following African American and Native American/Alaska Native women. While overall cancer mortality rates in other U.S. populations have improved, epidemiological research shows mortality rates among Native Hawaiians has dramatically increased since 1976. Several barriers prevent Native Hawaiian entry into health care. Frequently cited barriers are: a history of oppression; high prevalence of behavioral risk factors; ineffective screening, prevention and treatment efforts; poor utilization of existing services; poor financial and geographical access to care; an absence of culturally appropriate programs, and few Native Hawaiian health professionals. To address poor health service utilization and to sensitize the health care system in Hawai'i, the Native Hawaiian Breast Cancer Sub-Committee (NHBCSC) of the American Cancer Society Hawai'i Pacific, developed and implemented a culturally based training for health professionals. The training is designed to meet continuing medical and professional education requirements. Professional in-service training began in 2001, with over 300 of Hawai'i's health care professionals participating, to date (March 2004). This training provides a model for other cultural and ethnic groups.