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Background: Hospitals are transitioning away from traditional pagers to secure text messaging (STM) applications. STM is perceived to improve efficiency and accessibility. There is limited research on user's impressions of how STM impacts patient safety, provider wellness, and quality of patient care. Objectives: To understand the use and perceptions of a clinical STM by pediatric residents at a free-standing quaternary care children's hospital. Methods: A survey was conducted of pediatric residents regarding their experience with Diagnotes®. Demographic data were obtained along with use patterns, ability to perform tasks, and perceptions of intended purpose. Further questions evaluated agreement with communication strategies and satisfaction with features. Three open-ended questions asked about experience where STM impacted (1) patient care coordination and (2) patient safety. A final question asked for any additional STM feedback. Results: Of 169 surveys, there were 112 respondents (66.3 % response rate). Respondents unanimously endorsed daily STM use on their personal mobile devices with good knowledge of basic features. Respondents were overall satisfied with Diagnotes® (73.9 %) including the ability to communicate efficiently (84.8 %) and effectively (79.5 %). Yet only 32.1 % were satisfied with Diagnotes® training. Only 59.5 % believed Diagnotes® was appropriate for urgent patient care needs and only 43.2 % believed its purpose was to inform the team of patient emergencies. Key qualitative themes included improved coordination of patient care tasks through STM, but there were concerns raised around sending and receiving messages, the additional cognitive burden placed by STM, and differences in culture of use that created conflict. Conclusions: Diagnotes® is viewed positively including use for effective coordination of patient care and familiarity of functions of Diagnotes®. Barriers included unclear interprofessional expectations for use. Future research should incorporate a broad range of healthcare professionals' perceptions and co-creation of STM best practice guidelines for use, including around urgent or emergent patient care issues.

Skill decay is the decrement in performance on acquired knowledge and skills after a period of nonuse. Although there is a fair amount of work on individual skill decay, the literature on team-level skill decay is very limited. Thus, using a synthetic task environment, the objective of this study was to compare individual and team performance in terms of skill acquisition, retention (decay), and reacquisition. Eighty-one individuals in 27 three-person teams were trained to perform a complex computer-based simulation. The initial acquisition phase comprised a 2-day, 5-hour training protocol. After an average 73.33-day nonuse interval (SD = 30.18), participants returned for a 2-hour reacquisition session. Participants completed the performance task as both individuals and teams. The results indicated that, compared to individual performance, team performance improved faster during the skill acquisition phase. However, unlike individual performance, the amount of decay for team performance was dependent on whether the first retention performance session for team members was performed as individuals—where trainees had the opportunity to perform all components of the task—or as a team, with the latter resulting in the most decay. By extension, these results highlight the impact of a relatively brief individual post-retention (nonuse) interval training to mitigate team skill decay. In short, our results indicate that a little individual practice can go a long way toward maintaining team retention performance, but in contrast, a little team practice does not do the same for individual retention performance. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to explore the extent to which prior military service may moderate the relationship between chronic disease multimorbidity and substance use among African American men in the United States. Design: Data for this cross-sectional study was downloaded from the 2016 -2019 United States (US) National Survey on Drug Use and Health. We estimated three survey-weighted multivariable logistic regression models, where use of each of the following substances served as the dependent variables: illicit drugs, opioids, and tobacco. Differences in these outcomes were examined along two primary independent variables: veteran status and multimorbidity (and an interaction term for these variables). We also controlled for the following covariates: age, education, income, rurality, criminal behavior, and religiosity. Results: From the 37,203,237 (weighted N) African American men in the sample, approximately 17% reported prior military service. Veterans with ≥ 2 chronic diseases had higher rates of illicit drug use (aOR = 1.37, 95% CI = 1.01, 1.87; 32% vs. 28%) than non-veterans with ≥ 2 chronic diseases. Non-veterans with one chronic disease had higher rates of tobacco use (aOR = 0.80, 95% CI = 0.69, 0.93; 29% vs. 26%) and opioid misuse (aOR = 0.49, 95% CI = 0.36, 0.67; 29% vs. 18%) than veterans with one chronic disease. Discussion: Chronic disease multi-morbidity appears to be a context in which African American veterans may be at greater risk for certain undesirable health behaviors than African American non-veterans and at lower risk for others. This may be due to exposure to trauma, difficulty accessing care, socio-environmental factors, and co-occurring mental health conditions. These complex interactions may contribute to higher rates of SUDs among African American veterans compared to African American non-veterans. [ABSTRACT FROM AUTHOR]

Phelan–McDermid syndrome (PMS), caused by pathogenic variants in the SHANK3 gene or 22q13 deletions, is characterized by intellectual disability, autistic features, developmental delays, and neonatal hypotonia. Insulin-like growth factor 1 (IGF-1) and human growth hormone (hGH) have been shown to reverse neurobehavioral deficits in PMS. We assessed the metabolic profiling of 48 individuals with PMS and 50 controls and determined subpopulations by taking the top and bottom 25% of responders to hGH and IGF-1. A distinct metabolic profile for individuals with PMS showed a reduced ability to metabolize major energy sources and a higher metabolism of alternative energy sources. The analysis of the metabolic response to hGH or IGF-1 highlighted a major overlap between both high and low responders, validating the model and suggesting that the two growth factors share many target pathways. When we investigated the effect of hGH and IGF-1 on the metabolism of glucose, the correlation between the high-responder subgroups showed less similarity, whereas the low-responders were still relatively similar. Classification of individuals with PMS into subgroups based on responses to a compound can allow an investigation into pathogenic mechanisms, the identification of molecular biomarkers, an exploration of in vitro responses to candidate drugs, and eventually the selection of better candidates for clinical trials. [ABSTRACT FROM AUTHOR]

Purpose: Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given its time-dependent and progressive nature, priapism is a situation that both urologists and emergency medicine practitioners must be familiar with and comfortable managing. Methodology: A comprehensive search of the literature on acute ischemic priapism and non-ischemic priapism (NIP) was performed by Emergency Care Research Institute for articles published between January 1, 1960 and May 1, 2020. A search of the literature on NIP, recurrent priapism, prolonged erection following intracavernosal vasoactive medication, and priapism in patients with sickle cell disease was conducted by Pacific Northwest Evidence-based Practice Center for articles published between 1946 and February 19, 2021. Searches identified 4117 potentially relevant articles, and 3437 of these were excluded at the title or abstract level for not meeting inclusion criteria. Full texts for the remaining 680 articles were ordered, and ultimately 203 unique articles were included in the report. Results: This Guideline provides a clinical framework for the treatment (nonsurgical and surgical) of NIP, recurrent ischemic priapism, and priapism in patients with sickle cell disease. The treatment of patients with a prolonged erection following intracavernosal vasoactive medication is also included. The AUA guideline on the diagnosis of priapism and the treatment of acute ischemic priapism was published in 2021. Conclusions: All patients with priapism should be evaluated emergently to identify the sub-type of priapism (acute ischemic versus non-ischemic) and those with an acute ischemic event should be provided early intervention when indicated. NIP is not an emergency and treatment must be based on patient objectives, available resources, and clinician experience. Management of recurrent ischemic priapism requires treatment of acute episodes and a focus on future prevention of an acute ischemic event. Sickle cell disease patients presenting with an acute ischemic priapism event should initially be managed with a focus on urologic relief of the erection; standard sickle cell assessment and interventions should be considered concurrent with urologic intervention. Treatment protocols for a prolonged, iatrogenic erection must be differentiated from protocols for true priapism. [ABSTRACT FROM AUTHOR]

Advances at the intersection of artificial intelligence (AI) and education and training are occurring at an ever-increasing pace. On the education and training side, psychological and performance constructs play a central role in both theory and application. It is essential, therefore, to accurately determine the dimensionality of a construct, as it is often employed during both the assessment and development of theory, and its practical application. Traditionally, both exploratory and confirmatory factor analyses have been employed to establish the dimensionality of data. Due in part to inconsistent findings, methodologists recently resurrected the bifactor approach for establishing the dimensionality of data. The bifactor model is pitted against traditional data structures, and the one with the best overall fit (according to chi-square, root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker–Lewis index (TLI), and standardized root mean square residual (SRMR)) is preferred. If the bifactor structure is preferred by that test, it can be further examined via a suite of emerging coefficients (e.g., omega, omega hierarchical, omega subscale, H, explained common variance, and percent uncontaminated correlations), each of which is computed from standardized factor loadings. To examine the utility of these new statistical tools in an education and training context, we analyze data where the construct of interest is trust. We chose trust as it is central, among other things, to understanding human reliance upon and utilization of AI systems. We utilized the above statistical approach and determined the two-factor structure of widely employed trust scale is better represented by one general factor. Findings like this hold substantial implications for theory development and testing, prediction as in structural equation modeling (SEM) models, as well as the utilization of scales and their role in education, training, and AI systems. We encourage other researchers to employ the statistical measures described here to critically examine the construct measures used in their work if those measures are thought to be multidimensional. Only through the appropriate utilization of constructs, defined in part by their dimensionality, are we to advance the intersection of AI and simulation and training. [ABSTRACT FROM AUTHOR]

Effective governance is crucial for the success of conservation projects aimed at protecting wildlife populations and supporting human well-being. However, few large-scale, comprehensive syntheses have been conducted on the effects of different environmental governance types on conservation outcomes (i.e., biological and ecological effectiveness or effects of conservation on human well-being), and clarity on the quantity and quality of evidence remains dispersed and ambiguous. We attempted a systematic map of the evidence on the effectiveness of different governance types to meet desired conservation outcomes in Africa, Asia, and Latin America. However, early in this effort, we observed a general lack of empirical research on the links between governance and conservation outcomes. To fill observed data gaps in the evidence base, we tried triangulating governance data from alternative sources (Protected Planet database) and pooling evidence from research conducted within the same conservation areas. Limited data were contained in the Protected Planet database, and governance types in conservation areas and landscapes were complex, making it difficult to use these approaches to assign governance types to conservation areas. To illustrate our observations from the failed systematic map attempt, we prepared a rapid evidence map that outlines a subset of the evidence base of articles linking governance types and governance principles with conservation outcomes. Only 3.2% (34 of 1067) of the articles we screened directly related conservation outcomes to governance type, and even fewer related governance principles to conservation outcomes. Based on our findings, we recommend improving the evidence base by supporting empirical research and increasing the availability and quality of governance data in freely accessible databases. These recommendations are critical for enhancing understanding of the role of governance in conservation projects and improving conservation outcomes., (© 2024 The Author(s). Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Plans for expanding protected area systems (prioritizations) need to fulfill conservation objectives. They also need to account for other factors, such as economic feasibility and anthropogenic land-use requirements. Although prioritizations are often generated with decision support tools, most tools have limitations that hinder their use for decision-making. We outlined how the prioritizr R package (https://prioritizr.net) can be used for systematic conservation prioritization. This decision support tool provides a flexible interface to build conservation planning problems. It can leverage a variety of commercial (e.g., Gurobi) and open-source (e.g., CBC and SYMPHONY) exact algorithm solvers to identify optimal solutions in a short period. It is also compatible with a variety of spatially explicit (e.g., ESRI Shapefile, GeoTIFF) and nonspatial tabular (e.g., Microsoft Excel Spreadsheet) data formats. Additionally, it provides functionality for evaluating prioritizations, such as assessing the relative importance of different places selected by a prioritization. To showcase the prioritizr R package, we applied it to a case study based in Washington state (United States) for which we developed a prioritization to improve protected area coverage of native avifauna. We accounted for land acquisition costs, existing protected areas, places that might not be suitable for protected area establishment, and spatial fragmentation. We also conducted a benchmark analysis to examine the performance of different solvers. The prioritization identified 12,400 km 2 of priority areas for increasing the percentage of species' distributions covered by protected areas. Although open source and commercial solvers were able to quickly solve large-scale conservation planning problems, commercial solvers were required for complex, large-scale problems.. The prioritizr R package is available on the Comprehensive R Archive Network (CRAN). In addition to reserve selection, it can inform habitat restoration, connectivity enhancement, and ecosystem service provisioning. It has been used in numerous conservation planning exercises to inform best practices and aid real-world decision-making., (© 2024 The Author(s). Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Maintaining and restoring ecological connectivity will be key in helping to prevent and reverse the loss of biodiversity. Fortunately, a growing body of research conducted over the last few decades has advanced our understanding of connectivity science, which will help inform evidence-based connectivity conservation actions. Increases in data availability and computing capacity have helped to dramatically increase our ability to model functional connectivity using more sophisticated models. Keeping track of these advances can be difficult, even for connectivity scientists and practitioners. In this article, we highlight some key advances from the past decade and outline many of the remaining challenges. We describe the efforts to increase the biological realism of connectivity models by, for example, isolating movement behaviors, population parameters, directional movements, and the effects of climate change. We also discuss considerations of when to model connectivity for focal or multiple species. Finally, we reflect on how to account for uncertainty and increase the transparency and reproducibility of connectivity research and discuss situations where decisions may require forgoing sophistication for more simple approaches., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Ecology and Evolution published by John Wiley & Sons Ltd.)

The establishment of protected areas is a cornerstone of conservation, but permanent protection could be inefficient or even impossible in some situations. We synthesized the literature on temporarily conserved areas (TCAs) across Canada, the United States, and Mexico. We used a comprehensive search string to retrieve peer-reviewed articles published from 2000 to 2021 from the Web of Science. We identified 27 relevant peer-reviewed articles that examined the potential benefits of TCAs in the study area, indicating TCA is a relatively understudied area of research in the peer-reviewed literature. The TCA studies were highly clustered; 77% of studies focused on protecting a single life stage of migratory species and 61% of studies related to temporary conservation of breeding or staging habitats for migratory birds. Ninety-three percent of studies focused on preventing human-driven threats, mainly on public lands of coastal areas, the Great Plains, and the Mississippi Valley in the central United States. Short-term and experimental studies were the dominant study types. TCAs have the potential to complement permanently protected areas and provide protection when permanent protection is difficult. Some included studies examined their conservation value, but the ecological, social, and economic outcomes of TCAs are unclear. More TCA research is needed to determine the role they could play in conservation worldwide. Embracing the concept of TCAs as conservation tool could lead to more comprehensive and consistent reporting of the outcomes of temporary area-based conservation measures. However, a global review and analysis of effectiveness of TCAs will be required if they are to play a formal role in meeting international targets for biodiversity conservation., (© 2023 The Authors. Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Cities concentrate problems that affect human well-being and biodiversity. Exploring the link between mental health and biodiversity can inform more holistic public health and urban planning. Here we examined associations between bird and tree species diversity estimates from eBird community science datasets and national forest inventories with self-rated mental health metrics from the Canadian Community Health Survey. We linked data across 36 Canadian Metropolitan Areas from 2007-2022 at a postal code level. After controlling for covariates, we found that bird and tree species diversity were significantly positively related to good self-reported mental health. Living in a postal code with bird diversity one standard deviation higher than the mean increased reporting of good mental health by 6.64%. Postal codes with tree species richness one standard deviation more than the mean increased reporting of good mental health by 5.36%. Our results suggest that supporting healthy urban ecosystems may also benefit human well-being., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2024.)

Phelan-McDermid syndrome (PMS) is a genetic condition caused by SHANK3 haploinsufficiency and characterized by a wide range of neurodevelopmental and systemic manifestations. The first practice parameters for assessment and monitoring in individuals with PMS were published in 2014; recently, knowledge about PMS has grown significantly based on data from longitudinal phenotyping studies and large-scale genotype-phenotype investigations. The objective of these updated clinical management guidelines was to: (1) reflect the latest in knowledge in PMS and (2) provide guidance for clinicians, researchers, and the general community. A taskforce was established with clinical experts in PMS and representatives from the parent community. Experts joined subgroups based on their areas of specialty, including genetics, neurology, neurodevelopment, gastroenterology, primary care, physiatry, nephrology, endocrinology, cardiology, gynecology, and dentistry. Taskforce members convened regularly between 2021 and 2022 and produced specialty-specific guidelines based on iterative feedback and discussion. Taskforce leaders then established consensus within their respective specialty group and harmonized the guidelines. The knowledge gained over the past decade allows for improved guidelines to assess and monitor individuals with PMS. Since there is limited evidence specific to PMS, intervention mostly follows general guidelines for treating individuals with developmental disorders. Significant evidence has been amassed to guide the management of comorbid neuropsychiatric conditions in PMS, albeit mainly from caregiver report and the experience of clinical experts. These updated consensus guidelines on the management of PMS represent an advance for the field and will improve care in the community. Several areas for future research are also highlighted and will contribute to subsequent updates with more refined and specific recommendations as new knowledge accumulates., (© 2023 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.)

Background: Premature infants are at increased risk of kidney-related complications, including acute kidney injury (AKI) and chronic kidney disease (CKD). The risk of CKD in prematurely born infants is underrecognized by health care teams and caregivers. Understanding how to communicate the risk of CKD to caregivers is essential for longitudinal clinical follow-up and adherence., Objective: This study aimed to determine family caregiver attitudes toward kidney health and risk communication during a neonatal intensive care admission. We also sought to understand caregiver preferences for the communication of information surrounding the risk of CKD in premature infants., Methods: We augmented standard qualitative group sessions with human-centered design methods to assess parent preferences and clinician perspectives. Caregivers recruited had a prematurely born child who spent time in the neonatal intensive care unit at Riley Hospital for Children in Indianapolis, Indiana, and experienced AKI or another kidney complication, which put them at risk for future CKD. We used a variety of specific design methods in these sessions, including card sorting, projective methods, experience mapping, and constructive methods., Results: A total of 7 clinicians and 8 caregivers participated in 3 group sessions. Caregivers and clinicians readily acknowledged barriers to and drivers of long-term kidney monitoring as well as opportunities for communication of the risk of long-term kidney disease. Caregivers' primary concerns were for both the type and depth of information conveyed as well as the time at which it was communicated. Participants emphasized the importance of collaboration between the hospital care team and the primary care provider. Participant input was synthesized into several prototype concepts and, ultimately, into a rough prototype of a website and an informational flyer., Conclusions: Caregivers of premature infants are open to communication about kidney health during their neonatal admission. The next phase of this work will translate caregivers' preferences into family-centered communication tools and test their efficacy in the neonatal intensive care unit., (©Michelle C Starr, Samantha Wallace, Courtney Moore, Brandon Cockrum, Bridget Hawryluk, Aaron Carroll, William Bennett. Originally published in Journal of Participatory Medicine (https://jopm.jmir.org), 10.07.2023.)

Protected areas are a key instrument for conservation. Despite this, they are vulnerable to risks associated with weak governance, land-use intensification, and climate change. We used a novel hierarchical optimization approach to identify priority areas for expanding the global protected area system that explicitly accounted for such risks while maximizing protection of all known terrestrial vertebrate species. To incorporate risk categories, we built on the minimum set problem, where the objective is to reach species distribution protection targets while accounting for 1 constraint, such as land cost or area. We expanded this approach to include multiple objectives accounting for risk in the problem formulation by treating each risk layer as a separate objective in the problem formulation. Reducing exposure to these risks required expanding the area of the global protected area system by 1.6% while still meeting conservation targets. Incorporating risks from weak governance drove the greatest changes in spatial priorities for protection, and incorporating risks from climate change required the largest increase (2.52%) in global protected area. Conserving wide-ranging species required countries with relatively strong governance to protect more land when they bordered nations with comparatively weak governance. Our results underscore the need for cross-jurisdictional coordination and demonstrate how risk can be efficiently incorporated into conservation planning. Planeación de las áreas protegidas para conservar la biodiversidad en un futuro incierto., (© 2023 The Authors. Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Animals select habitats based on food, water, space, and cover. Each of those components are essential to the ability of an individual to survive and reproduce in a particular habitat. Selection of resources is linked to reproductive fitness and individuals likely vary in how they select resources relative to their reproductive state: during pregnancy, while provisioning young when nutritional needs of the mother are high, but offspring are vulnerable to predation, or if they lose young to mortality. We investigated the effects of reproductive state on selection of resources by maternal female desert bighorn sheep (Ovis canadensis nelsoni) by comparing selection during the last trimester of gestation, following parturition when females were provisioning dependent young, and if the female lost an offspring. We captured, and recaptured each year, 32 female bighorn sheep at Lone Mountain, Nevada, during 2016-2018. Captured females were fit with GPS collars and those that were pregnant received vaginal implant transmitters. We used a Bayesian approach to estimate differences in selection between females provisioning and not provisioning offspring, as well as the length of time it took for females with offspring to return levels of selection similar to that observed prior to parturition. Females that were not provisioning offspring selected areas with higher risk of predation, but greater nutritional resources than those that were provisioning dependent young. When females were provisioning young immediately following parturition, females selected areas that were safe from predators, but had lower nutritional resources. Females displayed varying rates of return to selection strategies associated with access to nutritional resources as young grew and became more agile and less dependent on mothers. We observed clear and substantial shifts in selection of resources associated with reproductive state, and females exhibited tradeoffs in favor of areas that were safer from predators when provisioning dependent young despite loss of nutritional resources to support lactation. As young grew and became less vulnerable to predators, females returned to levels of selection that provided access to nutritional resources to restore somatic reserves lost during lactation., (© 2023. The Author(s).)

Background: Musculoskeletal infections (MSKI), including osteomyelitis and septic arthritis, are among the most common invasive infections in children and have the potential to cause significant morbidity. Guidelines have been developed to optimize care based on clinician-developed endpoints. Patient-centered outcomes have not been defined for children with MSKI. This study identified outcomes most important to caregivers and patients with MSKI., Methods: This was a single-center prospective qualitative study of children 6 months to 18 years of age hospitalized with MSKI from November 2019 to September 2021. Using design-research methods, patients and caregivers participated in interviews and/or completed journals to describe their experiences during acute infection and recovery from MSKI., Results: A total of 51 patient/caregivers were approached to participate in the study, 35 of whom declined to participate, resulting in 8 interviews conducted and 14 journals collected from 16 patient/caregivers. From these, a journey map was created highlighting points of stress during the onset of symptoms, through hospitalization, and returning home with new challenges. In addition, patient-centered outcomes were identified. For caregivers, these included managing mental health, managing responsibilities, and receiving support. Both caregivers and patients shared the importance of understanding of treatment plans and responsibilities. For patients, improving mental and physical health was important., Conclusions: Management of children with MSKI is complex and requires a multidisciplinary team approach. Validation of the outcomes identified and development of a measurement tool are needed. Addressing the patient-centered outcomes we identified in this study can greatly improve the holistic care of children with MSKI., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

The knowledge-action gap in conservation science and practice occurs when research outputs do not result in actions to protect or restore biodiversity. Among the diverse and complex reasons for this gap, three barriers are fundamental: knowledge is often unavailable to practitioners and challenging to interpret or difficult to use or both. Problems of availability, interpretability, and useability are solvable with open science practices. We considered the benefits and challenges of three open science practices for use by conservation scientists and practitioners. First, open access publishing makes the scientific literature available to all. Second, open materials (detailed methods, data, code, and software) increase the transparency and use of research findings. Third, open education resources allow conservation scientists and practitioners to acquire the skills needed to use research outputs. The long-term adoption of open science practices would help researchers and practitioners achieve conservation goals more quickly and efficiently and reduce inequities in information sharing. However, short-term costs for individual researchers (insufficient institutional incentives to engage in open science and knowledge mobilization) remain a challenge. We caution against a passive approach to sharing that simply involves making information available. We advocate a proactive stance toward transparency, communication, collaboration, and capacity building that involves seeking out and engaging with potential users to maximize the environmental and societal impact of conservation science., (© 2021 The Authors. Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Neotropical countries receive financing and effort from temperate nations to aid the conservation of migratory species that move between temperate and tropical regions. If allocated strategically, these resources could simultaneously contribute to other conservation initiatives. In this study, we use novel distribution maps to show how those resources could aid planning for the recovery of threatened resident vertebrates.Using eBird-based relative abundance estimates, we first identified areas with high richness of Neotropical migrant landbirds of conservation concern (23 species) during the stationary non-breeding period. Within these areas, we then identified threatened species richness, projected forest loss and conducted a prioritization for 1,261 red-listed vertebrates using Terrestrial Area-of-Habitat maps.Richness for migrants was greatest along a corridor from the Yucatan peninsula south to the northern Andes but also included south-west Mexico and Hispaniola. Protected areas account for 22% of this region while 21% is at risk of forest loss. Within this focal region for migrants, all four vertebrate groups showed hotspots of threatened species richness along the west and east Andean slopes. Taxa-specific hotspots included montane areas of southern Mexico and central Guatemala (amphibians/reptiles) and the entire east slope of the Colombian East Andes (mammals).Our prioritization highlighted several areas of importance for conservation due to high threatened species richness and projected forest loss including (a) the Pacific dry forests of south-west Mexico, (b) montane regions of northern Central America and (c) the west Andean slope of Colombia and Ecuador. At a landscape scale in southern Colombia, we show how conservation efforts for six Neotropical migrants could benefit 56 threatened residents that share a similar elevational range. Synthesis and applications . Funding and effort for migratory bird conservation also has potential to benefit threatened resident vertebrates in the Neotropics. Our study highlights how novel, high-resolution information on species distributions and risk of forest loss can be integrated to identify priority areas for the two groups at regional and landscape scales. The approach and data can be further modified for more specific goals, such as within-country initiatives., Competing Interests: The authors have no conflict of interest to report., (© 2021 Her Majesty the Queen in Right of Canada. Journal of Applied Ecology published by John Wiley & Sons Ltd on behalf of British Ecological Society. Reproduced with the permission of the Minister of Environment and Climate Change Canada.)

Background: Altering the natural flow regime, an essential component of healthy fluvial systems, through hydropower operations has the potential to negatively impact freshwater fish populations. Establishing improved management of flow regimes requires better understanding of how fish respond to altered flow components, such as flow magnitude. Based on the results of a recent systematic map on the impacts of flow regime changes on direct outcomes of freshwater or estuarine fish productivity, evidence clusters on fish abundance and biomass responses were identified for full systematic review. The primary goal of this systematic review is to address one of those evidence clusters, with the following research question: how do changes in flow magnitude due to hydropower operations affect fish abundance and biomass?, Methods: This review follows the guidelines of the Collaboration for Environmental Evidence. It examined commercially published and grey literature originally identified during the systematic map process and a systematic search update. All articles were screened using an a priori eligibility criteria at two stages (title and abstract, and full-text) and consistency checks were performed at all stages. All eligible articles were assessed for study validity and specifically designed data extraction and study validity tools were used. A narrative synthesis included all available evidence and meta-analysis using the standardized mean difference (Hedges' g) was conducted where appropriate., Review Findings: A total of 133 studies from 103 articles were included in this systematic review for data extraction and critical appraisal. Most studies were from North America (60%) and were conducted at 146 different hydropower dams/facilities. Meta-analysis included 268 datasets from 58 studies, separated into three analyses based on replication type [temporal (within or between year replication) or spatial]. Fish abundance (226 datasets) and biomass (30 datasets) had variable responses to changes in flow magnitude with estimated overall mean effect sizes ranging from positive to negative and varying by study design and taxa. In studies with temporal replication, we found a detectable effect of alterations to the direction of flow magnitude, the presence of other flow components, sampling methods, season, and fish life stage. However, we found no detectable effect of these moderators for studies with spatial replication. Taxonomic analyses indicated variable responses to changes in flow magnitude and a bias towards salmonid species., Conclusions: This synthesis did not find consistent patterns in fish abundance or biomass responses to alterations or changes in flow magnitude. Fish responses to flow magnitude alterations or changes were highly variable and context dependent. Our synthesis suggests that biotic responses may not be generalizable across systems impacted by hydroelectric power production and operations, where specific features of the system may be highly influential. Site-specific and adaptive management may be necessary. To improve study validity and interpretability, studies with long-term continuous monitoring, and both temporal and spatial replication are needed. When this gold standard is unfeasible, studies should strive, at minimum, to maximize replication within both intervention and comparator groups for either temporal or spatial designs. To further address knowledge gaps, studies are needed that focus on non-salmonids, multiple seasons, and systems outside of North America., (© 2022. The Author(s).)

Objective: The past decade has seen platelet-rich plasma (PRP) become a popular therapy around the world as a treatment for androgenetic alopecia (AGA). These systematic review and meta-analyses assess the effectiveness and adverse effects of PRP to determine the role of PRP as a treatment for AGA among the other non-surgical treatment modalities., Methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and is registered under the PROSPERO ID CRD42019136329. Seven databases were searched from inception through May 2019. Meta-analyses of randomized controlled trials (RCTs) were performed to evaluate the effect of PRP treatments on hair density and hair thickness., Results: Thirty studies, including 687 patients, met our inclusion criteria. Twenty-nine studies reported beneficial results, and 24 studies reached statistical significance on a measured outcome. Ten RCTs were included. Our meta-analyses show that PRP treatment increases hair density and hair thickness., Conclusions: PRP is an autologous treatment that lacks serious adverse effects and effectively improves hair density and hair thickness in men and women with AGA. Future research should include low risk-of-bias RCTs to optimize treatment protocols, investigate variability among studies, and to obtain more data on hair thickness changes.