The development of compulsive cue-controlled-incentive-drug-seeking habits, a hallmark of substance use disorder, is predicated on an intrastriatal shift in the locus of control over behaviour from a nucleus accumbens (Nac) core - dorsomedial striatum network to a Nac core - anterior dorsolateral striatum (aDLS) network. Such shift parallels striatal adaptations to chronic drug, including cocaine self-administration, marked by dopamine transporter (DAT) alterations originating in the ventral striatum that spread eventually to encompass the aDLS. Having recently shown that heroin self-administration results in a pan-striatal reduction in astrocytic DAT that precedes the development of aDLS dopamine-dependent incentive heroin-seeking habits we tested the hypothesis that similar adaptations occur following cocaine exposure. We compared DAT protein levels in whole tissue homogenates and astrocytes cultured from ventral and dorsal striatal territories of drug naïve male Sprague Dawley rats to those of rats with a history of cocaine-taking or an aDLS dopamine-dependent incentive cocaine-seeking habit. Cocaine exposure resulted in a decrease in whole tissue and astrocytic DAT across all territories of the striatum. We further demonstrated that compulsive (i.e., punishment-resistant) incentive cocaine-seeking habits were associated with a reduction in DAT mRNA levels in the Nac shell, but not the Nac core-aDLS incentive habit system. Together with the recent evidence of heroin-induced downregulation of striatal astrocytic DAT, these findings suggest that alterations in astrocytic DAT may represent a common mechanism underlying the development of compulsive incentive drug-seeking habits across drug classes.

Exosomes, nanoscale extracellular vesicles (30-150 nm), play a critical role in intercellular communication by transporting bioactive molecules, including proteins, lipids, and nucleic acids. These vesicles have emerged as a transformative tool for drug delivery in brain diseases, particularly due to their ability to cross the blood-brain barrier (BBB), a major challenge in treating central nervous system (CNS) disorders. Recent studies have highlighted the potential of exosome-based therapies in treating neurodegenerative diseases such as Alzheimer’s and Parkinson’s, neuroinflammatory conditions, and brain tumors like glioblastoma. Exosomes can be engineered to enhance their targeting precision by modifying their surface to selectively deliver therapeutic agents to specific brain cells, including neurons, glial cells, and endothelial cells. This review explores the latest advancements in optimizing exosome-mediated drug delivery, focusing on surface modifications and other strategies to improve targeting efficiency and therapeutic outcomes. Additionally, exosomes are being investigated as diagnostic biomarkers for early disease detection and monitoring, offering a non-invasive alternative to traditional methods. Despite their promise, challenges such as large-scale production, cargo loading, safety concerns, and regulatory barriers remain. This review provides an overview of the current state of exosome-based therapies, critically evaluates the ongoing challenges, and explores future directions for optimizing their use in brain disease treatment, emphasizing enhancing targeted delivery and therapeutic efficacy.

not-yet-known not-yet-known not-yet-known unknown Pollination is a vital ecosystem service essential for the reproduction of most flowering plants. However, pollinators, especially insects, are in dramatic worldwide decline, threatening food security and global biodiversity. Urban areas, when managed well, can act as critical corridors and reserves for pollinators, benefiting ecosystems beyond the urban environment. This study assessed plant-pollinator interactions in urban gardens across the Mid-Atlantic (U.S.A)-region, focusing on two native plants: dense blazing star (Liatris spicata) and clustered mountain mint (Pycnanthemum muticum). Over 350 visual surveys in 52 gardens recorded 361 pollinator detection events involving 14 taxa, with 5 taxa dominating the detections. Using multi-species occupancy models (MSOMs) in a Bayesian framework, we evaluated how site and survey factors influenced species occupancy, detection, and richness. Species occupancy ranged from 0.04 (Halyomorpha halys) to 0.86 (Halictidae), with little influence from external variables. Detection was influenced by plant species, survey start time, Julian date, and urban distance. For instance, honey bees (Apis mellifera) and wasps (Vespoidea) were more likely to visit P. muticum, while Atalopedes campestris favored L. spicata. Detections of Halictidae increased in urban areas, while Bombus spp. were more common in rural settings. Our study demonstrates that MSOMs can be an effective tool for monitoring and investigating the urban pollinator community. We were able to estimate occupancy for the 14 observed insect taxa, 9 of which were detected fewer than 8 times. We also estimated effects of detection covariates that impacted multiple taxa and provide insight into ways to improve future pollinator monitoring efforts. These findings further our understanding of how plant species and the urban setting may variably influence pollinator activity and highlight the importance of urban gardens in supporting diverse insect communities.

not-yet-known not-yet-known not-yet-known unknown This paper explores the evolving landscape of respiratory disease management, emphasizing the critical role of pulmonary drug delivery systems in enhancing treatment efficacy. It highlights the significance of inhalation therapies, such as metered dose inhalers (MDIs), dry powder inhalers (DPIs), and nebulizers, which facilitate targeted medication delivery directly to the lungs, thereby minimizing systemic side effects. The discussion extends to innovative drug delivery technologies, including liposomes, polymeric nanoparticles, and inorganic nanoparticles, which offer promising avenues for improving therapeutic outcomes in complex respiratory conditions.Despite the advancements in these technologies, the paper addresses the challenges that hinder the transition from laboratory research to clinical application, such as formulation stability, safety concerns, and manufacturing scalability. It underscores the necessity for ongoing research to refine these systems and ensure their effectiveness in real-world settings.The paper concludes by emphasizing the importance of understanding lung physiology and drug delivery mechanisms to optimize treatment strategies for respiratory diseases. By overcoming existing barriers and leveraging innovative approaches, the potential for improved patient outcomes and enhanced quality of life for individuals with respiratory conditions can be realized. This comprehensive overview serves as a foundation for future research and development in the field of pulmonary medicine, aiming to address the increasing global burden of respiratory diseases.

Case Report

Chronic Budd-Chiari Syndrome in a Patient with Adrenal Insufficiency on Long-Term Hydrocortisone

Title: Successful management of Aspirin intolerance after ad hoc PCI: A case report and a developed algorithmShort title/running head: Personalizing Therapy for Aspirin Hypersensitive Patients

Unlike many countries in Africa, there is a long tradition of spotted hyenas and people living side by side in peace in Tigray, Ethiopia. While historically the co-existence has been remarkably peaceful, the recent war in Tigray threatens this co-existence. We investigated the effects of war on the scavenging and hunting behavior of spotted hyenas, and the consequences for local people in Tigray. We compared current spotted hyena foraging in sites where heavy fighting took place (n=6 battle sites) to sites where no fighting took place (n=6 control sites) across Tigray using diet analysis. We furthermore measured the abundance of spotted hyenas using playback experiments and conducted semi structured interviews in 1200 households at battle and control sites to assess human-wildlife interactions. Regarding foraging, we found that the spotted hyena scats contained primarily domestic livestock at both the battle and control sites. Human hair was prevalent in hyena scats from battle sites but was absent in scats collected from the control sites. In general, the number of spotted hyenas responding to call-ins was significantly higher at battle than at the control sites. There were several lines of evidence that human-wildlife interactions were more negative. There were more reports of livestock predation in battle than in control sites. Livestock predation was higher overall during the war. Spotted hyena is the largest being responsible for the increase in battle and war, likely scavenging on human remains. We conclude that changes in hyena feeding behavior during the war and siege period can be linked to changes in the availability of scavengable food sources. These results yield insight not only into the consequences of war for the people of Tigray, but also into how the many armed conflicts in regions with large scavenger/carnivore populations may have long-lasting impacts on human-wildlife conflict around the globe.

Aim: Telmatobius atacamensis presents Linnaean (unknown species), Wallacean (unknown geographic distributions), and Hutchinsonian (unknown abiotic tolerances) knowledge deficits that can be reduced with species distribution models (SDM). We calculated and validated the distribution range of T. atacamensis in the Andean plateau by combining geoprocessing tools and SDM configured with climatic and vegetation variables. Location: Andean plateau, northern Argentina. Taxon: Anura, Leptodactylidae. Methods: To estimate the niches of this microendemic species and know its conservation status we applied SDM configured with climatic and vegetation variables at one and 10 km spatial resolution. We apply and configure the Maxent, Random Forest, Support Vector Machine, and Domain algorithms from the R package ENMTML. We perform field validation of the predictions at sites with a high probability of detection. Results: All the predictions obtained showed high performances in 1k (AUC = 0.98 ± 0.02; Sorensen = 0.97 ± 0.03, mean ± standard deviation), and 10k (AUC = 0.90 ± 0.05; Sorensen = 0.94 ± 0.05) of spatial resolution. Depending on the environmental variables and spatial scales used, the SDM allowed the niche identification of Telmatobiidae, Leptodactylidae, Bufonidae families, Telmatobius genus, and the target species. Main conclusions: Combining climatic and vegetation variables could improve the algorithm’s performance and the amphibian’s predictions; our results expanded the databases for a microendemic species. T. atacamensis may not be strictly microendemic; field validation increased the database, suggesting wider distributions than previously thought. The conservation status of T. atacamensis is critical; besides being an endemic species, critically endangered, and with niches overlapping with the Lithium Triangle, only five conservation units protect 25.6% of its critical habitats. Our results partially reduce the Wallacean deficit; there are no management policies and expanding field validation efforts represent basic inputs that could outline new effective management and conservation strategies by national and international authorities.

Overtaking of heavy vehicles, like trucks, has a significant risk due to limited visibility and potential collisions. This research work addresses the challenge by accurately detecting and tracking vehicles in real time, predicting overtaking decisions and providing information to the drivers for safer driving. In recent years, deep learning methods have shown a robust performance compared to traditional techniques, and transformed how vehicles are detected and counted in various scenarios. This research focuses on enhancing safety during overtaking on single-lane roads by developing a vehicle detection and counting system using the MobileNet-SSD deep learning model. Through meticulous testing on Common Objects in Context (COCO) dataset, this system achieves an average accuracy of 98.7% in detecting and counting vehicles, demonstrating its efficacy and reliability. These results demonstrate the potential of intelligent vision-based systems to significantly improve safety and traffic .

In the era of the Anthropocene, the environmental factors controlling the distribution and abundance of wildlife populations are increasingly complicated by historical and ongoing urban development and industrialization. The legacy of industrialization has enduring impacts on contemporary environmental quality, with additional downstream consequences for wildlife that reside in cities. However, industrial contaminants are not evenly distributed across or within cities. Further, while the long-term fitness consequences of environmental contamination are well-documented for most taxa, their effects on free-ranging wildlife at the population and community levels remain poorly understood. Here, we investigated whether environmental contamination risk from industrial pollutants was associated with mammalian diversity and mesocarnivore activity in the Seattle-Tacoma metropolitan area, Washington, USA, a historically industrialized region. Using camera trap data collected across 74 sites and pre-existing data from the Washington Environmental Health Disparities Map, we modeled environmental contamination risk, natural land cover, and human population density against mammalian community diversity, richness, and evenness. We also modeled activity rates of three common mesocarnivore species (coyotes, raccoons, and Virginia opossums) via the number of detections. We found that mammalian diversity and evenness decreased as contamination risk increased, especially in Seattle. Among mesocarnivores in Seattle, coyote activity was negatively associated with contamination risk, while raccoon activity was positively associated with contamination risk; opossums showed no response. However, in Tacoma, contaminant risk was not significantly associated with mammalian biodiversity or activity; instead, human population density emerged as the most important predictor, with a negative influence on coyote activity and a positive influence on opossum activity. Our results highlight the importance of considering the legacy effects of industrialization and their impact on environmental quality in urban wildlife camera trap studies, and the need for species- and city-specific approaches in understanding the role environmental quality plays in shaping urban wildlife communities.

Allochrony is a form of reproductive isolation characterized by differences in the timing of breeding and may play a crucial role in the genetic and phenotypic divergence within species. This study explores the genetic and phenotypic divergence in Atlantic lumpfish (Cyclopterus lumpus), focusing on spring and autumn spawners along the Norwegian coast. Through genomic analysis and otolith morphology, we identified pronounced genetic and morphologic differences between the two spawning groups. Notably, chromosomes 13 and 14 exhibited local adaptations, while chromosome 1 showed parallel evolution across different localities, suggesting broader evolutionary processes influencing reproductive isolation and adaptive divergence. analysis revealed genes on chromosome 1 associated with responses to environmental stressors, possibly adaptations to seasonal variations at high latitudes. Morphological analysis of otoliths supported these findings, showing differences that may be adaptations to seasonal light availability. The presence of genomic islands of divergence, alongside a general lack of differentiation across the mitochondrial genome, suggests recent and rapid selection processes potentially moderated by ongoing gene flow. This study underscores the importance of considering temporal genetic structures in conservation and management strategies, particularly for species with bimodal spawning time to prevent overexploitation and optimize breeding programs.

Semantic Morphogenesis introduces a transformative framework designed to address limitations in contextual adaptability and semantic coherence within language models. Through the integration of tensorial dynamics, the approach enhances the capacity to process high-dimensional semantic relationships across varied linguistic contexts. The study implements a novel tensorial framework that dynamically refines attention mechanisms, enabling improved alignment between modelgenerated outputs and complex input semantics. Quantitative analyses demonstrate significant improvements in contextual accuracy, coherence, and robustness to input noise, with tasks spanning semantic similarity, ambiguity resolution, and summarization. The integration of low-rank tensor approximations facilitates computational efficiency, ensuring scalability across diverse domains and resource constraints. Performance comparisons reveal that the proposed model surpasses traditional transformer-based architectures, particularly in generalization to domain-specific tasks and few-shot learning scenarios. Statistical validations confirm the reliability and significance of the enhancements, highlighting the robustness of the methodology. Results further underscore the utility of tensorial embeddings in capturing nested syntactic structures and multi-scale dependencies, contributing to a more comprehensive understanding of contextual semantics. The proposed framework successfully bridges critical gaps in existing models, advancing capabilities in domain adaptation and semantic precision. Experimental results validate the adaptability and resilience of the approach across various contextual complexities, demonstrating its potential for widespread applicability. By leveraging tensorial dynamics, the study establishes a foundation for advancing computational semantics and enabling more sophisticated linguistic modeling. The outcomes suggest a promising direction for future innovations in the design and optimization of language models.

Cost-effective methods, such as dung counts, are widely used for monitoring wildlife population abundances but often yield estimates with low precision and wide confidence intervals. In this study, we assess the impact of different statistical analyses---traditional mathematical approaches, bootstrapping, and Bayesian modelling---on the precision and accuracy of population estimates for red and roe deer on Scotland's west coast. Both bootstrapping and Bayesian modelling reduced estimate uncertainty compared to traditional methods, providing more precise estimates. Bayesian modelling further accounted for the overdispersion characteristic of dung count data, offering a more ecologically robust and statistically sound approach to estimating population densities.

Ocean metaproteomics provides valuable insights into the structure and function of marine microbial communities. Yet, ocean samples are challenging due to their extensive biological diversity that results in a very large number of peptides with a large dynamic range. This study characterized the capabilities of data independent acquisition (DIA) mode for use in ocean metaproteomic samples. Spectral libraries were constructed from discovered peptides and proteins using machine learning algorithms to remove incorporation of false positives in the libraries. When compared with 1-dimensional and 2-dimensional data dependent acquisition analyses (DDA), DIA outperformed DDA both with and without gas phase fractionation. We found that larger discovered protein spectral libraries performed better, regardless of the geographic distance between where samples were collected for library generation and where the test samples were collected. Moreover, the spectral library containing all unique proteins present in the Ocean Protein Portal outperformed smaller libraries generated from individual sampling campaigns. However, a spectral library constructed from all open reading frames in a metagenome was found to be too large to be workable, resulting in low peptide identifications due to challenges maintaining a low false discovery rate with such a large database size. Given sufficient sequencing depth and validation studies, spectral libraries generated from previously discovered proteins can serve as a community resource, saving resequencing efforts. The spectral libraries generated in this study are available at the Ocean Protein Portal for this purpose.

Background: Integrin β4 (ITGB4) has been shown to enhance the invasiveness of papillary thyroid carcinoma (PTC). In addition, several microRNAs (miRNAs) have been identified as influencing the invasiveness of PTC. Aims: This study aims to explore whether ITGB4 exerts its pro-invasive effects by modulating miRNA expression. Methods and Results: Using RNA sequencing techniques, we found miR-21-5p was significantly upregulated in expression levels following the knockdown and introduction of ITGB4 expression in two PTC cell lines, K1 and TPC-1, respectively. Wound healing and transwell assays indicated miR-21-5p mediates the invasiveness of PTC cells induced by ITGB4. Analysis of the TCGA database revealed a positive correlation between the expression of both ITGB4 and miR-21-5p with increased lymph node metastasis, extra-thyroidal extension, and advanced TNM stages. Mechanistically, a negative correlation between the methylation levels of the miR-21 gene and the expression levels of both ITGB4 and miR-21-5p was identified based on bioinformatic analysis. RT-qPCR and bisulfite sequencing PCR demonstrated the reduction in miR-21-5p expression following ITGB4 knockdown was associated with increased methylation of the miR-21 gene. Treatment with the methyltransferase inhibitor 5-Aza-CdR reversed the methylation changes in the miR-21 gene and substantially restored miR-21-5p expression. Conversely, the induced expression of ITGB4 in TPC-1 cells led to a significant increase in miR-21-5p levels and a decreased methylation of the miR-21 gene. Conclusion: miR-21-5p is identified as a potential downstream miRNA of ITGB4, contributing to the pro-invasive effects associated with ITGB4 in PTC. ITGB4 enhances the expression of miR-21-5p by reducing the methylation levels of the miR-21 gene. The activation of the ITGB4/miR-21-5p axis may provide a molecular basis for the increased invasiveness of PTC.

Introduction: ADHD often persists into adulthood, with high comorbidity complicating diagnosis, particularly in women, who are less frequently diagnosed and typically present with the inattentive subtype. This study examined ADHD comorbidity in women with depressive or anxiety disorders and compared clinical features, including hyperfocus, between those with and without ADHD. Materials and Methods: Female patients from outpatient clinics completed the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Those meeting threshold scores underwent further assessment using the Wender-Utah Rating Scale (WURS), Hyperfocus Scale (HS), and Adult ADHD DSM-IV-Based Diagnostic Screening Scale, alongside structured clinical interviews (SCID-5-CV). After exclusions, 170 women were included. Results: ADHD was identified in 19.6% (n=33) of patients, 45.5% (n=15) of whom were previously undiagnosed. ADHD was most prevalent in patients with social anxiety disorder (46.4%), double depression (39.4%), dysthymia (35.1%) and generalized anxiety disorder (25.5%). In non-ADHD participants, hyperfocus scores correlated positively with depression and anxiety, but no such correlations were found in the ADHD group. Conclusions: ADHD is common in women with depressive or anxiety disorders and is often underdiagnosed, with hyperfocus as a notable but non-exclusive feature. Clinicians should consider ADHD in this population to improve diagnostic accuracy.

1. The linkages and mechanisms influencing biodiversity, primary productivity, and soil carbon stability in grassland ecosystems under the impact of climate change remain unclear. 2. In this study, we analyzed soil organic carbon mineralisation, plant species diversity, productivity, soil nutrients, microbial communities, and climatic variables using a large-scale belt transect field survey spanning over 2,000 km across the Mongolian Plateau. Additionally, soil organic carbon mineralisation potential was assessed through laboratory incubation experiments. Correlation regression analysis and structural equation modeling (SEM) were employed to investigate the relationships between these factors and their driving pathways associated with soil organic carbon mineralisation and species diversity. 3. The results indicated that (1) aboveground biomass (AGB) was increased through the two contrary strategies: species diversity may either increase or decrease, with the lowest community AGB recorded at Shannon-Wiener indices of 1.14 and 2.19, as well as Simpson indices of 0.49 and 0.72. (2) The direct drivers of plant diversity were soil pH, soil organic carbon (SOC), and mean annual temperature (MAT), with reductions in these factors contributing to variations in plant diversity. (3) Perennial grass functional groups primarily determined grassland productivity, whereas perennial forbs functional groups played a dominant role in influencing plant species diversity within the community. (4) The primary driver of potential soil organic carbon mineralisation was microbial biomass carbon (MBC), with mean annual precipitation (MAP) regulating MBC via SOC. (5) SOC exhibited contrasting effects on plant species diversity and SOC mineralisation. 4. Synthesis Our finding suggest that the properties of SOC pools are important factors driving contrasting change in grassland plant species diversity and organic carbon mineralisation.

A pilot soil and water conservation research project was conducted in the rainfed-low rainfall zone of Northern Iraq characterized by a Mediterranean type climate with seasonal rainfall between 300 and 400 mm. Runoff, soil and nutrients (N, P) losses, soil moisture storage and soil surface crust development were monitored for several consecutive rainfall seasons using small and large natural runoff plots under fallow- conventional tillage conditions. Data obtained were used to derive suitable single storm- rainfall-runoff erosivity factors for the region. Slight to moderate seasonal runoff and soil loss were recorded with one or two major rainstorms during the rainfall season account for the bulk of seasonal runoff and soil loss during that season. Significant losses in soil organic matter, N and P nutrients accompanied runoff and soil loss impacting soil productivity and water quality. Soil moisture level approaches the field capacity level during January, February and early March. A decrease in soil moisture storage during the rainfall season occurred during the past few decades due to the climate change effect. Rainfall infiltration rate drops drastically after a few rainstorms due to soil surface crust development. A preliminary assessment of direct groundwater recharge by rainfall in the region indicates between 3 and 11 percent of total seasonal rainfall contribute to such recharge.

The increasing resistance of weeds to long-term herbicide use presents a significant challenge in modern agriculture, necessitating the urgent development of new herbicides. Ageratina adenophora, a notorious perennial herb, has spread across pantropical and pansubtropical zones worldwide. In this study, we evaluated seven benzoic acid compounds as potential pesticides against A. adenophora and we identified methyl 4-hydroxyphenylacetate as an effective growth inhibitor for this weed. A 250 mM concentration of methyl 4-hydroxybenzoate dilution can completely kill A. adenophora plants that are 2 to 3 months old. For plants aged 5 to 6 months, the dilution can kill 60% to 70% of the leaf area. This indicates that methyl 4-hydroxybenzoate is effective as a pesticide for controlling A. adenophora. Observations show that within 30 minutes after spraying, the top buds, young leaves, tender stems, and some mature leaves begin to darken, wilt within 2 hours, and die within 4 hours. We examined the changes in six hormones (IAA, ABA, IP, JA, SA and TZ) during this process and found that IAA and ABA levels in A. adenophora were both down-regulated 4 hours after spraying with methyl 4-hydroxyphenylacetate and 20% alcohol. The two hormones changed potentially uncertain to plant death.

Reply to the Letter to the Editor by Kember et al, Regarding Wilson et al., “A Position Modification Device for the Prevention of Supine Sleep During Pregnancy: A Randomised Crossover Trial” Published in the British Journal of Obstetrics & Gynaecology on 16 September 2024.Danielle L. Wilson, MSc., PhD1,2,3; Carley Whenn1; Maree Barnes, MBBS1,4; Susan P. Walker, MBBS, MD, FRANZCOG, DDU, CMFM2,5; Mark E Howard, MBBS, FRACP, GDEB, PhD1,41Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia;2Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.3School of Electrical Engineering and Computer Science, The University of Queensland, St Lucia, Queensland, Australia.4Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.5Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia.Address correspondence to: Danielle L. Wilson, Institute for Breathing and Sleep, Level 5 Harold Stokes Building, Austin Health, Heidelberg, Victoria, Australia. Tel: 613 9496 3517; Fax: 613 9496 5124; e-mail: danielle.wilson@austin.org.auDear Prof. Aris Papageorghiou,We thank Dr. Kember and his colleagues1 for their interest in our recently published article2. Firstly, we acknowledge the recent publication by Coleman et al3 regarding the benefits of the Prenabelt on foetal growth, as revealed through re-analysis of their data using Bayesian methods. Unfortunately, this paper3 was published after our initial submission. Interestingly, while the frequentist analysis approach just fell short of significance, a Bayesian approach shows promise for supine sleep position interventions, by throwing an interesting light on the likelihood of a benefit depending on prior clinical beliefs. It remains that the mechanisms of action need further exploration however, given that supplemental data from the original publication4 suggests that objectively measured supine sleep in a subset of women did not differ between those using Prenabelt v sham.Secondly, we recognise our study was constrained by the measurement device used. The Night Shift Sleep Positioner (Night Shift) with neck placement was initially chosen, however, during our study a chest belt was introduced by the manufacturer. We performed a sub-study with N=20 of the participants wearing the device at both neck and abdominal placements for one night. An epoch-by-epoch comparison revealed substantial agreement between the two devices for all sleep positions with 88% concordance overall (unweighted κ = .797 [SE .006], p<.001). Regrettably, we neglected to include these data within the original publication.Despite the limitations of our measurement device, we believe that distinguishing between neck and pelvic position would not have substantially impacted our conclusions, given the high concordance between neck and abdominal devices revealed above, and particularly given that the intervention showed a nonsignificant increase in the proportion of supine sleep overnight. As Dr. Kember’s team have demonstrated, sleep positions where the thorax and pelvis are discordant (e.g., supine thorax with left pelvis tilt) are infrequent, occurring in less than 6% of “real-world” sleeping positions during pregnancy.5We agree that the Night Shift lacked sufficient resolution to fully appreciate the complex interplay between maternal positioning and foetal haemodynamics, as mentioned in the limitations section of our paper. Indeed, measurement limitations persist with all position sensing methodologies including infra-red video monitoring, with Dr. Kember’s recent paper5 demonstrating that while the most commonly occurring sleeping positions (left-lateral, right-lateral and supine) were well-recognised by modelling, the twisted/hybrid positions had intermediate performance, with the modelling particularly challenged by left or right tilted positions. To address the limitations of the Night Shift, we have recently completed data collection on a subsequent study using tri-axial accelerometry at abdominal level to characterise maternal sleep position in degrees of roll around the axial plane, with an aim to capture the subtleties of maternal position on uteroplacental haemodynamics and foetal growth.As mentioned, this is an understudied area. Dr. Kember and his team share our drive to gather objective evidence of a causal pathway between supine sleep position and foetal wellbeing, which we believe is particularly important given current guidelines regarding safe sleeping position in late pregnancy are based on retrospective cohort studies of self-reported “going-to-sleep” position. Our team congratulates Dr. Kember and his colleagues for their excellent work in the sleep position during pregnancy space, and we look forward to the outcomes from their upcoming DOSAGE Study.Disclosure of Interests:The authors have no financial disclosures or conflicts of interest.Contributions of Authorship:Dr. Wilson, Prof. Walker and Prof. Howard drafted and revised the manuscript, Ms. Whenn and Dr. Barnes critically revised the manuscript.Details of Ethics Approval:Additional analyses comparing device location were approved under an amendment to the original approval by the Mercy Hospital for Women Human Research Ethics Committee project number 2020-015, on 3rd June 2021.References:https://doi.org/10.1111/1471-0528.179521. Kember A. Placeholder for Letter to the Editor for BJOG.2. Wilson Danielle L, Whenn C, Barnes M, Walker Susan P, Howard Mark E. A position modification device for the prevention of supine sleep during pregnancy: A randomised crossover trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2024; .3. Coleman J, Grewal S, Warland J, Hobson S, Liu K, Kember A. Maternal positional therapy for fetal growth and customised birth weight centile benefit in a Bayesian reanalysis of a double-blind, sham-controlled, randomised clinical trial. BMJ Open. 2024; 14 (4): e078315.4. Coleman J, Okere M, Seffah J, et al. The Ghana PrenaBelt trial: a double-blind, sham-controlled, randomised clinical trial to evaluate the effect of maternal positional therapy during third-trimester sleep on birth weight. BMJ Open. 2019; 9 (4): e022981.5. Kember AJ, Zia H, Elangainesan P, et al. Transitioning sleeping position detection in late pregnancy using computer vision from controlled to real-world settings: an observational study. Sci Rep. 2024; 14 (1): 17380.

Re: “Necessity the mother of invention”-wider significance of novel mid-urethral rectus fascial sling. Petros, Peter. Response letter.Author: Abdalla Fayyad.Centre of Urogynaecology and Advanced Laparoscopic Surgery. 12 Khalidi Street, Amman, Jordan 11180.E mail: amfayyad@gmail.comDear Dr Aris Papageorghiou,We thank Professor Petros for the letter to the editor titled “Necessity is the mother of invention”-wider significance of novel mid-urethral rectus fascial sling1 and the interest shown in our novel technique of laparoscopic mid-urethral autologous fascial sling (LMAFS)2. In his letter to the editor, Professor Petros supports our novel approach of using the autologous rectus fascia as mid-urethral sling inserted laparoscopically. We are honored to have our technique endorsed by the discoverer of the integral theory (IT), and the co-developer of the mid-urethral sling (MUS).We agree with Professor Petros that restoring vaginal support does improve pelvic floor symptoms related to prolapse, lower urinary tract symptoms and obstructive daefecation3. We are currently examining the feasibility of using autologous rectus fascia laparoscopically to restore apical support as a non-mesh option. We agree that the potentials of using the rectus fascia laparoscopically can be numerous, but does indeed need further evaluation.It is important, however, to emphasize that surgical interventions for pelvic floor dysfunction should be considered after conservative measures have failed to improve patient’s bothersome symptoms. Regarding the symptoms of overactive bladder (OAB), e.g. urgency and urgency incontinence, we agree with Professor Petros that many patients with OAB do improve following corrective reconstruction of the support of the bladder base and trigone, as the stretch receptors in the bladder are no longer activated at low bladder volumes3. However, it is important to recognise that OAB is a nonspecific, complex and multifactorial symptom syndrome frequent in the general population, and among men as well4,5. There appear to be several distinct subtypes of OAB with different pathophysiology, with overlapping underlying factors including metabolic syndrome, affective disorders, gastrointestinal disorders, hormonal deficiency, and subclinical autonomic nervous dysfunction5. Surgery for prolapse does not necessarily address these potential underlying causes. The mainstay of managing this sub group of patients with OAB, is through conservative measures and medical treatment.In conclusion, we thank Professor Petros for his letter, and agree that understanding the IT provides an important insight into majority of pelvic floor dysfunction symptoms. We used the principles of the IT when we developed the technique of LMAFS1. We are certainly looking for further uses of laparoscopic rectus fascial sling in pelvic floor reconstruction.Word count: 368Conflict of interest: NoneFunding information: None

A document by MD. Deluwar Hussen. Click on the document to view its contents.

In this paper, we investigate the long-term stability of classical solution to 3D one-fluid Euler-Poisson system of electrons with non-zero vorticity. It is shown that the classical solution is well-posed for a lifesapn Tδ at least εδ, where ε>0 is the size of the initial perturbed density and velocity, δ>0 is the size of the initial vorticity. This implies that the lifespan Tδ only essentially depends on the size δ of the initial vorticity.