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Maya Kshatriya,1– 3 Kuan-Wen Wang,1,2 Julia Hildebrand,1,2 Rebecca Crawford,1,2,4 Ajantha Nadarajah,1– 3 Michael Youssef,1,2 Angelica Rivas,1,2,5 Ashleen Kaushal,1,2 Laura E Banfield,6 Lehana Thabane,7– 10 M Constantine Samaan1– 3,5,7 1Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; 2Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada; 3Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada; 4Indigenous Undergraduate Summer Research Program, McMaster University, Hamilton, Ontario, Canada; 5Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada; 6Health Sciences Library, McMaster University, Hamilton, Ontario, Canada; 7Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; 8Biostatistics Unit, St. Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada; 9Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; 10Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, CanadaCorrespondence: M Constantine Samaan, Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario, L8S 4K1, Canada, Tel +1-905-521-2100, ext. 75926, Fax +1-905-308-7548, Email samaanc@mcmaster.caBackground: Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada.Methods: Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence.Results: Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs.Conclusion: Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada.Systematic Review Registration: PROSPERO CRD42017072781.Keywords: child, ethnicity, obesity, diabetes, prevention

Ivory poaching continues to threaten African elephants. We (1) used criminology theory and literature evidence to generate hypotheses about factors that may drive, facilitate or motivate poaching, (2) identified datasets representing these factors, and (3) tested those factors with strong hypotheses and sufficient data quality for empirical associations with poaching. We advance on previous analyses of correlates of elephant poaching by using additional poaching data and leveraging new datasets for previously untested explanatory variables. Using data on 10 286 illegally killed elephants detected at 64 sites in 30 African countries (2002-2020), we found strong evidence to support the hypotheses that the illegal killing of elephants is associated with poor national governance, low law enforcement capacity, low household wealth and health, and global elephant ivory prices. Forest elephant populations suffered higher rates of illegal killing than savannah elephants. We found only weak evidence that armed conflicts may increase the illegal killing of elephants, and no evidence for effects of site accessibility, vegetation density, elephant population density, precipitation or site area. Results suggest that addressing wider systemic challenges of human development, corruption and consumer demand would help reduce poaching, corroborating broader work highlighting these more ultimate drivers of the global illegal wildlife trade.

Introduction: Diabetes mellitus is the most common endocrine disorder in children, and the prevalence of paediatric type 1 and type 2 diabetes continue to rise globally. Diabetes clinical care programs pivoted to virtual care with the COVID-19 pandemic-driven social distancing measures. Yet, the impact of virtual care on health-related quality of life in children living with diabetes remains unclear. This protocol reports on the methods that will be implemented to conduct a systematic review to assess the health-related quality of life and metabolic health impacts of virtual diabetes care., Methods and Analysis: We will search MEDLINE, Embase, EMCare, PsycInfo, Web of Science, and the grey literature for eligible studies. We will screen title, abstract, and full-text papers for potential inclusion and assess the risk of bias and the overall confidence in the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. A meta-analysis will be conducted if two studies report similar populations, study designs, methods, and outcomes.This systematic review will summarise the health-related quality of life outcomes for virtual diabetes care delivery models., Ethics and Dissemination: No ethics approval is required for this systematic review protocol as it does not include patient data. The systematic review will be published in a peer-reviewed journal and presented at international conferences., Prospero Registration Number: CRD42021235646., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Poaching is contributing to rapid declines in elephant populations across Africa. Following high-profile changes in the political environment, the overall number of illegally killed elephants in Africa seems to be falling, but to evaluate potential conservation interventions we must understand the processes driving poaching rates at local and global scales. Here we show that annual poaching rates in 53 sites strongly correlate with proxies of ivory demand in the main Chinese markets, whereas between-country and between-site variation is strongly associated with indicators of corruption and poverty. Our analysis reveals a recent decline in annual poaching mortality rate from an estimated peak of over 10% in 2011 to <4% in 2017. Based on these findings, we suggest that continued investment in law enforcement could further reduce poaching, but is unlikely to succeed without action that simultaneously reduces ivory demand and tackles corruption and poverty.

Combining protected areas with natural forest timber concessions may sustain larger forest landscapes than is possible via protected areas alone. However, the role of timber concessions in maintaining natural forest remains poorly characterized. An estimated 57% (303,525 km²) of Kalimantan's land area (532,100 km²) was covered by natural forest in 2000. About 14,212 km² (4.7%) had been cleared by 2010. Forests in oil palm concessions had been reduced by 5,600 km² (14.1%), while the figures for timber concessions are 1,336 km² (1.5%), and for protected forests are 1,122 km² (1.2%). These deforestation rates explain little about the relative performance of the different land use categories under equivalent conversion risks due to the confounding effects of location. An estimated 25% of lands allocated for timber harvesting in 2000 had their status changed to industrial plantation concessions in 2010. Based on a sample of 3,391 forest plots (1×1 km; 100 ha), and matching statistical analyses, 2000-2010 deforestation was on average 17.6 ha lower (95% C.I.: -22.3 ha- -12.9 ha) in timber concession plots than in oil palm concession plots. When location effects were accounted for, deforestation rates in timber concessions and protected areas were not significantly different (Mean difference: 0.35 ha; 95% C.I.: -0.002 ha-0.7 ha). Natural forest timber concessions in Kalimantan had similar ability as protected areas to maintain forest cover during 2000-2010, provided the former were not reclassified to industrial plantation concessions. Our study indicates the desirability of the Government of Indonesia designating its natural forest timber concessions as protected areas under the IUCN Protected Area Category VI to protect them from reclassification.

The ideal free distribution is a description of how organisms would distribute themselves in space if they were free to move so as to maximize fitness. The standard formulation of the ideal free distribution envisions the environment as consisting of finitely many discrete habitats. In this paper, a version of the ideal free distribution is derived for the case where the environment is a continuum. The continuum formulation allows computation of average fitness at the population level by taking account of both local fitness and the spatial distribution of the population. An example shows that the average fitness may have a different form than the local fitness; in particular, if local fitness is described by a logistic equation at each location, the average fitness may obey the theta-logistic equation of F. J. Ayala et al. (1973, Theor. Popul. Biol. 4, 331-356). This gives a mechanistic derivation of the theta-logistic equation.

One hundred and three patients (Group A), mean age 55.81 +/- 8.54 years, 94 males and 9 females, scheduled for coronary artery bypass graft (CABG) surgery were subjected to preoperative upper gastro-intestinal (UGI) endoscopy. 51.5% of these were found to have significant mucosal lesions in the UGI tract. Twenty one (20.4%) had severe lesions which could have bled, warranting postponement of their surgery. All of these 21 were treated with Omeprezole 20 mg / day for a mean of 35.87 +/- 4.64 days and subjected to check endoscopy after the treatment. 16 of these 21 patients were taken up for CABG after the lesions had healed. Five deferred surgery. None of the 103 patients had a postoperative UGI bleed. A retrospective analysis of 1274 patients (group B) was carried out for number of patients (42) having postoperative UGI bleed. The results of group A and group B were then compared. Patients in group A had significant lower incidence of postoperative UGI bleed than those in group B. Postoperative hospital stay in patients of UGI bleed in group B was 24.71 +/- 20.88 (range 8 days - 129 days). In group A it was 14.34 +/- 12.44 days (range 7 days - 88 days). The difference is statistically highly significant. It appears that patients who have postoperative UGI bleed probably bleed from pre existing lesions. We conclude that preoperative UGI endoscopy is a valuable tool in preventing postoperative UGI bleed.