The direct drivers of recent global anthropogenic biodiversity loss

Effective policies to halt biodiversity loss require knowing which anthropogenic drivers are the most important direct causes. Whereas previous knowledge has been limited in scope and rigor, here we statistically synthesize empirical comparisons of recent driver impacts found through a wide-ranging review. We show that land/sea use change has been the dominant direct driver of recent biodiversity loss worldwide. Direct exploitation of natural resources ranks second and pollution third; climate change and invasive alien species have been significantly less important than the top two drivers. The oceans, where direct exploitation and climate change dominate, have a different driver hierarchy from land and fresh water. It also varies among types of biodiversity indicators. For example, climate change is a more important driver of community composition change than of changes in species populations. Stopping global biodiversity loss requires policies and actions to tackle all the major drivers and their interactions, not some of them in isolation.Fil: Jaureguiberry, Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Titeux, Nicolas. German Centre For Integrative Biodiversity Research (idiv) Halle-Jena-Leipzig; Alemania. Luxembourg Institute Of Science And Technology; Luxemburgo. Helmholtz Zentrum Für Umweltforschung; AlemaniaFil: Wiemers, Martin. Helmholtz Zentrum Für Umweltforschung; Alemania. Senckenberg Gesellschaft Für Naturforschung; AlemaniaFil: Bowler, Diana E.. German Centre For Integrative Biodiversity Research (idiv) Halle-Jena-Leipzig; Alemania. Universitat Jena; Alemania. Helmholtz Zentrum Für Umweltforschung; AlemaniaFil: Coscieme, Luca. Hot Or Cool Institute; AlemaniaFil: Golden, Abigail S.. University of Washington; Estados Unidos. German Centre For Integrative Biodiversity Research (idiv) Halle-Jena-Leipzig; Alemania. Department Of Marine And Coastal Sciences; Estados UnidosFil: Guerra, Carlos A.. German Centre For Integrative Biodiversity Research (idiv) Halle-Jena-Leipzig; Alemania. Martin Luther University Halle Wittenberg; AlemaniaFil: Jacob, Ute. Universität Oldenburg; Alemania. Alfred-Wegener-Institut Helmholtz-Zentrum Für Polar- Und Meeresforschung; AlemaniaFil: Takahashi, Yasuo. Institute For Global Environmental Strategies; JapónFil: Settele, Josef. German Centre For Integrative Biodiversity Research (idiv) Halle-Jena-Leipzig; Alemania. University Of The Philippines, Los Baños; Filipinas. Helmholtz Zentrum Für Umweltforschung; AlemaniaFil: Díaz, Sandra Myrna. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Molnár, Zsolt. Institute Of Ecology And Botany; HungríaFil: Purvis, Andy. Imperial College London; Reino Unido. Natural History Museum; Reino Unid

The vital roles of blue foods in the global food system

Blue foods play a central role in food and nutrition security for billions of people and are a cornerstone of the livelihoods, economies, and cultures of many coastal and riparian communities. Blue foods are extraordinarily diverse, are often rich in essential micronutrients and fatty acids, and can often be produced in ways that are more environmentally sustainable than terrestrial animal-source foods. Capture fisheries constitute the largest wild-food resource for human extraction that would be challenging to replace. Yet, despite their unique value, blue foods have often been left out of food system analyses, policies, and investments. Here, we focus on three imperatives for realizing the potential of blue foods: (1) Bring blue foods into the heart of food system decision-making; (2) Protect and develop the potential of blue foods to help end malnutrition; and (3) Support the central role of small-scale actors in fisheries and aquaculture. Recognition of the importance of blue foods for food and nutrition security constitutes a critical justification to preserve the integrity and diversity of aquatic species and ecosystems.Additional co-authors: Christopher D. Golden. Benjamin S. Halpern, Christina C. Hicks, Malin Jonell, Avinash Kishore, J. Zachary Koehn, Rosamond L. Naylor, Michael J. Phillips, Elizabeth R. Selig, Rebecca E. Short, Rashid Sumaila, Shakuntala H. Thilsted, Max Troell, Colette C. C. Wabnit

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Trends, Causal Analysis, and Recommendations from 14 Years of Ferry Accidents

Ferries and other passenger vessels provide a crucial mode of transportation for many in the developing world, especially in archipelagic nations like Indonesia and in river delta nations like Bangladesh. However, this dependence on passenger vessels coincides with a high rate of accidents and fatalities in many countries, linked to purchase of old, substandard, and/or inappropriate vessels in low-income nations; overcrowding; inadequate training; and sudden hazardous weather. Any serious attempt to decrease the number and fatality count of ferry accidents in the developing world must have a complete record of past incidents on which to draw. This report compiles detailed information on the 232 major accidents that occurred around the world between 2000 and 2014. It assesses the prevalence of various common factors in ferry accidents, including human error, hazardous weather, and overcrowding, and makes recommendations for future research into the prevention of ferry accidents

Trends, Causal Analysis, and Recommendations from 14 Years of Ferry Accidents

Ferries and other passenger vessels provide a crucial mode of transportation for many in the developing world, especially in archipelagic nations like Indonesia and in river delta nations like Bangladesh. However, this dependence on passenger vessels coincides with a high rate of accidents and fatalities in many countries, linked to purchase of old, substandard, and/or inappropriate vessels in low-income nations; overcrowding; inadequate training; and sudden hazardous weather. Any serious attempt to decrease the number and fatality count of ferry accidents in the developing world must have a complete record of past incidents on which to draw. This report compiles detailed information on the 232 major accidents that occurred around the world between 2000 and 2014. It assesses the prevalence of various common factors in ferry accidents, including human error, hazardous weather, and overcrowding, and makes recommendations for future research into the prevention of ferry accidents

Combining natural history collections with fisher knowledge for community-based conservation in Fiji.

Harnessing the traditional ecological knowledge (TEK) of local communities has the potential to enhance conservation planning in developing regions. Marine protected areas (MPAs) that incorporate traditional beliefs about reef tenure are generally more successful in reaching conservation goals and ensuring the participation of local fishermen on vulnerable tropical reef systems. Fiji possesses a unique system of traditional reef management in which local clans or villages, called mataqali, control individual units of a reef, known as qoliqoli, and make independent management decisions based on traditional beliefs and conservation concerns. This is an example of a system, known as customary marine tenure, which has attracted interest from conservation scientists hoping to set up MPAs in vulnerable regions. As one example of this grassroots participation, Nagigi village on the Fijian island of Vanua Levu has expressed interest in setting up an MPA in part of its qoliqoli because of concerns about overfishing. In response to this interest, we took a two-pronged approach to assessing Nagigi's fishery status and conservation needs, first conducting a fishery-independent species survey using destructive sampling and then focusing on fisheries targets identified through fisher interviews. These interviews allowed us to identify heavily targeted species, assess villagers' understanding of reef dynamics over 30 or 40 years of fisheries expansion, and evaluate village support and expectations for a proposed conservation program. Based on our findings we recommend a temporary closure to be in effect for at least three years, allowing one of the more important fishery targets, Lethrinus harak (Forsskål, 1775; Lethrinidae), to complete at least one generation within the reserve. The methodology of matching the proposed marine protected area with the life histories and ecologies of heavily targeted species identified through fisherman and -woman interviews can offer a template for future conservation projects that seek to synthesize indigenous peoples' needs and knowledge with ecological data

Climate adaptation depends on rebalancing flexibility and rigidity in US fisheries management

Abstract: Fisheries face unprecedented environmental change. An important aspect of resilience to this change is the adaptive capacity of managers and stakeholders to respond to new conditions. A growing academic literature has demonstrated the value of fostering this adaptive capacity and highlighted key elements of fisheries social-ecological systems that can promote it. However, it is unclear to what extent these abstract academic ideas around adaptive capacity are relevant and valuable to on-the-ground resource managers, and if so, whether there are aspects of the literature that particularly resonate with their needs. Here, we compare academic concepts of adaptive capacity to the ways that management practitioners conceptualize and implement these ideas in practice, elicited through interviews with key professionals in United States federal fishery management bodies. Practitioners overwhelmingly cited flexibility to respond to change as the most consistently important element of adaptive capacity. Yet, they also detailed how the U.S. fishery management system routinely limits and constrains the flexibility of managers and stakeholders. Seeking out opportunities that enhance flexibility without jeopardizing other key aspects of adaptive capacity could increase management’s adaptive capacity to global change in the USA and elsewhere