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Purpose: Engagement in CME/CPD has a positive impact on healthcare professionals' (HCPs) knowledge, skills, and performance, and on patient outcomes, therefore it is critical to better understand the components of CME/CPD systems that foster engagement, high-quality education, and impact. Methods: An assessment of CME/CPD systems was conducted using a mixed-methods approach that included interviews with in-country subject matter experts and qualitative and quantitative data from practicing in-country physicians. Results: Results demonstrate areas of consistency in CME/CPD systems across world regions that included: types of educational providers; types of credit; educational formats; self-tracking of participation; high-degree of compliance when education is mandatory; overall satisfaction with available education; strong support for interprofessional education; and lack of alignment or evaluation of engagement in education with population health outcomes. Areas of variation included: whether engagement in education is required as a condition to practice medicine; whether regulations are uniformly applied; if mechanisms to ensure independence existed; and physician perceptions of independence. Conclusion: Results of this assessment maybe used by a variety of different stakeholders to assess how well country-level CME/CPD systems are meeting the needs of practicing physicians and determine what, if any, changes might need to be implemented to improve outcomes. [ABSTRACT FROM AUTHOR]

The assessment of global food security is imperative for sustainable development worldwide. However, limited data availability has impeded a comprehensive evaluation on a global scale. This study addresses this challenge by conducting a thorough food security analysis spanning 169 countries from 2008 to 2020. To overcome data limitations, an imputed database is generated using four machine learning models to estimate missing data. The results uncover significant disparities in food security across regions. Europe, Oceania, and North America exhibit higher levels, while East Asia and South America fall in the middle, and Africa and South Asia experience lower levels. Notably, six African countries have made considerable progress in food security, potentially attributed to support from nations such as France, the United States, China, and Japan. Policy recommendations include humanitarian relief, expanding social safety nets, developing transportation networks, supplying fertilizers in vulnerable areas, and stabilizing food prices through national fiscal policies are also proposed for economies with low food security performance. The study provides an imputed database for 44 indicators from 2008 to 2020, offering insights into food security and potential solutions for governments and international organizations. [ABSTRACT FROM AUTHOR]

Aims of this assessment were to describe requirements for physicians to engage in CME/CPD; explore perceptions of In-Country SMEs of their CME/CPD systems; describe perceptions of In-Country physicians about interprofessional continuing education (IPCE) and independent CME/CPD; and provide recommendations that may be adopted to improve quality and effectiveness. This assessment used a mixed-methods approach that included 1:1 interviews with in-country subject matter experts and an electronic survey capturing qualitative and quantitative data from practicing in-country physicians. This assessment reflects a country invested in the education of its physician workforce. CME/CPD systems have embedded governance structures, organizations authorized to provide education, and a recognized credit system. Governing bodies have implemented regulations to limit influence from commercial interest organizations on CME/CPD, and there is opportunity to expand delivery systems to reach physicians across diverse geographic regions, better align content to individual physicians’ gaps and learning needs, and reduce cost. There is opportunity to invest in IPCE within a country with a strong professional hierarchy system. This assessment reflects CME/CPD systems that are relatively mature and identifies several opportunities to expand and enhance systems to better meet educational needs of physicians and to positively impact practice and patient outcomes.

The Intergovernmental Science-Policy Platform for Biodiversity and Ecosystem Services (IPBES) held its tenth plenary session at Bonn, Germany. in July 2023. The key feature of this plenary was the Thematic Assessment of Invasive Alien Species, the discussion of which was marked by extensive wordsmithing. The summary for policy makers was accepted, but it took until the last minute. The two scoping reports for the upcoming assessment of biodiversity monitoring and ecological connectivity were accepted, allowing preparation of the work on these assessments to begin. We noted a missing balance between robust scientific knowledge and political and economic interest and see these tedious discussions as counterproductive to resolving biodiversity loss. The current fad for nature-positive rhetoric is not useful in resolving these dilemmas. Getting the balance right will be a real test as to whether IPBES is really helping solve problems, or if it is simply performance art. [ABSTRACT FROM AUTHOR]

Abstract Background Anorexia of aging is a common geriatric syndrome that includes loss of appetite and/or reduced food intake, with associated undernutrition, unintended weight loss, sarcopenia, functional decline, loss of independence and other adverse health outcomes. Anorexia of aging can have multiple and severe consequences and is often overlooked by healthcare professionals (HCPs). Even more concerningly, clinicians commonly accept anorexia of aging as an inevitable part of ‘normal’ aging. The aim of this assessment was to identify current gaps in professional knowledge and practice in identifying and managing older persons with anorexia. Results may guide educational programmes to fill the gaps identified and therefore improve patient outcomes. Methods This international assessment was conducted using a mixed‐methods approach, including focus group interviews with subject matter experts and an electronic survey of practicing HCPs. The assessment was led by the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) and was supported by in‐country collaborating organizations. Results A quantitative survey of 26 multiple‐choice questions was completed by physicians, dietitians and other HCPs (n = 1545). Most HCPs (56.8%) recognize a consistent definition of anorexia of aging as a loss of appetite and/or low food intake. Cognitive changes/dementia (91%) and dysphagia (87%) are seen as the biggest risk factors. Most respondents were confident to give nutritional (62%) and physical activity (59.4%) recommendations and engaged caregivers such as family members in supporting older adults with anorexia (80.6%). Most clinicians assessed appetite at each visit (66.7%), although weight is not measured at every visit (41.5%). Apart from the Mini‐Nutritional Assessment Short Form (39%), other tools to screen for appetite loss are not frequently used or no tools are used at all (29.4%). A high number of respondents (38.7%) believe that anorexia is a normal part of aging. Results show that treatment is focused on swallowing disorders (78%), dentition issues (76%) and increasing oral intake (fortified foods [75%] and oral nutritional supplements [74%]). Nevertheless, the lack of high‐quality evidence is perceived as a barrier to optimal treatment (49.2%). Conclusions Findings from this international assessment highlight the challenges in the care of older adults with or at risk for anorexia of aging. Identifying professional practice gaps between individual HCPs and team‐based gaps can provide a basis for healthcare education that is addressed at root causes, targeted to specific audiences and developed to improve individual and team practices that contribute to improving patient outcomes.

Aim: Anthropogenic climate change is predicted to drive unprecedented increases in the frequency and intensity of extreme climatic events, such as drought and cyclones. The impacts of these events on fully migratory species could be particularly severe and have cascading effects on the functioning of many ecosystems. We explore the relationships between geography, taxonomy, extinction risk and the exposure of fully migratory birds to drought and cyclones. Location: Global. Time Period: 1985–2014. Major Taxa Studied: 383 fully migratory bird species. Methods: We assessed the exposure of fully migratory birds to cyclones and droughts, quantifying exposure by calculating the percentage of spatial overlap between a species' range and the extent of an extreme event within a given time series. We compared the level of cumulative exposure sustained by species among different taxonomic groups and within their breeding and wintering ranges; we also assessed whether species currently classed as 'threatened' are more cumulatively exposed than 'non‐threatened' species. Results: We identified fully migratory bird species highly exposed to extreme climatic events and global geographic hotspots of species exposure. 4% of species were found to be highly exposed to cyclones and droughts in both their wintering and breeding ranges. Wintering ranges were, on average, more cumulatively exposed to cyclones than breeding ranges; there was no discernible difference in drought exposure between ranges. Species currently classed as threatened were shown to experience higher exposure to droughts than non‐threatened ones in both ranges. Main Conclusions: This exposure analysis provides the first step to a full global assessment of fully migratory bird species' vulnerability to extreme climatic events. Many species are at least as exposed to extreme events within their wintering ranges as in their breeding ranges, supporting calls for 'full cycle' assessment of migratory species' vulnerability to climate change. Our identification of hotspots of exposure may help to guide further monitoring, research and management. [ABSTRACT FROM AUTHOR]

Background: Pet and feeder rodents are one of the main sources of emerging infectious diseases. These rodents are purchased from pet shops, breeders, and online. Consequently, some of these rodents may subtly transmit diseases as they may be asymptomatic to certain pathogens. Materials and Methods: We systematically searched four academic databases viz. Google Scholar, PubMed, Web of Science, and Scopus to determine zoonotic pathogens associated with pet and feeder rodents globally. Our searches were performed in R statistical software using the packages "metagear" and "revtool". Results: We found 62 studies reporting on zoonotic pathogens between 1973 and 2022 from 16 countries representing 4 continents, namely Africa, Europe, Asia, and North America. The review identified 30 zoonotic pathogens isolated from pet and feeder rodents, including the African pygmy mouse (Mus minutoides), brown rat (Rattus norvegicus), and the house mouse (Mus musculus). The greatest number of pathogens was reported from the United States, followed by Togo and the United Kingdom. Bacterial pathogens were the most prevalent. However, the Seoul virus and rat bite fever (Streptobacillus moniliformis) were the most studied pathogens, found in more than one country, with reported outbreak cases. Most of the zoonotic pathogens were isolated from rodents acquired from pet shops. Conclusions: We recommend that pet and feeder rodents purchased from pet shops should be regularly screened for potential zoonotic pathogens as some of these animals may not show clinical signs of the illness. There is also a critical need to develop strict regulations and policies, especially in underdeveloped and developing regions for an effective surveillance process, which will include early detection, rapid response, and control of zoonotic diseases globally. [ABSTRACT FROM AUTHOR]

The binomial distribution is often used in modeling, including in applied climatology, when assessing the likelihood of adverse or dangerous climate-related impacts. The article outlines an algebraic algorithm for obtaining such estimates based on climate monitoring data or modeling data. Using only algebraic operations in calculations minimizes calculation time, which is important when performing detailed global assessments. As an example of such a calculation, the result of an assessment of the global climatic range of a dangerous insect pest of forest and garden trees and shrubs, the gypsy moth, is given. [ABSTRACT FROM AUTHOR]

● A composite N management index is proposed to measure agriculture sustainability. ● Nitrogen management has been moving towards sustainability targets globally. ● The improvement was achieved mainly by yield increase, while Nitrogen Use Efficiency (NUE) stagnated. ● No country achieved both yield and NUE targets and spatial variation is large. ● Region-specific yield targets can be used to supplement the standard Sustainable Nitrogen Management Index (SNMI). To represent the sustainability of nitrogen management in the Sustainable Development Goals indicator framework, this paper proposes a sustainable nitrogen management index (SNMI). This index combines the performance in N crop yield and N use efficiency (NUE), thereby accounting for the need for both food production and environmental protection. Applying SNMI to countries around the world, the results showed improvement in the overall sustainability of crop N management over the past four decades, but this improvement has been mainly achieved by crop yield increase, while global NUE has improved only slightly. SNMI values vary largely among countries, and this variation has increased since the 1970s, implying different levels of success, even failure, in improving N management for countries around the world. In the standard SNMI assessment, the reference NUE was defined as 1.0 (considered an ideal NUE) and the reference yield was defined as 90 kg·ha−1·yr−1 N (considering a globally averaged yield target for meeting food demand in 2050). A sensitivity test that replaced the reference NUE of 1.0 with more realistic NUE targets of 0.8 or 0.9 showed overall reduction in SNMI values (i.e., improved performance), but little change in the ranking among countries. In another test that replaced the universal reference yield with region-specific attainable yield, SNMI values declined (i.e., improved performance) for most countries in Africa and West Asia, whereas they increased for many countries in Europe and South America. The index can be improved by further investigation of approaches for setting region-specific yield targets and high-quality data on crop yield potentials. Overall, SNMI offers promise for a simple and transparent approach to assess progress of countries toward sustainable N management with a single indicator.

This review focuses on the role of science-policy interactions in the transformation of the United Nations Convention to Combat Desertification (UNCCD) from being narrow (region specific) environmental agreement to a position of global stewardship of land resources. Desertification as an environmental issue first appeared on the international agenda in the late 1970s as a reaction to the devastating Sahel droughts in 1969–1973. There was general agreement in both scientific and political circles regarding the existence of a negative global trend in drylands caused mostly by human factors. In the 1990s pioneer studies, based on remote sensing, had discovered that the Sahel was "re-greening" due to some increase in precipitation while the effects of human activity were small in scale and not always negative. The new global satellite-based assessment–GLADA–showed that most degraded lands were located in humid climates but not in drylands. These findings have been generally accepted by the UNCCD leadership, and the term "land degradation" has gained prominence over "desertification" as the former is not associated with specific geographical conditions. The thematic area of the UNCCD is also gradually expanding due to the assimilation of new concepts such as "ecosystem services," MDGs and SDGs. By successfully promoting adoption SDGs 15.3 on "Land Degradation Neutrality," the UNCCD strengthens its position among the other Rio Conventions–UNFCCC and UNCBD. [ABSTRACT FROM AUTHOR]

Non-native tree (NNT) species have been transported worldwide to create or enhance services that are fundamental for human well-being, such as timber provision, erosion control or ornamental value; yet NNTs can also produce undesired effects, such as fire proneness or pollen allergenicity. Despite the variety of effects that NNTs have on multiple ecosystem services, a global quantitative assessment of their costs and benefits is still lacking. Such information is critical for decision-making, management and sustainable exploitation of NNTs. We present here a global assessment of NNT effects on the three main categories of ecosystem services, including regulating (RES), provisioning (PES) and cultural services (CES), and on an ecosystem disservice (EDS), i.e. pollen allergenicity. By searching the scientific literature, country forestry reports, and social media, we compiled a global data set of 1683 case studies from over 125 NNT species, covering 44 countries, all continents but Antarctica, and seven biomes. Using different meta-analysis techniques, we found that, while NNTs increase most RES (e.g. climate regulation, soil erosion control, fertility and formation), they decrease PES (e.g. NNTs contribute less than native trees to global timber provision). Also, they have different effects on CES (e.g. increase aesthetic values but decrease scientific interest), and no effect on the EDS considered. NNT effects on each ecosystem (dis)service showed a strong context dependency, varying across NNT types, biomes and socio-economic conditions. For instance, some RES are increased more by NNTs able to fix atmospheric nitrogen, and when the ecosystem is located in low-latitude biomes; some CES are increased more by NNTs in less-wealthy countries or in countries with higher gross domestic products. The effects of NNTs on several ecosystem (dis)services exhibited some synergies (e.g. among soil fertility, soil formation and climate regulation or between aesthetic values and pollen allergenicity), but also trade-offs (e.g. between fire regulation and soil erosion control). Our analyses provide a quantitative understanding of the complex synergies, trade-offs and context dependencies involved for the effects of NNTs that is essential for attaining a sustained provision of ecosystem services.

The Intergovernmental Science-Policy Platform for Biodiversity and Ecosystem Services (IPBES) held its ninth plenary session in hybrid form at Bonn, Germany in July 2022. The plenary had a packed agenda with assessments on the Sustainable Use of Wild Species and Values of Biodiversity to consider, as well as discuss a "Nature Future Framework" and a scoping document for business and biodiversity. Here, we present key issues that emerged from the plenary and suggest some matters Platform members need to consider for the future. [ABSTRACT FROM AUTHOR]

The relationship between livestock production and climate change is the subject of hot debate, with arguments for major shifts in diets and a reduction in livestock production. This Perspective examines how global assessments of livestock‐derived methane emissions are framed, identifying assumptions and data gaps that influence standard life‐cycle analysis approaches. These include inadequate data due to a focus on industrial not extensive systems; errors arising due to inappropriate emission factors being applied; questions of how global warming potentials are derived for different greenhouse gases and debates about what baselines are appropriate. The article argues for a holistic systems approach that takes account of diverse livestock systems—both intensive and extensive—including both positive and negative impacts. In particular, the potential benefits of extensive livestock systems are highlighted, including supporting livelihoods, providing high‐quality nutrition, enhancing biodiversity, protecting landscapes, and sequestering carbon. By failing to differentiate between livestock systems, global assessments may mislead. Inappropriate measurement, verification and reporting processes linked to global climate change policy may in turn result in interventions that can undermine the livelihoods of extensive livestock‐keepers in marginal areas, including mobile pastoralists. In the politics of global assessments, certain interests promote framings of the livestock‐climate challenge in favour of contained, intensive systems, and the conversion of extensive rangelands into conservation investments. Emerging from a narrow, aggregated scientific framing, global assessments therefore can have political consequences. A more disaggregated, nuanced approach is required if the future of food and climate change is to be effectively addressed. This article is categorized under:Integrated Assessment of Climate Change > Assessing Climate Change in the Context of Other IssuesClimate and Development > Social Justice and the Politics of Development [ABSTRACT FROM AUTHOR]

It is well known that human trafficking is a very common problem. One of the reasons for this is that the number of victims of this crime worldwide is up to 40.5 million people, criminal activity with a solid income and the presence of a growing trend of interest on the part of legal scientists in the problems of human trafficking as one of the components of the "shadow economy". Such a large-scale assessment has led to the fact that some research scientists have recognized the data presented as unfounded. Counting the number of victims of human trafficking causes various difficulties, as there is an urgent need to improve the methodological foundations used in conducting such studies. The article in question reveals to the maximum the need to understand the methodologies that guide the study of the prevalence of human trafficking crime. In addition, the problem of human trafficking, the role of the State in combating it and the set of measures that are being taken are currently being considered in practice. Providing a comprehensive overview of previously conducted domestic and foreign studies related to human trafficking, recommendations are provided that are necessary for future research. Human trafficking includes not only trafficking in youth, but also trafficking in men and women. The purpose of sexual use of persons involved in human trafficking, the purpose of involvement in slavery and forced labor is clearly expressed in this issue. Thus, the removal of people from the countries of permanent residence on illegal grounds for use for selfish purposes causes the law enforcement agencies of the country more and more anxiety, excitement, and fear for our citizens. The main purpose of writing this article is to increase the level of awareness of the spread of the problem of human trafficking and contribute to solving this problem in the future.

Global biodiversitytargets require us to identify species at risk of extinction and quantify status and trends of biodiversity. The Red List Index (RLI) tracks trends in the conservation status of entire species groups over time by monitoring changes in categories assigned to species. Here, we calculate this index for the world's fishes in 2010, using a sampled approach to the RLI based on a randomly selected sample of 1,500 species, and also present RLI splits for freshwater and marine systems separately. We further compare specific traits of a worldwide fish list to our sample to assess its representativeness. Overall, 15.1% of species in the sample were estimated to be threatened with extinction, resulting in a sampled RLI of 0.914 for all species, 0.968 in marine and 0.862 in freshwater ecosystems. Our sample showed fishing as the principal threat for marine species, and pollution by agricultural and forestry effluents for freshwater fishes. The sampled list provides a robust representation for tracking trends in the conservation status of the world's fishes, including disaggregated sampled indices for marine and freshwater fish. Reassessment and backcasting of this index is urgent to check the achievement of the commitments proposed in global biodiversity targets. [ABSTRACT FROM AUTHOR]

Pancreatic adenocarcinoma is one of the most aggressive tumors. Its diagnosis is usually made in locally advanced or metastatic disease and survival is less than one year. The most frequent sites of metastatic involvement are the liver, peritoneum and lungs. Other organs such as the bones or the brain may be affected to a lesser extent. Cutaneous involvement of pancreatic adenocarcinoma is extremely rare with less than 150 cases reported in the literature since 1960. Most cases with cutaneous involvement involve the periumbilical region, in a lesion known as "Sister Mary Joseph's Node". Scalp metastases are very rare and their diagnosis suggests advanced disease and the prognosis will be dismal. It is very important to perform a complete physical examination and a global anamnesis to guide the request for diagnostic tests. Once the diagnosis of pancreatic adenocarcinoma has been made, a global assessment will be necessary, involving different medical specialists, nurses, psychologists and social workers among others. In many cases, supportive care is the mainstay of treatment., (© 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Lakes are fundamental to society and nature, yet they are currently exposed to excessive nutrients and climate change, resulting in algal blooms. In the future, this may change, but how and where still needs more scientific attention. Here, we explore future trends in algal blooms in lakes globally for >3500 'representative lakes' for the year 2050, considering the attribution of both nutrient and climate factors. We soft-coupled a process-based lake ecosystem model (PCLake+) with a watershed nutrient model (MARINA-Multi) to assess trends in algal blooms in terms of the Trophic State Index for chlorophyll-a (TSI-Chla). Globally between 2010 and 2050, we show a rising trend in algal blooms under fossil-fuelled development (TSI-Chla increase in 91 % of lakes) and a declining trend under sustainable development (TSI-Chla decrease in 63 % of lakes). These changes are significantly attributed to nutrients. While not always significant, climate change attributions point to being unfavourable for lakes in 2050, exacerbating lake water quality. Our study stresses prioritising responsible nutrient and climate management on policy agendas. This implies that the future of algal blooms in lakes is in our hands., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This scientific approach presents an updated global assessment of food insecurity and nutrition for up to the year 2021 and a scientific approach on progress towards meeting SDG Targets 1 and 2 ending hunger and ensuring access to safe, nutritious and sufficient food for all people all year round and eradicating all forms of malnutrition. Despite hopes that the world would emerge more quickly from the crisis and food security would begin to recover from the pandemic in 2021, the pandemic held its grip and even tightened it in some parts of the world. The rebound of gross domestic product (GDP) growth observed in most countries in 2021 did not translate into gains in food security in the same year. Enormous challenges are still faced by those who continue to be the most affected: those with less wealth, lower and more unstable incomes and poorer access to critical basic services. Another crisis is unfolding as this scientific approach is being written with potentially sobering implications for global food security and nutrition: the war in Ukraine. Although the statistics presented in this scientific approach represent the state of food security and nutrition up until 2021, the direct and indirect effects of the conflict in 2022 will have multiple implications for global agricultural markets through the channels of trade, production and prices. Ultimately, this casts a shadow over the state of food security and nutrition for many countries, in particular those that are already facing hunger and food crisis situations, and poses an additional challenge for achieving the SDG 2 targets of ending hunger and ensuring access to adequate food for all (SDG Target 1) and of eliminating all forms of malnutrition (SDG Target 2). [ABSTRACT FROM AUTHOR]

Birds are crucial for the functioning of Earth's ecosystems but bird population declines have been documented worldwide in recent decades. A global assessment of potential causes of population declines is needed. Our goal here was to combine the power of big data and machine learning to identify predictors correlated with bird population declines and to predict population declines for species with unknown population trends on the IUCN Red List. From existing online databases, we gathered detailed species‐level data for 10 964 extant bird species around the world, featuring life history, ecology, distribution, taxonomy and categorical population trend information (i.e. decreasing or not decreasing). For the 10 163 species with known population trends, we split the data into a 75% training set to tune and train a machine‐learning model (Light Gradient Boosting Machine – 'LightGBM') and a 25% test set to evaluate the trained model. Our model predicted (i) bird population declines with an ROC AUC score of 0.828, F1 score of 0.748 and average accuracy of 0.747, and (ii) that 47% (n = 801) of bird species with currently unknown population trends are declining. Correlation analyses suggested that, globally, the top predictor associated with bird population declines was a severely fragmented population, with non‐migratory birds in South American and Southeast Asian tropical and subtropical forests being particularly vulnerable. Despite the lack of long‐term quantitative population trend data for all species worldwide, our study presents big data and machine learning as a useful tool for informing conservation priorities, lending insight, albeit imperfect, into bird population declines on the global scale for the first time. [ABSTRACT FROM AUTHOR]

Mercury is a toxic compound to which humans are exposed by consumption of fish. Current fish consumption advisories focus on minimizing the risk posed by the species that are most likely to have high levels of mercury. Less accounted for is the variation within species, and the potential role of the geographic origin of a fish in determining its mercury level. Here we surveyed the mercury levels in 117 yellowfin tuna caught from 12 different locations worldwide. Our results indicated significant variation in yellowfin tuna methylmercury load, with levels that ranged from 0.03 to 0.82 μg/g wet weight across individual fish. Mean mercury levels were only weakly associated with fish size (R2

David Leiman,1,2 Maurice Jové,3 Gail Rosen Spahn,4 Pamela Palmer4 1HD Research, Houston, TX, USA; 2University of Texas at Houston, Department of Surgery, Houston, TX, USA; 3Atlanta Bone and Joint Specialists, Atlanta, GA, USA; 4Medical Affairs, AcelRx Pharmaceuticals, Inc, Redwood City, CA, USACorrespondence: David Leiman Email leimanmd@gmail.comObjective: This analysis reports the healthcare professional global assessment (HPGA) and patient global assessment (PGA) scores and the adverse event (AE) profile by age, body mass index (BMI), sex, and race from the three Phase III registration studies for sufentanil sublingual tablet (SST) 30 mcg.Methods: Global assessments and treatment-related AEs were analyzed from patients treated with SST 30 mcg for moderate-to-severe acute pain following surgery or in the emergency department (ED). Pooled data were analyzed across patient demographic subgroups.Results: A total of 283 patients were included in the HPGA/PGA analyses. The majority underwent abdominal surgery, with the remaining patients undergoing orthopedic or “other” types of surgery. Overall, SST 30 mcg was highly rated by both healthcare professionals and patients across the demographic subgroups. A total of 323 patients were included in the safety evaluation. The majority of patients did not experience any SST-related AEs; however, those that did experienced common opioid-related side effects such as nausea, headache, dizziness, and vomiting. No patients experienced unexpected AEs or required the use of naloxone.Conclusion: SST 30 mcg was highly rated and well tolerated across demographic subgroups with the majority of patients not experiencing any adverse event related to SST 30 mcg. These findings support the use of sublingual sufentanil in all adult patients, regardless of age, BMI, sex, or race for the treatment of moderate-to-severe acute pain.Keywords: acute pain, demography, global assessment, sublingual administration, sufentanil, surgery

Mitigating climate change is an urgent global issue, and agricultural carbon emissions are an important component of global emissions. Hence, it is imperative to fully understand the current state of carbon emissions in agriculture and accurately evaluate emissions throughout various farming processes. This review aims to understand and evaluate these emissions, focusing on the agricultural sector. A systematic review of existing literature and data on agricultural carbon emissions was conducted, exploring the potential of innovative technology and approaches for mitigation. The effectiveness of energy-saving carbon emission reduction strategies and the role of technological innovation in achieving environmentally sustainable agriculture were assessed. The findings reveal that sustainable development goals have fostered a global strategy for achieving highly productive, efficient, and environmentally sustainable agriculture. In addition, potential transitions towards more sustainable agricultural practices, driven by technological innovation and effective carbon policies, were identified as significant means for mitigating carbon emissions. In this sense, there is an urgent need for a close global effort to implement carbon policies and technological innovation to mitigate the climate impacts of agriculture. Therefore, this research is a time-noting study to help international policymakers achieve environmental sustainability-oriented policies. [Display omitted] • Mitigating climate change has emerged as a crucial agenda. • Carbon emissions from agriculture contribute to 10–12% of total global emissions. • Global policies and technological innovations drive the reduction of emissions in agriculture. • Carbon policies are crucial for tackling climate change in sustainable agriculture. [ABSTRACT FROM AUTHOR]

Environmental quality is frequently explored as indicator of welfare and its linkage with cleaner energy use to fuel economic expansion, but the natural habitat capital and its diversity is often ignored as an important ingredient to sustaining a standard of living. International organizations point towards balancing renewable energy infrastructure development and conserving biodiversity, which calls for a non-linear effects analysis. This study explores the non-linear clean energy effects on biodiversity to find U or inverted-U shaped interaction, using the robust distribution Panel Autoregressive Distributed Lag model for 66 countries. Furthermore, the Quantilewise estimates indicate that the short-run and long-run effects vary across different quantiles of biodiversity distribution. The long-run estimates infer that urbanization and globalization increase significantly enhances the environmental performance at 76 percentiles and all percentiles, respectively. While, output growth has a negative effect at 25 and 50 percentiles, and above the 50 percentiles, it positively affects environmental performance. The outcomes showed that clean energy has an inverted U-shaped effect on environmental performance. The research has found the best levels of green energy to match up with different levels of diversity in a country. Eventually, it guides further studies on why rapid renewable energies infrastructure development may harm biodiversity. [ABSTRACT FROM AUTHOR]

The entire world has been suffering from the coronavirus disease 2019 (COVID‐19) pandemic since March 11, 2020. More than a year later, the COVID‐19 vaccination brought hope to control this viral pandemic. Here, we review the unknowns of the COVID‐19 vaccination, such as its longevity, asymptomatic spread, long‐term side effects, and its efficacy on immunocompromised patients. In addition, we discuss challenges associated with the COVID‐19 vaccination, such as the global access and distribution of vaccine doses, adherence to hygiene guidelines after vaccination, the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants, and vaccine resistance. Despite all these challenges and the fact that the end of the COVID‐19 pandemic is still unclear, vaccines have brought great hope for the world, with several reports indicating a significant decline in the risk of COVID19‐related infection and hospitalizations. Highlights: 1.Vaccination plays a pivotal role in reducing the death toll of the COVID‐19 infection.2.The immunity provided by vaccines is still disputable leading to some challenges like the asymptomatic spread; therefore, staying strict to hygiene guidelines is necessary.3.Hence, COVID‐19 vaccines' related long‐term side effects are still unknown; cautions should be taken when injected to various individuals of the community.4.COVID‐19 vaccines' effectiveness are strongly related to their effect on emergent COVID‐19 variants, but until now approved vaccines can still show some protective effects against new variants. [ABSTRACT FROM AUTHOR]

We conducted a global systematic literature review of climate change adaptation in fisheries. We addressed three specific questions: (i) What are fisheries adapting to? (ii) How are fisheries adapting? and (iii) What research gaps need to be addressed? We identified, characterized and examined case studies published between 1990 and 2019 that lie at the intersection of the domains of climate change, adaptation and fisheries. We characterized the documented climate change effects in fisheries that are being adapted to multiple stressors, general climate impacts, extreme events, ocean conditions, marine system shifts, climate variability, fishery dynamics, species distribution and atmospheric warming. Three categories of adaptive responses came to light: coping mechanisms (e.g. changing fishing location, use of traditional knowledge); adaptive strategies (e.g. livelihood diversification, incorporation of technology); and management responses (e.g. adaptive management, adaptation planning). We identified key potential areas for future research, including studies on the limits and barriers for adaptation, studies using specific conceptual and methodological approaches, and studies focussing on the top‐producing countries such as China, Indonesia, Peru and Russia. This analysis gives broader insights to the fisheries industry and to climate change adaptation research to proceed in the face of new global challenges. [ABSTRACT FROM AUTHOR]

Land use has greatly transformed Earth's surface. While spatial reconstructions of how the extent of land cover and land‐use types have changed during the last century are available, much less information exists about changes in land‐use intensity. In particular, global reconstructions that consistently cover land‐use intensity across land‐use types and ecosystems are missing. We, therefore, lack understanding of how changes in land‐use intensity interfere with the natural processes in land systems. To address this research gap, we map land‐cover and land‐use intensity changes between 1910 and 2010 for 9 points in time. We rely on the indicator framework of human appropriation of net primary production (HANPP) to quantify and map land‐use‐induced alterations of the carbon flows in ecosystems. We find that, while at the global aggregate level HANPP growth slowed down during the century, the spatial dynamics of changes in HANPP were increasing, with the highest change rates observed in the most recent past. Across all biomes, the importance of changes in land‐use areas has declined, with the exception of the tropical biomes. In contrast, increases in land‐use intensity became the most important driver of HANPP across all biomes and settings. We conducted uncertainty analyses by modulating input data and assumptions, which indicate that the spatial patterns of land use and potential net primary production are the most critical factors, while spatial allocation rules and uncertainties in overall harvest values play a smaller role. Highlighting the increasing role of land‐use intensity compared to changes in the areal extent of land uses, our study supports calls for better integration of the intensity dimension into global analyses and models. On top of that, we provide important empirical input for further analyses of the sustainability of the global land system. [ABSTRACT FROM AUTHOR]

Over the past decades, water scarcity has become prevalent in many regions of the world. Previous water scarcity assessments largely considered "blue water" (surface and groundwater) and overlooked "green water" (soil moisture), despite its key role in supporting crop production. Moreover, the long‐term evolution of water scarcity remains unclear. Here, we propose an agricultural water scarcity index (WSIAW) that explicitly combines green and blue water. The WSIAW measures the degree to which both green and blue water availabilities can satisfy the agricultural water requirement. The WSIAW can directly indicate water scarcity in both rainfed and irrigated areas, which cannot be captured by the blue water scarcity index alone. Using the WSIAW, we assessed the evolution of water scarcity across regions of the world during 1971–2010 at a spatial resolution of 0.5 arc degree. We found that 22% of the 228 river basins with a WSIAW of >1 presented a much broader geographical coverage compared with estimates of water scarcity based on blue water only (8% of total basins). The WSIAW also exhibited a clear trend of increasing severity over the study period, particularly in major agricultural regions. Expanding cropland and increasing/competing water withdrawals by other sectors were the main reasons for the intensification of water scarcity, which was pronounced in some Asian and African river basins. The proposed WSIAW can be applied to different regions with various scales and is important for addressing global water scarcity issues. Key Points: We propose a new agricultural water scarcity index (WSIAW) by explicitly incorporating green and blue water for crop productionWSIAW indicated severe water scarcity over a much broader geographical coverage compared with water scarcity based on blue water onlyWSIAW exhibited an increasing trend in many regions, mainly due to expanding cropland and increasing water withdrawals by other sectors [ABSTRACT FROM AUTHOR]

For applications such as weather, flood, and drought forecasting that need water level estimates as soon as possible, near real-time (NRT) products are most appropriate. Unlike in-situ sensors for water level measurements, which typically deliver NRT data, satellite altimeters deliver physically meaningful observations with substantial delays after acquisition. The new radar altimetry mission, Sentinel-3, is capable of delivering NRT water levels within a few hours of observation. Currently, it remains unexplored how accurate the NRT product is in the context of river monitoring. This study assesses Sentinel-3A/B NRT products in mapping river water level variations globally. Based on a three-year comparison, we find that the water level derived from NRT is almost as good as that from the delayed products (median root-mean-square error (RMSE): 21.5 cm and 23.5 for S3A and S3B), and both products achieve very similar RMSE values (median: 52.5 cm and 59.0 cm for NRT and non-time critical) against in-situ data at 25 locations. This study highlights the usefulness of Sentinel-3 NRT product for river monitoring and forecasting. And we recommend the NRT product if latency is a primary concern.

Aims of this assessment were to describe requirements for physicians to engage in CME/CPD; explore perceptions of In-Country SMEs of their CME/CPD systems; describe perceptions of In-Country physicians about interprofessional continuing education (IPCE) and independent CME/CPD; and provide recommendations that may be adopted to improve quality and effectiveness. This assessment used a mixed-methods approach that included 1:1 interviews with in-country subject matter experts and an electronic survey capturing qualitative and quantitative data from practicing in-country physicians. This assessment reflects a country invested in the education of its physician workforce. CME/CPD systems have embedded governance structures, organizations authorized to provide education, and a recognized credit system. Governing bodies have implemented regulations to limit influence from commercial interest organizations on CME/CPD, and there is opportunity to expand delivery systems to reach physicians across diverse geographic regions, better align content to individual physicians' gaps and learning needs, and reduce cost. There is opportunity to invest in IPCE within a country with a strong professional hierarchy system. This assessment reflects CME/CPD systems that are relatively mature and identifies several opportunities to expand and enhance systems to better meet educational needs of physicians and to positively impact practice and patient outcomes., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Introduction: Reflection and self‐assessment are critical skills for healthcare providers. Identification of gaps in knowledge, skills and attitudes, along with the ability to critically think and problem solve to fill gaps, is the ultimate outcome for lifelong learning. The aims of this study were to (a) refine an instrument used for measuring reflective ability, and conduct comprehensive reliability testing, and (b) describe a process for rater calibration. Materials and Methods: Students develop e‐portfolios over a four‐year span with assignments that require reflection and self‐assessment. The final piece of the portfolio includes a global reflection written the last semester of the programme. Three faculty raters independently evaluated 106 dental students' global reflections using the revised grading rubric. An intraclass correlation coefficient measured the level of agreement between the three raters. Results: Analysis of the 318 faculty ratings (106/rater) resulted in an intraclass correlation of.708. Based on a 5‐point grading scale (0 = does not respond to the assignment to 5 = reconstructing), the ratings of the 106 global reflections ranged from 1.3 to 5.0 (M = 3.1, SD =0.66). Discussion: This study provides confidence in the reliability of a grading rubric designed to assess reflective ability, along with suggestions for calibration. An overall mean of 3.1 (Level 3 = relating—includes evidence of lessons learned) illustrates the complexity of teaching reflection and self‐assessment. Conclusion: Use of a reliable grading rubric for assessing reflective writing could assist schools interested in incorporating reflection and self‐assessment into the curriculum, ultimately supporting lifelong and enhanced health care. [ABSTRACT FROM AUTHOR]

Balancing food production and biodiversity conservation is a global challenge today. Livestock grazing is one of the main activities triggering habitat degradation and land-use change around the world. Its effects on biodiversity have been widely explored, with birds being the most studied vertebrates. However, its impact seems to be contradictory given the disparity of the results. To understand the influence of livestock grazing on birds, we conducted a meta-analysis exploring the effects of several grazing characteristics on bird abundance and species richness. Our results showed that livestock grazing has a significant negative effect on bird abundance (mean effect size -0.422 ± 0.140), and species richness (mean effect size -0.391 ± 0.141). Livestock grazing affected negatively the bird abundance in riparian habitats in contrast to the other habitat types. Species richness was negatively affected by grazing in woody habitats and Afrotropical and Neotropical regions. Grazing by cattle was more detrimental for both bird richness and abundance than sheep grazing or a mixture of domestic livestock. Moreover, intermediate grazing intensity seems appropriate to maintain bird abundance and richness, as high grazing intensity dropped both bird abundance and species richness substantially, and low grazing intensity reduced bird species richness. This pattern supposes a non-linear effect of grazing intensity on birds. Therefore, the management of grazing intensity and type of livestock could help to reduce the negative effect on bird abundance and richness, as moderate grazing intensities and mix of livestock types appear to have a minor or null impact on bird abundance and richness. Future studies should explore in-depth the effect of moderate grazing intensities on bird diversity and composition to provide better management recommendations to enhance avian conservation in rangelands. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Journal of Actual Problems of Jurisprudence / Habaršy. Zan̦ Seriâsy is the property of Al-Farabi Kazakh National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Intergovernmental Science-Policy Platform for Biodiversity and Ecosystem Services held its 8th plenary session online in June 2021, during which a new budget was approved up to 2023, continuing work plans were agreed, and scoping documents for two new assessments, the nexus and transformative change assessments, were accepted. [ABSTRACT FROM AUTHOR]

Hydrokinetic energy conversion refers to the conversion of kinetic energy in moving water to electricity. It offers an alternative to conventional hydropower, with benefits of modularity and scalability, in addition to being environmentally and socially less impactful. This study aims to determine the theoretical global riverine hydrokinetic resource. We use a 35 year modelled daily discharge data set and vectorised representation of rivers, with near-global coverage and suitable spatiotemporal resolution, to determine the mean annual energy yield of 2.94 million river reaches. The mean global resource (excluding Greenland) is estimated to be 58 400 ± 109 TWh yr−1 (6.660 ± 0.012 TW). Consideration of global spatial distribution, by river reach, illustrates regional variation and shows a tendency for potential to be concentrated along major rivers and in areas of significant elevation change. China, Russia and Brazil are found to be the countries with the greatest potential. After normalisation by total river length, Bhutan, Nepal and Tajikistan also show great potential. Hydrokinetic energy conversion can benefit isolated communities currently without access to electricity. We consider how the specific advantages of this particular technology have the potential to be combined with and complement other established forms of renewable energy technology, providing the means to support the reduction of energy poverty. • Method developed for global riverine hydrokinetic resource assessment. • Theoretical global riverine hydrokinetic resource estimated to be 58000 TWh/yr. • Mean power of global rivers over the period 1979–2013 estimated to be 6.7 TW. • China, Russia, Brazil, Bhutan, Nepal and Tajikistan offer great potential. • Hydrokinetic energy conversion can benefit isolated communities in energy poverty. [ABSTRACT FROM AUTHOR]

Objective: Identify disease categories in which single-item global impression (GI) scales were included in product labeling of new drugs approved by the US Food and Drug Administration (FDA) in January 2009-December 2019 and review the characteristics of GIs included in product labeling of new FDA-approved drugs (January 2017-December 2019).Methods: FDA Clinical Outcome Assessment (COA) Compendium was reviewed for drug labels that included GIs for drugs approved in 2009-2016. The indication, year of approval, ICD-10 code, and GI respondent were noted. A manual review of labels of FDA-approved drugs (2017-2019) was undertaken to identify GIs included in the labels. Corresponding drug approval packages were reviewed to identify details of any regulatory reviewer comments related to GIs. GI characteristics were noted from the drug label or the review documents, including the respondent, type of measure (static or dynamic), item wording, concept assessed, and response options.Results: Product labeling containing GIs was most common in diseases related to the skin, nervous system, behavioral disorders, and the musculoskeletal system. GIs were included in 30/77 (39.0%) drug labels in the four disease categories.Conclusion: In the past 10 years, GIs have been included as endpoint measures in confirmatory clinical trials and have generated evidence of treatment benefit in diseases related to the skin, nervous system, behavioral disorders, and the musculoskeletal system. GIs frequently provide important insights into the patient experience. Before GIs are included in clinical trials to assess treatment benefit, it is important to ensure that they are valid, reliable, and responsive. [ABSTRACT FROM AUTHOR]

Context: National borders remain an impediment to efficient preservation of biodiversity and ecosystems. For transboundary water resources, conservation planning becomes more challenging, as competitive interests make these sensitive and productive systems focal points of interstate conflicts. Objectives: This global study aims to explore the patterns of protection coverage for transnational lakes and their catchments, highlighting gaps and inconsistencies at the protection observed among countries sharing the same lake. Methods: Identifying 793 transnational lakes globally, we initially investigated protection coverage at their water bodies. Next, we explored protection coverage patterns across each lake's catchment, in which we also quantified human pressures' extent and intensity. Socio-economic and political parameters were examined as potential predictors of the observed patterns. Results: Only half of the world's transnational lakes are fully or partly covered by existing protected areas. Our analysis demonstrated that in only 37% of the protected transnational lakes, the extent of protection coverage was similar in the neighboring counties sharing the same lake. Protection patterns were not driven by the relative area of the transnational lakes found in the neighboring countries. Moreover, protection cover focuses mainly on lakes' water surface ignoring the terrestrial surroundings, while more than 75% of the catchments are subjected to intense human pressures. Conclusions: Providing the first overview of the protection gaps of transnational lakes globally, we highlight a failure of policy responses to cross-border conservation of sensitive freshwater ecosystems. Consequently, such limitations are likely to loom risks for human well‐being and for the initiation of intense conflicts. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Intellectual Property Law / Revista Română de Dreptul Proprietăţii Intelectuale is the property of Universul Juridic Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Citizen science is increasingly recognised as a valuable approach to improve the knowledge and understanding required for robust environmental management. We report on the results of a citizen science survey conducted on the status and trends of over 500 wetlands from across the globe. Whilst many wetlands were reported as being in fair or good ecological character state, many (particularly those already in a poor state) were reported as deteriorating. Although designated Ramsar Sites were reported as currently having a slightly better state than other wetlands, widespread deterioration of Ramsar Sites as well as other wetlands was reported. Significant regional differences were reported on the state of wetlands and their extent of improvement or deterioration. Large wetlands, particularly in Africa but also in Latin America and the Caribbean, were reported to be in a worse, and increasingly deteriorating, state than smaller wetlands in North America, Europe and Oceania. Numerous drivers are contributing to degradation and loss of wetlands. However, our data suggest that positive outcomes can be delivered where local community awareness, implementation of conservation measures, cultural values/traditions, tourism and forestry are proactively integrated in order to achieve the wise use of wetlands. [ABSTRACT FROM AUTHOR]

Abstract—The Land Degradation Neutrality (LDN) concept is a result of the development of global experience in assessing land degradation over the past 40 years and is worked out to harmonize different national methods for monitoring and evaluating the implementation of the sustainable development indicator 15.3.1: "proportion of land that is degraded over total land area". The paper reviews the results of land assessment for Russia using LDN concept approaches, first calculated for individual regions (federal subjects) using the Trends.Earth GIS module. This module uses global databases to interpret three main proxy indicators: land cover dynamics, land productivity dynamics, the dynamics of soil organic carbon stocks. Using "one out all out" principle, the Trends.Earth calculation for the entire territory of Russia shows the proportion of 12.3% of degraded lands, which is a very averaged indicator for the country with a high variety of socioeconomic and physical–geographical conditions. The variation in the of degraded lands calculated by this method ranges from about 63-67% in Rostov and Volgograd oblasts to less than 1% in Amur, Kaluga and Ivanovo oblasts. Considering the multidirectional trends in land quality change the "LDN index" is proposed for the development of the concept. It means the difference between the share of "improved" and "degraded" lands within a certain territory. The results of calculations should be considered as indicative, they will be specified as the LDN approach is developed and adapted for the territory of Russia. [ABSTRACT FROM AUTHOR]

There have been calls for greater inclusion of Indigenous and local knowledge (ILK) in applied ecosystems research and ecological assessments. The Intergovernmental Science‐Policy Platform on Biodiversity and Ecosystem Services (IPBES) Global Assessment (GA) is the first global scale assessment to systematically engage with ILK and issues of concern to Indigenous peoples and local communities (IPLC). In this paper, we review and reflect on how the GA worked with ILK and lessons learned.The GA engaged in critical evaluation and synthesis of existing evidence from multiple sources, using several deliberative steps: having specific authors and questions focus on ILK; integrating inputs from ILK across all chapters; organizing dialogue workshops; issuing calls for contributions to identify other forms and systems of knowledge; and encouraging IPLC to be key stakeholders and contributors.We identify content areas where attention to ILK was particularly important for questions in applied ecology. These include: (a) enriching understandings of nature and its contributions to people, including ecosystem services; (b) assisting in assessing and monitoring ecosystem change; (c) contributing to international targets and scenario development to achieve global goals like the Aichi Biodiversity Targets and the Sustainable Development Goals and (d) generating inclusive and policy‐relevant options for people and nature. However, challenges in engaging different knowledge systems were also encountered.Policy implications. The Intergovernmental Science‐Policy Platform on Biodiversity and Ecosystem Services (IPBES) Global Assessment (GA) demonstrated the importance of Indigenous peoples and local communities (IPLC) to global biodiversity conservation and ecosystem management. Initiatives seeking to engage Indigenous and local knowledge (ILK) can learn from the experience of the GA. Successfully bringing ILK into assessment processes and policy arenas requires a deliberate framework and approach from the start that facilitates recognition of different knowledge systems, identifies questions relevant at various scales, mobilizes funding and recognizes time required and engages networks of stakeholders with diverse worldviews. In turn, fostering inclusion of ILK and partnering with IPLC can help future assessments understand how natural and cultural systems co‐produce each other, identify trends of change through diverse biocultural indicators and improve sustainable development goals and policies. [ABSTRACT FROM AUTHOR]

Background: Dermatitis can impair the quality of life (QoL) of patients. Knowledge of the QoL‐associated factors and the impact of patch testing on QoL is limited. Objectives: To identify demographic and clinical factors affecting QoL, and to measure the impact of patch testing on QoL of dermatitis patients. Methods: The data and Dermatology Life Quality Index (DLQI) questionnaires of 519 dermatitis patients were analyzed. Of these, 107 underwent patch testing and completed the questionnaires two times (once before testing and again 60 days afterward). Results: The overall mean (±standard deviation) DLQI was 9.5 (±6.4). Patients aged 20 to 59 years and those who had more frequent disease exacerbations demonstrated significantly higher DLQIs. For each DLQI question, being female and aged 20 to 59 years were associated with impairments of various aspects of life, whereas the anatomical site of dermatitis impacted each question differently. The DLQI scores of the patients undergoing patch testing decreased significantly, irrespective of whether the test results were positive or negative. Conclusions: Being of a working age and having more frequent disease exacerbations had negative QoL impacts. In addition, patch testing improved almost every aspect of the DLQI. [ABSTRACT FROM AUTHOR]

Purpose: In advanced minimally invasive surgery the laparoscopic camera navigation (LCN) quality can influence the flow of the operation. This study aimed to investigate the applicability of a scoring system for LCN (SALAS score) in colorectal surgery and whether an adequate scoring can be achieved using a specified sequence of the operation. Methods: The score was assessed by four blinded raters using synchronized video and voice recordings of 20 randomly selected laparoscopic colorectal surgeries (group A: assessment of the entire operation; group B: assessment of the 2nd and 3rd quartile). Experience in LCN was defined as at least 100 assistances in complex laparoscopic procedures. Results: The surgical teams consisted of three residents, three fellows, and two attendings forming 15 different teams. The ratio between experienced and inexperienced camera assistants was balanced (n = 11 vs. n = 9). Regarding the total SALAS score, the four raters discriminated between experienced and inexperienced camera assistants, regardless of their group assignment (group A, p < 0.05; group B, p < 0.05). The score's interrater variability and reliability were proven with an intraclass correlation coefficient of 0.88. No statistically relevant correlation was achieved between operation time and SALAS score. Conclusion: This study presents the first intraoperative, objective, and structured assessment of LCN in colorectal surgery. We could demonstrate that the SALAS score is a reliable tool for the assessment of LCN even when only the middle part (50%) of the procedure is analyzed. Construct validity was proven by discriminating between experienced and inexperienced camera assistants. [ABSTRACT FROM AUTHOR]

The first Global Assessment of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) found widespread, accelerating declines in Earth's biodiversity and associated benefits to people from nature. Addressing these trends will require science-based policy responses to reduce impacts, especially at national to local scales. Effective scaling of science-policy efforts, driven by global and national assessments, is a major challenge for turning assessment into action and will require unprecedented commitment by scientists to engage with communities of policy and practice. Fulfillment of science's social contract with society, and with nature, will require strong institutional support for scientists' participation in activities that transcend conventional research and publication. The IPBES Global Assessment released in the spring of 2019 is a significant milestone for the international scientific community; the critical challenge now is to disseminate and apply its findings at national and local scales where most policy and management decisions affecting biodiversity and ecosystem services are made. Effective, enduring action from assessments requires collaborative, multidisciplinary science-policy processes that frame and cogenerate knowledge with decision makers and stakeholders from many sectors. Examples of assessments driving policy responses to recover biodiversity and ecosystem services highlight the need for significant, long-term commitments by governments, non-governmental organizations (NGOs), the private sector, civil society, and the scientific community. [ABSTRACT FROM AUTHOR]

Despite their ecological and socioeconomic importance, the forested areas of tropical dry ecosystems remain among the most threatened biomes worldwide. There has been limited research on the current extent, fragmentation, and conservation status of tropical dry forests on a global scale. In this study, we used the GLAD UMD Forest Height dataset to provide a high-resolution global assessment of the extent, patch size distribution, and protection levels of Tropical and Subtropical Dry Broadleaf Forests (TBDF) and forested areas of the Tropical and Subtropical Grasslands, Savannas, and Shrublands (TSGSS) by ecoregion and country. We find that despite increasing protection, degradation continues to rise with less than ⅓ of the original TBDF and TSGSS currently forested and over 80 % of those forests currently exposed to edge effects. <1 % of the remaining forest patches are large (>10 km2), and <25 % of the remaining forests are located in conservation or protection zones (TBDF:16 %; TSGSS:21 %), with a heavy protection bias in S.E. Asia. These results indicate high levels of degradation and low conservation leading to potentially severe ecological consequences. Systematic and coordinated efforts are needed to reduce the pressure on this ecosystem and ensure the ongoing provisioning of biodiversity and ecosystem services in these ecoregions. • Less than ⅓ of the original tropical dry forest extent is currently forested. • The remaining tropical dry forest is severely degraded with 20 % in core forest areas. • Less than ⅕ of current forest areas are protected at regional and national levels. • Of protected areas, <10 % are managed by indigenous communities. • There is a geographic mismatch of remaining core forests & highly protected areas. [ABSTRACT FROM AUTHOR]

• First global application of the Erosion Potential Model (EPM) is done. • Model validation is done using sediment yield data for more than 100 catchments. • Two SDR equations were tested for the estimate of the net erosion rates. • Modified version of the EPM (mEPM) yields better results compared to the EPM. • Both EPM and mEPM are also associated with several shortcomings. Soil erosion is expected to increase in the future due to climate change. Soil erosion models are useful tools that can be used by decision makers and other stakeholders to deal with soil erosion problems or the implementation of soil protection measures. Most of the modelling applications are using Universal Soil Loss Equation (USLE)-type models. In this study, we evaluate the applicability of the Erosion Potential Model (EPM) and its modified version (mEPM) for the estimation of the gross and net erosion rates at a global scale. The sensitivity analysis shows that the model results have the highest variability due to the soil protection (land cover) coefficient followed by the soil erodibility parameter. The models' evaluations indicate that that the EPM cannot be applied to cold regions while the mEPM overcomes this issue. The erosion rates based on the EPM were 1.5–2.5 times larger than the ones obtained from the mEPM. Increasing the number of catchment properties as inputs to the model may help in improving the performance of the tested EPM and mEPM. Moreover, a comparison of net soil losses by mEPM with long-term suspended sediment yield data for 116 catchments located around the globe indicates a median bias of less than 10%, although the bias for around 1/3 of catchments was above 100%. Furthermore, a direct comparison with other soil erosion models such as USLE-type models is not possible since the EPM and mEPM do take into consideration other processes such as soil slumps and gully erosion and not just sheet and rill erosion. Therefore, as expected, the gross erosion rates by the EPM and mEPM are higher compared to the USLE-type models. Hence, the mEPM, despite its limitations, could be regarded as an interesting approach for the describing erosion processes around the globe and should be further tested using small- and medium-sized catchments from various climate zones. [ABSTRACT FROM AUTHOR]

In this paper, the author analyzes the factor of the independent distinctive role of the earlier sign in the composite sign from different points of view. First, the author determines important characteristics that the earlier mark must have in order to retain an independent distinctive role in the composite sign. After that, the author analyzes the stage in the process of assessing likelihood of confusion in trade at which this factor should be considered - whether it is the stage of comparing the signs or the stage of making a global assessment of all relevant factors. Finally, the author analyzes how and to what extent this factor has an impact on likelihood of confusion in trade. For the purposes of this work, the most used is the case-law of the General Court of the EU.

Excessive nitrate in surface waters deteriorates the water quality and threatens human health. Human activities have caused increased nitrate concentrations in global surface waters over the past 50 years. An assessment of the long-term trajectory of surface-water nitrate exposure to world populations and the associated potential health risks is imperative but lacking. Here, we used global spatially explicit data on surface-water nitrate concentrations and population density, in combination with thresholds for health risks from epidemiological studies, to quantify the long-term changes in surface-water nitrate exposure to world populations at multiple spatial scales. During 1970-2010, global populations potentially affected by acute health risks associated with surface-water nitrate exposure increased from 6 to 60 million persons per year, while populations at potential chronic health risks increased from 169 to 1361 million persons per year. Potential acute risks have increasingly affected Asian countries. Populations potentially affected by chronic risks shifted from dominance by high-income countries (in Europe and North America) to middle-income countries (in Asia and Africa). To mitigate adverse health effects associated with surface-water nitrate exposure, anthropogenic nitrogen inputs to natural environments should be drastically reduced. International and national standards of maximum nitrate contamination may need to be lowered.