Interprofessional education in pharmacy: Bridging collaborative competence and clinical impact.

Anterior cruciate ligament injuries are debilitating, often requiring surgical reconstruction and prolonged recovery. Female adolescent athletes are at particularly high risk for anterior cruciate ligament injury and display distinct neuromuscular control patterns during jump landing that further increase injury risk. Neuromuscular training (NMT) designed to reduce injury risk can be enhanced with automated movement corrective biofeedback to improve neuromuscular control and landing biomechanics; however, the central nervous system responses to targeted NMT that underlie adaptive biomechanical responses are not well-understood. This study aimed to identify the effects of NMT on landing biomechanics and task-related brain activity, examine the relationship of changes in these variables, and determine if additive visual biofeedback (augmented versus sham) provides a meaningful impact on injury-related outcomes. This study included 55 female middle- and high-school athletes (age mean = 15.73 ± 1.40 yr) who participated in ~6 wk of NMT (3×/wk; 18 sessions), which included up to 12 sessions of additive biofeedback (augmented: n = 28; sham: n = 27). Testing at pre- and post-NMT included a drop vertical jump task to assess landing biomechanics (sagittal and frontal plane hip and knee kinematics and kinetics) and a supine bilateral leg press task during functional magnetic resonance imaging to assess brain activity during a complex sensorimotor movement task. NMT improved landing biomechanics (η 2 range = 0.04-0.41, P s < 0.049) and reduced task-related brain activity in sensorimotor regions ( Prange = 0.015-0.032). Pre-post increases in postcentral gyrus brain activity predicted a reduction in left knee peak abduction moment (odds ratio = 22.61, 95% confidence interval [2.41, 212.21], P = 0.048). Additive biofeedback did not appear to influence outcomes of interest. NMT improved sensorimotor efficiency and landing biomechanics. However, increased somatosensory activity emerged as a critical predictor of improved landing patterns, highlighting the role of enhanced sensory processing in biomechanical risk-reduction.

Social Determinants of Health: Unique Considerations in Transitions of Care.

This study investigates pharmacogenetic determinants of pitavastatin disposition using a candidate-gene approach. In 48 healthy volunteers, 138 variants across 40 genes involved in drug metabolism and transport were analysed to assess their relationship with pitavastatin pharmacokinetics, alongside the influence of sex and biogeographical origin. Women exhibited 35% higher AUC and Cmax values than men; however, these differences disappeared after adjusting for the dose/weight (DW) ratio, with only a 22% increase in t1/2 remaining. The most prominent finding was the 50%-65% increase in AUC/DW and Cmax/DW observed in decreased function (DF) individuals compared with increased function (IF) and normal function (NF) carriers of SLCO1B1 phenotype, reinforcing its role as the primary hepatic uptake transporter for pitavastatin. Additional variants in efflux transporters such as ABCB1, ABCC3 and ABCG2 may also contribute to interindividual variability, albeit to a lesser extent. Among drug-metabolising enzymes, CYP4F2 emerged as a candidate for further investigation, given the 36% reduction in AUC48h/DW associated with the rs3093200 variant. No significant associations were detected for CYP2D6 or CYP2C9 genes. Evidence to date does not indicate a meaningful impact of UGT enzymes on pitavastatin pharmacokinetics. Overall, these findings highlight several genetic factors that may modulate pitavastatin disposition, warranting confirmation through functional studies or larger population cohorts.

Artificial intelligence (AI) applications in neurology have reached an inflection point. Despite US Food and Drug Administration approval of numerous algorithms in neuroimaging, neurophysiology, genetics and chatbots, their real-world impact remains limited. This disconnect between research promise and clinical reality represents a gap in understanding how to translate AI algorithms into clinical benefit for patients globally. In this Perspective, we examine the challenges that prevent clinical AI use in neurology moving beyond pilot studies towards meaningful clinical impact. We consider the steps required in the process of translation, including research, validation of AI models, regulatory approval pathways and clinical implementation. We discuss implementation of AI models as stand-alone products versus embedded platforms, and the requirements for sustainable deployment. Beyond traditional clinical decision support tools, we examine paraclinical applications of AI, including chatbots and ambient voice documentation. We recommend expanding capacity for prospective validation and scaling by implementing and validating technologies across multiple sites and countries, which requires infrastructure from long-term partnerships. Neurology must shift from asking whether AI can work to understanding how to use it safely at scale.

Open cranial biopsy is reserved for patients with progressive nonneoplastic neurological conditions of unknown etiology who have failed exhaustive noninvasive evaluation, raising questions regarding its diagnostic yield, clinical utility, and risk profile. To characterize the diagnostic yield, treatment impact, and procedural risk of open cranial biopsy in a contemporary cohort of diagnostically refractory patients with nonneoplastic neurological conditions. We performed a single-institution retrospective cohort study of patients undergoing open cranial biopsy for nonneoplastic undiagnosed neurological conditions (August 2016-July 2021). Primary outcomes were diagnostic yield, treatment alteration, and complication rate, reported with exact binomial 95% confidence intervals. Twenty-one patients (mean age, 54.3 years; 52% male) met the inclusion criteria. The definitive diagnostic yield was 23.8% (5/21; 95% CI 8.2%-47.2%); including suggestive findings, the informative yield was 52.4% (11/21; 95% CI 29.8%-74.3%). Treatment alteration occurred in 23.8% (5/21; 95% CI 8.2%-47.2%), including cases with nondiagnostic or suggestive results. The most common diagnoses were vasculitis and cerebral amyloid angiopathy. Three patients (14.3%; 95% CI 3.0%-36.3%) experienced fatal biopsy-attributable complications, all in patients with advanced comorbidity. No significant differences were observed between targeted and non-targeted approaches. Open cranial biopsy demonstrates limited definitive diagnostic yield but meaningful clinical impact in a subset of patients, highlighting a disconnect between histopathological diagnosis and therapeutic decision-making. Complication rates reflect patient severity rather than procedural risk. Careful multidisciplinary patient selection and preference for targeted biopsy when feasible are essential.

Agricultural training programs are widely recognized as essential instruments for improving farmers' knowledge, skills, and productivity in developing countries. This study aimed to examine the impact of training programs on apple farmers' income in Maidan Wardak Province, Afghanistan. A purposive sampling design was employed, and primary data were collected from 30 apple farmers in Sayedabad District. Structured interview schedules were used to capture socio-economic characteristics, input use, crop costs, and returns both before and after training participation. Descriptive statistics and cost-return analysis were applied. Results revealed that the total variable cost of apple cultivation declined from Rs. 3,89,750 per hectare before training to Rs. 3,64,328 after training, primarily due to reduced chemical fertilizer and plant protection chemical use. Net returns increased significantly from Rs. 2,62,846 to Rs. 3,92,441 per hectare, representing a 49 percent improvement. The benefit-cost ratio improved from 1.55 to 1.86, and the cost per kilogram of output declined from Rs. 14.24 to Rs. 11.14. The findings confirm that training programs organized by the Ministry of Agriculture, Irrigation and Livestock of Afghanistan in collaboration with the Food and Agriculture Organization had a positive and statistically meaningful impact on production efficiency and farm income. The study recommends scaling up farmer training programs with emphasis on integrated pest management, market-oriented production, and post-harvest handling to maximize long-term income gains.

Malaria remains a major global health burden. Vaccines targeting the Circumsporozoite protein represent a significant advancement in malaria control and have demonstrated meaningful public health impact. However, no validated correlate of protection has yet been established, making it critical to assess antibody functionality alongside antigen-specific antibody quantitation to evaluate vaccine candidates. Antibody-dependent phagocytosis is one such mechanism that contributes to parasite clearance, which can be modelled using cell lines. While THP-1 (monocyte-like) assays have been described, HL-60 (neutrophil-like) models are less established in the malaria field. Here, we aimed to develop and characterize a PfCSP repeat region (NANP6) bead-based opsonophagocytic assay using differentiated HL-60 cells, to adapt a THP-1 assay, and to assess IgG subclass- and FcγR-dependent differences between these in vitro models. Ultimately, our goal is to demonstrate the potential application of these assays for exploratory assessment of human clinical samples. Fluorescent NANP6-coated beads were opsonized with recombinant IgG1-2-3-4 monoclonalantibodies (identical binding domain, different Fc) or human sera from an RTS, S/AS01E trial. Opsonized beads were incubated with model effector cells, phagocytosis was quantified by flow cytometry, and EC50 values were derived using four-parameter logistic regression. FcγR-blocking experiments and assay performance (precision, dilution linearity, sensitivity) were evaluated. Both assays discriminated phagocytic potency across IgG subclasses, revealing that FcγR dependence differs by subclass and between the two cell models. Both assays were successfully adapted to human sera, demonstrating robust performance with high precision, strong dilution linearity, and high sensitivity across samples with varying anti-CSP antibody levels. These characteristics support their suitability for reproducible assessment of functional antibody responses in clinical samples. Two opsonophagocytic assays recapitulating monocyte-like and neutrophil-like effector pathways were developed and characterized. Both demonstrated precise, sensitive, and quantitative measurement of antibody-dependent phagocytosis in human sera, while capturing distinct functional differences between the models, supporting their use as exploratory tools to evaluate functional antibody responses in clinical samples.

Phenylephrine is widely used for pharmacological mydriasis in routine ophthalmic practice. While its vascular and pupillary effects are well established, its influence on anterior segment structures and intraocular inflammatory parameters remains unclear. This study aimed to evaluate the effects of topical phenylephrine on anterior scleral thickness (AST) and aqueous humor flare levels in healthy eyes. This prospective study included the right eyes of 20 healthy volunteers. Topical phenylephrine 2.5% was administered three times at 5-minute intervals. Measurements were obtained 45min after the final instillation. Nasal and temporal AST were measured at the scleral spur (AST-0) and at 1000μm (AST-1) and 2000μm (AST-2) posterior to the scleral spur using anterior segment optical coherence tomography. Aqueous flare levels were assessed using laser flare photometry. Fellow untreated eyes served as controls. At the scleral spur level (AST-0), scleral thickness increased significantly in both nasal and temporal regions following phenylephrine administration (p = 0.0003 and p = 0.01, respectively). At 1000μm posterior to the scleral spur, temporal AST decreased significantly (p = 0.005), while other changes in AST-1 and AST-2 were not statistically significant. Aqueous flare levels showed an increase after phenylephrine instillation; however, this change was not statistically significant (p = 0.2). No significant changes were observed in the fellow control eyes. Topical phenylephrine was associated with localized changes in anterior scleral thickness, characterized by thickening at the scleral spur and relative thinning posteriorly. Although aqueous flare levels tended to increase, this effect was not statistically significant and likely reflects a minimal effect size. These findings suggest that phenylephrine may be associated with alterations in scleral configuration without a clinically meaningful impact on intraocular inflammatory status in healthy eyes.

HealthySteps Comprehensive Services and Preventive Care: A Medicaid Claims Analysis.

The Radiation Oncology-Biology Integration Network (ROBIN) initiative addresses critical gaps in radiation oncology by integrating advanced biological research, technological innovation, and clinical practice. ROBIN leverages “omics” technologies, data science, and integrative analyses to elucidate the mechanisms governing tumor and normal tissue responses to radiation therapy (RT). Through five specialized centers – OligoMET, ImmunoRad, GenRad, METEOR, and KIDSROBIN – the network covers a broad spectrum of cancer and radiation biology research. Each center conducts translational programs linked to clinical trials, targeting key domains including metastasis biology, RT-immune system interactions, and genomic determinants of treatment response. KIDSROBIN assures the invaluable inclusion of pediatric cancers to the consortium. By collecting clinically annotated human biospecimens and applying single-cell and spatially resolved omics, ROBIN enables mechanistic insights into radiation effects directly in patients. A central pillar of the initiative is its commitment to data standardization and sharing, using cloud-based platforms to generate accessible and interoperable datasets. ROBIN also prioritizes education and cross-disciplinary training to cultivate the next generation of scientists in radiation biology and oncology. This integrated approach positions ROBIN to drive transformative advances in radiation oncology and multimodal cancer therapy, informing personalized treatment strategies and improving patient outcomes.This review provides an overview of the ROBIN program and its key strategies, research activities, and contributions to advancing radiation biology and oncology. The vision and leadership of Dr. Norman Coleman have been foundational to the development of the ROBIN initiative, inspiring a collaborative ecosystem that bridges science and clinical practice to drive meaningful impact in patient care.

Medical education increasingly acknowledges the importance of well-being, yet prevailing frameworks often remain tethered to transactional logics that contribute to burnout, moral injury, and fragmented physician formation. Many existing approaches rely on psychological constructs or organizational interventions without offering a coherent account of the human condition or the formative processes through which professional identity develops. By contrast, critical medical humanities scholarship emphasizes that flourishing and formation are inseparable from the narratives, practices, and moral ecologies that shape professional life. This article develops an analytic model of flourishing grounded in theological anthropology as a wisdom tradition. Using interpretive analysis of exemplary biblical texts, lexical patterns, and narrative design motifs, we examine how formation processes give rise to divergent developmental trajectories of human flourishing or distortion. Psalm 1 serves as a paradigmatic Old Testament text, articulating pathways of narrative alignment, communal practice, and embodied identity as foundations of flourishing outcomes. These texts also illuminate the formative role of testing and agreement structures. We then describe the Eden-Exile pattern as a central biblical archetype for interpreting formation within systems that generate counter-flourishing, instrumentalized flourishing, or human flourishing. These dynamics are further extended through parallel analysis of the Beatitudes as a paradigmatic New Testament text. We translate these insights into a conceptual model of formation spaces shaped by agreement structures and oriented along a flourishing continuum defined by agency, trust, and meaningful impact. Formation spaces are emergent, dynamic attractor states within a formation ecosystem. We argue that medical education environments inevitably embody underlying assumptions about the human person and the good life; clarifying these assumptions is therefore essential for aligning physician formation with human flourishing in pluralistic contexts. By situating biblical theology as one interpretive tradition among others, this study contributes to transdisciplinary conversations in critical medical humanities and offers a framework for reimagining the conditions under which future physicians may be formed to flourish.

Multiple myeloma (MM) remains an aggressive and largely incurable plasma cell malignancy, with relapse common despite therapeutic advances. Although CAR-T cells have transformed the field, their clinical use is constrained by toxicity, complex manufacturing, and limited accessibility. These limitations have accelerated interest in CAR-engineered natural killer (CAR-NK) cells as a safer, more scalable, and potentially off-the-shelf immunotherapeutic platform. This review goes beyond a descriptive summary of CAR-NK research in MM by providing an integrated framework that connects antigen targeting, synthetic engineering, tumor microenvironment adaptation, biomarker-guided response monitoring, and translational manufacturing barriers. In doing so, it highlights not only what has been achieved, but also what currently limits clinical implementation and where the field is most likely to advance next. We performed a comprehensive literature analysis of preclinical and clinical studies on CAR-NK cell therapy in MM, focusing on target selection, persistence-enhancing strategies, immune evasion, biomarker development, combination approaches, and GMP-compatible manufacturing platforms. CAR-NK cells offer several advantages over CAR-T therapy, including lower risks of cytokine release syndrome, neurotoxicity, and graft-versus-host disease. Beyond summarizing currently explored targets such as BCMA, CD138, SLAMF7, and GPRC5D, this review identifies the main design principles driving next-generation CAR-NK development: cytokine armoring, genome editing, dual-targeting strategies, and nanotechnology-enabled delivery. Importantly, we also synthesize emerging translational priorities, including predictive biomarkers for patient stratification, serial monitoring of treatment response, and scalable closed-system manufacturing approaches that may determine clinical feasibility. CAR-NK therapy is evolving from a promising concept into a realistic therapeutic platform for MM. This review contributes a forward-looking translational roadmap by integrating engineering innovation, biomarker-based precision medicine, and manufacturing scalability, thereby defining the key steps needed to move CAR-NK cells toward durable and clinically meaningful impact in refractory MM.

ABSTRACT Australian Acacia species are invasive in South Africa and traditionally controlled through felling followed by herbicide application to the stumps. In some instances, a cleared area is burnt or felled, and biomass is removed where affordable. Seed-attacking biological control agents have been released against these Acacia species to reduce spread. Here, we studied the changes in the abundance of Acacia saligna (Labill.) H. L. Wendl. (Fabaceae) and Acacia cyclops A. Cunn. ex G. Don (Fabaceae), in the presence of biological control, to assess whether investments made in the development of the biological control agents contributed to conventional control. Biological control had no meaningful impact in the short-term (up to six years) and resulted in no material cost reductions in other control interventions over this period. However, for the medium-term (up to 12 years), substantial cost reductions in alternative control methods were recorded. Considering the 12-year assessment period, the most realistic estimated savings per hectare of land treated amounted to USD304. Savings were higher (USD322) where both burn scars and areas with evidence of biomass removal were included. For the long-term (22 years), the impact of biological control was substantial, with the cost of control being reduced by between USD831 and USD827/ha for two scenarios using the Le Maitre (1998. An analysis of invasion processes and risks and a strategy for modelling invasions by alien plant species at a national and regional scale. Appendix 7. In D. B. Versfeld, D. C. Le Maitre, & R. A. Chapman (Eds.), Alien invading plants and water resources in South Africa: A preliminary assessment. Report TT99/98. Water Research Commission) and Higgins et al. (2000. Using a dynamic landscape model for planning the management of alien plant invasions. Ecological Applications, 10(6), 1833–1848) models as benchmarks. Biological control of these two Acacia species contributed materially to reducing the cost of conventional control methods, but this saving was realised in the medium to long-term.

Recessive Dystrophic Epidermolysis Bullosa (RDEB) is a rare genetic skin condition causing fragile skin, blistering, and scarring. It leads to chronic pain, slow wound healing, and severe limitations, profoundly impacting patient and family quality of life. Umbilical cord tissue-derived mesenchymal stromal cells (UC-MSC) have shown therapeutic promise. The Mission EB trial (ISRCTN14409785; registration date 25/03/2021) assessed UC-MSC safety and effectiveness in children with RDEB in a placebo-controlled, double-blinded, crossover study. This study used a qualitative research design with semi-structured interviews and thematic analysis, to explore Mission EB trial treatment impact on the quality of life of patients and parents. Parents and patients were interviewed at two time points (approximately 3- and 12-months post-randomisation). Purposive sampling included 10 parents and 6 children; 13 individuals (8 adults, 5 children) were interviewed twice (once in each study period). Interviews were transcribed verbatim, independently coded, with overall impressions agreed upon prior to unblinding. RDEB significantly impacted daily life, marked by pain and itch. Participants were hopeful of the trial, willing to pursue minor improvements. UC-MSC infusions led to reduced pain/itchiness, improved wound healing, and resulted in fewer self-reported dressing changes. These benefits often translated to increased energy, improved eating, and greater daily activity participation. Benefits were more pronounced with active treatment. Negative effects were minimal, primarily venous access difficulties. Blinded participants could discern active UC-MSC from placebo based on symptom changes; 10 of 13 showed clear differences aligning with treatment. All parents interviewed expressed willingness for their child to receive treatment again. This qualitative research provides valuable insights into perceived benefits of UC-MSC treatment for children with RDEB. Interview findings regarding symptom improvement and participants' ability to discern active treatment shed light on its perceived benefit in RDEB, especially in milder RDEB patients. The study highlights the critical importance of qualitative methodologies in adding to quantitative trial outcomes and capturing the meaningful impact of interventions on the lives of patients and families particularly where quantitative measures may not fully reflect lived experience.

Despite rapid growth, digital mental health tools rarely deliver meaningful clinical impact. Psychiatrists' attitudes to technology and private-industry partnerships are key. To embed safe, effective technologies into real-world psychiatric care, a shift from proliferation to precision is required. Co-production, equity, implementation science and academia-industry-clinical partnerships need emphasis.

Femoral artery collapse ratio as a real-time physiologic marker of cardiopulmonary resuscitation quality: A case series.

Although immune checkpoint inhibitors (ICIs) and targeted therapies (TTs) have transformed the treatment of non-small cell lung cancer (NSCLC) across disease stages, real-world access remains highly unequal worldwide. Persistent cost barriers, fragmented reimbursement frameworks, and heterogeneous regulatory pathways limit equitable availability. The rapid proliferation of me-too agents has been proposed to counter monopolies; yet, this expansion has not consistently improved affordability. Heterogeneous evidentiary requirements-along with differences in clinical end points, comparator selection, crossover policies, and treatment duration-fragment therapeutic markets and complicate assessment of incremental clinical benefit. Divergent regulatory decisions, particularly between the US Food and Drug Administration and European Medicines Agency, underscore how trial design and geographic representation influence drug availability, especially when approvals rely on single-country data sets. These challenges are amplified in perioperative treatment strategies and rare oncogene-defined subgroups, where feasibility constraints and limited clinical equipoise hinder large randomized trials. As a result, an increasingly crowded therapeutic landscape makes cross-trial comparisons difficult and allows disparities in patient access to persist despite multiple approved therapies. Dose selection has historically followed maximum tolerated dose principles, even when preclinical and pharmacologic data suggest activity plateaus at lower exposure of ICI and TT. Dose and schedule optimization-through reduced dosing, extended intervals, or other deintensified strategies-therefore represents a rational and ethically grounded approach with a meaningful clinical impact. Such strategies may preserve efficacy while improving tolerability, reducing treatment burden, and mitigating financial toxicity, particularly in resource-limited settings. Aligning regulatory frameworks with dose optimization could promote more scalable, equitable, and sustainable NSCLC innovation.

1077 Background: Despite availability of novel endocrine treatment (ET) options for patients with ER+ HER2- ABC, many patients experience early disease progression under 2 nd line ET-based regimen after AI+CDK4/6i, underscoring a significant rate of endocrine resistance. Timely identification of endocrine-refractory disease at progression under 1 st line is critical to optimize treatment selection and consider non-ET strategies, such as antibody-drug conjugates or chemotherapy. FES PET/CT enables a non-invasive, whole-body assessment of ER expression; absent or heterogeneous FES uptake may indicate ER loss or downregulation, key mechanisms of resistance. Our objective was to evaluate the impact of FES PET/CT on 2 nd line treatment decisions. Methods: In this non-randomized prospective multicenter trial (NCT05486182), patients with ER+ HER2- ABC progressing on 1 st line AI+CDK4/6i underwent standard-of-care FDG PET/CT followed by FES PET/CT. Oncologists prospectively documented therapeutic management plans, before and after FES PET/CT. Patients rated pain and apprehension for FES PET/CT vs. biopsy on a Visual Analogue Scale. Primary endpoint was the proportion of patients with a therapeutic management change after FES PET/CT, and primary objective was to demonstrate that at least 10% of patients had their therapeutic management changed after FES PET/CT (Wald test). Results: Of 153 patients enrolled, 129 were evaluable for the primary endpoint. When compared with FDG PET/CT, FES uptake was classified as “all lesions ER+” in 65 (50%), “mixed ER+/- lesions” in 38 (30%), and “all lesions ER-” in 25 (19%) patients. Therapeutic management was changed based on incorporation of FES PET/CT results in 46/129 patients (35.7%; 96% CI [27.0-44.3], p&lt;0.0001), including treatment type (n=38), diagnostic modalities (n=8), and planned follow-up (n=12). Treatment changes mostly consisted of using chemotherapy instead of ET (n=16), ET instead of chemotherapy (n=3), adding targeted therapy to single agent ET (n=2), changing the targeted therapy paired with ET (n=8), adding radiation therapy to disease sites (n=4), and performing surgery (n=2). Oncologist confidence in FES PET/CT was on average 7.8/10 (Q1-Q3: 7-9). Patients reported significantly lower pain and apprehension for FES PET/CT vs. biopsy (Pain: Mean 0.8 vs 4.5; Apprehension: Mean 1.8 vs 5.2; both p&lt;0.0001). Conclusions: ESTROTIMP shows that, at progression under AI+CDK4/6i, ER expression is completely or partially lost in about half of patients with ER+ HER2- ABC. The trial reached its primary endpoint, demonstrating a clinically meaningful impact on therapeutic management, and supporting the use of FES PET/CT as a standard workup at time of progression under 1 st line AI+CDK4/6i. Clinical trial information: NCT05486182 .

Human population growth and changing settlement patterns fuel the development of urban fringe lands worldwide, with implications for biodiversity. We conducted a 12-year study of birds in the fast-developing urban fringe lands of the central Puget Sound region, Washington, USA, to examine the effect of development configuration on birds. We hypothesized that lower-intensity conservation developments, compared to higher-intensity planned community developments, would benefit the overall bird community, as well as native forest birds (avoiders of human development) and avian generalist species (adapters to human development), but that higher-intensity planned community developments would benefit synanthropic species (exploiters of human development). We fit single-species and multi-species occupancy models to test these hypotheses. Consistent with our hypotheses, we found that a greater proportion of the overall community, avoiders, and adapters occupied lower-intensity conservation developments compared to higher-intensity planned community developments. However, we did not detect an effect of development type on the exploiter guild, and we found that species in the exploiter guild are variable in their response to the configuration of suburban developments. We also hypothesized that human tolerance guilds would be a useful predictor of individual species responses to development type. This hypothesis was somewhat supported: we found that, for avoiders, 87% of species in the guild had the same response to development type as the overall guild; for adapters, 63% had the same response as the overall guild, and for exploiters, only 44% had the same response as the overall guild. Our results indicate that the configuration of suburban developments can have a meaningful impact on bird communities, particularly on those species that are most sensitive to any level of development.