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In recent decades, the literature on climate change and biodiversity conservation has proposed numerous climate change adaptation options; however, their effectiveness and feasibility have rarely been evaluated by those involved in frontline decision-making. In this paper, we use data from a two-day climate change adaptation workshop held at Bruce Peninsula National Park and Fathom Five National Marine Park, in Ontario, Canada, to understand stakeholder views on different types of adaptation options. We found that most (45%) adaptation options identified by participants were “conventional” (i.e., they are already in use and are relatively low risk and familiar to practitioners) and oriented towards directing change (i.e., they aim to help species and ecosystems respond to change and transition to a desired future state). These options also received higher effectiveness and feasibility ratings than “novel” ones. The remaining options (55%) were either “conventional” and aimed towards resisting change, or else were “novel.” Our results suggest that practitioners are open to working with change; however, there is some management resistance to more dynamic “novel” options (e.g., adjusting species assemblages), which in many instances will be required to effectively deal with inevitable climate change impacts. By focusing on understanding the factors that influence the prioritization and feasibility of adaptation options at the regional scale, and by providing practical recommendations to enhance organizational capacity to adapt to climate change, we address key implementation gaps identified in the literature.

This study reports characteristics and outcomes of adults who received Azacitidine-Venetoclax (AZA-VEN) compared to other salvage therapies (NO-AZA-VEN) as first salvage therapy for acute myeloid leukemia (AML). The clinical data of 81 patients with a diagnosis of relapsed or refractory AML were analyzed. The ORR was comparable for both groups (55% vs 57%, p = 0.852). Median OS (6.8 vs 11.2 months, p = 0.053) and median RFS (6.9 vs 11.2 months, p = 0.488) showed a trend in favor of the NO-AZA-VEN group. OS was significantly longer with NO-AZA-VEN for ELN 2022 risk category sub-group, patients under 60 years old, primary AML and for patients who underwent allo-hematopoietic stem cell transplant after salvage therapy. There was no statistical difference in complications of treatment such as febrile neutropenia, intensive care unit stay, septic shock and total parenteral nutrition. Those results do not support the preferential use of AZA-VEN over other regimens in R/R acute myeloid leukemia. [ABSTRACT FROM AUTHOR]

Other effective area-based conservation measures (OECMs) are sites outside of protected areas that deliver the effective, long-term conservation of biodiversity. Both protected areas and OECMs contribute to the implementation of the Global Biodiversity Framework's Target 3, which calls for the conservation of 30% of marine, terrestrial and inland water areas by 2030. This paper provides the first global assessment of the contribution of OECMs to GBF Target 3. Between 2019 and 2023, 820 sites in nine countries and territories were reported to the World Database on OECMs, covering 1.9 million km2 of the Earth's surface and, in the terrestrial realm, contributing over 1% to the 30% coverage target. Notably, over 50% of reported OECMs are under governance by governments and less than 2% are governed by Indigenous peoples and local communities. In countries and territories that have reported OECMs, a far greater proportion of OECMs than protected areas are under shared governance (40.9% compared to 2.5%), and collaborative governance is the most common governance sub-type among reported OECMs. This paper finds that almost 30% of the 820 reported OECMs overlap with identified Key Biodiversity Areas, which are one global classification of areas of particular importance for biodiversity. With Target 3's pressing deadline of 2030, there is an urgent need to scale up understanding and local to national engagement with the OECM framework, ensuring that it fulfills its potential to recognize diverse forms of equitable governance and effective conservation. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions The clinical benefit of systemic anticancer therapies can be unclear despite positive trials, and outcomes may not translate to real‐world practice. This study evaluated the benefit of soft tissue sarcoma (STS) treatments using the European Society of Medical Oncology Magnitude of Clinical Benefit Scale (MCBS) v1.1 and measured the robustness of STS trial results using Fragility Index (FI).Database searches for adult phase II or III trials in advanced STS (January 1998–December 2023) were performed. Therapies with trial outcomes that met the criteria for MCBS were scored 1–5 (≥4 represents substantial clinical benefit). For randomized clinical trials with positive time‐to‐event endpoints, the number of additional events that would render results nonsignificant, FI, was calculated and expressed as a proportion of the experimental arm size (fragility quotient [FQ]). Higher FI/FQ implies more robust results.Among 194 trials, 19 (9.8%) were phase III. Most phase II trials (146/175; 83.4%) had single‐arm or non‐comparative design. Trials that were eligible for MCBS scoring (n = 78; 40.2%) evaluated 56 different agents/regimens. Median MCBS score was 2. Only three agents/regimens (all cytotoxic therapies) had an MCBS score ≥4. Among 47 randomized clinical trials, 16 (8 phase II; 8 phase III) trials had positive outcomes. Median FI was 7 (range, 2–52) and 10 trials (62.5%) had an FQ < 10%, with median of 7% (range, 1%–59%).Most systemic therapies in STS trials did not confer substantial clinical benefit per European Society of Medical Oncology‐MCBS. Additionally, positive randomized trials were often fragile. Novel STS therapy trials should use clinically meaningful endpoints and real‐world efficacy confirmation is essential, especially for less robust trials. [ABSTRACT FROM AUTHOR]

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours that originate from the interstitial cells of Cajal. GISTs are mainly driven by gain-of-function mutations in receptor tyrosine kinase or platelet-derived growth factor receptor alpha. Surgical resection is the only curative treatment for localized tumours and all currently approved medical GIST treatments are based on orally available tyrosine kinase inhibitors. Recent discoveries in the molecular and clinical features of GISTs have greatly impacted GIST management. Due to the provincially rather than nationally administered Canadian healthcare system, there have been inconsistencies in the treatment of GISTs across the country. Therefore, guidance on the latest knowledge, clinical management and treatment of GIST is needed to standardize the approach to GIST management nationwide. To establish pan-Canadian guidance, provide up-to-date data and harmonize the clinical practice of GIST management in high- and low-throughput centres across Canada; a panel of 20 physicians with extensive clinical experience in GIST management reviewed relevant literature. This included radiologists, pathologists, interventional radiologists, surgeons and medical oncologists across Canada. The structured literature focused on seven key domains: molecular profiling, radiological techniques/reporting, targeted localized therapy, intricacies of systemic treatments, emerging tests, multidisciplinary care and patient advocacy. This literature review, along with clinical expertise and opinion, was used to develop this concise and clinically relevant consensus paper to harmonize the knowledge and clinical practice on GIST management across Canada. The content presented here will help guide healthcare providers, especially in Canada, in terms of approaching and managing GIST. [ABSTRACT FROM AUTHOR]