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The unprecedented rate of extinction calls for efficient use of genetics to help conserve biodiversity. Several recent genomic and simulation-based studies have argued that the field of conservation biology has placed too much focus on conserving genome-wide genetic variation, and that the field should instead focus on managing the subset of functional genetic variation that is thought to affect fitness. Here, we critically evaluate the feasibility and likely benefits of this approach in conservation. We find that population genetics theory and empirical results show that conserving genome-wide genetic variation is generally the best approach to prevent inbreeding depression and loss of adaptive potential from driving populations toward extinction. Focusing conservation efforts on presumably functional genetic variation will only be feasible occasionally, often misleading, and counterproductive when prioritized over genome-wide genetic variation. Given the increasing rate of habitat loss and other environmental changes, failure to recognize the detrimental effects of lost genome-wide genetic variation on long-term population viability will only worsen the biodiversity crisis.

Cancer is currently the first or second most common contributor to premature mortality in most countries of the world. The global number of patients with cancer is expected to rise over the next 50 years owing to the strong influence of demographic changes, such as population ageing and growth, on the diverging trends in cancer incidence in different regions. Assuming that the latest incidence trends continue for the major cancer types, we predict a doubling of the incidence of all cancers combined by 2070 relative to 2020. The greatest increases are predicted in lower-resource settings, in countries currently assigned a low Human Development Index (HDI), whereas the predicted increases in national burden diminish with increasing levels of national HDI. Herein, we assess studies modelling the future burden of cancer that underscore how comprehensive cancer prevention strategies can markedly reduce the prevalence of major risk factors and, in so doing, the number of future cancer cases. Focusing on an in-depth assessment of prevention strategies that target tobacco smoking, overweight and obesity, and human papillomavirus infection, we discuss how stepwise, population-level approaches with amenable goals can avert millions of future cancer diagnoses worldwide. In the absence of a step-change in cancer prevention delivery, tobacco smoking will remain the leading preventable cause of cancer, and overweight and obesity might well present a comparable opportunity for prevention, given its increasing prevalence globally in the past few decades. Countries must therefore instigate national cancer control programmes aimed at preventing cancer, and with some urgency, if such programmes are to yield the desired public health and economic benefits in this century.Assuming that the latest incidence trends continue for the major cancer types, the incidence of all cancers combined will double by 2070 relative to 2020, with the greatest increases predicted in lower-resource settings. The authors of this Perspective discuss how population-level approaches with amenable goals should be considered an integral part of cancer control.

The Coronavirus Disease 2019 (COVID-19) pandemic has changed many social, economic, environmental and healthcare determinants of health. We applied an ensemble of 16 Bayesian models to vital statistics data to estimate the all-cause mortality effect of the pandemic for 21 industrialized countries. From mid-February through May 2020, 206,000 (95% credible interval, 178,100–231,000) more people died in these countries than would have had the pandemic not occurred. The number of excess deaths, excess deaths per 100,000 people and relative increase in deaths were similar between men and women in most countries. England and Wales and Spain experienced the largest effect: ~100 excess deaths per 100,000 people, equivalent to a 37% (30–44%) relative increase in England and Wales and 38% (31–45%) in Spain. Bulgaria, New Zealand, Slovakia, Australia, Czechia, Hungary, Poland, Norway, Denmark and Finland experienced mortality changes that ranged from possible small declines to increases of 5% or less in either sex. The heterogeneous mortality effects of the COVID-19 pandemic reflect differences in how well countries have managed the pandemic and the resilience and preparedness of the health and social care system. Application of Bayesian models to vital statistics data from 21 industrialized countries shows that approximately 206,000 additional people died than if the COVID-19 pandemic had not occured. The heterogeneous distribution of excess deaths across the countries reflects differences in how the pandemic has been managed as well as the resilience of healthcare systems in these nations.

Pollination is a critical ecosystem service underpinning the productivity of agricultural systems across the world. Wild insect populations provide a substantial contribution to the productivity of many crops and seed set of wild flowers. However, large-scale evidence on species-specific trends among wild pollinators are lacking. Here we show substantial inter-specific variation in pollinator trends, based on occupancy models for 353 wild bee and hoverfly species in Great Britain between 1980 and 2013. Furthermore, we estimate a net loss of over 2.7 million occupied 1 km 2 grid cells across all species. Declines in pollinator evenness suggest that losses were concentrated in rare species. In addition, losses linked to specific habitats were identified, with a 55% decline among species associated with uplands. This contrasts with dominant crop pollinators, which increased by 12%, potentially in response agri-environment measures. The general declines highlight a fundamental deterioration in both wider biodiversity and non-crop pollination services. Pollinator loss is a concern but data on their status is lacking. Here Powney et al. use occupancy modelling to estimate the degree of loss in wild bee and hoverfly species across Great Britain, and report a 55% decline in upland species and a 12% increase in dominant crop pollinators.

Anthropogenic drivers of global change include rising atmospheric concentrations of carbon dioxide and other greenhouse gasses and resulting changes in the climate, as well as nitrogen deposition, biotic invasions, altered disturbance regimes, and land-use change. Predicting the effects of global change on terrestrial plant communities is crucial because of the ecosystem services vegetation provides, from climate regulation to forest products. In this paper, we present a framework for detecting vegetation changes and attributing them to global change drivers that incorporates multiple lines of evidence from spatially extensive monitoring networks, distributed experiments, remotely sensed data, and historical records. Based on a literature review, we summarize observed changes and then describe modeling tools that can forecast the impacts of multiple drivers on plant communities in an era of rapid change. Observed responses to changes in temperature, water, nutrients, land use, and disturbance show strong sensitivity of ecosystem productivity and plant population dynamics to water balance and long-lasting effects of disturbance on plant community dynamics. Persistent effects of land-use change and human-altered fire regimes on vegetation can overshadow or interact with climate change impacts. Models forecasting plant community responses to global change incorporate shifting ecological niches, population dynamics, species interactions, spatially explicit disturbance, ecosystem processes, and plant functional responses. Monitoring, experiments, and models evaluating multiple change drivers are needed to detect and predict vegetation changes in response to 21st century global change.

Seabird population changes are good indicators of long-term and large-scale change in marine ecosystems, and important because of their many impacts on marine ecosystems. We assessed the population trend of the world's monitored seabirds (1950-2010) by compiling a global database of seabird population size records and applying multivariate autoregressive state-space (MARSS) modeling to estimate the overall population trend of the portion of the population with sufficient data (i.e., at least five records). This monitored population represented approximately 19% of the global seabird population. We found the monitored portion of the global seabird population to have declined overall by 69.7% between 1950 and 2010. This declining trend may reflect the global seabird population trend, given the large and apparently representative sample. Furthermore, the largest declines were observed in families containing wide-ranging pelagic species, suggesting that pan-global populations may be more at risk than shorter-ranging coastal populations.

We consider the long-term relationship between human demography, food production, and Holocene climate via an archaeological radiocarbon date series of unprecedented sampling density and detail. There is striking consistency in the inferred human population dynamics across different regions of Britain and Ireland during the middle and later Holocene. Major cross-regional population downturns in population coincide with episodes of more abrupt change in North Atlantic climate and witness societal responses in food procurement as visible in directly dated plants and animals, often with moves toward hardier cereals, increased pastoralism, and/or gathered resources. For the Neolithic, this evidence questions existing models of wholly endogenous demographic boom–bust. For the wider Holocene, it demonstrates that climate-related disruptions have been quasi-periodic drivers of societal and subsistence change.

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health 1 , 2 . Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities 3 . Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories 4 . We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people’s ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health. A study examining how cities can foster well-being and positive mental health in young residents synthesizes opinions from researchers, practitioners, advocates and young people, highlighting factors that policymakers and urban planners should consider.

Montane species worldwide are shifting upslope in response to recent temperature increases. These upslope shifts are predicted to lead to mountaintop extinctions of species that live only near mountain summits, but empirical examples of populations that have disappeared are sparse. We show that recent warming constitutes an “escalator to extinction” for birds on a remote Peruvian mountain—high-elevation species have declined in both range size and abundance, and several previously common mountaintop residents have disappeared from the local community. Our findings support projections that warming will likely drive wide-spread extirpations and extinctions of high-elevation taxa in the tropical Andes. Such climate change-driven mountaintop extirpations may be more likely in the tropics, where temperature seems to exert a stronger control on species’ range limits than in the temperate zone. In contrast, we show that lowland bird species at our study site are expanding in range size as they shift their upper limits upslope and may thus benefit from climate change.

The population infected with HIV is getting older and these people will increasingly develop age-related non-communicable diseases (NCDs). We aimed to quantify the scale of the change and the implications for HIV care in the Netherlands in the future. We constructed an individual-based model of the ageing HIV-infected population, which followed patients on HIV treatment as they age, develop NCDs—including cardiovascular disease (hypertension, hypercholesterolaemia, myocardial infarctions, and strokes), diabetes, chronic kidney disease, osteoporosis, and non-AIDS malignancies—and start co-medication for these diseases. The model was parameterised by use of data for 10 278 patients from the national Dutch ATHENA cohort between 1996 and 2010. We made projections up to 2030. Our model suggests that the median age of HIV-infected patients on combination antiretroviral therapy (ART) will increase from 43·9 years in 2010 to 56·6 in 2030, with the proportion of HIV-infected patients aged 50 years or older increasing from 28% in 2010 to 73% in 2030. In 2030, we predict that 84% of HIV-infected patients will have at least one NCD, up from 29% in 2010, with 28% of HIV-infected patients in 2030 having three or more NCDs. 54% of HIV-infected patients will be prescribed co-medications in 2030, compared with 13% in 2010, with 20% taking three or more co-medications. Most of this change will be driven by increasing prevalence of cardiovascular disease and associated drugs. Because of contraindications and drug–drug interactions, in 2030, 40% of patients could have complications with the currently recommended first-line HIV regimens. The profile of patients in the Netherlands infected with HIV is changing, with increasing numbers of older patients with multiple morbidities. These changes mean that, in the near future, HIV care will increasingly need to draw on a wide range of medical disciplines, in addition to evidence-based screening and monitoring protocols to ensure continued high-quality care. These findings are based on a large dataset of HIV-infected patients in the Netherlands, but we believe that the overall patterns will be repeated elsewhere in Europe and North America. The implications of such a trend for care of HIV-infected patients in high-burden countries in Africa could present a particular challenge. Medical Research Council, Bill & Melinda Gates Foundation, Rush Foundation, and Netherlands Ministry of Health, Welfare and Sport.