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ABSTRACT Objective Materials and Methods Results Conclusions To explore the oral health‐related quality of life and its possible risk factors among adults with Osteogenesis Imperfecta using the Oral Health Impact Profile (OHIP)‐49 questionnaire. Secondary objectives were to investigate the impact of self‐reported Osteogenesis Imperfecta, Dentinogenesis Imperfecta, and age on various dental parameters.A cross‐sectional questionnaire was distributed online to 417 Dutch adults with Osteogenesis Imperfecta at three national referral centers. Multivariate linear regression was performed to identify indicators for OHIP‐49 Scores. The effect of Osteogenesis Imperfecta, Dentinogenesis Imperfecta, and age on various dental parameters was investigated using logistic regressions (p < 0.05).One hundred and fifty‐five questionnaires (37.2%) were suitable for analysis. Osteogenesis Imperfecta type III was significantly associated with higher OHIP‐49 scores as compared to type I. Symptoms of temporomandibular disorders, missing teeth or dentures also increased the OHIP‐49 scores significantly. Osteogenesis Imperfecta type IV and increasing age were associated with missing teeth. There was a 31.94 times (95% CI: 8.56–119.13) higher odds of tooth fracture with self‐reported Dentinogenesis Imperfecta.Adults with Osteogenesis Imperfecta type III report a lower oral health‐related quality of life compared to Osteogenesis Imperfecta type I adults. [ABSTRACT FROM AUTHOR]

Plants adopt particular growth‐forms when they are exposed to extreme environmental conditions. In this study, we describe a unique woody plant growth‐form induced by large mammalian herbivores and discuss that this growth‐form could have evolved as a strategy for escaping the browser zone in herbivore driven ecosystems.We analysed responses of key architectural and morphological attributes (branching and thorn density, tree dimensions, presence of flowers and fruits) of three Eurasian spiny tree species (Malus sylvestris, Prunus cerasifera and Pyrus communis) to different levels of browsing by large herbivores in the temperate Białowieża Forest, Poland.Under high browsing pressure, studied trees displayed two distinct forms of the crown: a bottom sterile part developing into a densely branched structure with high density of thorns ('cage‐form'), and an upper reproductive part that escaped from herbivore control ('escaped‐form'). The size of cage‐form influenced the feeding behaviour of red deer (Cervus elaphus) by increasing the time deer spend foraging and increasing the bite rate. The height at which cages started to escape and their diameter matched with foraging reach of red deer.Synthesis. We argue that the frequency and cage dimensions of this woody growth‐form in the landscape could inform on the type and intensity of recent herbivory. Moreover, its distinctive inducibility suggests that this growth‐form did not emerge recently under anthropogenic pressure but could be the legacy of ancient herbivory effects. Observational evidence suggests that this growth‐form emerged in several herbivore‐driven systems around the globe and may be used to identify the dominant herbivores that control vegetation structure in these ecosystems. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Background: In people with intellectual disabilities and mental disorders and/or challenging behaviours, rates of psychotropic drug prescription are high. In clinical treatments and evaluations, all stakeholders should be involved in a process of shared decision‐making (SDM). We aimed to investigate the perspectives of clients and their carers on clients' treatments with psychotropic drugs. Methods: We conducted a survey among adults with intellectual disabilities in a Dutch mental healthcare centre providing community, outpatient and inpatient care. Data were collected between January and June 2022. Questions focused on experiences with the provision of information, treatment involvement and SDM and participants' wishes in this regard. Findings: Respondents (57 clients and 21 carers) were largely satisfied with the overall care from their clinicians, and with how information on the pharmacological treatment was provided verbally, but written information was insufficient or not provided. Seventy per cent of clients and 60% of carers reported being involved in medication decision‐making. However, over 75% of participants desired greater involvement in SDM and over 60% in medication reviews. Conclusions: Service users and representatives were satisfied about the treatment and verbal information on their psychotropic drug use. The provision of written information, the SDM process and ongoing evaluation of psychotropic medication use could be improved. Accessible summaries: People with intellectual disabilities are often prescribed medication for mental or behavioural disorders.It is important that healthcare professionals listen to the views of people who are prescribed this medication.However, people may not be involved enough when decisions are made about their medication. They might not have enough information about their medication in a way that they understand. We wanted to know the views of clients with intellectual disability about their psychotropic medication use. We invited clients, their representatives and paid carers of a specialist mental healthcare centre to take part in a survey. Questions were about: (1)The relationship with their doctor.(2)If they were given the right information.(3)Involvement in medication evaluations.(4)Involvement in decisions regarding their medications. Seventy‐eight service users (57 clients and 21 carers) completed the questionnaire. Answers were that: (1)Service users were satisfied with the overall care from their doctor.(2)Service users were satisfied with the information about the prescription of medication that was provided verbally.They were less satisfied about written information that they received about their psychotropic medication.(3)Most service users reported being involved in medication decision‐making, but fewer than half were completely satisfied with this.(4)Most service users wanted to be more involved in decisions about their medication. Our findings mean that healthcare professionals need to do more to involve service users with learning disabilities in decisions about their medication. [ABSTRACT FROM AUTHOR]

Camera trapping has revolutionized wildlife ecology and conservation by providing automated data acquisition, leading to the accumulation of massive amounts of camera trap data worldwide. Although management and processing of camera trap‐derived Big Data are becoming increasingly solvable with the help of scalable cyber‐infrastructures, harmonization and exchange of the data remain limited, hindering its full potential. There is currently no widely accepted standard for exchanging camera trap data. The only existing proposal, "Camera Trap Metadata Standard" (CTMS), has several technical shortcomings and limited adoption. We present a new data exchange format, the Camera Trap Data Package (Camtrap DP), designed to allow users to easily exchange, harmonize and archive camera trap data at local to global scales. Camtrap DP structures camera trap data in a simple yet flexible data model consisting of three tables (Deployments, Media and Observations) that supports a wide range of camera deployment designs, classification techniques (e.g., human and AI, media‐based and event‐based) and analytical use cases, from compiling species occurrence data through distribution, occupancy and activity modeling to density estimation. The format further achieves interoperability by building upon existing standards, Frictionless Data Package in particular, which is supported by a suite of open software tools to read and validate data. Camtrap DP is the consensus of a long, in‐depth, consultation and outreach process with standard and software developers, the main existing camera trap data management platforms, major players in the field of camera trapping and the Global Biodiversity Information Facility (GBIF). Under the umbrella of the Biodiversity Information Standards (TDWG), Camtrap DP has been developed openly, collaboratively and with version control from the start. We encourage camera trapping users and developers to join the discussion and contribute to the further development and adoption of this standard. [ABSTRACT FROM AUTHOR]

The wolf (Canis lupus) is arguably the most successful species at recolonizing its now human‐dominated former ranges in Europe and North America. Over the centuries while the wolf was absent, humans have transformed ecosystems to a large extent. In this paper, we highlight key aspects of these human‐modified ecosystems that include changes to (meso)carnivore communities, wolves themselves (genetics, behaviour), woody plant communities and the playing field for predator–prey interactions (landscape structure).We argue that the recognition of the novelty of human‐modified ecosystems logically leads to novel pathways of how wolves can influence ecosystem functioning. Thus far, the ecological impacts of wolves in human‐dominated systems have largely been predicted based on the documented effects they have on prey species or lower trophic levels in well‐preserved systems with low human impact. However, wolves in human‐modified ecosystems will engage in an array of novel interactions and potential novel trophic cascades that do not occur in more natural ecosystems with lower human impact.This should encourage us to re‐assess the questions we ask about wolf impacts in novel systems. A promising direction for future studies is exploring what novel interactions establish and under what conditions wolves can exert their ecosystem impacts (context dependence) in the human‐modified ecosystems wolves are recolonizing.Policy implications. Understanding these novel interactions and the context dependence of ecosystem impacts could guide us to act to improve conditions to enable wolves to exert their ecosystem impacts again. These novel interactions may be the true ecological and societal value of having wolves returning to human‐modified landscapes. [ABSTRACT FROM AUTHOR]

The term pyric herbivory was first introduced in 2009, describing how fire shapes herbivory as burned areas attract herbivores and, simultaneously, herbivory shapes fuel load and fire behaviour. Pyric herbivory results in a mosaic of patches with varying levels of herbivory and grazing intensity fire intensity and frequency. The importance of pyric herbivory for ecosystem heterogeneity and biodiversity has been described for North American, Australian and African systems, but the concept remains largely untested in a European context.We introduced fire and herbivory in a full‐factorial experiment in a temperate European wood‐pasture system to test whether pyric herbivory operates in ways comparable to grassy systems elsewhere in the world. Using camera traps, we observed the behaviour of cattle in burned subplots (49 m2) compared with unburned subplots. We measured grass height and the proportion of the subplot that burned as variables affecting cattle preference and to assess how grazing affects fire behaviour. We also examined the effect on plant species and life‐form composition after six seasons of treatment.Cattle spent more time grazing in burned than in unburned subplots in the most productive paddock, where a larger proportion of the subplot burned. The proportion of a subplot that burned was positively related to pre‐fire grass height. Moreover, both grass height and the proportion of subplot burned declined in the burned subplots during the 6‐year study period and fire and cattle grazing altered the relative cover of graminoids and shrubs (Rubus spp.), with more graminoids in grazed and/or burned subplots and more shrubs in ungrazed subplots at the end of the study.Synthesis and applications. In our temperate European wood pasture, fire and (cattle) grazing interacted in ways comparable to pyric herbivory in grassy ecosystems elsewhere in the world, especially in the most productive paddock. Fire attracted grazing, with cattle grazing longer on subplots that burned more fully. Grazing also affected fire, where over the course of our experiment cattle grazing reduced grass height and the proportion of a subplot that burned. We suggest that pyric herbivory is an interesting management method to further explore in the European context to address the loss of biodiversity in open ecosystems, particularly in more productive sites. [ABSTRACT FROM AUTHOR]

Summary: Function as a service (FaaS) promises low operating costs, reduced complexity, and good application performance. However, it is still an open question how to migrate monolithic applications to FaaS. In this paper, we present a guideline for software designers to split monolithic applications into smaller functions that can be executed in a FaaS environment. This enables independent scaling of individual parts of the application. Our approach consists of three steps: We first identify the main tasks (and their subtasks) of the application to split. Then, we define the program flow to be able to tell which application tasks can be converted to functions and how they interact with each other. In the final step, we specify actual functions and possibly merge those that are too small and which would produce too much communication overhead or maintenance effort. Compared to existing work, our approach applies to applications of any size and results in functions that are small enough—but not too small—for efficient execution in a FaaS environment. We evaluate the usefulness of our approach by applying it to a real‐world application for the storage of geospatial data. We describe the experiences made and finish the paper with a discussion, conclusions, and ideas for future work. [ABSTRACT FROM AUTHOR]

Many mesocarnivores are fossorial and use burrow systems to avoid predators. But fossorial animals cannot stay safely underground forever; they must also risk emerging overground to forage and find mates. To make this trade‐off effectively and maximise their own fitness, it is imperative they assess how risk varies in space and time and adapt their denning behaviour accordingly. We used the badger in Białowieża Forest, Poland, as a model for investigating how the denning behaviour of a fossorial mesocarnivore varies in response to short‐term large carnivore risk. To this end, we experimentally simulated perceived wolf presence outside 10 badger setts using audio playbacks of wolves (their howls). We assayed two behavioural measures of fear: badger emergence time from setts on the day playbacks were broadcast and their presence in setts on the day after. We found that neither badger emergence time nor next‐day sett use varied in response to wolf playbacks. The results of the present study contrast with a previous study of ours that found badgers used setts in areas with high landscape level perceived wolf risk less often than those in lower‐risk areas. Together, these papers' findings suggest that different spatiotemporal scales of perceived risk can have differential effects on badger behaviour. We conclude that rather than take risk avoidance measures at all risky times and places, badgers likely display a diversity of reactions to large carnivore presence that depend on the context and spatiotemporal scale of the risk being perceived. [ABSTRACT FROM AUTHOR]

Background: Effects of staff provided positive behaviour support (PBS) for individuals with intellectual disabilities are unclear. Method: Using a multicentre non‐randomised cluster controlled design, 26 teams of residential group homes, including 245 staff members of 167 individuals with intellectual disabilities, were allocated to a PBS or control group. Conducting multilevel analyses (n = 123) we examined individuals' changes in irritability, other challenging behaviours and quality of life. Results: Compared to controls, irritability did not significantly decrease more in the intervention group, but lethargic behaviours did. Personal development and self‐determination significantly increased. Irritability of individuals in the PBS group with higher levels of irritability or lower levels of intellectual disability significantly reduced more compared to controls. Conclusions: PBS was effective in reducing irritability of individuals with severe levels of irritability or intellectual disabilities. Moreover, PBS decreased lethargic behaviours and improved several domains of quality of life. [ABSTRACT FROM AUTHOR]

Terrestrial ecosystems are shaped by interacting top‐down and bottom‐up processes, with the magnitude of top‐down control by large carnivores largely depending on environmental productivity. While carnivore‐induced numerical effects on ungulate prey populations have been demonstrated in large, relatively undisturbed ecosystems, whether large carnivores can play a similar role in more human‐dominated systems is a clear knowledge gap. As humans influence both predator and prey in a variety of ways, the ecological impacts of large carnivores can be largely modified. We quantified the interactive effects of human activities and large carnivore presence on red deer (Cervus elaphus) population density and how their impacts interacted and varied with environmental productivity.Data on red deer density were collected based on a literature survey encompassing 492 study sites across 28 European countries. Variation in density across study sites was analysed using a generalized additive model in which productivity, carnivore presence (grey wolf, European lynx, Brown bear), human activities (hunting, intensity of human land‐use activity), site protection status and climatic variables served as predictors.The results showed that a reduction in deer density only occurred when wolf, lynx and bear co‐occurred within the same site. In the absence of large carnivores, red deer density varied along a productivity gradient without a clear pattern. Although a linear relationship with productivity in the presence of all three large carnivore species was found, this was not statistically significant. Moreover, hunting by humans had a stronger effect than the presence of all large carnivores in reducing red deer density and red deer density increased with increasing intensity of human land use, with stronger large carnivore effects (all three carnivore species present) at sites with low human land‐use activities.Synthesis and applications. This study provides evidence for the dominant role played by humans (i.e. hunting, land‐use activities) relative to large carnivores in reducing red deer density across European human‐dominated landscapes. These findings suggest that when we would like large carnivores to exert numeric effects, we should focus on minimizing human impacts to allow the ecological impacts of large carnivores on ecosystem functioning. [ABSTRACT FROM AUTHOR]

Nurse clinician‐scientists are increasingly expected to show leadership aimed at transforming healthcare. However, research on nurse clinician‐scientists' leadership (integrating researcher and practitioner roles) is scarce and hardly embedded in sociohistorical contexts. This study introduces leadership moments, that is, concrete events in practices that are perceived as acts of empowerment, in order to understand leadership in the daily work of newly appointed nurse clinician‐scientists. Following the learning history method we gathered data using multiple (qualitative) methods to get close to their daily practices. A document analysis provided us with insight into the history of nursing science to illustrate how leadership moments in the everyday work of nurse clinician‐scientists in the "here and now" can be related to the particular histories from which they emerged. A qualitative analysis led to three acts of empowerment: (1) becoming visible, (2) building networks, and (3) getting wired in. These acts are illustrated with three series of events in which nurse clinician‐scientists' leadership becomes visible. This study contributes to a more socially embedded understanding of nursing leadership, enables us to get a grip on crucial leadership moments, and provides academic and practical starting points for strengthening nurse clinician‐scientists' leadership practices. Transformations in healthcare call for transformed notions of leadership. [ABSTRACT FROM AUTHOR]

This article explores the potential use of fecal microbiota transplantation (FMT) as a treatment for Parkinson's disease (PD) by targeting the gut-brain axis. It discusses the role of the gut in PD and the differences in gut microbiota composition between PD patients and healthy individuals. FMT has the potential to modify the gut microbiota and potentially reduce inflammation and PD symptoms, but more research is needed to determine its efficacy and safety. The article emphasizes the need for caution and further testing before considering microbiota-modifying strategies for PD. Additionally, the article titled "Movement Disorders Clinical Practice 2023" provides a comprehensive overview of movement disorders, including PD, and is a valuable resource for those researching this topic. [Extracted from the article]

Objective: Whereas in the treatment of rheumatoid arthritis much evidence exists on the effects of current pharmacologic treatment on clinical outcomes, little is known about the effects on patient‐reported outcomes. This systematic review aims to evaluate the effects of disease‐modifying antirheumatic drugs (DMARDs) on the patient‐relevant domains of pain, fatigue, activity limitation, overall emotional and physical health impact, and work/school/housework ability and productivity. Methods: A literature search was conducted to identify randomized controlled trials wherein registered DMARDs were compared with placebo or methotrexate and reported the effects on patient‐reported outcomes included in the International Consortium of Health Outcomes Measurement standard set for inflammatory arthritis. Random effects meta‐analyses using the standardized mean differences of change scores as the effect measure were performed for the domains of pain, fatigue, and activity limitation, comparing DMARDs with placebo and methotrexate. The other 2 domains were presented narratively. Results: Across the 5 domains, 69 records belonging to 52 studies were identified. All meta‐analyses showed a decrease of burden when DMARDs were compared with placebo (standardized mean differences [95% confidence interval] in pain −0.80 [−0.99, −0.61], fatigue −0.48 [−0.64, −0.32], and activity limitation −0.56 [− 0.63, −0.49]) and when compared with methotrexate (−0.55 [−0.70, −0.41), −0.44 [−0.55, −0.33], and − 0.37 [−0.44, −0.30], respectively). Conclusion: DMARDs decrease the burden in all the domains that are relevant to patients. Effect sizes may be influenced by DMARD type. Therefore, in the decision for rheumatoid arthritis treatment, patient‐reported outcomes should be taken into account. [ABSTRACT FROM AUTHOR]

New treatment options and centralization of surgery have improved survival for patients with non‐metastatic esophageal or gastric cancer. It is unknown, however, which patients benefitted the most from treatment advances. The aim of this study was to identify best‐case, typical and worst‐case scenarios in terms of survival time, and to assess if survival associated with these scenarios changed over time. Patients with non‐metastatic potentially resectable esophageal or gastric cancer diagnosed between 2006 and 2020 were selected from the Netherlands Cancer Registry. Best‐case (20th percentile), upper‐typical (40th percentile), typical (median), lower‐typical (60th percentile) and worst‐case (80th percentile) survival scenarios were defined, and regression analysis was used to investigate the change in survival time for each scenario across years. For patients with esophageal cancer (N = 24 352) survival time improved on average 12.0 (until 2011), 1.5 (until 2018), 0.7, 0.4 and 0.2 months per year for the best‐case, upper‐typical, median, lower‐typical and worst‐case scenario, respectively. For patients with gastric cancer (N = 9993) survival time of the best‐case scenario remained constant, whereas the upper‐typical, median, lower‐typical and worst‐case scenario improved on average with 1.0 (until 2018), 0.5, 0.2 and 0.2 months per year, respectively. Subgroup analyses showed that, survival scenarios improved for nearly all patients across treatment groups and for patients with squamous cell carcinomas or adenocarcinomas. Survival improved for almost all patients suggesting that in clinical practice the vast majority of patients benefitted from treatment advances. The clinically most meaningful survival advantage was observed for the best‐case scenario of esophageal cancer. [ABSTRACT FROM AUTHOR]

Objective: Dysregulated APRIL/BAFF signaling is implicated in the pathogenesis of multiple autoimmune diseases, including systemic lupus erythematosus and lupus nephritis. We undertook this study to develop and evaluate a high‐affinity APRIL/BAFF antagonist to overcome the clinical limitations of existing B cell inhibitors. Methods: A variant of TACI‐Fc generated by directed evolution showed enhanced binding for both APRIL and BAFF and was designated povetacicept (ALPN‐303). Povetacicept was compared to wild‐type (WT) TACI‐Fc and related molecules in vitro and in vivo. Results: Povetacicept inhibited APRIL and BAFF more effectively than all evaluated forms of WT TACI‐Fc and selective APRIL and BAFF inhibitors in cell‐based reporter assays and primary human B cell assays, mediating potent suppression of B cell proliferation, differentiation, and immunoglobulin (Ig) secretion. In mouse immunization models, povetacicept significantly reduced serum immunoglobulin titers and antibody‐secreting cells more effectively than anti‐CD20 monoclonal antibodies, WT TACI‐Fc, or APRIL and BAFF inhibitors. In the NZB × NZW mouse lupus nephritis model, povetacicept significantly enhanced survival and suppressed proteinuria, anti–double‐stranded DNA antibody titers, blood urea nitrogen, glomerulonephritis, and renal immunoglobulin deposition. In the bm12 mouse lupus model, povetacicept significantly reduced splenic plasmablasts, follicular helper T cells, and germinal center B cells. In non‐human primates, povetacicept was well tolerated, exhibited high serum exposure, and significantly decreased serum IgM, IgA, and IgG levels after a single dose. Conclusion: Enhanced APRIL and BAFF inhibition by povetacicept led to greater inhibition of B cell populations critical for autoantibody production compared to WT TACI‐Fc and CD20‐, APRIL‐, or BAFF‐selective inhibitors. Potent, dual inhibition by povetacicept has the potential to significantly improve clinical outcomes in autoantibody‐related autoimmune diseases. [ABSTRACT FROM AUTHOR]

Conditional relative survival (CRS) is useful for communicating prognosis to patients as it provides an estimate of the life expectancy after having survived a certain time after treatment. Our study estimates the 3‐year relative survival conditional on having survived a certain period for patients with esophageal or gastric cancer. Patients with nonmetastatic esophageal or gastric cancer diagnosed between 2006 and 2020 treated with curative intent (resection with or without [neo]adjuvant therapy, or chemoradiotherapy) were selected from the Netherlands Cancer Registry. CRS was calculated since resection or last day of chemoradiotherapy. The probability of surviving an additional 3 years (ie, 3‐year CRS), if the patients survived 1, 3 and 5 years after diagnosis was 62%, 79%, 87% and 69%, 84%, 90% for esophageal and gastric cancer, respectively. The 3‐year CRS after having survived 3 years for patients with esophageal cancer who underwent a resection (n = 12 204) was 91%, 88%, 77% and 60% for pathological Stage 0, I, II and III, and for patients with esophageal cancer who received chemoradiotherapy (n = 4158) was 51% and 66% for clinical Stage II and III, respectively. The 3‐year CRS after having survived 3 years for patients with gastric cancer who underwent a resection (n = 6531) was 99%, 90%, 73% and 59% for pathological Stage 0, I, II and III, respectively. Despite poor prognosis of patients with esophageal or gastric cancer, life expectancy increases substantially after patients have survived several years after treatment. Our study provides valuable information for communication of prognosis to patients during follow‐up after treatment. [ABSTRACT FROM AUTHOR]

Prior models have been developed to predict survival for patients with esophagogastric cancer undergoing curative treatment or first‐line chemotherapy (SOURCE models). Comprehensive clinical prediction models for patients with esophagogastric cancer who will receive second‐line chemotherapy or best supportive care are currently lacking. The aim of our study was to develop and internally validate a new clinical prediction model, called SOURCE beyond first‐line, for survival of patients with metastatic esophagogastric adenocarcinoma after failure of first‐line palliative systemic therapy. Patients with unresectable or metastatic esophageal or gastric adenocarcinoma (2015‐2017) who received first‐line systemic therapy (N = 1067) were selected from the Netherlands Cancer Registry. Patient, tumor and treatment characteristics at primary diagnosis and at progression of disease were used to develop the model. A Cox proportional hazards regression model was developed through forward and backward selection using Akaike's Information Criterion. The model was internally validated through 10‐fold cross‐validations to assess performance. Model discrimination (C‐index) and calibration (slope and intercept) were used to evaluate performance of the complete and cross‐validated models. The final model consisted of 11 patient tumor and treatment characteristics. The C‐index was 0.75 (0.73‐0.78), calibration slope 1.01 (1.00‐1.01) and calibration intercept 0.01 (0.01‐0.02). Internal cross‐validation of the model showed that the model performed adequately on unseen data: C‐index was 0.79 (0.77‐0.82), calibration slope 0.93 (0.85‐1.01) and calibration intercept 0.02 (−0.01 to 0.06). The SOURCE beyond first‐line model predicted survival with fair discriminatory ability and good calibration. [ABSTRACT FROM AUTHOR]

Background: Interventions for challenging behaviours in individuals with intellectual disabilities benefit from outcome monitoring that takes clients' preferences into account. We determined clients' and representatives' preferred outcome domains and measures to secure their involvement in treatment decisions for challenging behaviours. Method: We used an inclusive Delphi method. A focus group of individuals with mild intellectual disabilities and representatives of those with moderate and severe intellectual disabilities prepared the first round by assisting us in collecting possible outcomes. Panels of individuals with intellectual disabilities and representatives were composed to achieve consensus on instruments for preferred outcome domains. Results: Preferred outcome domains were behaviour, side‐effects of psychotropic drugs, quality of life, daily functioning, caregiver burden and family quality of life. Corresponding outcome measures included self‐report, interview and proxy‐scales, including spoken versions. Conclusion: Including the preferred domains on outcomes of interventions for challenging behaviours is recommended. Research on corresponding outcome measures is necessary. [ABSTRACT FROM AUTHOR]

Aim: Several large‐mammal species in Europe have recovered and recolonized parts of their historical ranges. Knowing where suitable habitat exists, and thus where range expansions are possible, is important for proactively promoting coexistence between people and large mammals in shared landscapes. We aimed to assess the opportunities and limitations for range expansions of Europe's two largest herbivores, the European bison (Bison bonasus) and moose (Alces alces). Location: Central Europe. Methods: We used large occurrence datasets from multiple populations and species distribution models to map environmentally suitable habitats for European bison and moose across Central Europe, and to assess human pressure inside the potential habitat. We then used circuit theory modeling to identify potential recolonization corridors. Results: We found widespread suitable habitats for both European bison (>120,000 km2) and moose (>244,000 km2), suggesting substantial potential for range expansions. However, much habitat was associated with high human pressure (37% and 43% for European bison and moose, respectively), particularly in the west of Central Europe. We identified a strong east–west gradient of decreasing connectivity, with major barriers likely limiting natural recolonization in many areas. Main conclusions: We identify major potential for restoring large herbivores and their functional roles in Europe's landscapes. However, we also highlight considerable challenges for conservation planning and wildlife management, including areas where recolonization likely leads to human–wildlife conflict and where barriers to movement prevent natural range expansion. Conservation measures restoring broad‐scale connectivity are needed in order to allow European bison and moose to recolonize their historical ranges. Finally, our analyses and maps indicate suitable but isolated habitat patches that are unlikely to be colonized but are candidate locations for reintroductions to establish reservoir populations. More generally, our work emphasizes that transboundary cooperation is needed for restoring large herbivores and their ecological roles, and to foster coexistence with people in Europe's landscapes. [ABSTRACT FROM AUTHOR]

Objective: Laser‐based tissue perfusion monitoring techniques have been increasingly used in animal and human research to assess blood flow. However, these techniques use arbitrary units, and knowledge about their comparability is scarce. This study aimed to model the relationship between laser speckle contrast imaging (LSCI) and laser Doppler perfusion imaging (LDPI), for measuring tissue perfusion over a wide range of blood flux values. Methods: Fifteen healthy volunteers (53% female, median age 29 [IQR 22–40] years) were enrolled in this study. We performed iontophoresis with sodium nitroprusside on the forearm to induce regional vasodilation to increase skin blood flux. Besides, a stepwise vascular occlusion was applied on the contralateral upper arm to reduce blood flux. Both techniques were compared using a linear mixed model analysis. Results: Baseline blood flux values measured by LSCI were 33 ± 6.5 arbitrary unit (AU) (Coefficient of variation [CV] = 20%) and by LDPI 60 ± 11.5 AU (CV = 19%). At the end of the iontophoresis protocol, the regional blood flux increased to 724 ± 412% and 259 ± 87% of baseline measured by LDPI and LSCI, respectively. On the other hand, during the stepwise vascular occlusion test, the blood flux reduced to 212 ± 40% and 412 ± 177% of its baseline at LDPI and LSCI, respectively. A strong correlation was found between the LSCI and LDPI instruments at increased blood flux with respect to baseline skin blood flux; however, the correlation was weak at reduced blood flux with respect to baseline. Discussion: LSCI and LDPI instruments are highly linear for blood flux higher than baseline skin blood flux; however, the correlation decreased for blood flux lower than baseline. This study's findings could be a basis for using LSCI in specific patient populations, such as burn care. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic performance and clinical utility of the Rotterdam Early Arthritis Cohort (REACH) and the Clinical Arthritis Rule (CARE) referral rules in an independent population of unselected patients from primary care. Methods: This study consisted of adults who were suspected of the need for referral to a rheumatologist by their general practitioner. Diagnostic accuracy measures and a net benefit approach were used to compare both rules to usual care for recognizing inflammatory arthritis and inflammatory rheumatic diseases (IRDs). Using the least absolute shrinkage and selection operator method and cross‐validation we created an optimal prediction rule for IRD. Results: This study consisted of 250 patients, of whom 42 (17%) were diagnosed with inflammatory arthritis and 55 (22%) with an IRD 3 months after referral. Considering inflammatory arthritis, the area under the receiver operating characteristic curve (AUC) was 0.72 (95% confidence interval [95% CI] 0.64–0.80) for REACH and 0.82 (95% CI 0.75–0.88) for CARE. Considering IRD, the AUC was 0.66 (95% CI 0.58–0.74) for REACH and 0.76 (95% CI 0.69–0.83) for CARE. CARE was of highest clinical value when compared to usual care. The composite referral rule for IRD of 10 parameters included sex, age, joint features, acute onset of symptoms, physical limitations, and duration of symptoms (AUC 0.82 [95% CI 0.75–0.88]). Conclusion: Both validated rules have a net benefit in recognizing inflammatory arthritis as well as IRD compared to usual care, but CARE shows superiority over REACH. Although the composite referral rule indicates a greater diagnostic performance, external validation is needed. [ABSTRACT FROM AUTHOR]

This article draws on ethnographic research to conceptualise how nurses mobilise assemblages of caring to organise and deliver COVID care; particularly so by reorganising organisational infrastructures and practices of safe and good care. Based on participatory observations, interviews and nurse diaries, all collected during the early phase of the pandemic, the research shows how the organising work of nurses unfolds at different health‐care layers: in the daily care for patients and their families, in the coordination of care in and between hospitals, and at the level of the health‐care system. These findings contrast with the dominant pandemic‐image of nurses as 'heroes at the bedside', which fosters the classic and microlevel view of nursing and leaves the broader contribution of nurses to the pandemic unaddressed. Theoretically, the study adds to the literature on translational mobilisation and assemblage theory by focussing on the layered and often invisible organising work of nurses in health care. [ABSTRACT FROM AUTHOR]

The recent COVID‐19 pandemic has increased the focus on hygienic and contactless identity verification methods. However, the pandemic led to the wide use of face masks, essential to keep the pandemic under control. The effect of wearing a mask on face recognition (FR) in a collaborative environment is a currently sensitive yet understudied issue. Recent reports have tackled this by evaluating the masked probe effect on the performance of automatic FR solutions. However, such solutions can fail in certain processes, leading to the verification task being performed by a human expert. This work provides a joint evaluation and in‐depth analyses of the face verification performance of human experts in comparison to state‐of‐the‐art automatic FR solutions. This involves an extensive evaluation by human experts and 4 automatic recognition solutions. The study concludes with a set of take‐home messages on different aspects of the correlation between the verification behaviour of humans and machines. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the associations between individual staff and staff team characteristics and quality of life of individuals with intellectual disabilities and challenging behaviours. Method: With multilevel analyses, we examined educational level, experience, attitudes and behaviours of 240 staff members, in relation to their perception of quality of life of 152 individuals with intellectual disabilities and challenging behaviours they cared for. Results: Two individual staff characteristics were related to better quality of life: higher educational and self‐reflection levels. Of the team characteristics, higher educational level, higher self‐efficacy and more friendly behaviour were associated with better quality of life. Unexpectedly, higher staff‐individual ratio was related to lower quality of life. Conclusions: Both individual staff and staff team characteristics are associated with quality of life, indicating the need to take staff team characteristics into account when examining quality of life. [ABSTRACT FROM AUTHOR]

Objectives: Patients on chronic lithium therapy sometimes develop chronic kidney disease. For clinical decision–making, it is important to know whether discontinuation of lithium can lead to improvement of renal function. We studied the trajectory of renal function in a population previously on chronic lithium therapy. Methods: From a large database of patients on chronic lithium therapy, we selected a group of patients who stopped using lithium and whose creatinine values at least half a year after lithium withdrawal were available. We measured the slope of renal function (eGFR) before and after discontinuation of lithium. We compared the subgroup of patients with improvement of the renal function with those who showed further deterioration of the eGFR. Results: eGFR slope significantly improved after discontinuation of lithium. Of patients with chronic kidney disease stage 3 or more (eGFR<60 ml/min), the vast majority showed an increase of eGFR or a decrease in the rate of decline after lithium withdrawal. The group of patients with further deterioration of the renal function had a mean eGFR of 32 ml/min, which was significantly lower than the patients with an improvement of the kidney function. Conclusions: Discontinuation of lithium leads in the majority of patients to improvement in renal function or at least less rapid deterioration. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The recolonization of human‐dominated landscapes by large carnivores has been followed with considerable scientific interest; however, little is known about their interactive effect on ungulate foraging behavior. This study compared the risks imposed by humans and lynx on ungulate foraging behavior by examining the effects of browsing intensity (at two spatial scales), diet quality, and tree species selection. We hypothesized that: (1) in areas with high risk imposed by humans and lynx browsing intensity would be reduced; (2) risk effects would interact with habitat visibility at a fine scale, resulting in contrasting browsing patterns in response to humans versus lynx risk; (3) ungulates compensate for the higher costs incurred in high‐risk areas by switching to a higher diet quality, and (4) browse a higher proportion of more‐preferred tree species. These hypotheses were tested by measuring browsing intensity along 48 transects located at different distances from human settlements within the hunted and nonhunted areas of the Bavarian Forest. Dung samples were collected and analyzed as a proxy of diet quality (C:N ratio, fiber). The spatial patterns of browsing intensity, diet quality, and tree species selection were then linked to lynx risk, hunting intensity, recreation intensity, and distance to human settlements. Our results showed that (1) browsing intensity strongly decreased with increasing recreational activities, whereas it increased with lynx risk; (2) only in close proximity to human settlements tree browsing was higher in dense habitats and (3) a higher diet quality was obtained. (4) We found a stronger avoidance of the less preferred tree species in high‐hunting intensity areas. In conclusion, our results indicate that the risk effects of human activities outweigh those of a natural large carnivore. Thus, highlighting the importance of taking those activities into account in predicting the impacts of large carnivores on ungulates and their plant‐food choices. [ABSTRACT FROM AUTHOR]

Humans are increasingly acknowledged as apex predators that shape landscapes of fear to which herbivores adapt their behaviour. Here, we investigate how humans modify deer space‐use and their effects on vegetation at two spatial scales; zones with different types of human use (largescale risk factor) and, nested within that, trails (fine‐scale risk factor). In zones with three contrasting types of human activities: 1) no recreation, no hunting, 2) with recreation, no hunting and 3) with recreation and hunting, we linked deer space‐use (dropping counts) to browsing intensity, relative growth and survival of planted saplings. Plots were located at two distances to trails (20 versus 100 m) to test how trails affect deer space‐use and sapling performance. Additionally, plots were distributed over forest and heathland as risk effects are habitat‐dependent. Deer space‐use was highest in the zone without recreation or hunting, resulting in higher browsing levels and lower sapling growth and survival, but only in heathland. In contrast, deer space‐use and sapling performance did not differ between zones with recreation only and zones with recreation and hunting. Deer dropping counts were lower near trails used for recreation, but this was not associated with browsing impact or sapling performance. Our results show that recreational use modifies deer space‐use which is associated with browsing impact on woody vegetation, while seasonal hunting activities in zones with recreation did not have additive year‐round effects. Yet, effects were only observed at the larger scale of recreation zones and not near trails. Furthermore, deer space‐use was only associated with sapling performance in open heathland, where high visibility presumably increases avoidance behaviour because it increases detectability and decreases escape possibilities. This suggests that recreation creates behaviourally mediated cascading effects that influence vegetation development, yet these effects are context‐dependent. We advocate incorporating human‐induced fear effects in conservation, management and research. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Face recognition is an essential technology in our daily lives as a contactless and convenient method of accurate identity verification. Processes such as secure login to electronic devices or identity verification at automatic border control gates are increasingly dependent on such technologies. The recent COVID‐19 pandemic has increased the focus on hygienic and contactless identity verification methods. The pandemic has led to the wide use of face masks, essential to keep the pandemic under control. The effect of mask‐wearing on face recognition in a collaborative environment is currently a sensitive yet understudied issue. Recent reports have tackled this by using face images with synthetic mask‐like face occlusions without exclusively assessing how representative they are of real face masks. These issues are addressed by presenting a specifically collected database containing three sessions, each with three different capture instructions, to simulate real use cases. The data are augmented to include previously used synthetic mask occlusions. Further studied is the effect of masked face probes on the behaviour of four face recognition systems—three academic and one commercial. This study evaluates both masked‐to‐non‐masked and masked‐to‐masked face comparisons. In addition, real masks in the database are compared with simulated masks to determine their comparative effects on face recognition performance. [ABSTRACT FROM AUTHOR]

Background: A high prevalence of COVID‐19 associated pulmonary aspergillosis (CAPA) has been reported, though histopathological evidence is frequently lacking. To assess the clinical significance of Aspergillus species in respiratory samples of mechanically ventilated COVID‐19 patients, we implemented routine screening for Aspergillus in tracheal aspirate (TA). Patients/methods: From all adult COVID‐19 patients admitted to the intensive care unit (ICU), TA samples were collected twice a week for Aspergillus screening by PCR and or culture. Bronchoalveolar lavage (BAL) sampling was performed in patients with a positive screening result if possible. Clinical information was obtained from the electronic patient record and patients were categorised according to the recently published consensus case definition for CAPA. Results: Our study population consisted of 63 predominantly (73%) male patients, with a median age of 62 years and total median ICU stay of 18 days. Aspergillus species were present in TA screening samples from 15 patients (24%), and probable CAPA was diagnosed in 11 (17%) patients. Triazole resistance was detected in one patient (14%). Concordance between TA and BAL was 86%, and all TA culture positives were confirmed in BAL. We were able to withhold treatment in three of fifteen patients with positive screening (20%) but negative BAL results. Conclusions: Positive culture, molecular detection and or antigen detection of Aspergillus species do not equal infection. Until we understand the clinical relevance of Aspergillus species detected in respiratory samples of COVID‐19 patients, minimal‐invasive screening by TA is a feasible method to monitor patients. Positive screening results should be an indication to perform a BAL to rule out upper airway colonisation. [ABSTRACT FROM AUTHOR]

Background: Staff supporting individuals with intellectual disabilities are at risk of burnout symptoms. Evidence suggests an association between exposure to challenging behaviours of individuals with intellectual disabilities and burnout symptoms of staff, but the protective role of staff psychological resources in this relation has been understudied. Method: We investigated the association between exposure to challenging behaviours and burnout symptoms of staff and the direct and moderating effects of several psychological resources. Staff (N = 1271) completed an online survey concerning burnout symptoms (subscale Emotional Exhaustion of the Maslach Burnout Inventory), exposure to challenging behaviours and a range of potential psychological resources. We examined main and moderating effects with multilevel analyses. In order to control for the multiple comparisons, P values corrected for false discovery rate (PFDR) were reported. Results: We found a direct relation between exposure to challenging behaviours and increased levels of burnout symptoms in staff (b =.15, t(670) = 4.466, PFDR <.0001). Perceived supervisor social support (b = −.97, t(627) = −7.562, PFDR <.0001), staff self‐efficacy (b = −.23, t(673) = −3.583, PFDR <.0001), resilience (b = −.19, t(668) = −2.086, PFDR <.05) and extraversion (b = −.20, t(674) = −3.514, PFDR <.05) were associated with reduced burnout symptoms. None of the proposed psychological resources moderated the association between exposure to challenging behaviours and burnout symptoms of staff. Conclusions: Of the psychological resources found to be associated with reduced risk of burnout symptoms, staff self‐efficacy and access of staff to supervisor social support seem to be the factors that can be influenced best. These factors thus may be of importance in reducing the risk of developing burnout symptoms and improving staff well‐being, even though the current study was not designed to demonstrate causal relations between psychological resources and burnout symptoms. [ABSTRACT FROM AUTHOR]

Although environmental variability and predictability have been proposed as the underlying ecological context in which transgenerational plasticity (TGP) arises, the adaptive significance and interaction with within‐generation plasticity (WGP) in such scenarios is still poorly understood. To investigate these questions, we considered the tolerance to upper thermal limits of larvae and adults of the desert endemic Drosophila mojavensis adapted to different climatic regions (Desert vs. Mediterranean climate).Thermal plasticity was investigated by acclimating parents and offspring at 36°C (vs. at 25°C). We then used historical temperature variation data from both regions to perform individual‐based simulations by modelling expected components of adaptive plasticity in multiple life stages.Our results indicated that thermal response to ramping heat shocks was more pronounced in larvae, where acclimation treatments in parents and offspring increased their heat‐shock performance, while heat knockdown in adults was only increased by offspring acclimation of adults. The relative contribution of WGP and TGP was greater for the population from the more thermally variable Sonoran Desert.Similarly, individual‐based simulations of evolving maternal effects indicated that variation in tolerance to upper thermal limits across life stages and climates is expected from its adaptive significance in response to environmental predictability.Our approach offers a new perspective and interpretation of adaptive plasticity, demonstrating that environmental predictability can drive thermal responses across generations and life stages in a scenario with regional climate variability. A free Plain Language Summary can be found within the Supporting Information of this article. [ABSTRACT FROM AUTHOR]

Many medium‐sized carnivores are fossorial and use burrow systems to reduce predation risk or avoid predators. But fossorial species cannot stay safely underground forever, and they must also risk emerging overground, to forage and find mates. To make this trade‐off effectively and maximize their own fitness, it is imperative they assess how predation risk varies in space and time, and adapt their denning behaviour accordingly. We used European badger (Meles meles) burrows (setts) in Białowieża Forest, Poland as a model for investigating how the denning behaviour of a fossorial mesocarnivore varies across gradients of landscape scale perceived risk imposed by wolves (Canis lupus) and humans, defined as wolf space use and distance to settlements, respectively. We monitored seventeen setts with varying levels of perceived human and wolf risk with camera traps for two months to study three denning behaviours: frequency of badger sett use, frequency of badger sett sharing with other mesocarnivore species and badger emergence time. Frequency of sett use varied relative to perceived wolf but not human risk. Setts in the highest risk areas were used ca. 60% less often than those in the lowest perceived risk areas, and setts with juveniles were only present in areas of lower perceived risk. Food availability, quantified as earthworm abundance in an area of 2.1 km2 around setts, did not affect the frequency setts were used. Emergence time and frequency of sett sharing with other mesocarnivores, which have been proposed to be anti‐predator strategies, did not vary with either perceived risk factor. These results show fossorial species can adapt their use of burrows to the prevailing risk landscape and suggest burrows deserve more attention in studies on the ecological impacts of apex predators. [ABSTRACT FROM AUTHOR]

Antisense oligonucleotide (AON) therapies involve short strands of modified nucleotides that target RNA in a sequence‐specific manner, inducing targeted protein knockdown or restoration. Currently, 10 AON therapies have been approved in the United States and Europe. Nucleotides are chemically modified to protect AONs from degradation, enhance bioavailability and increase RNA affinity. Whereas single stranded AONs can efficiently be delivered systemically, delivery of double stranded AONs requires capsulation in lipid nanoparticles or binding to a conjugate as the uptake enhancing backbone is hidden in this conformation. With improved chemistry, delivery vehicles and conjugates, doses can be lowered, thereby reducing the risk and occurrence of side effects. AONs can be used to knockdown or restore levels of protein. Knockdown can be achieved by single stranded or double stranded AONs binding the RNA transcript and activating RNaseH‐mediated and RISC‐mediated degradation respectively. Transcript binding by AONs can also prevent translation, hence reducing protein levels. For protein restoration, single stranded AONs are used to modulate pre‐mRNA splicing and either include or skip an exon to restore protein production. Intervening at a genetic level, AONs provide therapeutic options for inherited metabolic diseases as well. This review provides an overview of the different AON approaches, with a focus on AONs developed for inborn errors of metabolism. [ABSTRACT FROM AUTHOR]

The severe cutaneous adverse reaction epidermal necrolysis (EN) which includes toxic epidermal necrolysis and the milder Stevens‐Johnson syndrome is characterized by epidermal loss due to massive keratinocyte apoptosis and/or necroptosis. EN is often caused by a drug mediating a specific TCR‐HLA interaction via the (pro)hapten, pharmacological interaction or altered peptide loading mechanism involving a self‐peptide presented by keratinocytes. (Memory) CD8 + T cells are activated and exhibit cytotoxicity against keratinocytes via the perforin/granzyme B and granulysin pathway and Fas/FasL interaction. Alternatively drug‐induced annexin release by CD14 + monocytes can induce formyl peptide receptor 1 death of keratinocytes by necroptosis. Subsequent keratinocyte death stimulates local inflammation, activating other immune cells producing pro‐inflammatory molecules and downregulating regulatory T cells. Widespread epidermal necrolysis and inflammation can induce life‐threatening systemic effects, leading to high mortality rates. Research into genetic susceptibility aims to identify risk factors for eventual prevention of EN. Specific HLA class I alleles show the strongest association with EN, but risk variants have also been identified in genes involved in drug metabolism, cellular drug uptake, peptide presentation and function of CD8 + T cells and other immune cells involved in cytotoxic responses. After the acute phase of EN, long‐term symptoms can remain or arise mainly affecting the skin and eyes. Mucosal sequelae are characterized by occlusions and strictures due to adherence of denuded surfaces and fibrosis following mucosal inflammation. In addition, systemic pathology can cause acute and chronic hepatic and renal symptoms. EN has a large psychological impact and strongly affects health‐related quality of life among EN survivors. [ABSTRACT FROM AUTHOR]

Despite the effectiveness of positive behavior support (PBS) in reducing challenging behaviors, the availability of PBS for individuals with intellectual disabilities is limited in many countries including the Netherlands. Training care staff supporting individuals with intellectual disabilities in PBS may be a way to improve the provision of PBS. We aimed to explore the preliminary effectiveness of a PBS training for staff in reducing challenging behaviors of individuals with intellectual disabilities. Using a one group, double pretest–posttest design, 24 staff members involved in the care of 11 adult individuals with intellectual disabilities and challenging behaviors participated. We assessed changes in challenging behaviors and quality of life of the individuals, in staff self‐efficacy in dealing with challenging behaviors, and in the use of restraints, using staff rated questionnaires, structured interviews, and medical files. At posttest, we found significant reductions in challenging behaviors, improved quality of life, and increased staff self‐efficacy, but no changes in the use of restraints. In contrast, no significant changes on any of the measures appeared between the two pretests. These findings suggest that a staff training in PBS may be effective for reducing challenging behaviors in individuals with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: Non‐pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta‐analysis is to update the existing evidence, to investigate long‐term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness. Method: An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi‐experimental designs were included. We performed an overall random‐effect meta‐analysis and subgroup analyses. Results: We found a significant moderate overall effect of non‐pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352–0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs. Conclusions: Non‐pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Mollusc biogenic carbonates are valuable records of past environmental conditions. In particular, carbonate oxygen (δ18O) and carbon (δ13C) stable isotopes can be used to reconstruct different physical and chemical parameters, according to the different genera used (marine, freshwater or terrestrial). The Last Interglacial (early Eemian) palaeolake of Neumark‐Nord 2 (NN2), Germany provides an excellent example of a Neanderthal archaeological site with abundant freshwater carbonate remains. As in other European contexts, one of the most abundant species is Bithynia tentaculata. In order to provide a robust regional baseline for the interpretation of the archaeological data, this study includes a calibration phase on modern B. tentaculata opercula. The results indicate that these calcitic structures are likely to be subjected to a growth slowdown/cessation during summer, which influences their geochemistry, reflecting mainly the water properties of the rest of the year. This modern calibration, together with the existing palaeoenvironmental reconstructions developed for NN2 (e.g. pollen data), represents a valuable opportunity to establish B. tentaculata opercula as reliable environmental proxies applicable to several other freshwater contexts. The isotope data of the NN2 opercula, in agreement with the pollen record, indicate that the major archaeological horizon was formed during a rather wet period and potentially in a semi‐forested environment. However, human occupation occurred also during drier phases at the site and within a wide temperature range, indicating the absence of restricted environmental preferences by the local Neanderthal groups. [ABSTRACT FROM AUTHOR]

The long‐term influence of persistent small herbivores on successional plant community configuration is rarely studied. We used a herbivore exclusion experiment along the successional gradient in a salt‐marsh system, to investigate the effects of hares and geese, and hares alone, on plant diversity at five successional stages (the earliest, two early, the intermediate and the late successional stages) in the short and long term, i.e. 7 and 22 years, respectively.Plant diversity declined over time at all successional stages except for the earliest one. Small herbivores slowed down species decline, but only at one early successional stage.Small herbivores slowed down species decline via decreasing dominance of preferred grass Festuca rubra in the short term, and less preferred Elytrigia atherica in the long term. The effects of hares and geese were more pronounced than hares alone, indicating an important additive role of geese, especially in the long term.Synthesis. Small herbivores can have a strong and long‐lasting impact on plant diversity, but it highly depends on the abundance of small herbivores, which in turn depends on the quality and abundance of forage plants. A diverse herbivore community may have more positive effects on regulating plant communities. [ABSTRACT FROM AUTHOR]

Article impact statement: Participation is not a panacea for the Białowieża conflict; scientific evidence exists and can inform valid policy options. [ABSTRACT FROM AUTHOR]

Background: Many people with intellectual disabilities use risperidone long term for the management of challenging behaviours, despite its limited proof of effectiveness and its clear association with adverse events. Therefore, this study aimed to investigate the effectiveness of ongoing treatment with risperidone in reducing challenging behaviours versus controlled discontinuation on behaviour and health parameters. Method: This was a placebo‐controlled, double‐blind, randomised discontinuation trial of risperidone. In the discontinuation group, risperidone was gradually replaced by a placebo over 14 weeks, while the control group maintained their existing dosage. Eight weeks after discontinuation, behaviour (as measured by the 'Aberrant Behavior Checklist') and health parameters (dyskinesia, akathisia, parkinsonism, weight, waist circumference, sedation and laboratory outcomes) were compared in both groups. Results: A total of 25 participants were included in the trial, of which 11 were randomised into the discontinuation group and 14 were randomised into the continued treatment group. In the discontinuation group, 82% completely withdrew from risperidone. There was no significant change in irritability, compared with the continuation group, although there was a Group*Time effects on stereotypical behaviour in favour of the continuation group. Significant Group*Time effects were also found for weight, waist, body mass index, prolactin levels and testosterone levels, with beneficial effects for the discontinuation group. Conclusion: Discontinuation of long‐term risperidone for reducing challenging behaviours is possible, without an increase in irritability. Discontinuation of risperidone may have beneficial effects on weight, waist circumference, prolactin levels and testosterone levels. The study suffered from difficulties in achieving the required sample size, which affected study power and generalizability. [ABSTRACT FROM AUTHOR]

Spatial variation in habitat riskiness has a major influence on the predator–prey space race. However, the outcome of this race can be modulated if prey shares enemies with fellow prey (i.e., another prey species). Sharing of natural enemies may result in apparent competition, and its implications for prey space use remain poorly studied. Our objective was to test how prey species spend time among habitats that differ in riskiness, and how shared predation modulates the space use by prey species. We studied a one‐predator, two‐prey system in a coastal dune landscape in the Netherlands with the European hare (Lepus europaeus) and European rabbit (Oryctolagus cuniculus) as sympatric prey species and red fox (Vulpes vulpes) as their main predator. The fine‐scale space use by each species was quantified using camera traps. We quantified residence time as an index of space use. Hares and rabbits spent time differently among habitats that differ in riskiness. Space use by predators and habitat riskiness affected space use by hares more strongly than space use by rabbits. Residence time of hare was shorter in habitats in which the predator was efficient in searching or capturing prey species. However, hares spent more time in edge habitat when foxes were present, even though foxes are considered ambush predators. Shared predation affected the predator–prey space race for hares positively, and more strongly than the predator–prey space race for rabbits, which were not affected. Shared predation reversed the predator–prey space race between foxes and hares, whereas shared predation possibly also released a negative association and promoted a positive association between our two sympatric prey species. Habitat riskiness, species presence, and prey species’ escape mode and foraging mode (i.e., central‐place vs. noncentral‐place forager) affected the prey space race under shared predation. [ABSTRACT FROM AUTHOR]

Background: Results of discontinuation of antipsychotics in people with intellectual disability are variable and may depend on staff factors. Method: We attempted to taper off antipsychotics in 14 weeks after which participants were free to restart. We investigated the influence of support professionals' feelings towards challenging behaviour, their knowledge of psychotropic drugs and clinicians' judgements of participants' behavioural functioning on whether or not antipsychotics were completely discontinued after 16, 28 and 40 weeks. Results: Of the 129 participants, 61% achieved discontinuation at 16 weeks; at 28 and 40 weeks, 46% and 40% were completely discontinued. Staff's feelings of Depression/Anger towards their client's behaviour, less knowledge about psychotropic medication and clinicians' judgements of behavioural worsening were negatively associated with achievement of discontinuation. Conclusions: To enhance discontinuation off‐label drug use, staff's feelings should be explored, their knowledge of psychotropic drugs improved and reasons for clinicians' judgements of participants' behavioural worsening investigated. [ABSTRACT FROM AUTHOR]

Health‐related quality of life in people with intellectual disabilities can be affected by challenging behaviors and side effects of antipsychotics. The aim of this study was to evaluate the effect of discontinuation antipsychotic drugs on health‐related quality of life, including data from 2 discontinuation trials: an open‐label trial of various antipsychotic drugs and a double‐blind trial of risperidone. In both studies, antipsychotics were discontinued in 14 weeks, with steps of 12.5% of the baseline dosage every 2 weeks. Health‐related quality of life was measured at baseline and at 16 weeks, and 40 weeks after baseline, by means of the RAND‐36 (domains on physical well‐being, role limitations caused by physical or emotional problems, vitality, pain, mental well‐being, social functioning, general health, and changes in health). Participants who had completely discontinued antipsychotics according to the scheduled discontinuation and were still free of use at 40 weeks were compared with those who had incompletely discontinued. Physical well‐being showed an increase in the group that had achieved complete discontinuation. Social functioning showed a decrease in the group that incompletely discontinued, which recovered at follow‐up. Mental well‐being decreased at 16 weeks but recovered at follow‐up, regardless of complete or incomplete discontinuation. To conclude, discontinuation of antipsychotics had a positive effect on physical well‐being when complete discontinuation was possible. When complete discontinuation was not possible, there was a negative effect on health‐related quality‐of‐life domains. However, none of the unfavorable effects were irreversible. [ABSTRACT FROM AUTHOR]

Abstract: Although physicians are aware of the risks of prescribing long‐term off‐label antipsychotics in people with intellectual disability, attempts to discontinue often fail. This study aimed to identify potential determinants of successful and failed discontinuation. Long‐term off‐label antipsychotics were tapered in 14 weeks, with 12.5% of baseline dose every 2 weeks. Participants living in facilities offered by intellectual disability service providers, ≥6 years, with an IQ <70 were eligible to discontinue antipsychotic use, as judged by their physicians. The primary outcome was achievement of complete discontinuation at 16 weeks; changes in the Aberrant Behavior Checklist (ABC) and its 5 subscales were secondary outcomes. Potential determinants of the success or failure in discontinuing antipsychotics were psychotropic drug use and participants’ living circumstances, medical health conditions, and severity of behavioral symptoms and neurologic side effects. Of 499 eligible clients, 129 were recruited. Reasons for client non‐participation were clinician concerns that discontinuation might increase challenging behaviors and changes in clients’ environment. Of the 129 participants, 61% had completely discontinued antipsychotics at 16 weeks, 46% at 28 weeks, and 40% at 40 weeks. ABC total scores increased in 49% of participants with unsuccessful discontinuation at 16 weeks. Autism, higher dose of antipsychotic drug, higher ABC and akathisia scores, and more‐frequent worsening of health during discontinuation were associated with a lower incidence of complete discontinuation. Thus, in a selected sample of participants whom responsible clinicians had deemed discontinuation of antipsychotics could be attempted, 40% had achieved and maintained discontinuation at end of follow‐up. Physicians should try to address patients’ conditions that may hamper discontinuation. [ABSTRACT FROM AUTHOR]

Large carnivores can be a key factor in shaping their ungulate prey's behavior, which may affect lower trophic levels. While most studies on trade‐offs between food acquisition and risk avoidance by ungulate prey species have been conducted in areas with limited human impact, carnivores are now increasingly returning to highly anthropogenic landscapes. Many of these landscapes are dominated by forestry, and ungulate‐forestry conflicts are an increasing issue. The aim of this study was to test if the indirect effects of a re‐colonizing large predator, the wolf Canis lupus, results in a change in browsing intensity by moose Alces alces in young forest plantations in a boreal forest in Sweden. We selected 24 different forest plantations, with 12 located in low‐wolf and 12 in high‐wolf utilization areas. In each plantation, we measured browsing intensity, tree height, tree density, distance to the closest forest edge and we counted the number of moose pellet groups. In contrast to our predictions, wolf utilization was not the main driver of moose browsing patterns. Instead, moose browsing intensity declined with tree density and height. Separate analyses on the main tree species showed that wolf utilization had an influence, but browsing intensity was in fact higher in the high‐wolf utilization areas for three out of five tree species. This pattern seemed to be driven by a strong confounding relationship between wolf utilization, tree density and height, which were both lower in the high‐wolf utilization areas. We argue that this confounding effect is due to wolves being pushed towards the less productive parts of the landscape away from human activity centers. Therefore, we concluded that in order to better understand carnivore driven risk‐mediated effects on herbivore behavior in anthropogenic landscapes we need to better understand the complexity of human–carnivore–prey‐ecosystem interactions. [ABSTRACT FROM AUTHOR]

Background: It is unknown why professionals' adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care is insufficient. This study aimed to explore barriers and facilitators in the implementation and use of these recommendations. Methods: In‐depth interviews with four intellectual disability physicians, two psychiatrists and five behavioural scientists were used to explore the implementation and use of guideline recommendations. Results: Barriers in adhering to recommendations were lack of collaboration of different disciplines involved in the treatment of psychiatric and behavioural disorders and lack of enforcement of an appropriate monitoring of side‐ and treatment effects. When guideline recommendations were translated into organizational policies, clinicians were able to divide responsibilities and tasks, needed to appropriately implement guideline recommendations in daily clinical practice. Conclusions: To facilitate the use of guideline recommendations, organizations should translate recommendations into organization‐specific policies, involving physicians and behavioural scientists in this process, while simultaneously creating more practical and technological support. [ABSTRACT FROM AUTHOR]