Protected area targets post-2020 Visconti, Piero; Butchart, Stuart H M; Brooks, Thomas M ...
Science,
2019-Apr-19, 2019-04-19, 20190419, Volume:
364, Issue:
6437
Journal Article
Peer reviewed
Open access
Outcome-based targets are needed to achieve biodiversity goals
In 2010, Parties to the Convention on Biological Diversity (CBD) adopted the Strategic Plan for Biodiversity 2011–2020, and its 20 Aichi ...Biodiversity Targets, to catalyze national and international conservation efforts and reverse negative biodiversity trends. With the plan nearing an end, and attention turning toward a post-2020 biodiversity framework, it is timely to assess the strengths, weaknesses, and effectiveness of the Aichi Targets. Aichi Target 11, concerned with establishing effective and representative networks of protected areas (PAs) by 2020, has attracted considerable interest owing to widespread recognition of the pivotal role that appropriately situated and well-managed PAs have in conserving biodiversity (
1
). Substantial advances have been made toward the areal components of Aichi Target 11, with the PA estate increasing by 2.3% on land and 5.4% in the oceans since 2010 and now covering 15% of land and inland freshwater globally and 7% of the oceans (
2
). However, species' population abundance within and outside PAs continues to decline (
1
), the placement and resourcing of the majority of PAs has been poor (
1
,
3
,
4
), and more than half of PAs established before 1992 have suffered increasing human pressure (
5
). We discuss four problems with Aichi Target 11 that have contributed to its limited achievement and propose a formulation for a target for site-based conservation beyond 2020 aimed at overcoming them.
In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was ...developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk of bias. The QUADAS-2 tool is applied in 4 phases: summarize the review question, tailor the tool and produce review-specific guidance, construct a flow diagram for the primary study, and judge bias and applicability. This tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.
Background. Randomized trials assessing BCG vaccine protection against tuberculosis have widely varying results, for reasons that are not well understood. Methods. We examined associations of trial ...setting and design with BCG efficacy against pulmonary and miliary or meningeal tuberculosis by conducting a systematic review, meta-analyses, and meta-regression. Results. We identified 18 trials reporting pulmonary tuberculosis and 6 reporting miliary or meningeal tuberculosis. Univariable meta-regression indicated efficacy against pulmonary tuberculosis varied according to 3 characteristics. Protection appeared greatest in children stringently tuberculin tested, to try to exclude prior infection with Mycobacterium tuberculosis or sensitization to environmental mycobacteria (rate ratio RR, 0.26; 95% confidence interval CI, .18–.37), or infants (RR, 0.41; 95% CI, .29–.58). Protection was weaker in children not stringently tested (RR, 0.59; 95% CI, .35–1.01) and older individuals stringently or not stringently tested (RR, 0.88; 95% CI, .59–1.31 and RR, 0.81; 95% CI, .55–1.22, respectively). Protection was higher in trials further from the equator where environmental mycobacteria are less and with lower risk of diagnostic detection bias. These associations were attenuated in a multivariable model, but each had an independent effect. There was no evidence that efficacy was associated with BCG strain. Protection against meningeal and miliary tuberculosis was also high in infants (RR, 0.1; 95% CI, .01–.77) and children stringently tuberculin tested (RR, 0.08; 95% CI, .03–.25). Conclusions. Absence of prior M. tuberculosis infection or sensitization with environmental mycobacteria is associated with higher efficacy of BCG against pulmonary tuberculosis and possibly against miliary and meningeal tuberculosis. Evaluations of new tuberculosis vaccines should account for the possibility that prior infection may mask or block their effects.
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IMPORTANCE: Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. OBJECTIVE: To conduct a systematic review ...of the benefits and adverse events (AEs) of cannabinoids. DATA SOURCES: Twenty-eight databases from inception to April 2015. STUDY SELECTION: Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. DATA EXTRACTION AND SYNTHESIS: Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. MAIN OUTCOMES AND MEASURES: Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs. RESULTS: A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio OR, 3.82 95% CI, 1.55-9.42; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 95% CI, 0.99-2.00; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference WMD, −0.46 95% CI, −0.80 to −0.11; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, −0.12 95% CI, −0.24 to 0.01; 5 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. CONCLUSIONS AND RELEVANCE: There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs.
Abstract Objective To classify the sources of bias and variation and to provide an updated summary of the evidence of the effects of each source of bias and variation. Study Design and Setting We ...conducted a systematic review of studies of any design with the main objective of addressing bias or variation in the results of diagnostic accuracy studies. We searched MEDLINE, EMBASE, BIOSIS, the Cochrane Methodology Register, and Database of Abstracts of Reviews of Effects (DARE) from 2001 to October 2011. Citation searches based on three key papers were conducted, and studies from our previous review (search to 2001) were eligible. One reviewer extracted data on the study design, objective, sources of bias and/or variation, and results. A second reviewer checked the extraction. Results We summarized the number of studies providing evidence of an effect arising from each source of bias and variation on the estimates of sensitivity, specificity, and overall accuracy. Conclusions We found consistent evidence for the effects of case–control design, observer variability, availability of clinical information, reference standard, partial and differential verification bias, demographic features, and disease prevalence and severity. Effects were generally stronger for sensitivity than for specificity. Evidence for other sources of bias and variation was limited.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Assessment of risk of bias is regarded as an essential component of a systematic review on the effects of an intervention. The most commonly used tool for randomised trials is the Cochrane ...risk-of-bias tool. We updated the tool to respond to developments in understanding how bias arises in randomised trials, and to address user feedback on and limitations of the original tool.
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Striped Bass naturally inhabit a wide range of temperatures, yet little is known about the processes that control their acute and chronic temperature limits. The objective of this study was to ...determine the effect of temperature acclimation on acute thermal maxima and physiology of juvenile Striped Bass. Juvenile fish were acclimated to 15, 25 or 30 °C for 4 weeks, then split into two sampling groups: post-acclimation and post-critical thermal maximum trials. We found that fish survived in all acclimation temperatures with little change to underlying hematology, and that critical thermal maximum (CT
max
) increased with increasing acclimation temperature. At CT
max
, fish acclimated to 30 °C had elevated plasma cortisol, lactate and potassium levels. These results suggest that, while 30 °C is likely to be outside their thermal optima, Striped Bass can survive at high temperatures. This ability to cope with warm temperatures may provide an advantage with increasing global temperatures.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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