The development of buildings and other infrastructure in cities is viewed as a threat to local biodiversity and ecosystem functioning because natural habitat is replaced. However, there is momentum for implementing green infrastructure (GI), such as green roofs, wetland detention basins and community gardens, that partially offset these impacts and that benefit human health. GI is often designed to explicitly support ecosystem services, including implied benefits to biodiversity. The effects of GI on biodiversity have been rarely quantified, but research on this topic has increased exponentially in the last decade and a synthesis of the literature is needed. Here, we examined 1,883 published manuscripts and conducted a meta‐analysis on 33 studies that were relevant. We determined whether GI provides additional benefits to biodiversity over conventional infrastructure or natural counterparts. We also highlighted research gaps and identified opportunities to improve future applications. We determined that GI significantly improves biodiversity over conventional infrastructure equivalents, and that in some cases GI had comparable measures of biodiversity to natural counterparts. Many studies were omitted from these analyses because we found GI research has generally neglected conventional experimental design frameworks, including controls, replication or adequate sampling effort. Synthesis and applications. Our synthesis identified that taxa specificity is an important consideration for green infrastructure (GI) design relative to the more common measurements at the community level. We also identified that ignoring multi‐trophic interactions and landscape‐level patterns can limit our understanding of GI effects on biodiversity. We recommend further examination of species‐specific differences among infrastructures (i.e. green, conventional or natural equivalents) or using functional traits to improve the efficacy of GI implementation on urban biodiversity. Furthermore, we encourage policy makers and practitioners to improve the design of GI to benefit urban ecosystems because of the potential benefits for both humans and global biodiversity.

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IMPORTANCEOveractivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.ObjectiveTo determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.DESIGN, SETTING, AND PARTICIPANTSIn 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).INTERVENTIONSPatients 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 MEASURESThe 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.RESULTSOn 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 RELEVANCEIn 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 REGISTRATIONClinicalTrials.gov Identifier: NCT02735707

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1. Invasive alien plant species (IAPs) in urban areas can have detrimental effects on biodiversity, ecosystem services and human well-being. Urban areas are complex social management mosaics with high land-use diversity, complex land tenure patterns and many different stakeholder groups, some of which derive benefits from invading species. Urban conservation practitioners face complex decisions about which IAPs require management. Yet most IAPs prioritization frameworks have been designed for and implemented in natural or rural areas and are generally inadequate for guiding effective and sustainable interventions in urbanized areas.2. We modified an existing prioritization scheme to develop a framework for prioritizing terrestrial IAPs in urban areas which applies evidence-based (data-driven) and stakeholder-based (local knowledge) assessments to score and rank alien plant species in terms of their priority for management using an objective set of criteria.3. The framework consists of 46 criteria, grouped into eight modules which assess invasion status, habitat requirements, biological characteristics, dispersal ability, distribution, impacts (positive and negative) and potential for control for each alien plant species under consideration. 4. We use the city of Toronto, Canada as a case study to test our framework-a list of 50 IAPs were effectively scored and ranked in order of high to low priority for control. Species with the highest total prioritization scores were Vincetoxicum rossicum (Dog Strangling Vine), Convolvulus arvensis (Field Bindweed) and Taraxacum officinale (Common Dandelion, ranked 1, 2 and 3 respectively).5. Many of the identified high priority species align with those previously flagged as of management concern by conservation practitioners, but also include those that are not actively managed due to their perceived lower ecological impacts.These species still require high resource investment for other objectives such as aesthetics. This highlights the complexity of alien plant species management in urban areas.6. Synthesis and applications. Prioritizing invasive alien plants for management in urban areas is particularly challenging due to often conflicting ecological, economic and social objectives. We use available evidence and local stakeholder knowledge to develop an objective and systematic prioritization tool which can | 873