The savannah–forest mosaic of the Rupununi region of Guyana is a dispersal corridor between large tracts of intact Guiana Shield forests and a subsistence hunting ground for Indigenous Makushi and Wapichan communities. We conducted a camera-trap survey at 199 sites across four major forested habitat types and used multi-species occupancy modelling to determine regional-scale drivers of mammalian occupancy at both species and community levels, accounting for imperfect detection. We detected 47 savannah- and forest-dwelling mammal species, with the occupancy of medium- and large-bodied terrestrial mammal species (community occupancy) positively related to per cent forest cover and negatively to the presence of gallery forest habitat. The occupancy of 15 of 30 species was positively related to forest cover, suggesting the importance of maintaining forested habitat within the broader mosaic comprising savannahs and intermediate habitats for sustaining maximum mammal diversity. Jaguar Panthera onca occupancy was associated with the presence of livestock, and giant anteater Myrmecophaga tridactyla occupancy was negatively associated with distance to the nearest road, both results of concern in relation to potential human–wildlife conflict. The probability of detecting terrestrial mammal species (community detectability) increased away from villages, as did the detectability of two large-bodied, hunted species, the lowland tapir Tapirus terrestris and collared peccary Pecari tajacu, potentially indicating the negative effects of subsistence and commercial hunting in this savannah mosaic habitat. We use our findings to discuss how management strategies for hunting, fire, timber harvest and agriculture within Indigenous titled lands could help ensure the sustainability of these traditional livelihood activities.

Heath forests, or known locally as kerangas, in Indonesia and Malaysia form a distinct and understudied ecoregion. We document the distribution and ecological significance of the largest extent of kerangas in Kalimantan, Indonesian Borneo. We mapped 16,586 km2 of kerangas to the nearest one square kilometre across Kalimantan, showing a significant reduction from previous estimates. About 19% of this area exists as a poorly documented mosaic landscape in Central Kalimantan’s Rungan-Kahayan region. Here, peat-based forests transition to heath and dipterocarp forests, making it difficult to reliably classify these forests for conservation planning. Using remote sensing and tree plot data, we identified three forest types—kerangas, low pole, and mixed swamp. Vegetation structure is influenced by soil, topography, and hydrology, while peat depth and elevation affect species diversity. Our findings indicate that these forests are dynamic ecosystems with diverse vegetation communities adapted to peat as well as sandy soils. Lowland heath forests in Rungan-Kahayan exhibits higher tree densities compared to other Bornean heath forests, reflecting unique ecological adaptations to challenging environments. Despite covering just 3% of Kalimantan’s forest area, these ecosystems remain largely unprotected, facing threats from land conversion and fire. Our study highlights the ecological complexity of kerangas and underscores the urgent need for targeted conservation and further research on these forests.

In individuals with irritable bowel syndrome (IBS), eliminating dietary triggers can alleviate symptoms but may lead to nutrient deficiencies and overall health decline. Although various nutritional supplements show promising results in relieving IBS symptoms due to their potential to alter the microbiome, conclusive scientific evidence remains lacking. This exploratory study aims to assess the bifidogenic properties of four nutritional supplement interventions and their impact on IBS-symptoms, faecal microbiota composition, faecal short-chain fatty acid (SCFA) concentrations, stool pattern, and quality of life (QoL), compared to a placebo control. Seventy subjects with IBS, meeting the ROME IV criteria, participated in this randomised, double-blind, placebo-controlled parallel intervention study. Subjects were assigned to one of the four treatment groups, receiving either resistant starch, pea fibre, chondroitin sulfate, protein hydrolysate, or placebo daily for four weeks. Daily reports on stool pattern and gastrointestinal complaints were collected. Stool samples and questionnaires on dietary intake, symptom severity, QoL, and anxiety and depression were collected at baseline and after the 4-week intervention. The results show no significant increase in Bifidobacterium abundance or faecal SCFA levels after the 4-week intervention with any of the four nutritional supplement interventions. While some improvements in symptom severity and QoL were observed within-groups, these were not significantly different from changes observed with placebo. In conclusion, the tested nutritional supplements did not increase Bifidobacterium abundance in subjects with IBS within four weeks. Furthermore, we conclude that future studies should consider a run-in period and a larger sample size to study improvements in IBS symptoms.

While it is vital to agree to a set of global objectives and targets to reduce plastic pollution as part of the Global Plastic Treaty, past negotiations have been troubled by differences in regional and national priorities and needs. To take these different priorities and needs into account, this letter proposes the adoption of an interdisciplinary source-to-sea approach. A source-to-sea approach emphasizes the connected nature between land-based sources of marine plastic pollution along the life cycle of plastic products on the one hand, and air, soil, and water cycles that determine marine plastic flows and associated sustainability risks on the other hand. It takes into account how we know more about the way in which production, use and plastic waste contribute to the pollution of rivers and seas in one location (e.g. in Europe), than we do for rivers and seas in other places (e.g. Africa). There are also regional and national differences in how much awareness exist about plastic pollution and how it is governed and regulated. These differences translate in different priorities and needs in terms of how to most efficiently and effectively reduce plastic pollution. The letter argues that these differences should be embraced and that an interdisciplinary source-to-sea approach can help to develop tailor-made regional and national targets and measures that in turn contribute to achieving the global ambitions of the Global Plastic Treaty. A key role is foreseen for existing governance institutions, such as river basin commissions and regional seas conventions (coordinated by UNEP Regional seas Programme), while the Global Plastic Treaty can become a platform for sharing of approaches, lessons and strategies between regions and countries so that over time, plastic pollution will be reduced worldwide.

Background: Efgartigimod, a human immunoglobulin (Ig)G1 antibody Fc fragment, blocks the neonatal Fc receptor, reducing IgGs involved in chronic inflammatory demyelinating polyneuropathy (CIDP). The multi-stage, double-blinded, placebo-controlled ADHERE (NCT04281472) and open-label extension ADHERE+ (NCT04280718) trials (interim analysis cutoff: February 16, 2024) assessed efgartigimod PH20 SC in participants with CIDP. Methods: Participants with active CIDP received open-label, weekly efgartigimod PH20 SC 1000 mg during ≤12-week run-in (stage-A). Responders were randomized (1:1) to efgartigimod or placebo for ≤48 weeks (stage-B). Participants with clinical deterioration in stage-B or who completed ADHERE entered ADHERE+. Week 36 changes from run-in baseline (CFB) in adjusted Inflammatory Neuropathy Cause and Treatment (aINCAT), Inflammatory Rasch-built Overall Disability Scale (I-RODS), and grip strength scores were evaluated. Results: Of 322 stage-A participants, 221 were randomized and treated in stage-B, and 99% entered ADHERE+. Mean CFB (SE) in aINCAT, I-RODS, and grip strength scores were -1.2 (0.15) and 8.8 (1.46) and 17.5 (2.02), respectively, at ADHERE+ Week 36 (N=150). Half the participants with clinical deterioration during ADHERE stage-B restabilized on efgartigimod from ADHERE+ Week 4. Conclusions: Interim results from ADHERE+ indicate long-term effectiveness of efgartigimod PH20 SC in clinical outcomes in participants with CIDP.

Background: Efgartigimod, a human immunoglobulin (Ig)G1 antibody Fc fragment, blocks the neonatal Fc receptor, reducing IgGs involved in chronic inflammatory demyelinating polyneuropathy (CIDP), a rare, progressive, immune-mediated disease that can lead to irreversible disability. The multi-stage, double-blinded, placebo-controlled ADHERE (NCT04281472) trial assessed efgartigimod PH20 SC in participants with CIDP. Methods: Participants with active CIDP received open-label, weekly efgartigimod PH20 SC 1000 mg during ≤12-week run-in (stage-A). Responders were randomized (1:1) to weekly efgartigimod or placebo for ≤48 weeks (stage-B). This posthoc analysis evaluated changes from run-in baseline (study enrollment) to stage-B last assessment and items of the Inflammatory Rasch-built Overall Disability Scale (I-RODS). Results: Of 322 participants who entered stage-A, 221 were randomized and treated in stage-B, and 191/221 had data for run-in baseline and post–stage-B timepoints. Mean (SE) I-RODS change at stage-B last assessment vs run-in baseline was 5.7 (1.88) and -4.9 (1.82) in participants randomized to efgartigimod and placebo, respectively. 37/97 (38.1%) and 24/92 (26.1%) participants randomized to efgartigimod and placebo, respectively, experienced ≥4-point improvements in I-RODS score. Efgartigimod-treated participants improved ≥1 point in I-RODS items of clinical interest. Conclusions: Participants who received efgartigimod in stage-B experienced improvements in I-RODS score from study enrollment to stage-B last assessment.

Background: Late-onset Pompe disease (LOPD) is caused by a deficiency of acid α-glucosidase (GAA), leading to progressive muscle and respiratory decline. Cipaglucosidase alfa (cipa), a recombinant human GAA naturally enriched with bis-mannose-6-phosphate, exhibits improved muscle uptake but is limited by inactivation at near-neutral blood pH. Miglustat (mig), an enzyme stabiliser, binds competitively and reversibly to cipa, enhancing its stability and activity. Methods: In dose-finding studies, Gaa-/- mice were treated with cipa (20 mg/kg) +/- mig (10 mg/kg; equivalent human dose ~260 mg). Clinical study methodologies have been published (Schoser et al. Lancet Neurol 2021:20;1027–37; Schoser et al. J Neurol 2024:271;2810–23). Results: In Gaa-/- mice, cipa+mig improved muscle glycogen reduction more than cipa alone and grip strength to levels approaching wild-type mice. LOPD patients (n=11) treated with cipa alone showed dose-dependent decreases in hexose tetrasaccharide (Hex4) levels by ~15% from baseline, decreasing another ~10% with added mig (260 mg). In a head-to-head study, cipa+mig had a similar safety profile to alglucosidase alfa. Among 151 patients (three trials), mig-related adverse events occurred in 21 (13.9%), none serious. Conclusions: Mig stabilised cipa in circulation, improving cipa exposure, further reducing Hex4 levels and was well tolerated in clinical studies in patients with LOPD. Sponsored by Amicus Therapeutics, Inc.

Background: Transcranial doppler ultrasound (TCD) in a pediatric neurocritical setting can determine cerebral hemodynamics by assessing the blood flow velocity in main cerebral arteries. In large vessel occlusions (LVO) that require endovascular thrombectomy (EVT), TCD can monitor recanalization and arterial re-occlusion. We describe one case in a previously healthy 13-year-old girl with a right M1 middle cerebral artery occlusion. Methods: Analysis was done via a retrospective case review. Results: Our patient underwent a successful endovascular thrombectomy (EVT) six hours after symptom onset. Follow up TCDs done at 4, 8, and 24 hours showed stable peak systolic velocities (PSV) on the narrowing of right M1 ranging from 245 to 270 cm/s with stable pre-stenotic PSV around 110 cm/s, indicating focal and stable narrowing of M1 without reocclusion. No high transient signals (HITS) were identified on sub 10 minute TCDs. An urgent echocardiogram revealed a bicuspid aortic valve with vegetations, with later confirmation of infective endocarditis. The patient made an impressive recovery with only mild deficits. Conclusions: TCD can be an effective tool in a pediatric neurocritical setting in guiding initial recanalization after EVT and monitoring for arterial re-occlusion, HITS and hyperperfusion. TCD monitoring also decreases the amount of radiation exposure via CTA.

Students’ interfering behaviour is a common concern among educators working in special and general education classrooms. Interfering behaviour can significantly compromise students’ educational experiences and educators’ ability to create a conducive learning environment. Evidence-based assessments and interventions for interfering behaviour in the classroom involve identifying the variables in the student’s immediate environment influencing these behaviours. There has been little to no dissemination of evidence-based assessments for classroom management in developing nations such as South Africa and Vietnam. In the current study, we used a single-case design to assess the effectiveness and acceptability of behavioural skills training (BST) in teaching educators from South Africa and Vietnam how to assess students’ interfering behaviour in the classroom. The training was divided into four phases, with the different steps involved in teaching participants how to assess interfering behaviour. All participants successfully acquired the trained skills and demonstrated a shift in their explanation of the causes of interfering behaviour.

We report the radio continuum detection of well known Galactic Planetary Nebula (PN) NGC5189, observed at 943MHz during the Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) survey. Two detections of NGC5189 have been made during the survey, of better resolution than previous radio surveys. Both measurements of the integrated flux density are consistent with each other, at S943 MHz = 0.33 ± 0.03 Jy, and the spectral luminosity is L943 MHz = 8.89 × 1013 W m–2 Hz–1. Using available flux density measurements for radio-detections of NGC5189, we calculate a radio surface brightness at 1GHz and measure Σ1 GHz = 6.0 × 10–21 W m–2 Hz–1 sr–1, which is in the expected range for Galactic PNe. We measure an apparent size of 3.′4×2.′2 corresponding to physical diameters of 1.48 pc × 0.96 pc, and combine available radio observations of NGC5189 to estimate a spectral index of α = 0.12 ± 0.05. Hence, we agree with previous findings that NGC5189 is a thermal (free–free) emitting nebula. Additional measurements of the optical depth (τ = 0.00246) and electron density (Ne = 138 cm–3) support our findings that NGC5189 is optically thin at 943 MHz. Furthermore, the radio contours from the ASKAP–EMU image have been overlaid onto a Hubble Space Telescope (HST) Wide Field Camera 3 image, demonstrating that the radio morphology closely traces the optical. Notably, the contour alignment for the innermost region highlights the two envelopes of gas previously reported to be low-ionisation structures, which is considered a defining feature of post common–envelope PNe that surround a central Wolf-Rayet star.

Food insecurity affects the health of college-aged individuals, but its impact on the gut microbiome (GM) over time is poorly understood. This study explored the association between food insecurity and the GM in eighty-five college students, identifying microbial taxa, metabolites and pathways linked to food security status and examining GM stability and microbe–metabolite interactions. Longitudinal GM and metabolomic data were collected from first-year students over an academic year, encompassing periods of variable food security status. Participants were categorised into three groups: food insecure (FI, n 13), food secure (FS, n 44) and variable (VAR, n 28) status. GM composition varied significantly between FS classifications (Bray–Curtis dissimilarity, P ≤ 0·005). Stability analysis revealed correlations between stability scores and microbial features, pathways and metabolites. Specific microbes (e.g. Bifidobacterium species, Faecalibacterium prausnitizii D and Lachnospiraceae), pathways (energy and microbial turnover) and metabolites (cadaverine, N-acetylcadaverine, putrescine, testosterone sulfate and creatine) associated with FI status were identified. Multi-omic integration revealed metabolic pathways influenced by differentially abundant microbial species and co-occurring fecal metabolites in FI participants related to the microbial production of polyamines, detoxification and energy metabolism. The transition from FS to FI showed no significant differences at specific taxonomic, functional or metabolite levels. This study uncovers complex interactions between food security, GM composition and metabolism. Significant differences were found in microbial community variability and metabolic pathways associated with food security status, but the transition from food security to insecurity disrupted the GM without clear taxonomic or functional distinctions, emphasising the need for further research into these mechanisms.

While adapting to future sea-level rise (SLR) and its hazards and impacts is a multidisciplinary challenge, the interaction of scientists across different research fields, and with practitioners, is limited. To stimulate collaboration and develop a common research agenda, a workshop held in June 2024 gathered 22 scientists and policymakers working in the Netherlands. Participants discussed the interacting uncertainties across three different research fields: sea-level projections, hazards and impacts, and adaptation. Here, we present our view on the most important uncertainties within each field and the feasibility of managing and reducing those uncertainties. We find that enhanced collaboration is urgently needed to prioritize uncertainty reductions, manage expectations and increase the relevance of science to adaptation planning. Furthermore, we argue that in the coming decades, significant uncertainties will remain or newly arise in each research field and that rapidly accelerating SLR will remain a possibility. Therefore, we recommend investigating the extent to which early warning systems can help policymakers as a tool to make timely decisions under remaining uncertainties, in both the Netherlands and other coastal areas. Crucially, this will require viewing SLR, its hazards and impacts, and adaptation as a whole.