Spatially explicit species distribution models: A missed opportunity in conservation planning?

Aim: Systematic conservation planning is vital for allocating protected areas given the spatial distribution of conservation features, such as species. Due to incomplete species inventories, species distribution models (SDMs) are often used for predicting species habitat suitability and species probability of occurrence. Currently, SDMs mostly ignore spatial dependencies in species and predictor data. Here, we provide a comparative evaluation of how accounting for spatial dependencies, that is, autocorrelation, affects the delineation of optimized protected areas. Location: Southeast Australia, Southeast U.S. Continental Shelf, Danube River Basin. Methods: We employ Bayesian spatially explicit and non-spatial SDMs for terrestrial, marine and freshwater species, using realm-specific planning unit shapes (grid, hexagon and subcatchment, respectively). We then apply the software gurobi to optimize conservation plans based on species targets derived from spatial and non-spatial SDMs (10% 50% each to analyse sensitivity), and compare the delineation of the plans. Results: Across realms and irrespective of the planning unit shape, spatially explicit SDMs (a) produce on average more accurate predictions in terms of AUC, TSS, sensitivity and specificity, along with a higher species detection probability. All spatial optimizations meet the species conservation targets. Spatial conservation plans that use predictions from spatially explicit SDMs (b) are spatially substantially different compared to those that use non-spatial SDM predictions, but (c) encompass a similar amount of planning units. The overlap in the selection of planning units is smallest for conservation plans based on the lowest targets and vice versa. Main conclusions: Species distribution models are core tools in conservation planning. Not surprisingly, accounting for the spatial characteristics in SDMs has drastic impacts on the delineation of optimized conservation plans. We therefore encourage practitioners to consider spatial dependencies in conservation features to improve the spatial representation of future protected areas. © 2019 The Authors. Diversity and Distributions Published by John Wiley and Sons LtdThis study was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 642317. SDL has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska‐Curie grant agreement No. 748625, and SCJ from the German Federal Ministry of Education and Research (BMBF) for the “GLANCE” project (Global Change Effects in River Ecosystems; 01 LN1320A). We wish to thank Gwen Iacona and two anonymous referees for their constructive comments on an earlier version of the manuscript

A systematic approach towards the identification and protection of vulnerable marine ecosystems

Author Posting. © The Author(s), 2013. This is the author's version of the work. It is posted here by permission of Elsevier for personal use, not for redistribution. The definitive version was published in Marine Policy 49 (2014):146-154, doi:10.1016/j.marpol.2013.11.017.The United Nations General Assembly in 2006 and 2009 adopted resolutions that call for the identification and protection of vulnerable marine ecosystems (VMEs) from significant adverse impacts of bottom fishing. While general criteria have been produced, there are no guidelines or protocols that elaborate on the process from initial identification through to the protection of VMEs. Here, based upon an expert review of existing practices, a 10-step framework is proposed: 1) Comparatively assess potential VME indicator taxa and habitats in a region; 2) determine VME thresholds; 3) consider areas already known for their ecological importance; 4) compile information on the distributions of likely VME taxa and habitats, as well as related environmental data; 5) develop predictive distribution models for VME indicator taxa and habitats; 6) compile known or likely fishing impacts; 7) produce a predicted VME naturalness distribution (areas of low cumulative impacts); 8) identify areas of higher value to user groups; 9) conduct management strategy evaluations to produce trade-off scenarios; 10) review and re-iterate, until spatial management scenarios are developed that fulfil international obligations and regional conservation and management objectives. To date, regional progress has been piecemeal and incremental. The proposed 10-step framework combines these various experiences into a systematic approach.The New Zealand Ministry of Science and Innovation (now known as the Ministry of Business, Innovation and Employment) provided funding for the worksho

Use of a formal consensus development technique to produce recommendations for improving the effectiveness of adult mental health multidisciplinary team meetings

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Multidisciplinary team (MDT) meetings are the core mechanism for delivering mental health care but it is unclear which models improve care quality. The aim of the study was to agree recommendations for improving the effectiveness of adult mental health MDT meetings, based on national guidance, research evidence and experiential insights from mental health and other medical specialties. METHODS: We established an expert panel of 16 health care professionals, policy-makers and patient representatives. Five panellists had experience in a range of adult mental health services, five in heart failure services and six in cancer services. Panellists privately rated 68 potential recommendations on a scale of one to nine, and re-rated them after panel discussion using the RAND/UCLA Appropriateness Method to determine consensus. RESULTS: We obtained agreement (median ≥ 7) and low variation in extent of agreement (Mean Absolute Deviation from Median of ≤1.11) for 21 recommendations. These included the explicit agreement and auditing of MDT meeting objectives, and the documentation and monitoring of treatment plan implementation. CONCLUSIONS: Formal consensus development methods that involved learning across specialities led to feasible recommendations for improved MDT meeting effectiveness in a wide range of settings. Our findings may be used by adult mental health teams to reflect on their practice and facilitate improvement. In some other contexts, the recommendations will require modification. For example, in Child and Adolescent Mental Health Services, context-specific issues such as the role of carers should be taken into account. A limitation of the comparative approach adopted was that only five members of the panel of 16 experts were mental health specialists.This report presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the Health Services and Delivery Research programme or the Department of Health

Дослідження «великого терору» у науково-документальній серії книг «Реабілітовані історією»

У статті автор аналізує результати дослідження «великого терору» 1937–1938 рр. у контексті реалізації Державної програми науково-документальної серії книг «Реабілітовані історією».В статье автор анализирует результаты исследования «большого террора» 1937–1938 гг. в контексте реализации Государственной программы научно-документальной серии книг «Реабилитированные историей».The author analyzes the results of a study of the «great terror» 1937–1938 in the context of implementing the State Program for Research, a documentary series of books «Rehabilitated history»

Effects of posture and venous insufficiency on endothelial-dependent and -independent cutaneous vasodilation in the perimalleolar region

Objectives: To assess the effects of posture, endothelial function and venous insufficiency on cutaneous microvascular vasodilator function in the gaiter area, in particular defining factors which may affect microangiopathy and ulcer formation. Methods: Endothelial-dependent and –independent vasodilator responses to incremental-doses of acetylcholine (Ach) and sodium nitroprusside (SNP) were evaluated in the perimalleolar region in the supine and standing positions in middle-aged patients with isolated superficial venous insufficiency (ISVI) (n=25) and health controls (n=28) using laser Doppler fluximetry (LDF) and iontophoresis of vasodilators. Results: The venoarteriolar reflex (vasoconstriction on standing) was equally present in both groups, and reduced the vasodilator responses to SNP in the upright position (e.g for patients with ISVI, peak SNP response was 82+11 PU [standing] vs 123+15 PU [supine]). The presence of ISVI had no effect on endothelial vasodilator function in the supine position, but on standing cutaneous reactivity to Ach was significantly reduced (e.g peak Ach response 69+8 PU [ISVI] vs 109+11 PU [controls], p<0.003). Conclusions: Upright posture impairs cutaneous endothelial-dependent vasodilation in the gaiter area of patients with ISVI. This may be of clinical and prognostic utility in identifying which patients with uncomplicated ISVI are at highest risk of tissue breakdown and ulcer formation in the gaiter area

Determinants of treatment plan implementation in multidisciplinary team meetings for patients with chronic diseases: a mixed-methods study.

This is the final version of the article. Available from the publisher via the DOI in this record.OBJECTIVE: Multidisciplinary team (MDT) meetings are assumed to produce better decisions and are extensively used to manage chronic disease in the National Health Service (NHS). However, evidence for their effectiveness is mixed. Our objective was to investigate determinants of MDT effectiveness by examining factors influencing the implementation of MDT treatment plans. This is a proxy measure of effectiveness, because it lies on the pathway to improvements in health, and reflects team decision making which has taken account of clinical and non-clinical information. Additionally, this measure can be compared across MDTs for different conditions. METHODS: We undertook a prospective mixed-methods study of 12 MDTs in London and North Thames. Data were collected by observation of 370 MDT meetings, interviews with 53 MDT members, and from 2654 patient medical records. We examined the influence of patient-related factors (disease, age, sex, deprivation, whether their preferences and other clinical/health behaviours were mentioned) and MDT features (as measured using the 'Team Climate Inventory' and skill mix) on the implementation of MDT treatment plans. RESULTS: The adjusted odds (or likelihood) of implementation was reduced by 25% for each additional professional group represented at the MDT meeting. Implementation was more likely in MDTs with clear goals and processes and a good 'Team Climate' (adjusted OR 1.96; 95% CI 1.15 to 3.31 for a unit increase in Team Climate Inventory (TCI) score). Implementation varied by disease category, with the lowest adjusted odds of implementation in mental health teams. Implementation was also lower for patients living in more deprived areas (adjusted odds of implementation for patients in the most compared with least deprived areas was 0.60, 95% CI 0.39 to 0.91). CONCLUSIONS: Greater multidisciplinarity is not necessarily associated with more effective decision making. Explicit goals and procedures are also crucial. Decision implementation should be routinely monitored to ensure the equitable provision of care.This project was funded by the NIHR Health Services and Delivery Research programme (project number 09/2001/ 04) and will be published in full in the Health Services and Delivery Research Journal. Further information available at: (http://www.netscc.ac.uk/hsdr/projdetails.php?ref=09-2001-04). In accordance with NIHR regulations, the findings reported here are to be referred to as initial until the NIHR final report has been published. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, the writing of the report, or the decision to submit the report for publication

Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority, randomised trial

Background Whole brain radiotherapy (WBRT) and dexamethasone are widely used to treat brain metastases from non-small cell lung cancer (NSCLC), although there have been no randomised clinical trials showing that WBRT improves either quality of life or overall survival. Even after treatment with WBRT, the prognosis of this patient group is poor. We aimed to establish whether WBRT could be omitted without a signifi cant eff ect on survival or quality of life. Methods The Quality of Life after Treatment for Brain Metastases (QUARTZ) study is a non-inferiority, phase 3 randomised trial done at 69 UK and three Australian centres. NSCLC patients with brain metastases unsuitable for surgical resection or stereotactic radiotherapy were randomly assigned (1:1) to optimal supportive care (OSC) including dexamethasone plus WBRT (20 Gy in five daily fractions) or OSC alone (including dexamethasone). The dose of dexamethasone was determined by the patients’ symptoms and titrated downwards if symptoms improved. Allocation to treatment group was done by a phone call from the hospital to the Medical Research Council Clinical Trials Unit at University College London using a minimisation programme with a random element and stratifi cation by centre, Karnofsky Performance Status (KPS), gender, status of brain metastases, and the status of primary lung cancer. The primary outcome measure was quality-adjusted life-years (QALYs). QALYs were generated from overall survival and patients’ weekly completion of the EQ-5D questionnaire. Treatment with OSC alone was considered noninferior if it was no more than 7 QALY days worse than treatment with WBRT plus OSC, which required 534 patients (80% power, 5% [one-sided] signifi cance level). Analysis was done by intention to treat for all randomly assigned patients. The trial is registered with ISRCTN, number ISRCTN3826061. Findings Between March 2, 2007, and Aug 29, 2014, 538 patients were recruited from 69 UK and three Australian centres, and were randomly assigned to receive either OSC plus WBRT (269) or OSC alone (269). Baseline characteristics were balanced between groups, and the median age of participants was 66 years (range 38–85). Signifi cantly more episodes of drowsiness, hair loss, nausea, and dry or itchy scalp were reported while patients were receiving WBRT, although there was no evidence of a difference in the rate of serious adverse events between the two groups. There was no evidence of a diff erence in overall survival (hazard ratio 1·06, 95% CI 0·90–1·26), overall quality of life, or dexamethasone use between the two groups. The diff erence between the mean QALYs was 4·7 days (46·4 QALY days for the OSC plus WBRT group vs 41·7 QALY days for the OSC group), with two-sided 90% CI of –12·7 to 3·3. Interpretation Although the primary outcome measure result includes the prespecifi ed non-inferiority margin, the combination of the small diff erence in QALYs and the absence of a diff erence in survival and quality of life between the two groups suggests that WBRT provides little additional clinically signifi cant benefi t for this patient group

Protocol for PIT: a phase III trial of prophylactic irradiation of tracts in patients with malignant pleural mesothelioma following invasive chest wall intervention.

INTRODUCTION: Histological diagnosis of malignant mesothelioma requires an invasive procedure such as CT-guided needle biopsy, thoracoscopy, video-assisted thorascopic surgery (VATs) or thoracotomy. These invasive procedures encourage tumour cell seeding at the intervention site and patients can develop tumour nodules within the chest wall. In an effort to prevent nodules developing, it has been widespread practice across Europe to irradiate intervention sites postprocedure--a practice known as prophylactic irradiation of tracts (PIT). To date there has not been a suitably powered randomised trial to determine whether PIT is effective at reducing the risk of chest wall nodule development. METHODS AND ANALYSIS: In this multicentre phase III randomised controlled superiority trial, 374 patients who can receive radiotherapy within 42 days of a chest wall intervention will be randomised to receive PIT or no PIT. Patients will be randomised on a 1:1 basis. Radiotherapy in the PIT arm will be 21 Gy in three fractions. Subsequent chemotherapy is given at the clinicians' discretion. A reduction in the incidence of chest wall nodules from 15% to 5% in favour of radiotherapy 6 months after randomisation would be clinically significant. All patients will be followed up for up to 2 years with monthly telephone contact and at least four outpatient visits in the first year. ETHICS AND DISSEMINATION: PIT was approved by NRES Committee North West-Greater Manchester West (REC reference 12/NW/0249) and recruitment is currently on-going, the last patient is expected to be randomised by the end of 2015. The analysis of the primary end point, incidence of chest wall nodules 6 months after randomisation, is expected to be published in 2016 in a peer reviewed journal and results will also be presented at scientific meetings and summary results published online. A follow-up analysis is expected to be published in 2018. TRIAL REGISTRATION NUMBER: ISRCTN04240319; NCT01604005; Pre-results