Journals
2026 EN
Milligan Megan C. · Coates Peter S. · Prochazka Brian G.
+6 more
ABSTRACT Aim Population ecologists often focus on changes in the distribution and abundance of wildlife species, which are useful for trend analyses and status assessments. However, rarely are these responses evaluated simultaneously for a single species, despite their unique contributions to fully assess a species' viability. For example, focusing solely on total abundance can mask important losses in overall distribution within a metapopulation structure that may contribute to long‐term population instability that results from the extirpation of small peripheral populations. Location Bi‐State region of Nevada and California, USA. Methods We simultaneously evaluated changes in population abundance and distribution for greater sage‐grouse (hereafter sage‐grouse; Centrocercus urophasianus ) within the Bi‐State Distinct Population Segment (DPS), a genetically distinct and isolated population straddling the border of Nevada and California. We combined population counts, demographic data, and information on space use from marked individuals to evaluate changes in population distribution and abundance over three time periods that corresponded to the three most recent population nadirs (1995–2019, 2002–2019 and 2008–2019). Results The Bi‐State DPS exhibited evidence of ~1.2%–2.5% declines annually, over the short/medium‐term (1995–2019;λ ̂ lambda} $$ = 0.987, 95% CRI: 0.970–0.999), short‐term (2002–2019;λ ̂ lambda} $$ = 0.975, 95% CRI: 0.963–0.985) and recent‐term (2008–2019;λ ̂ lambda} $$ = 0.988, 95% CRI: 0.973–1.001). Since 1995, the spatial distribution of sage‐grouse abundance in the Bi‐State DPS shifted amongst subpopulations, with peripheral subpopulations suffering the largest declines. Main Conclusions Gains in abundance and distribution amongst expanding subpopulations did not offset losses in the remaining subpopulations, with a net loss in occupied distribution of 156 km 2 since 1995. Reductions in spatial distribution could have implications for metapopulation persistence as peripheral populations become more vulnerable to stochastic events, which would not have been apparent from the evaluation of overall metapopulation abundance on its own.
Journals
2026 EN
Tchuwa Isaac · Katonda Vincent · Gondwe Steven
+1 more
Abstract Malawi's exposure to climate‐induced extremes reveals gaps in loss and damage (L&D) governance, especially with respect to non‐economic losses that lie outside of standard post‐disaster accounts. Drawing on household loss inventories, participatory mapping, geospatial analysis, and community consultations in the districts of Nsanje and Zomba, this study develops and tests an operational L&D programming framework. The framework organises community‐reported economic and non‐economic losses, coded for salience, severity, persistence, and reversibility, into a theme‐by‐site matrix linked to geospatial hazard footprints. It then links this evidence to attribution and finance cues that clarify when climate finance, disaster risk reduction, or humanitarian instruments are most appropriate. The results show systematic undervaluation of non‐economic loss, spatially clustered burdens, and finance needs that exceed current pilot initiatives. Centred on Malawi in southeast Africa yet designed for wider adaptation, the framework offers a transferable model for climate vulnerable countries seeking credible and equitable L&D governance.
Journals
2026 EN
Hanson Jessica · Majnemer Annette · Shikako Keiko
+6 more
Abstract Aim To understand the impact of a knowledge translation strategy that integrates the Early Detection and Intervention Toolkit for Cerebral Palsy (EDIT‐CP) electronic knowledge translation toolkit to support rehabilitation professionals using evidence‐based interventions. Method A mixed‐methods study using the Knowledge‐to‐Action Framework evaluated the knowledge translation strategy. Twenty‐three rehabilitation professionals participated in a 15‐week knowledge translation strategy, including online training, newsletters, and support for site champions. Baseline and post‐intervention assessments measured changes in evidence‐based practice (EBP) activities, attitudes, confidence, and resources. Feasibility, acceptability, and appropriateness of the toolkit were also assessed. Focus groups provided qualitative data on organizational barriers and facilitators. Results No significant change was found across the three EBP constructs. The largest effect was for EBP attitudes/confidence ( r = 0.49), followed by resources ( r = 0.26) and activities ( r = 0.22). One mentorship‐related item reached significance ( p < 0.05). Participants rated the toolkit as acceptable and feasible, though systemic challenges may limit sustainability. Interpretation The knowledge translation strategy enhanced EBP uptake among rehabilitation professionals working with children with cerebral palsy. Addressing organizational challenges is essential for long‐term success.
Journals
2026 EN
Reynolds Robert J. · Goldsmith Shona · Mcintyre Sarah
+1 more
Abstract Directed acyclic graphs (DAGs) are increasingly used to clarify assumptions, identify sources of bias, and structure reasoning about causal pathways across the health sciences. In developmental medicine, where causes often span the preconception to postnatal periods, DAGs offer a systematic way to navigate complexity. This review introduces foundational DAG concepts for clinicians and researchers in childhood‐onset disability, with an emphasis on accessibility and applied relevance. We review examples involving cerebral palsy, autism, and attention‐deficit/hyperactivity disorder, showing how DAGs support confounder control, effect estimation, and study design. The figures throughout the review use a consistent, clinically grounded example to walk readers through concepts like mediation, backdoor paths, and collider bias. Beyond modeling rigor, DAGs help foster collaboration across disciplines and communicate causal structure to families and individuals with lived experience. We also show how DAGs can support intervention prioritization by identifying strategic leverage points using network measures such as node centrality and graph characteristics. Finally, we emphasize the importance of drawing DAGs before data collection, when their guidance is most actionable.
Journals
2026 EN
Mantovani Marta · Kwiendacz Hanna · Irlik Krzysztof
+11 more
Abstract Aims Diabetes is characterized by clinical heterogeneity. This study aimed to identify different clinical phenotypes of real‐world people with diabetes and to assess their associations with major adverse cardiovascular events (MACEs). Methods From a prospective Polish registry of people with diabetes, hierarchical cluster analysis was performed based on 19 variables, including co‐morbidities and cardiovascular (CV) risk factors. The primary outcome was the risk of MACEs (CV death, acute coronary syndrome and myocardial revascularizations, ischaemic stroke, new onset heart failure, and hospitalization for CV reasons). Secondary exploratory outcomes were each MACE component and all‐cause death. Results On 2109 participants (median age 60 years, interquartile range [IQR] 45–69, 51.3% men) included, three different phenotypes were identified: (i) cluster 1 (27.8%) – young with type 1 diabetes; (ii) cluster 2 (42.0%) – elderly with type 2 diabetes and high complexity; (iii) cluster 3 (30.2%) – middle‐aged with type 2 diabetes and cardiometabolic risk factors. Compared to cluster 1, the risk of primary outcome was higher for clusters 2 and 3 (adjusted hazard ratio [aHR] 2.93, 95% CI 1.60–5.36, and aHR 1.85 95% CI 1.07–3.20, respectively). Using cluster 3 as the reference, cluster 1 was associated with a lower risk (aHR 0.54, 95% CI 0.31–0.94), and cluster 2 with a higher risk (aHR 1.58, 95% CI 1.08–2.33). Conclusions People with diabetes aggregate into different clinical phenotypes, each with different risks of MACEs. Integrated approaches tailored to these diverse clinical profiles are needed to improve outcomes in this heterogeneous and multifaceted disease.
Journals
2026 EN
Malin Steven K. · Heiston Emily M. · Battillo Daniel J.
+5 more
Abstract Aims Mixed evidence exists on whether metformin adds to or attenuates the insulin‐sensitising effects of exercise. To date, no studies have tested whether metformin differentially impacts exercise training intensity–mediated insulin sensitivity. We tested the hypothesis that metformin would blunt metabolic insulin sensitivity and carbohydrate oxidation in an intensity‐based manner among adults with metabolic syndrome (MetS) risk. Materials and methods In a double‐blind, placebo‐controlled trial, participants were randomised to low‐intensity exercise plus placebo (~55% VO 2 max 5 days/week, LoEx + PL, n = 22) or metformin (2000 mg/day, LoEx + Met, n = 21) and high‐intensity exercise plus placebo (~85% VO 2 max 5 days/week, HiEx + PL, n = 24) or metformin (HiEx + Met, n = 24) for 16 weeks. A 120‐min euglycaemic–hyperinsulinemic clamp (40 mU/m 2 /min, 90 mg/dL) was conducted pre‐ and post‐treatment to assess metabolic insulin sensitivity (M‐value/insulin). Fasting and insulin‐stimulated carbohydrate oxidation was also assessed using indirect calorimetry. Adipokines (leptin, high molecular weight (HWM), and total adiponectin) were measured at 0 and 120 min of the clamp. Aerobic fitness (VO 2 max) and body composition (DXA) were also analysed. Results HiEx + PL increased metabolic insulin sensitivity ( p = 0.017) while HiEx + Met, LoEx + PL, or LoEx + Met did not. HiEx + PL also raised insulin‐stimulated carbohydrate oxidation and decreased fat oxidation compared with LoEx + Met (both, p = 0.008). Increased metabolic insulin sensitivity related to reductions in fasting glucose ( r = −0.41, p = 0.025), VO 2 max ( r = 0.55, p = 0.002), fasting leptin ( r = −0.54, p = 0.01), and weight loss ( r = −0.60, p < 0.001) after exercise and placebo, but not exercise and metformin. Conclusions Metformin attenuated metabolic insulin sensitivity and insulin‐stimulated carbohydrate oxidation after high‐intensity exercise training in adults at risk for MetS.
Journals
2026 EN
Nwaneshiudu Chinwe · Girdhar Kiran · Kleopoulos Steven P.
+7 more
ABSTRACT Individuals with cocaine use disorder (CUD) who attempt abstinence experience craving and relapse that can benefit from multimodal treatment monitoring. Longitudinal studies linking behavioral manifestations in CUD to the blood transcriptome are not only limited but also computationally complex. Therefore, we developed an analytical pipeline to investigate the connection between drug use behaviors during abstinence and change in the blood transcriptome. We conducted a longitudinal study with CUD ( n = 12 subjects) and collected behavioral metrics and blood RNA‐seq at baseline, 3, 6, and 9 months. Our analytical pipeline of the high‐dimensional data encompasses hierarchical k‐means clustering to classify subjects to responder groups based on behavioral scores and abstinence duration, in silico cell deconvolution, differential analysis with correlated multivariate testing over time, gene set enrichment analysis, and gene co‐expression with time splines and RNA‐seq data. The pipeline captured dynamic changes in behavioral scores and abstinence duration in responder groups. Genes showing differential transcript‐level expression were enriched in substance use and cardiovascular disease‐associated genetic risk loci in responder groups. Lastly, time‐dependent gene co‐expression revealed dynamic changes related to immune processes, cell cycle, RNA‐protein synthesis, and second messenger signaling for days of abstinence. This is a preliminary investigation, providing an innovative and scalable pipeline for blood‐based longitudinal RNA‐seq studies in CUD, potentially applicable to other substance use disorders. It outlines a data‐driven approach for analyzing composite longitudinal drug use behavioral phenotypes with blood‐based transcriptomics. We also demonstrate changes in drug use behaviors and the blood transcriptome during drug abstinence.
Journals
2026 EN
Crockett Erin T. H. · Guo Qinfeng · Atkins Jeff W.
+9 more
ABSTRACT Biodiversity can enhance forest resistance to drought, but the forms of diversity involved and conditions under which diversity confers resistance remain unclear. We used Forest Inventory and Analysis (FIA) plot data to examine whether four variables—structural richness (variation in tree heights, stand density, canopy cover and/or spatial heterogeneity), species richness (number of tree species), structural evenness and species evenness—are associated with the resistance of net primary productivity to drought and whether these relationships change with drought severity and by ecoregion. Structural richness was positively associated and species evenness was negatively associated with resistance, but the strength of these relationships varied by ecoregion. Relationships between structural richness and resistance and between species evenness and resistance became stronger under more severe droughts, supporting the stress gradient hypothesis. Forest managers cannot readily change abiotic conditions but could increase structural richness and select certain species to enhance forest resistance to drought.
Journals
2026 EN
Florko Katie R. N. · Ross Tyler R. · Ferguson Steven H.
+5 more
ABSTRACT Prey availability and predation risk drive animal distribution, movement, and foraging ecology, yet studies rarely analyse multiple predator–prey levels together. Understanding how predators optimise risk–reward tradeoffs is important for species conservation and management, especially in systems facing extreme ecosystem change. We examined how top‐down (modelled polar bear habitat selection) and bottom‐up (modelled fish diversity) processes influence the habitat selection, movement, and foraging behaviour of 26 ringed seals (greater than 70,000 dives and 10,000 locations over 877 seal days). Our results suggest that polar bears spatially restrict seal movements and reduce the time seals spend foraging, potentially decreasing foraging success. Seals were more likely to be present and dive longer in high‐predation risk areas when prey diversity was high. Further, seal habitat selection models excluding polar bears overestimated core space use. These findings illustrate the dynamic tradeoffs that mesopredators make when balancing predation risk and resource acquisition.
Journals
2026 EN
Klein Pavel · Aungaroon Gewalin · Biton Victor
+10 more
Abstract Objective Staccato® alprazolam is a hand‐held inhalation device that provides rapid systemic delivery of alprazolam through the intrapulmonary route. This trial explored the pharmacokinetics and tolerability of single‐dose Staccato alprazolam 2 mg in adolescents with epilepsy. Pharmacokinetic data were included in a population pharmacokinetic analysis to support adolescent dose selection in the Phase 3 trials. Methods Multicenter, Phase 1, open‐label trial in adolescents (12–17 years) with focal, generalized, or focal and generalized epilepsy (UP0100/NCT04857307). A single dose of Staccato alprazolam 2 mg was administered in the morning following overnight fast. Pharmacokinetic data were used to update an existing population pharmacokinetic model in adults, which was used to investigate dosing in adolescents with epilepsy. Results Fourteen patients (6 weighing <50 kg, 8 weighing ≥50 kg) were enrolled and administered Staccato alprazolam 2 mg. Individual plasma alprazolam concentration−time profiles indicated generally rapid absorption (median time to maximum plasma concentration [ C max ]: 10.5 [range: 2–120] min) with linear elimination. Geometric mean C max , area under the plasma concentration–time curve (AUC) from time 0 to last quantifiable concentration (AUC 0–t ), AUC from time 0 to infinity (AUC inf ), and apparent total body clearance (CL/ F ) were similar across body weight groups (<50 kg, ≥50 kg). Three patients in the ≥50 kg group reported treatment‐emergent adverse events (TEAEs), including dysgeusia, somnolence, dizziness, cough, and hiccups. No severe or serious TEAEs were reported. Simulations of exposure estimates using the updated population pharmacokinetic model indicated similar exposure (AUC inf ) for adolescents administered Staccato alprazolam 2 mg compared with the adult reference range, with a slight increase in C max at lower body weight. Significance Alprazolam was rapidly absorbed in most adolescent patients with epilepsy following administration with the Staccato device. No clinically relevant differences between body weight groups were observed on primary pharmacokinetic or safety outcomes. Staccato alprazolam 2 mg was well tolerated. Overall, the present data support the use of Staccato alprazolam 2 mg in adolescents with epilepsy (12–17 years of age).