A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world's population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs). It has been estimated that TBI costs the global economy approximately $US400 billion annually. Deficiencies in prevention, care, and research urgently need to be addressed to reduce the huge burden and societal costs of TBI. This Commission highlights priorities and provides expert recommendations for all stakeholders—policy makers, funders, health-care professionals, researchers, and patient representatives—on clinical and research strategies to reduce this growing public health problem and improve the lives of people with TBI.Additional co-authors: Endre Czeiter, Marek Czosnyka, Ramon Diaz-Arrastia, Jens P Dreier, Ann-Christine Duhaime, Ari Ercole, Thomas A van Essen, Valery L Feigin, Guoyi Gao, Joseph Giacino, Laura E Gonzalez-Lara, Russell L Gruen, Deepak Gupta, Jed A Hartings, Sean Hill, Ji-yao Jiang, Naomi Ketharanathan, Erwin J O Kompanje, Linda Lanyon, Steven Laureys, Fiona Lecky, Harvey Levin, Hester F Lingsma, Marc Maegele, Marek Majdan, Geoffrey Manley, Jill Marsteller, Luciana Mascia, Charles McFadyen, Stefania Mondello, Virginia Newcombe, Aarno Palotie, Paul M Parizel, Wilco Peul, James Piercy, Suzanne Polinder, Louis Puybasset, Todd E Rasmussen, Rolf Rossaint, Peter Smielewski, Jeannette Söderberg, Simon J Stanworth, Murray B Stein, Nicole von Steinbüchel, William Stewart, Ewout W Steyerberg, Nino Stocchetti, Anneliese Synnot, Braden Te Ao, Olli Tenovuo, Alice Theadom, Dick Tibboel, Walter Videtta, Kevin K W Wang, W Huw Williams, Kristine Yaffe for the InTBIR Participants and Investigator

Species distribution models (SDMs) are increasingly proposed to support conservation decision making. However, evidence of SDMs supporting solutions for on-ground conservation problems is still scarce in the scientific literature. Here, we show that successful examples exist but are still largely hidden in the grey literature, and thus less accessible for analysis and learning. Furthermore, the decision framework within which SDMs are used is rarely made explicit. Using case studies from biological invasions, identification of critical habitats, reserve selection and translocation of endangered species, we propose that SDMs may be tailored to suit a range of decision-making contexts when used within a structured and transparent decision-making process. To construct appropriate SDMs to more effectively guide conservation actions, modellers need to better understand the decision process, and decision makers need to provide feedback to modellers regarding the actual use of SDMs to support conservation decisions. This could be facilitated by individuals or institutions playing the role of ‘translators’ between modellers and decision makers. We encourage species distribution modellers to get involved in real decision-making processes that will benefit from their technical input; this strategy has the potential to better bridge theory and practice, and contribute to improve both scientific knowledge and conservation outcomes.

A common feature of ecological data sets is their tendency to contain many zero values. Statistical inference based on such data are likely to be inefficient or wrong unless careful thought is given to how these zeros arose and how best to model them. In this paper, we propose a framework for understanding how zero-inflated data sets originate and deciding how best to model them. We define and classify the different kinds of zeros that occur in ecological data and describe how they arise: either from Ôtrue zeroÕ or Ôfalse zeroÕ observations. After reviewing recent developments in modelling zero-inflated data sets, we use practical examples to demonstrate how failing to account for the source of zero inflation can reduce our ability to detect relationships in ecological data and at worst lead to incorrect inference. The adoption of methods that explicitly model the sources of zero observations will sharpen insights and improve the robustness of ecological analyses.

Climate change and habitat loss are both key threatening processes driving the global loss in biodiversity. Yet little is known about their synergistic effects on biological populations due to the complexity underlying both processes. If the combined effects of habitat loss and climate change are greater than the effects of each threat individually, current conservation management strategies may be inefficient and at worst ineffective. Therefore, there is a pressing need to identify whether interacting effects between climate change and habitat loss exist and, if so, quantify the magnitude of their impact. In this paper, we present a metaanalysis of studies that quantify the effect of habitat loss on biological populations and examine whether the magnitude of these effects depends on current climatic conditions and historical rates of climate change. We examined 1,319 papers on habitat loss and fragmentation, identified from the past 20 years, representing a range of taxa, landscapes, land-uses, geographic locations and climatic conditions. We find that current climate and climate change are important factors determining the negative effects of habitat loss on species density and/or diversity. The most important determinant of habitat loss and fragmentation effects, averaged across species and geographic regions, was current maximum temperature, with mean precipitation change over the last 100 years of secondary importance. Habitat loss and fragmentation effects were greatest in areas with high maximum temperatures. Conversely, they were lowest in areas where average rainfall has increased over time. To our knowledge, this is the first study to conduct a global terrestrial analysis of existing data to quantify and test for interacting effects between current climate, climatic change and habitat loss on biological populations. Understanding the synergistic effects between climate change and other threatening processes has critical implications for our ability to support and incorporate climate change adaptation measures into policy development and management response.

In November 2017, the Lancet Neurology Commission on Traumatic Brain Injury (TBI) highlighted existing deficiencies in epidemiology, patient characterization, identifying best practice, outcome assessment, and evidence generation. The Commission concluded that C needed to address deficiencies in prevention , and made a recommendation for large collaborative studies which could provide the framework for precision medicine and comparative effectiveness research (CER).

In a review of landscape-scale empirical studies, Fahrig (2017a) found that ecological responses to habitat fragmentation per se (fragmentation independent of habitat amount) were usually non-significant (> 70% of responses) and that 76% of significant relationships were positive, with species abundance, occurrence, richness, and other response variables increasing with habitat fragmentation per se. Fahrig concluded that to date there is no empirical evidence supporting the widespread assumption that a group of small habitat patches generally has lower ecological value than large patches of the same total area. Fletcher et al.(2018) dispute this conclusion, arguing that the literature to date indicates generally negative ecological effects of habitat fragmentation per se. They base their argument largely on extrapolation from patchscale patterns and mechanisms (effects of patch size and isolation, and edge effects) to landscape-scale effects of habitat fragmentation. We argue that such extrapolation is unreliable because: (1) it ignores other mechanisms, especially those acting at landscape scales (e.g., increased habitat diversity, spreading of risk, landscape complementation) that can counteract effects of the documented patch-scale mechanisms; and (2) extrapolation of a small-scale mechanism to a large-scale pattern is not evidence of that pattern but, rather a prediction that must be tested at the larger scale. Such tests were the subject of Fahrig's review. We find no support for Fletcher et al.'s claim that biases in Fahrig's review would alter its conclusions. We encourage further landscape-scale empirical studies of effects of habitat fragmentation per se, and research aimed at uncovering the mechanisms that underlie positive fragmentation effects.

14Landscape structure and fragmentation have important effects on ecosystem 15 services, with a common assumption that fragmentation reduces service 16 provision. This is based on fragmentation's expected effects on ecosystem 17 service supply, but ignores how fragmentation influences the flow of services to 18 people. Here, we develop a new conceptual framework that explicitly considers 19 the links between landscape fragmentation, the supply of services, and the flow 20 of services to people. We argue that fragmentation's effects on ecosystem service 21 flow can actually be positive or negative and use our framework to construct 22 testable hypotheses about the effects of fragmentation on final ecosystem service 23 provision. Empirical efforts to apply and test this framework are critical to 24 improve landscape management for multiple ecosystem services. Humans continue to heavily modify natural ecosystems around the world, 31 with negative consequences for biodiversity (see Glossary) and natural capital 32 [1,2]. At the same time, demand for ecosystems to provide benefits, or services, 33 to society is growing rapidly [3]. This has significantly increased the need to 34 understand and manage landscapes simultaneously for ecosystem services and 35 biodiversity. Recently, the potential of managing landscape structure [4][5][6], and 36 in particular landscape fragmentation [7,8], for these multiple goals has been 37 highlighted. Interest in landscape fragmentation -the breaking apart of areas of 38 natural land cover into smaller pieces independent of a change in the amount of 39 natural land cover -has a long history in ecology [9]. Consequently, a well-40 developed understanding exists of its effects on biodiversity and ecosystem 41 functioning [10]. However, the shift in research interest from biodiversity 42 towards the concept of ecosystem services has recast what before were solely 43 ecological questions into social-ecological ones [11][12][13]. This recasting means 44 that predictions about the ecological effects of landscape fragmentation on 45 biodiversity and ecosystem functioning are unlikely to translate directly into 46 ecosystem service provision. This will be especially true if fragmentation has 47 contrasting effects on people and how they interact with ecosystems to produce 48 ecosystem services compared to biodiversity and ecosystem functioning. It is 49 therefore critical to rethink how fragmentation alters all of the components of 50 ecosystem service provision in order to improve landscape management for 51 multiple services. 52 4 Ecosystem service provision depends on three elements: supply, demand, 53 and flow (Figure 1), each of which can respond differently to landscape 54 fragmentation. Ecosystem service supply is the potential for natural capital to 55 generate a benefit for people, irrespective of it being realized or used [14]. In 56 turn, ecosystem service demand is the level of service provision desired or 57 required by people, and is influenced by human needs, values, ...

ABSTRACT. Many protected areas (PAs) have followed the conventional and exclusionary approach applied at Yellowstone in 1872. As such, many parks have failed to fully integrate other important factors, such as social, cultural, and political issues. In some cases, this has triggered adverse social impacts on local communities, disrupting their traditional ways of living and limiting their control of and access to natural resources. Such an outcome can undermine protection policies through conflicts between park managers and local communities. The success of conservation strategies through protected areas may lie in the ability of managers to reconcile biodiversity conservation goals with social and economic issues and to promote greater compliance of local communities with PA conservation strategies. However, there are very few quantitative studies identifying what the key factors are that lead to better compliance with PA conservation policies. To address this issue, we conducted a meta-analysis of 55 published case studies from developing countries to determine whether the level of compliance of local communities with PA regulations was related to: (1) PA age, (2) PA area, (3) the existence of a buffer zone, (4) the level of protection as defined by IUCN categories, (5) gross domestic product per capita, (6) population density in the vicinity of PAs, and (7) the level of local community participation in PA management. We found that local community participation in the PA decision-making process was the only variable that was significantly related to the level of compliance with PA polices. In general, the higher the level of participation, the higher the level of compliance. This has important implications for PA management and suggests that greater inclusion of local communities in management should be a key strategy for ensuring the integrity of PAs.