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Abstract Nature‐based tourism has a unique opportunity, and arguably responsibility, to promote widespread action on climate change. However, research suggests an aversion to providing information that might appear divisive or ‘ruin’ peoples day, particularly in places that are vulnerable to degradation. We explore how exposure to climate change information in vulnerable nature settings influences indicators of (i) the visitor experience and (ii) climate change engagement. Using a quasi‐experimental approach, we provided climate information on tourist boats operating on the Great Barrier Reef, Australia and compared visitor experiences with a control condition where climate information was not provided. Visitor surveys (n = 656) assessed perceptions and experiences. Overall, visitors on trips where climate information was provided were more likely to report that the reef experience exceeded their expectations and did not report any reduction in subjective trip satisfaction. However, we detected minimal effects of climate information on indicators of climate engagement (threat awareness, action awareness, or information seeking), suggesting room for improvement in interpretation approach and design. Indeed, visitors reported high levels of acceptability for incorporating more information about climate change, particularly about actions. Synthesis and applications: These results suggest that providing climate information does not undermine visitor experiences and while further research is required to determine the most effective approach for influencing climate change engagement, an appetite for more information exists. It is possible that what tourism operators are fearful of, may be an opportunity to improve outcomes aligned with both industry and environmental objectives. Read the free Plain Language Summary for this article on the Journal blog.

BackgroundAdvances in DNA sequencing revolutionized plant genomics and significantly contributed to the study of genetic diversity. However, predicting phenotypes from genomic data remains a challenge, particularly in the context of plant breeding. Despite significant progress, accurately predicting phenotypes from high-dimensional genomic data remains a challenge, particularly in identifying the key genetic factors influencing these predictions. This study aims to bridge this gap by integrating explainable artificial intelligence (XAI) techniques with advanced machine learning models. This approach is intended to enhance both the predictive accuracy and interpretability of genotype-to-phenotype models, thereby improving their reliability and supporting more informed breeding decisions.ResultsThis study compares several ML methods for genotype-to-phenotype prediction, using data available from an almond germplasm collection. After preprocessing and feature selection, regression models are employed to predict almond shelling fraction. Best predictions were obtained by the Random Forest method (correlation = 0.727 ± 0.020, an R2 = 0.511 ± 0.025, and an RMSE = 7.746 ± 0.199). Notably, the application of the SHAP (SHapley Additive exPlanations) values algorithm to explain the results highlighted several genomic regions associated with the trait, including one, having the highest feature importance, located in a gene potentially involved in seed development.ConclusionsEmploying explainable artificial intelligence algorithms enhances model interpretability, identifying genetic polymorphisms associated with the shelling percentage. These findings underscore XAI’s efficacy in predicting phenotypic traits from genomic data, highlighting its significance in optimizing crop production for sustainable agriculture.

# Background Athlete injury risk assessment and management is an important, yet challenging task for sport and exercise medicine professionals. A common approach to injury risk screening is to stratify athletes into risk groups based on their performance on a test relative to a cut-off threshold. However, one potential reason for ineffective injury prevention efforts is the over-reliance on identifying these ‘at-risk’ groups using arbitrary cut-offs for these tests and measures. The purpose of this commentary is to discuss the conceptual and technical issues related to the use of a cut-off in both research and clinical practice. # Clinical Question How can we better assess and interpret clinical tests or measures to enable a more effective injury risk assessment in athletes? # Key Results Cut-offs typically lack strong biologic plausibility to support them; and are typically derived in a data-driven manner and thus not generalizable to other samples. When a cut-off is used in analyses, information is lost, leading to potentially misleading results and less accurate injury risk prediction. Dichotomizing a continuous variable using a cut-off should be avoided. Using continuous variables on its original scale is advantageous because information is not discarded, outcome prediction accuracy is not lost, and personalized medicine can be facilitated. # Clinical Application Researchers and clinicians are encouraged to analyze and interpret the results of tests and measures using continuous variables and avoid relying on singular cut-offs to guide decisions. Injury risk can be predicted more accurately when using continuous variables in their natural form. A more accurate risk prediction will facilitate personalized approaches to injury risk mitigation and may lead to a decline in injury rates. # Level of Evidence 5

Research has shown that pomefruit orchard production can be forecast. Basic information about orchard characteristics as tree density, fruit load and fruit size can translate into useful information on orchard production. In most cases the complete flow of this information is only available after harvest. Precision horticulture integrates this information in order to evaluate the management performed by the grower, and to assess whether it is in line to achieve the desired targets or not. The Department of Agricultural Sciences of the University of Bologna and HK-Horticultural Knowledge (HK, 2011) after several years of conducting experiences of precise fruit growing in commercial orchards cooperate to bring to fruition this novel approach. Precise measurement of fruit growth is justified on the concept that the fruit can be considered as the most relevant indicator of how well is the process progressing. A four year experiment will be presented. Fruit maximum diameter was recorded every other week during the cell expansion phase of growth. The data were processed and a diagnosis was released in real time to the grower, assessing the progress of the crop, and serving as a verification that the applied management techniques are yielding the expected production result. The real time forecast has been used to evaluate a comparison between predicted and the real breakdown of the total yield into size categories, which allows to release also a very accurate estimate of orchard yield for the packing house.

Abstract Background Psychological readiness is an important consideration for athletes and clinicians when making return to sport decisions following anterior cruciate ligament reconstruction (ACLR). To improve our understanding of the extent of deficits in psychological readiness, a systematic review is necessary. Objective To investigate psychological readiness (measured via the Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI)) over time after ACL tear and understand if time between injury and surgery, age, and sex are associated with ACL-RSI scores. Methods Seven databases were searched from the earliest date available to March 22, 2022. Articles reporting ACL-RSI scores after ACL tear were included. Risk of bias was assessed using the ROBINS-I, RoB-2, and RoBANS tools based on the study design. Evidence certainty was assessed for each analysis. Random-effects meta-analyses pooled ACL-RSI scores, stratified by time post-injury and based on treatment approach (i.e., early ACLR, delayed ACLR, and unclear approach). Results A total of 83 studies were included in this review (78% high risk of bias). Evidence certainty was ‘weak’ or ‘limited’ for all analyses. Overall, ACL-RSI scores were higher at 3 to 6 months post-ACLR (mean = 61.5 [95% confidence interval (CI) 58.6, 64.4], I2 = 94%) compared to pre-ACLR (mean = 44.4 [95% CI 38.2, 50.7], I2 = 98%), remained relatively stable, until they reached the highest point 2 to 5 years after ACLR (mean = 70.7 [95% CI 63.0, 78.5], I2 = 98%). Meta-regression suggests shorter time from injury to surgery, male sex, and older age were associated with higher ACL-RSI scores only 3 to 6 months post-ACLR (heterogeneity explained R2 = 47.6%), and this reduced 1–2 years after ACLR (heterogeneity explained R2 = 27.0%). Conclusion Psychological readiness to return to sport appears to improve early after ACL injury, with little subsequent improvement until ≥ 2-years after ACLR. Longer time from injury to surgery, female sex and older age might be negatively related to ACL-RSI scores 12–24 months after ACLR. Due to the weak evidence quality rating and the considerable importance of psychological readiness for long-term outcomes after ACL injury, there is an urgent need for well-designed studies that maximize internal validity and identify additional prognostic factors for psychological readiness at times critical for return to sport decisions. Registration: Open Science Framework (OSF), https://osf.io/2tezs/ .

The knowledge about the behaviour of different fruit tree species when subjected to water shortage is pivotal to pair correctly the species with the environment, as well as to choose the most reliable index for monitoring the plant water status. Net photosynthesis (Pn) and stomatal conductance (gs) are considered some of the most reliable variables describing the plant water status, functionality and potential productivity, but their measurement are actually time consuming, complex and expensive. The aims of the present study were to investigate the effect of a progressive water stress on leaf functioning and plant water status of two stone fruit trees species; to study the water relations within the Soil-Plant-Atmosphere Continuum; to assess a pool of indices for estimating Pn and gs by means of other variables quick to be measured, potentially through less expensive and user-friendly sensors. The trial was carried out on an early ripening apricot variety (Prunus armeniaca L. cv. Primius) and on a late ripening peach variety (Prunus persica (L.) Batsch cv. Calred) subjected to progressive dry down. Trees were monitored for stem water potential, leaf temperature, chlorophyl fluorescence, Pn and gs. “Primius” and “Calred” behaved as near anisohydric and near-isohydric plants, respectively. In “Primius” Pn and gs were more affected by soil water content than vapour pressure deficit (VPD) and the opposite occurred in “Calred”, suggesting a different approach to be used for managing water in the two cultivars. Chlorophyll fluorescence variables and leaf to air temperature difference (ΔT), combined properly by means of stepwise multiple regression analysis approach, were selected as good predictors of Pn for both the species. ΔT and VPD were selected to estimate gs, using the same approach. The prediction performance of the models resulted good suggesting their possible use for driving irrigation in a more sustainable and plant-based way.

Almond [Prunus dulcis Miller (D. A. Webb), syn. Prunus amygdalus L.)] is the major tree nut crop worldwide in terms of production and cultivated area. Almond domestication was enabled by the selection of individuals bearing sweet kernels, which do not accumulate high levels of the toxic cyanogenic glucoside amygdalin. Previously, we showed that the Sweet kernel (Sk) gene, controlling the kernel taste in almond, encodes a basic helix loop helix (bHLH) transcription factor regulating the amygdalin biosynthetic pathway. In addition, we characterized a dominant allele of this gene, further referred to as Sk-1, which originates from a C1036→T missense mutation and confers the sweet kernel phenotype. Here we provide evidence indicating that the allele further referred to as Sk-2, originally detected in the cultivar “Atocha” and arising from a T989→G missense mutation, is also dominantly inherited and confers the sweet kernel phenotype in almond cultivated germplasm. The use of single nucleotide polymorphism (SNP) data from genotyping by sequencing (GBS) for population structure and hierarchical clustering analyses indicated that Sk-2 occurs in a group of related genotypes, including the widespread cultivar “Texas”, descending from the same ancestral population. KASP and dual label functional markers were developed for the accurate and high-throughput selection of the Sk-1 and Sk-2 alleles, and the genotyping of a panel of 134 almond cultivars. Overall, our results provide further insights on the understanding of the almond cultivation history. In addition, molecular marker assays and genotypic data presented in this study are expected to be of major interest for the conduction of almond breeding programs, which often need to select sweet kernel individuals in segregant populations.

Rootstock selection and crop load adjustment are key practices in apple orchard management; nevertheless, the effects of rootstocks and crop load levels on important physiological processes of the scions, such as photosynthetic performance and carbohydrate accumulation, are still unclear. To investigate the impact of different rootstocks and crop load levels on scion photosynthesis and carbohydrate buildup, in 2020, ‘Honeycrisp’ trees grafted on rootstocks ‘G.41’, ‘G.935’, and ‘M.9-T337’ were thinned to low and high crop load levels, and photosynthetic performance and carbohydrate accumulation in leaves and fruit were evaluated. Leaves from ‘G.935’ showed the highest net photosynthesis and electron use efficiency of photosynthesis and the lowest activity for non-net carboxylative processes, all together indicative of enhanced photosynthetic performance. High crop load determined an increase in gas exchange, suggesting a positive feedback of high fruit competition on carbon assimilation. While rootstock ‘M.9-T337’ showed a higher accumulation of starch in leaves, no pattern regarding the composition of leaf-soluble sugars among rootstocks could be identified. Conversely, by the end of the harvest season, leaves from low-cropping trees had higher fructose, glucose, and sorbitol than those from high-cropping trees, but differences in starch content were not significant. Fructose and sorbitol concentrations were affected by rootstock and crop load, respectively. Overall, this study showed that high cropping enhanced photosynthesis in ‘Honeycrisp’ apple and determined lower accumulation of some soluble carbohydrates (fructose, glucose, sorbitol) in leaves. This study also provided insights into how rootstocks affect photosynthetic performance of ‘Honeycrisp’, highlighting ‘G.935’ as the rootstock conferring the highest photosynthetic capacity under the present experimental conditions.

Elbow injuries are a significant and increasing issue in baseball. Elbow injuries account for 16% of all injuries sustained at the professional level and collegiate level. Because of the continued rise in injury rates, loss of performance value, and medical burden, sports medicine clinicians have attempted to research the causes underlying this injury epidemic in an attempt to help mitigate baseball elbow injuries. Shoulder range of motion (ROM) is the most researched clinical metric related to elbow injuries in baseball and has the greatest consensus as a viable prognostic factor specifically for medial elbow injury. Shoulder ROM is easy to measure, can be modified through stretching and manual therapy interventions, and can be easily assessed during preseason screening throughout all baseball levels. Despite a large number of studies and the widespread use of shoulder ROM in injury risk screening, current findings are unclear as to whether there is a true cause-effect relation with baseball elbow injuries. We argue that the conflicting findings revolving around the value of shoulder ROM measurements associated with baseball elbow injuries are the result of 4 gaps in the research approaches implemented to date: ambiguous research questions, mixed study populations, statistical models used, and shoulder ROM methodology. Specifically, there is a mismatch of methods, statistical models, and conclusions such as (1) investigating the association (i.e., correlation) between shoulder ROM measurements and injury and (2) investigating the cause-effect relation of shoulder ROM to baseball injuries. The purpose of this article is to detail the required scientific steps to evaluate whether preseason shoulder ROM is a potential causal factor for pitching elbow injury. We also provide recommendations to allow for future causal inferences to be made between shoulder ROM and elbow injury. This information will ultimately assist in informing clinical models of care and decision making for baseball throwers.

Background: Athlete injury risk assessment and management is an important, yet challenging task for sport and exercise medicine professionals. A common approach to injury risk screening is to stratify athletes into risk groups based on their performance on a test relative to a cut-off threshold. However, one potential reason for ineffective injury prevention efforts is the over-reliance on identifying these 'at-risk' groups using arbitrary cut-offs for these tests and measures. The purpose of this commentary is to discuss the conceptual and technical issues related to the use of a cut-off in both research and clinical practice. Clinical Question: How can we better assess and interpret clinical tests or measures to enable a more effective injury risk assessment in athletes? Key Results: Cut-offs typically lack strong biologic plausibility to support them; and are typically derived in a data-driven manner and thus not generalizable to other samples. When a cut-off is used in analyses, information is lost, leading to potentially misleading results and less accurate injury risk prediction. Dichotomizing a continuous variable using a cut-off should be avoided. Using continuous variables on its original scale is advantageous because information is not discarded, outcome prediction accuracy is not lost, and personalized medicine can be facilitated. Clinical Application: Researchers and clinicians are encouraged to analyze and interpret the results of tests and measures using continuous variables and avoid relying on singular cut-offs to guide decisions. Injury risk can be predicted more accurately when using continuous variables in their natural form. A more accurate risk prediction will facilitate personalized approaches to injury risk mitigation and may lead to a decline in injury rates. Level of Evidence: 5 [ABSTRACT FROM AUTHOR]

Assess the efficacy of an 8-week virtual, physiotherapist (PT)-guided knee health program (Stop OsteoARthritis (SOAR)) to improve knee extensor strength in individuals at risk of post-traumatic knee osteoarthritis (PTOA). In this superiority, randomized delayed-control trial, persons aged 16–35 years, 1–4 years after a self-reported knee joint injury were randomly assigned (1:1) to receive the SOAR program immediately (experimental group) or after a 9-week delay (control group). SOAR includes 1) one-time Knee Camp (virtual PT-guided group education, knee assessment, 1:1 exercise and physical activity (PA) goal-setting); 2) Weekly personalized home-based exercise and PA program with tracking; 3) Weekly 1:1 PT counseling (virtual). The primary outcome was a change in isokinetic knee extensor strength (baseline to 9-weeks). Additional outcomes included change in self-reported knee-related quality-of-life (QOL), self-efficacy, self-management and kinesiophobia, and PA (accelerometer) at 9 and 18-weeks. Linear regression models estimated the effect of the 8-week intervention at the primary endpoint (9-week). 49 of 54 randomized participants completed the study (91%). Participants were a mean ± standard deviation age of 27 ± 5.0 years, and 2.4 ± 0.9 years post-injury. No mean between group differences for the primary (0.05; 95% confidence interval (CI): −0.10, 0.19) or other outcomes were seen at 9 weeks except for greater improvements in perceived self-management (Partner in Health Scale; 11.3/96, 95%CI: 5.5, 17.1) and kinesiophobia (Tampa Scale of Kinesiophobia; −4.4/33, 95%CI: −7.0, −1.8). For active persons with elevated risk of PTOA, an 8-week SOAR program did not change knee-related strength, QOL, self-efficacy, or PA, on average, but may benefit the ability to self-manage knee health and kinesiophobia. [ABSTRACT FROM AUTHOR]

Microclimatic and soil management studies emphasize that roofing above the canopy or soil mulching contributes to reduce water losses from horticultural cropping systems and, at the same time, to increase water use efficiency. The aim of this 2-year on-farm study, carried out on a late ripening peach (cv. California) orchard, was to investigate the combined effect of water supply (full or deficit irrigation, DI), incoming light (hail or shading net), and soil management (tilling or mulching) on: microclimate; fruit growth; yield; irrigation water use productivity (WPI); and soil water stress coefficient (Ks). Shading hail net reduced air temperature (−1°C), wind speed (−57%), solar radiation (−32%), while increased relative air humidity (+9.5%). Compared to the control treatment (hail net coverage, soil tillage, and full irrigation), the innovative management (DI + shading hail net + mulching) reduced seasonal volumes of irrigation water (−25%) and increased both final yield (+36%) and WPI (+53%). Saving water resources without losing yield is an achievable goal by peach orchards growing under the Mediterranean climate if the DI agro-technique is adopted conjointly with shading hail net and soil mulching.

Estimate the association between index leg knee muscle strength and rate of torque development (RTD), and self-reported and performance-based (i.e., hop) knee function in persons 1–4 years after a sport-related knee joint injury. Data were collected at baseline of a clinical trial. Assessments included the Knee injury and Osteoarthritis Outcome Score Sport & Recreation subscale (KOOS sport), 6-m timed hop (TH), and peak concentric isokinetic knee extensor and flexor torque and isometric RTD. Associations between peak torque and RTD with KOOS sport and TH were assessed using multivariable regression with nonlinear transformations. 53 participants (64.2% female) were included. Knee extensor peak torque was nonlinearly related to TH time, with a strong inverse relationship at lower torque values that changed as torque increased. Results were inconsistent for flexor peak torque, extensor RTD and flexor RTD, with inconsistencies in relationship shape and estimates of association between primary and sensitivity analyses. There was no association between strength/RTD and KOOS sport. There was a nonlinear relationship between knee extensor strength and hop function, with lower strength being associated with a stronger relationship. As strength values increased, the relationship attenuated. Knee extensor and flexor strength, or RTD, were not associated with self-reported function. • The relationship between knee extensor strength and timed hop was nonlinear. • Muscle performance was unrelated to self-reported function after knee injury. • Clinicians should continue to focus on knee extensor strength recovery post injury. • These findings should not be interpreted as cause-effect. [ABSTRACT FROM AUTHOR]

Semi-arid conditions are favorable for the cultivation of late ripening peach cultivars; however, seasonal water scarcity and reduction in soil biological fertility, heightened by improper soil management, are jeopardizing this important sector. In the present two-year study, four soil managements were compared on a late ripening peach orchard: (i) completely tilled (control); (ii) mulched with reusable reflective plastic film; (iii) mulching with a Leguminosae cover-crop flattened after peach fruit set; (iv) completely tilled, supplying the water volumes of the plastic mulched treatment, supposed to be lower than the control. Comparison was performed for soil features, water use, tree functionality, fruit growth, fruit quality, yield and water productivity. Even receiving about 50% of the regular irrigation, reusable reflective mulching reduced water loss and soil carbon over mineralization, not affecting (sometimes increasing) net carbon assimilation, yield, and fruit size and increasing water productivity. The flattening technique should be refined in the last part of the season as in hot and dry areas with clay soils and low organic matter, soil cracking increased water evaporation predisposing the orchard at water stress. The development and implementation of appropriate soil management strategies could be pivotal for making peach production economically and environmentally sustainable.

Leaf photosynthetic performance of a new red-skinned inter-specific hybrid pear variety called ‘PremP009’ (PIQA®BOO®) is presently unknown and therefore was compared to the Asian pear variety ‘Hosui’. The seasonal growth patterns and the final dry matter accumulation of all tree components were also investigated for both genotypes in their first year of growth after grafting. Leaf gas exchange and tree growth comparisons were assessed using an innovative grafted plant system, which involved a bi-axis tree with the presence of combinations of identical or mixed (one of each genotype) ‘PremP009’ and ‘Hosui’ scion genotypes grafted onto a single clonal rootstock (‘Buerre Hardy’ BA29). This experimental grafted plant system allowed a technique for comparing leaf photosynthesis of two scion genotypes on the same root system, thereby avoiding between-plant differences in plant water relations. ‘PremP009’ had higher leaf photosynthesis and higher leaf mass compared with ‘Hosui.’ However, by the end of the first year of growth, primary shoots of ‘PremP009’ were shorter with fewer nodes, corresponding to less dry weight gain in primary shoot leaves and stems. This vegetative behavior of ‘PremP009’ is likely a response to the smaller individual leaf area in the early season affecting light capture that greatly limits dry matter accumulation of young trees.HIGHLIGHTS- The bi-axis grafting technique never showed before in a scientific paper presents a strategic system for a comparative study of red/green leaf photosynthetic performance and related dry matter partitioning.

Researchers often assign a label (such as a risk factor or predictor) to a characteristic that is statistically associated with an outcome (such as future injury). Labeling signifies that the characteristic has an established clinical value. More often than not, these labels are assigned prematurely and haphazardly. The rampant practice conflates research goals, the ultimate clinical value of the findings, and many risk factors/predictors that may not warrant the label. To address these issues and improve injury prevention research, we (1) outline the problem; (2) clarify the key differences between the research goals of description, causation, and prediction/prognosis (along with labeling conventions); (3) differentiate the clinical implications for each label; and (4) frame an appropriate scientific process to follow before applying a label. [ABSTRACT FROM AUTHOR]

Introduction: Consensus recommendations bridge knowledge gaps in patellofemoral pain (PFP) research and/or clinical practice. The prevalence of PFP is 29% in elite, and 23% in amateur, female athletes.1 Consensus recommendations depend on the expertise of panelists who take part in the consensus process. To represent their target population, panels should include persons impacted by their work.2 Objectives: To assess who has been invited and whose opinions have counted towards consensus recommendations on PFP or Patellofemoral osteoarthritis (PF-OA). Study Design: A secondary analysis of data from a scoping review. Methods: The Joanna Briggs Institute Manual for Evidence Synthesis was used to map consensus statements in PFP and PF-OA. Two reviewers extracted data on the panelists including: number of panelists; definition of expertise; sex; country; country income level; and the reason they were invited to participate. Population: PFP 'experts'. Inclusion criteria -- had to be a panelist in a consensus statement making recommendations on PFP. Results: Twenty-two consensus statements were included. Thirteen (59%) focused on treatment recommendations. Nine (39%) provided a justification for why panelists were invited. Sixteen (73%) reported panelist numbers (N=365). Eleven (50%) reported panelist sex; 66% of panelists were male (111 of 169). Twelve (55%) reported panelist country; 44% (117 of 263) of panelists represented the USA or Canada. All panels included either a medical doctor or physical therapist. One consensus panel included a patient. Conclusions: PFP and PF-OA consensus statements have often failed to define who counts as an expert and the panels have lacked diversity. Experience--the metric most often used to identify experts--is not a perfect proxy for expertise.3 The patient/athlete voice has been missing from consensus panels, meaning that recommendations may not serve the athletic population who are affected by PFP. [ABSTRACT FROM AUTHOR]

* BACKGROUND: There is no consensus on the components of return-to-sport (RTS) testing following anterior cruciate ligament (ACL) reconstruction or whether passing RTS criteria can reduce a patient's risk of reinjury. * OBJECTIVES: To determine whether impartial, criteria-based RTS decisions are associated with less risk of a second ACL injury (either graft failure or contralateral ACL injury). * METHODS: In this systematic review with meta-analysis, the authors conducted an electronic literature search in PubMed/MEDLINE, Embase, CINAHL, SPORTDiscus, and ProQuest Dissertations and Theses Global using database-specific vocabulary related to ACL reconstruction and return to sport. Individual study quality was assessed using the modified Downs and Black checklist, and overall quality of evidence was determined with the Grading of Recommendations Assessment, Development and Evaluation scale. Pooled risk difference (passed versus failed RTS criteria), injury incidence proportion, and the diagnostic accuracy of each RTS criterion were calculated. * RESULTS: Four studies met the selection criteria. Overall, 42.7% (95% confidence interval [CI]: 18%, 59%) of patients passed RTS criteria, and 14.4% (95% CI: 8%, 21%) of those who passed experienced a second ACL injury (graft rupture or contralateral ACL injury). There was a nonsignificant 3% reduced risk of a second ACL injury after passing RTS criteria (risk difference, -3%; 95% CI: -15%, 10%; I² = 74%, P =,610). The evidence rating of the Grading of Recommendations Assessment, Development and Evaluation scale was "very low quality," due to imprecision and heterogeneity of the pooled risk difference estimate. * CONCLUSION: Passing RTS criteria did not show a statistically significant association with risk of a second ACL injury. The quality-of-evidence rating prevents a definitive conclusion on this question and indicates an opportunity for future research. * LEVEL OF EVIDENCE: Prognosis, Level 2a-. [ABSTRACT FROM AUTHOR]

Seagrass meadows, one of the world′s greatest natural assets, are globally declining due to direct-anthropogenic (e.g., pollution, coastal development, run-off) and climate change (e.g., cyclones, floods, marine heatwaves) threats. One of the primary constraints in seagrass management and restoration is a lack of societal awareness about their role in the marine environment, their importance to human well-being, and their vulnerability. Public perception studies are useful tools to assess communities′ ecological knowledge and attitudes. The Great Barrier Reef World Heritage Area (GBRWHA), famous worldwide for its iconic coral reef, also hosts one of the world′s largest areas of seagrass meadows, which provide many ecosystem services to the associated communities (e.g., nursery habitat, coastal protection, carbon sequestration etc.). However, the perception of seagrasses among coastal communities of the GBRWHA is poorly understood. Through an online survey of marine recreational users, we assessed public awareness of the role seagrasses play, its benefits, and threats to seagrasses in the GBRWHA, in comparison to coral reefs. Our results showed that there is an imbalance in perception of the role and ecosystem services provided by seagrasses and coral reefs among frequent visitors of the GBRWHA. Only 17% of respondents recognized 'seagrass' as a habitat of the GBRWHA. Ecosystem services from coral reefs were considered greater than from seagrasses (p < 0.05). Compared to previous studies, a higher percentage of participants believe in climate change (75%). Nevertheless, the general perception is that climate change impact magnitude is higher in coral reefs compared to seagrasses (p < 0.05). Additionally, climate change mitigation, a seagrass-related ecosystem service, was equally attributed to coral reefs and seagrasses (p > 0.05). Willingness-to-pay for coral reef restoration was higher than for seagrass (p < 0.05). For both marine habitats, willingness-to-pay for restoration was higher in younger people and participants with a university degree. Content analysis showed that people believe that marine habitats′ conservation/restoration can be achieved as a collective effort. On the other hand, a lack of trust in government actions was identified as a barrier to willingness-to-pay. These results confirm the need to raise awareness about the importance of seagrasses and of its vulnerability to climate change. To achieve that, we provide two key recommendations: to enhance purposeful experiences through citizen science and to increase effective scientific communication. • Awareness of seagrass as a habitat of the GBRWHA is low, even among frequent visitors. • People aren′t aware of the carbon reservoir provided by seagrasses in the GBRWHA. • Public awareness of the vulnerability of seagrasses to climate change is low. • Young adults are more willing to pay for habitat restoration in the GBRWHA. • Recommendations: promote citizen science and increase science communication. [ABSTRACT FROM AUTHOR]