Identification of ancient evolutionary lineages and areas of natural admixture between them can have important implications for practical conservation. The island gecko Tarentola boettgeri is threatened by the introduced California king snake (Lampropeltis californiae) within Gran Canaria, Canary Islands. We sampled T. boettgeri from its natural range: Gran Canaria, El Hierro and the Selvagens archipelago. A 1.9 Gb genome was assembled de novo from PacBio HiFi reads. Sequences obtained by genotyping-by-sequencing (GBS) were aligned to this reference and provided over 440 thousand SNPs in 134 geckos from 40 sample sites. Admixture analyses supported five genomic groups within Gran Canaria and two groups from the other islands. Phylogenomic and divergence time analyses of both GBS sequences and SNPs revealed lineage divergence within Gran Canaria, starting 1.5-2.9 Ma, and also between-island divergence due to colonization of both the Selvagens and El Hierro around 1 Ma. Lineage divergence within Gran Canaria was followed by secondary contact and admixture. Clustering and Bayesian multispecies coalescent analyses allowed estimation of admixture between spatially adjacent lineages. As for hybrid zones in other vertebrates, admixture was limited to a few kilometres around contact zones. This spatial limitation is typical in cases of lower relative fitness of hybrids which, in turn, suggests that the genomic integrity of the five Gran Canarian lineages should be conserved. We therefore argue that our identification and designation of sites/areas with no admixture should form the basis for practical conservation actions, including locations of snake exclusion areas and sampling for ex situ captive breeding.

Parasites are expected to hybridise in similar ways to free living organisms, although this may be modified by their reduced genome architecture. Recombinant strains and taxa of hybrid origin can be studied in nature where hosts come into secondary contact. Here we apply genome-wide analysis to parasites from a contact previously characterised for many individuals using classical markers. The host contact is the European house mouse hybrid zone; the parasites are lung fungus Pneumocystis and gut pinworm Syphacia. The multilocus and multi-individual datasets are broadly consistent in scale and centering. Whole mitogenome comparisons confirm earlier suggestions that parasite divergence is low compared to their hosts, perhaps due to reduced genome stabilising selection. In the recombining genome we are able to show blocks of parasite genome of alternating host origin, including one Pneumocystis strain which appears to be an F3+ cross and one recombinant Syphacia strain found over multiple localities. Functional analyses of introgressing genes show enrichment for genes likely important for parasitic lifestyle.

Integrating diverse biological features such as formativeness of topological properties and gene expression presents a significant challenge due to the complexity of determining each feature's individual contribution to predictive models. Ensuring the outcomes reflect the underlying biological structure of the information within the network, while noise and irrelevant data are at a minimum, is crucial. This study identifies the importance of rigorous pre-analyses to determine statistically significant correlations and joint effects among the pre-process features before the application of machine learning techniques. Using multidimensional datasets, we propose a systematic multi-feature framework that combines optimization graph clustering, weighted Jaccard Similarity, and PCA-based dimensionality reduction to uncover previously uncharacterized gene associations in complex biological systems. The network-based framework has employed graph clustering internally for the efficacious allotment of research resource by identification of genes with significant changes in certain community contexts. Moreover, it provides more in-depth insights into how genes interact in their communities, highlighting patterns and relationships that may be obscured in holistic data analyses. The effectiveness of the proposed approach was validated using the benchmark dataset from the DREAM5 challenge project, illustrating its power in analyzing complex biological networks.

Environmental stressors significantly influence molecular pathways underlying behavioral adaptations in animals. In this study, we integrated game theory and molecular biology to explain molecular interactions regulating mating behavior in guppy fish (Poecilia reticulata), focusing on the expression of androgen receptor (AR) gene, and the melanocortin 4 receptor (MC4r) gene as players. Experimental treatments included varying predator densities (none, low, high) and male competitor intensities (low, high), with gene expression analyzed at four time points (5 minutes, 5 hours, 5 days, and 15 days). MC4r expression showed significant variation at multiple time points post-exposure, with the greatest difference observed 5 hours after exposure to both predator and rival males (P < 0.05). AR gene expression decreased significantly 5 minutes after exposure, especially under high-risk conditions, correlating with reduced reproductive activity (P < 0.05). Subsequently, the Nash equilibrium analysis identified low expression of both genes as the optimal strategy, minimizing energy expenditure under stress. These findings offer novel insights into adaptive molecular responses and propose a framework for integrating game theory into behavioral and ecological studies.

Urban grasslands host important plant biodiversity while offering multiple ecosystem services. These grasslands comprise a multitude of open habitats varying from species-rich semi-natural grasslands to more species-poor recent grasslands. However, they often fail to sustain populations of specialised species. To foster plant biodiversity in urban grasslands, we need to understand how their communities are assembled. Here, we studied 200 urban grasslands in the Helsinki Capital region, Finland. The grasslands represented wide variation in grassland types, productivity, and landscape context. We investigated semi-natural grasslands, landscape grasslands, lawns, and grasslands resulting from deliberate biodiversity actions: reduced management intensity in lawns and the sowing of grassland seed mixtures. We analysed the plant communities, the environmental factors driving them, and the relationships between species niches and traits by using non-metric multidimensional scaling (NMDS) and hierarchical modelling of species communities (HMSC). Species and trait composition varied according to two main gradients: productivity and disturbance, aligning with Grime’s CSR strategies. The productivity gradient divided sites from rocky to dry and mesic grasslands. The disturbance gradient divided sites from ruderal to semi-natural and forest-influenced grasslands. The highest species richness and specialised species were associated with long-term intermediate disturbance and non-extreme productivity, while more ruderal, eutrophicated or barren sites had lower species richness. Biodiversity actions increased species richness as compared to lawns, but often failed to include many of the specialised grassland species. Our results suggest that the wide variation in urban grassland plant communities can be understood through their degree of disturbance and productivity. Moreover, recent grasslands may develop towards semi-natural grasslands under suitable long-term management if productivity is not too high or low, and if dispersal occurs. We conclude that long-term extensive maintenance, reducing nutrients and facilitating dispersal can help in developing species-rich urban grasslands.

Successful sexual reproduction in flowering plants is determined by the quantity and quality of pollen available for pollination. Flower pollen donor interactions, in particular competition between genetically distinct pollen grains, have been shown to play an important role in plant population dynamics by determining genetic diversity and offspring performance. We measured the variation in conspecific pollen donor quantity and reproductive synchrony on individual reproductive success in the self-incompatible cactus Opuntia cantabrigiensis. We found that 1) increasing pollen donor quantity through hand pollination experiments significantly increased fruit and seed production in this species, 2) flowering is highly synchronous and may favor exogenous conspecific pollen flow. Our results indicate that reproductive success of self-incompatible species increases with pollen donor abundance and pollen flow between genetically distinct individuals, thus disruption of pollination services and/or reduced abundance of compatible reproductive individuals may lead to increased pollen limitation and reduced fecundity in a local plant system, together these factors may limit population recruitment and alter long-term population dynamics.

Outdoor stone heritage accounts for a large portion of UNESCO World Heritage Sites and is an essential carrier of the ancient civilization of our society. Unfortunately, they usually suffer from serious biodeterioration by diverse microbial colonizers, especially when the environment is available. As microbial communities evolve with the environment, it is difficult to diagnose the bio-deteriogens and biodeterioration processes accurately. Here, we used an integrative high-throughput sequencing and comparative metabolomic approach to unravel the biodeterioration of the Leizhou Stone Dog monuments. Contrary to our initial hypothesis of congruence between the biodeterioration of the monuments in the same yard, we observed divergent physicochemical features of the sedimentary soils at the bottom of the monuments, highlighting the need for a nuanced framework capturing the keystone microorganism–metabolite interplay. The divergence and similarity of the composition of microbial biofilms colonizing the monuments indicated that photoautotrophic bacteria (e.g., Leptolyngbya, Chroococcidiopsis, and Chloroplast) and nitrifying archaea (e.g., the family Nitrososphaeraceae) and/or bacteria (e.g., Massilia and Bacillus) are the keystone taxa governing the biodeterioration processes. Further, the correlation between the keystone taxa and physicochemical properties confirmed the consistency of the observations of the keystone metabolisms involved in the biodeterioration processes. Our study highlights the necessity of a case-by-case diagnosis of the keystone taxa and metabolisms before any therapy, advancing the conservation science of cultural heritage.

The endocannabinoid system plays a role in sleep-wake regulation. In clinical practice, people with central disorders of hypersomnolence (CDH) frequently report use of cannabis. We compared lifetime and current use of cannabis of people with CDH to the Dutch general population. Additionally, we assessed cannabis use in relation to hypersomnolence symptoms. In total, 76 (out of 88) patients completed the online questionnaire. Lifetime cannabis use (42% vs 23%, p<0.001) and current use (18% vs 4%, p<0.001) were higher in people with CDH compared to the Dutch general population. For 57% of patients currently using cannabis, improvements of at least one symptom was the motivation for use. Out of all study participants, 79% reported cannabis-related effects on a symptom, which were mostly positive (43%), some negative (7%) or mixed effects (29%). This study provides a rationale for future research on the potential benefits of cannabis in CDH.

A document by Sarah Neumann. Click on the document to view its contents.

Currently, limited data are available on the association between psoriasis deterioration and coronavirus disease 2019 (COVID-19) infection in the Chinese population. Our study aims to investigate the correlation between treatment modalities and the state of disease control and exacerbation following COVID-19. We conducted a cross-sectional study based on patients from the psoriasis database of the Chinese Clinical Trial Registry (ChiCTR) between January 16, 2023, and September 20, 2023, collecting clinical characteristics and symptoms associated with COVID-19. A total of 583 patients completed a questionnaire, with 474 (81.3%) reporting COVID-19. Our study indicated that young patients with moderate to severe psoriasis faced a higher risk of experiencing psoriasis deterioration and various dermatological diseases following COVID-19. Laboratory tests conducted during the first wave of the pandemic revealed significantly decreased serum prealbumin levels and GGT levels among psoriasis patients affected by COVID-19. In conclusion, COVID-19 exacerbates the susceptibility of young patients with moderate to severe psoriasis, leading to an increased likelihood of experiencing deterioration and other dermatological conditions following COVID-19. The administration of biologics does not exacerbate the severity of COVID-19 symptoms. Psoriasis confers a protective effect against COVID-19-induced liver damage.

Coatings are often applied in the materials industry to impart hydrophobic properties to the produced materials. Commonly used coatings contain plastics as well as perfluorinated compounds. Coatings based on natural wax, such as rapeseed, soy, palm or beeswax constitute a key bioalternative. Wax is characterised by high hydrophobicity and is also considered biodegradable. Wax coating constitutes a protective layer that undergoes biodegradation after a certain amount of time. This paper presents the results of studies concerning the development of a wax coating characterised by a coarse microstructure that increases the water resistance, and an appropriate susceptibility to biodegradation. It was revealed that all the analysed coatings were susceptible to biodegradation. Palm wax has a significant effect on inhibiting the wax coating biodegradation rate given that its surface undergoes morphic changes due to the influence of biosurfactants secreted by bacteria. This increases the adhesion of organic and inorganic matter particles, and the layer thus established limits the diffusion of oxygen, enzymes and microorganisms to the wax coating.

A document by Jennifer Holbein,. Click on the document to view its contents.

Xylem conduit morphology is shaped by the dual challenges of minimizing hydraulic resistance and preventing conduit wall collapse during vertical sap transport. While hydraulic theories predict that conduits widen from tip to base to minimize resistance, theory has not addressed how collapse prevention influences vertical variation in conduit morphology. Additionally, scaling relationships in roots remain largely unexplored. Here, we evaluate existing theories for conduit diameter scaling and derive new theory for vertical variation in thickness-to-span ratios. We test these theories using a novel bootstrapping approach to minimize sampling biases and analyze a dataset of nearly seven million observations spanning above- and belowground organs from five conifer species. As predicted, conduits widened with distance from the stem tip, with scaling exponents closely aligning with theoretical predictions. Conduits also widened from fine roots to coarse roots, mirroring aboveground patterns. Thickness-to-span ratios increased from base to tip and consistently exceeded the predicted critical collapse limit. These findings reveal how the physics of sap transport shape xylem morphology to balance hydraulic efficiency and structural stability. By combining novel theory, robust statistical methods, and comprehensive data, this study refines scaling predictions and advances understanding of mechanisms shaping xylem anatomy across plant organs.

A document by Bibek Shrestha. Click on the document to view its contents.

Brucellosis is a zoonotic disease that is caused by the species of bacteria, Brucella affecting goats and other livestock, that leads to economic deprivation and the likelihood of human transmission. This study sought to develop a highly sensitive and specific TaqMan® real-time PCR assay integrating hydrolysis probes for multiplex assay to differentiate active Brucella infection from passive shedding in goats targeting specific genes associated with Brucella melitensis. Using discontinuous conserved sequences, primers were designed for B. melitensis genes i.e. omp25, omp31, and IS711 with their compatible fluorescent dyes (Hex, FAM, Texas Red), and quencher molecules (BHQ1, BHQ1, BHQ2) respectively enabling multi-target detection within the same assay. The sensitivity of the multiplex assay for determining the Limit of Detection was evaluated by log 10 serial dilutions of Brucella nucleic acid (DNA, showing the presence of bacteria) and (RNA showing the presence of live bacteria), for each gene and optimized by probe, primer, and template titrations. LOD calculated for DNA was 8.53×10 10 (dil.1) to 8.53×10 7(dil.3) for omp25-HEX, = 1.32×10 11 (dil.1) to 1.32×10 8 (dil.3) for omp31-FAM, 1.08×10 11 (dil.1) to 1.08×10 7 (dil.4) for IS711-Texas Red. The lowest detectable limits were 8.53×10 7 , 1.32×10 8 , and 1.32×10 8 copies, respectively. For RNA (cDNA) LOD calculated was 1.58×10 10 (dil.1) to 1.58×10 7 (dil.3) for omp25-HEX, 2.45×10 10 (dil.1) to 1.8×10 6 (dil.4) for omp31-HEX, 2.0×10 10 (dil.1) to 2.0×10 6 (dil.4) for IS711-Texas Red. The lowest detectable limits were 1.58×10 7, 1.8×10 6 and 2.0×10 6 copies, respectively.LOD calculated from the cloned plasmid (target genes were cloned into pGEM-T Easy vector) was 2.6×10 4, 1.8×10 5 , 1.6×10 4 in simplex qPCR assay and 2.6×10 4, 1.8×10 5 , 1.6×10 5 in multiplex QPCR assay for omp31, omp21, IS711 genes respectively, making it easier to distinguish between animals that are actively shedding and those that are passively releasing non-viable Brucella. The specificity of the assay was confirmed through validation by comparing the nucleic acids from Brucella melitensis culture with Escherichia coli (Gram-negative) and Staphylococcus aureus, (Gram-positive) with the latter generating no specific response. This assay has the potential to supplement epidemiological research to ascertain the true prevalence of Brucella infection in goats. It also shows promise as a replacement for culture-based tests.

Quantifying crop responses to increasing temperatures is critical for predicting the productivity and sustainability of agricultural systems under environmental change. Physiological trait data associated with Rubisco carboxylation ( V cmax) and electron transport ( J max) rates are especially important predictors of crop response to elevated temperatures. However, when generating V cmax and J max data, steady-state methods of gas exchange measurements are time-consuming; thus, non-steady-state methods have been developed to obtain these measurements faster, prospectively allowing for trait data collection of considerably more varieties of crops. Globally important and geographically widespread vineyards are of particular interest due to the high economic value and the susceptibility of these managed systems to climate warming, especially in Canada, where the annual rate of warming far exceeds global averages. In this study, we examined the efficacy of the high-throughput, non-steady-state dynamic assimilation technique (DAT) for obtaining V cmax and J max data from wine grapes. Specifically, we measured V cmax and J max (alongside leaf nitrogen [N] concentrations and leaf mass per unit area [LMA]) across seven of the world’s most common wine grape ( Vitis vinifera L.) varieties, namely, Cabernet franc, Cabernet sauvignon, Merlot, Pinot noir, Riesling, Sauvignon blanc, and Viognier. Our results show that V cmax and J max estimates derived from the DAT were strongly correlated to those obtained through steady-state methods ( r 2=0.748 and 0.908, respectively), and J max did not differ significantly between the two methods. Additionally, leaf N explained 43-46% and 56-58% of the variation in V cmax and J max, respectively, across both methods. Our results suggest the DAT represents a viable tool for rapidly estimating intraspecific variation in important physiological traits and allows for increased replication and the inclusion of additional varieties when evaluating the responses of wine grape and other crops to elevated temperatures.

Objective: To compare childbirth satisfaction and obstetrical outcomes with outpatient versus inpatient induction of labour (IOL). Design: Multicentre, randomised-controlled trial Setting: Eight hospitals in Norway. Population: A total of 283 women scheduled for IOL with single cephalic presentation, ≥ 37 weeks, no previous uterine scar and low risk of complications by predefined criteria, were randomised to outpatient or inpatient setting, after stratification by parity. Methods: All women received 25ug oral misoprostol as primary induction agent, for up to 48 hours/12 tablets. If labour was not established, further IOL with secondary induction agents was continued in hospital for all women. The Childbirth Experience Questionnaire (CEQ) and the Experience with Induction Tool (EXIT) was used to assess childbirth satisfaction. Main outcome measures: Childbirth satisfaction. Secondary outcome measures: Obstetrical outcomes. Results: Of 283 women randomised, 152 women were assigned to outpatient and 131 to inpatient setting. Outpatient IOL resulted in a more positive childbirth experience (mean CEQ-score 3.1 (0.44) vs. 3.0 (0.45), p=0.01 with multiparous women reporting highest satisfaction (mean EXIT-score 3.6 (0.63) vs. 3.3 (0.61), p=0.03 and mean CEQ-score 3.3 (0.39) vs. 3.1 (0.43), p<0.01. In the outpatient group, 101 women (67%) were admitted to hospital due to contractions, 25 (28%) required further IOL. Obstetrical outcomes were alike and there were no cases of hyperstimulation in the latent phase or serious adverse events observed. Conclusion: Outpatient IOL with oral misoprostol resulted in higher childbirth satisfaction with similar obstetrical outcomes compared to inpatient IOL. This method should be an option to selected women.

This paper presents the Enhanced Turbulent Flow of Water-Based Optimization (ETFWO), a novel algorithm designed to enhance energy management in hybrid microgrids. With the increasing global demand for energy and the pressing need to reduce greenhouse gas emissions, hybrid microgrids that integrate renewable energy sources such as solar photovoltaic (PV) and wind power with conventional generators are becoming increasingly vital. The ETFWO algorithm utilizes the chaotic dynamics of turbulent flow to optimize real-time energy production, storage, and consumption, effectively addressing the challenges posed by the intermittent nature of renewable energy sources.

Neural stem cells (NSCs) are primitive cells that are multipotent, undifferentiated, and self-renewable. The discovery of NSCs challenges the long-held belief that neurons, once lost or damaged, cannot be replaced. However, there is a lack of studies identifying NSCs in rodents and humans. This study aims to identify and analyze NSCs, specifically their protein markers and locations in rodents and humans. The study employed a systematic review, conducted according to the PRISMA guidelines. Data were retrieved from databases such as PubMed, Science Direct, and Nature. A total 47 studies were analyzed, highlighting the positive staining of proteins such as Nestin, GFAP, Olig2, DCX, SOX2, SOX9, Ki-67, β-tubulin III, and S100β. These proteins were predominantly located in the inner part of the subventricular zone (SVZ) or subependymal zone (SEZ) along the lateral ventricle walls, as well as the subgranular zone (SGZ) of the hippocampus. In humans, NSC can be detected by analyzing GFAP-positive areas in the SVZ and the hippocampus region of the human brain. NSC-positive markers detected in rodents included Nestin and GFAP, which align with findings in the human brain. Furthermore, the location of NSCs in both rodents and humans predominantly shows positive results in the SVZ along the lateral ventricle walls and SGZ of the dentate gyrus in the hippocampus. This comprehensive analysis provides a foundation for future research and clinical applications.

Reduced vigilance can be captured in measures of attentional lapses in sustained attention tasks, but just how these lapses relate to task-induced fatigue and motivation to maintain optimal performance is unclear. We used the sustained attention to response task (SART) to induce fatigue, and manipulated motivation levels for the last block of the task in young and older participants (N = 34), while recording EEG to track electrophysiological markers of vigilance change, motivation and fatigue. Despite significant increases in subjective fatigue and mind wandering over 45 minutes, no vigilance decline in the task was observed. However, the age groups differed markedly in their response strategies from the outset (adopting distinct speed-accuracy trade-off strategies) with faster/more erroneous responses in the younger and slower/more accurate responses in the older participants. Pre-stimulus alpha power increased over time, but although this mirrored the subjective rise in fatigue/mind wandering that also occurred over time, these were not correlated. Post-stimulus activity showed two distinguishable beta signatures: a fronto-central topography as a marker of response strategy and a fronto-parietal distribution modulated by motivation per se. We speculate that these two signatures contribute to offset performance declines over time.

Title: Case report of a Complex Congenital Heart disease with Arteria lusoria with Common Origin of RCA and Left main coronary artery from left posterior aortic sinus.

INTRODUCTIONAn 11-month-old castrated male Maine Coon originally imported from a known breeder in Budapest, presented to WestVet with a 12-day history of progressive paraparesis, anorexia, lethargy, non-specific pain, and difficulty defecating. Full body CT scan with the referring veterinarian showed pulmonary changes suggestive of pneumonia or transient atelectasis, but no evidence of aggressive, acute traumatic, or other osseous lesions of the spine. Contrast-enhanced MRI of the brain and thoracolumbar spine at the referral hospital revealed two plaque-like mass lesions associated with the right frontal bone and ventral calvarium near the brainstem with a separate lesion of the thoracic spinal cord. During anesthetic recovery, a single, smooth, non-ulcerated, pink, fleshy mass, ~1x2cm was noted in the inferior fornix of the left eye. The mass was aspirated several times with 22- and 25-gauge needles. The cytology read by a clinical pathologist was consistent with large cell lymphoma. The cat started treatment with oral lomustine and its neurologic status remained static. The cat went home following 8 days of hospitalization with oral medications and plan to follow up with the primary care veterinarian for additional lomustine treatment. At 18 days post-discharge, the cat was euthanized for undescribed progression of clinical signs.

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Authors:Sunny Ssu-Yu Chen 1,2,3Affiliations:Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 11230, Taiwan.School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan.Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, 40201, TaiwanCorresponding author: Dr. Sunny Ssu-Yu Chen: No.155, Sec.2, Linong Street, Taipei, 11230, Taiwan; TEL: 886-2- 28267000#66134, E-mail: k95081@gmail.comConflict of interest : The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.Dear Editor,We recently had the privilege of reading the article by Salim et al. [1], which integrates data from the Multicenter Analysis of Primary Distal Medium Vessel Occlusions: Effect of Mechanical Thrombectomy (MAD-MT) Registry across 37 centers in North America, Asia, and Europe. The study explores the management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO), comparing endovascular therapy (EVT) with medical management (MM) to assess which approach is superior. The article mentions that after applying Inverse Probability of Treatment Weighting (IPTW), the EVT group showed better mRS scores and lower mortality rates. This finding suggests that EVT can be a preferred treatment for DMVO, improving patient outcomes. However, after reviewing the study, we believe there are several issues worth further consideration.Firstly, we would like to address some statistical issues in the study. The authors mention that IPTW was primarily used to balance patient characteristics between the groups. Although IPTW adjusts for missing data through inverse probability weighting (IPW), this method may not be entirely accurate [2]. A more precise approach would be for the researchers to perform adjustments and analyses of missing data directly to obtain more accurate results.Secondly, the authors included baseline comorbidities, medication use, and baseline mRS as covariates in propensity score matching (PSM) to enhance the matching of patient characteristics between the two groups. However, prior research has identified strong correlates such as chronic kidney disease [3] and other established cardiovascular diseases [4,5], such as coronary artery disease, which were not considered in this study. We suggest that these factors should be incorporated into the analysis to avoid potential bias from unmeasured confounders.Finally, we have some concerns regarding the classification of patients in the study. Although the primary focus of this study is on the impact of EVT on patient outcomes, there appear to be other differences in treatment between the groups. For example, in Table 2, there is a noticeable difference in the use of intravenous thrombolytics (IVT) between the two groups. Previous research suggests that the use of IVT may influence patient outcomes [5]. Therefore, we recommend that, when comparing the EVT and MM groups, the treatment variables should be controlled for to ensure a more accurate comparison.Overall, we are honored to have read Salim et al. [1] and to gain further insights into the management of DMVO. The suggestions we have made do not diminish the value of this important study but rather aim to contribute to future research improvements and directions.References:Salim HA, Pulli B, Yedavalli V, et al. Endovascular therapy versus medical management in isolated posterior cerebral artery acute ischemic stroke: A multinational multicenter propensity score-weighted study. Eur Stroke J. Published online October 21, 2024.Lunceford JK, Davidian M. Stratification and weighting via the propensity score in estimation of causal treatment effects: a comparative study [published correction appears in Stat Med. 2017 Jun 30;36(14):2320.Chen Y, Wright N, Guo Y, et al. Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0·5 million Chinese adults. Lancet Glob Health. 2020;8(4):e580-e590.Romoli M, Matteo E, Migliaccio L, et al. Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis. Eur Stroke J. 2023;8(1):117-124.Suzuki K, Matsumaru Y, Takeuchi M, et al. Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial [published correction appears in JAMA. 2021 May 4;325(17):1795. doi: 10.1001/jama.2021.5454]. JAMA. 2021;325(3):244-253.