Frontiers in Ecology and Evolution

1. Sandy beaches along urbanized coasts are increasingly managed through beach nourishment and hard infrastructure, yet these interventions often constrain natural dune-building processes. Along the Belgian coast, where much of the beach-dune interface is bordered by dikes, promenades and intensive recreation, strandline vegetation may provide an overlooked mechanism for retaining sand and initiating embryo dune development. 2. We assessed the potential for four pioneer dune plant species (Cakile maritima, Calamagrostis arenaria, Elymus farctus and Salsola kali) to establish, develop vegetation cover and contribute to sand accumulation along the Belgian coast. Using field surveys from 2017-2023, LiDAR-derived beach elevation and annual sediment dynamics, we modelled species occurrence and abundance/cover in low-disturbance reference zones and projected these relationships across the wider coastline. 3. Occurrence models identified where abiotic conditions allow plants to establish and persist until the late growing season, whereas zero-inflated abundance/cover models estimated expected vegetation development across environmental gradients. Predicted occurrence was widespread for several species, suggesting that the abiotic gradients modelled here are not the primary constraints on potential establishment across large parts of the coast. In contrast, expected abundance/cover showed stronger species-specific responses, particularly to sand accretion, indicating that sediment dynamics mainly affect post-establishment vegetation development rather than occurrence alone. 4. Independent field measurements of embryo dunes showed positive relationships between vegetation cover and local sand accumulation for all four species. When scaled using spatial predictions of potential abundance/cover, pioneer vegetation could retain substantial volumes of sand, with Cakile maritima contributing the largest share, followed by Salsola kali, Elymus farctus and Calamagrostis arenaria. Estimated volumes depended on assumptions about whether vegetation occurs as dispersed units or aggregated patches. 5. Synthesis and applications. Our results show that, even along a heavily urbanized and nourished coastline, abiotic conditions can support strandline vegetation and embryo dune initiation where disturbance is reduced. Management actions such as limiting trampling, adapting beach cleaning and protecting strandline vegetation could enhance the retention of nourished sand and support nature-based coastal defense. Rather than replacing engineered interventions, strandline vegetation may increase the efficiency with which available sediment is retained within the beach-dune system.

AO_SCPLOWBSTRACTC_SCPLOWO_LICommunity assembly graphs (CAGs) summarize which species combinations can coexist and how single-species invasions drive transitions between them, encoding the pathways, alternative endpoints, and cycles that make up a communitys assembly history. Constructing CAGs from dynamical models requires methods that are both computationally tractable and faithful to the underlying ecological dynamics. However, existing methods rely on restrictive assumptions, such as global stability, that exclude alternative stable states and non-equilibrium dynamics known to occur in empirical systems. C_LIO_LIWe develop a computational pipeline that constructs CAGs from any generalized Lotka-Volterra model. Building on the invasion graph framework and its connection to permanence, the pipeline verifies that community dynamics are bounded, identifies which subsets of species coexist in the sense of permanence, determines which single-species invasions are dynamically realized, and assigns each community a topographic height equal to the length of the longest assembly path leading to it. We also provide a numerical algorithm to simulate the dynamics of community assembly. C_LIO_LIWe prove several general properties of the resulting graphs, including that a successful invader is never subsequently excluded and that, in the absence of assembly cycles, permanent communities can be reassembled by introducing their species one at a time in the right order. We prove that the CAG faithfully reproduces the compositional shifts seen in the numerically simulated dynamics of assembly. Applying the pipeline to three empirically based models (a New Zealand grassland, a European pasture, and a Puerto Rican ant community), we show how competition strength and mutualistic feedbacks reshape the assembly landscape and how intransitive competition generates assembly cycles. C_LIO_LIOur approach accommodates alternative stable states and non-equilibrium dynamics without requiring global stability, and it turns the long-standing landscape metaphor into a quantitative, mechanistically grounded object by resolving what "height" means. More broadly, it makes the topography of the assembly pathways measurable, providing a way to compare the historical contingency and predictability of the assembly in ecological systems. C_LI

Sakumo Lagoon, a small (1 km2) semi-open coastal lagoon in Ghana, lies between the cities of Accra and Tema. The lagoon and its surrounding wetland were designated a Ramsar Site in 1992, mainly because it served as a refuge for 66 local and migratory bird species. Its ecology, and the biology of its major fish species, notably the blackchin tilapia (Sarotherodon melanotheron) were thoroughly studied in 1971, when the lagoon was a diverse, mainly brackish ecosystem supporting a traditionally and well-managed fishery. In 2016-2017, another study found the lagoon mostly covered by floating vegetation and plastic waste. Finally, in 2024, a visual survey established that the floating vegetation had been almost completely replaced by terrestrial plants, with only a few square meters of garbage-strewn water in front of a culvert connecting the lagoon to the open sea. Several lagoons along the coast of Ghana have been similarly lost to urban sprawl and its various forms of pollution, but Sakumo Lagoon is a Ramsar Site, and its imminent disappearance should not remain undocumented.

The article introduces a new Forest Stress Index (ISF) based on a plant hydraulic modelling approach rather than classical climatic drought indices. Unlike other index like scPDSI or SPEI, ISF is grounded in xylem embolism dynamics simulated with the mechanistic SurEau model. The goal is to better link climatic anomalies to tree physiological functioning and mortality risk. ISF is defined using a locally adapted ideotype characterized by an optimal P50 value under a reference hydraulic functioning threshold. Simulations are performed across Europe and France using multiple climate datasets. The index is robust to model parameterization choices and assumptions about plant functional traits. Results show strong spatial and temporal consistency and significant correlations with SPEI and scPDSI. However, ISF more strongly highlights extreme drought years and exhibits a more skewed distribution. Future projections under SSP5-8.5 indicate a widespread increase in hydraulic stress with strong regional contrasts. Overall, ISF provides a mechanistic and complementary drought indicator more directly linked to forest mortality processes.

Species distribution models (SDMs) increasingly inform conservation and biosecurity decisions in freshwater systems, where the reliability of its uncertainty estimates matters as much as its point predictions. Ensemble SDMs derive prediction intervals from across-replicate variance, but this variance captures systematic error only when replicates disagree about it, an assumption that fails when training data are contaminated with low-accuracy records, the norm in citizen-science datasets. Whether this failure is spatially uniform or concentrates in identifiable parts of a range is unknown. Using a panel of European freshwater crayfish spanning native headwater-associated species and invasive lowland colonizers, we show that contamination-induced calibration failure is strongly spatially structured: it concentrates at stream-network headwaters, the topological tops of the network, where upstream-aggregated predictors are structurally undefined, and scales with contamination severity, replicated across four species and both dominant ensemble protocols (replicate and consensus). The failure is driven by upward prediction bias, not by intervals failing to widen: contaminated ensembles overpredict suitability in headwaters, and because the bias is shared across ensemble members, the intervals do not flag it. This is a conservation-relevant blind spot, because headwaters are both refugia for threatened native crayfish and front lines for invasion; an SDM that silently overpredicts suitability there misdirects survey and management effort toward the segments where its predictions are least trustworthy. Standard leave-one-basin-out conformal calibration, the recommended panel-wide remedy, repairs marginal coverage but leaves headwaters undercovered, because a single calibration threshold is dominated by the abundant non-headwater segments. A group-conditional (Mondrian) variant, calibrating the two populations separately, restores reliable coverage in both at no extra cost and reallocates width where it is needed. We recommend network-position-stratified calibration as a default for ensemble SDMs in dendritic freshwater systems.

Background Nipah virus (NiV) is a priority zoonotic pathogen causing high-fatality outbreaks. Early NiV outbreaks in Malaysia and Singapore had limited transmission beyond spillover events. However, since 2001, NiV outbreaks with person-to-person transmission have occurred in Bangladesh and India, driven by the NiV-Bangladesh genotype and NiV-India genotype. Our study aims to estimate the reproduction number, offspring dispersion, and serial interval governing NiV transmission in Bangladesh and India during 2001-2026. Methods We conducted a systematic review of NiV outbreak investigations in Bangladesh and India, searching PubMed, Embase, Web of Science, and grey literature through 28 February 2026. Case-level offspring counts from 27 eligible sources (323 cases across 67 outbreaks) were used as input to a hierarchical Bayesian negative binomial offspring distribution model. The serial interval was estimated by parametric distribution fitting to 137 transmission pairs. Country-stratified and sensitivity analyses were performed to evaluate the robustness of estimates. Results Pooling across 67 outbreaks, we estimated a median reproduction number of 0.46 (95% CrI: 0.28-0.73), an offspring dispersion parameter of 0.07 (0.05-0.10), and a serial interval of 13.3 days (95% CI: 12.8-13.8). Country-stratified median reproduction numbers were 0.48 (0.23-0.97) for India and 0.35 (0.19-0.59) for Bangladesh, and dispersion parameters were 0.04 (0.02-0.07) and 0.11 (0.06-0.18), respectively, indicating marked overdispersion in both settings. Conclusion NiV transmission is self-limiting on average and highly overdispersed, suggesting that a disproportionate share of onward transmission arises from a small number of cases. This epidemiological profile supports targeted containment measures, including contact tracing and quarantine, for effective NiV outbreak control.

UNC-6/Netrin is a conserved regulator of dorsal-ventral axon and cell migrations. UNC-6 is composed of a Laminin N-terminal domain (LN), three epidermal growth factor repeats (EGF), and a Netrin C terminal domain (NC). Here, we identified missense mutations in distinct UNC-6 domains and assessed their roles in dorsal VD/DD motor axon guidance and ventral AVM axon guidance. A missense mutation in a conserved residue of the LN domain (G289D) resulted in dorsal and ventral axon guidance defects similar to unc-6 null. A distinct missense mutation in the LN domain (S120F) was hypomorphic and strongly perturbed ventral AVM axon guidance with minimal effects on dorsal VD/DD axon guidance, showing that S120F is predominantly required for ventral guidance. Missense mutations altering conserved cysteine residues involved in di-sulfide bonding in the EGF domains were analyzed. EGF1(C321G) caused both ventral and dorsal axon guidance defects albeit weaker than unc-6 null, indicating that EGF1 is required for both. EGF2(C347Y) strongly affected dorsal VD/DD axon guidance similar to unc-6 null, with weaker perturbation of ventral AVM axon guidance. Previous results revealed that EGF3(C410Y) specifically disrupted dorsal axon guidance, a result that we confirmed. Our studies using missense mutations in the endogenous unc-6 locus complement previous structure-function studies using transgenic expression, and identify domains specifically required for ventral AVM guidance (S120Y in the LN domain) and dorsal VD/DD axon guidance (C410Y in EGF3). The crystal structure of UNC-6 indicates conserved N-linked glycosylation at N114 and N128. Mutation of these sites in UNC-6 had no effect on dorsal ventral axon guidance, showing that they do not play a major role. However, the N114 and N128 mutations interacted genetically with unc-40 and unc-5 mutations, indicating that these glycosylation sites indeed have a role in UNC-6 signaling. Our results will inform studies on how these distinct UNC-6 domains interact with guidance receptors (e.g. UNC-40/DCC and UNC-5) and other extracellular molecules to mediate dorsal-ventral axon guidance.

Does the distribution of fitness effects of new mutations vary across the genome? Under the classical Fisher Geometric Model (FGM) we might not expect it to. In FGM, phenotypic traits are envisioned as dimensions of a landscape, with fitness determined by position in the landscape, i.e., the particular combination of traits of an individual. New mutations are represented by vectors that move from an ancestral to a new phenotype. In classical FGM these vectors affect all trait dimensions simultaneously (universal pleiotropy). However, introducing partial and modular pleiotropy into an FGM framework leads to an expectation that parameters of the DFE will vary with mutational pleiotropy-the number of traits affected by individual mutations. Here we address this prediction by investigating whether traits related to mutational pleiotropy, expression level and network connectivity, affect the parameters of the DFE using whole genome data from A. thaliana and C. grandiflora, two closely related Brassica species that vary significantly in their demography and mating system, and therefore, in effective population size and the effects of linked selection. Results were similar across both species. We found that expression level and network connectivity were predictive of the parameters of the deleterious DFE, even once co-correlations among genome biology traits were accounted for. Our results suggest that, across the genome, molecular evolutio(high mutational pleiotropy). nary patterns agree with the predictions of FGM, albeit relaxing the assumption of universal pleiotropy, and that variation in mutational pleiotropy among genes is sufficient to have detectible effects on the DFE. Significance statementHow do the effects of new mutations vary across the genome? If mutations in some genes affect many traits (high mutational pleiotropy), we hypothesise they will be more strongly deleterious, with lower variance in their selective effects. We test this by investigating the distribution of effects of new mutations across genes that vary in features that are related to mutational pleiotropy: expression level, gene network connectivity, and number of associated GO terms. The mean strength and coefficient of variation of selection of new mutations varied across genes with different features in the manner expected by our hypothesis. This demonstrates that important parameters of molecular evolution can vary across the genome with genome architecture.

Reactive nitrogen species (RNS), particularly peroxynitrite generated from the reaction of superoxide and nitric oxide, are implicated in thermally-induced oxidative stress but remain difficult to resolve in live coral cells. We optimized fluorescent dye strategies to directly quantify superoxide, nitric oxide, and peroxynitrite production in thermally stressed Pocillopora acuta cell suspensions. Thermal stress was associated with an increase in intracellular peroxynitrite concentration, but not in its precursors, nitric oxide and superoxide, highlighting challenges with the application of fluorescent probes and their controls to live coral cells. Compounds developed for mammalian systems often translate poorly to non-model systems such as corals: strong endogenous fluorescence and multiple membrane barriers within the coral symbiocyte, for instance, limited the function of the nitric oxide probe, DAF-2DA. Despite these limitations, the detection of peroxynitrite in live, thermally stressed P. acuta cells represents a step forward in understanding the mechanism of coral bleaching. We also outline strategies for improving the performance of commercial dyes in non-model systems, including media optimization with EDTA treatment to preserve both cell viability and probe performance.

The main olfactory epithelium (MOE) is the primary site of olfaction and consists of multiple cell types including olfactory sensory neurons (OSNs), sustentacular cells, and immune cells. Neuroimmune interactions in epithelial tissues are critical in maintaining tissue function, but how OSNs and immune cells interact in the MOE in healthy and diseased states is largely unknown. Cellular responses in the MOE determine how and whether OSNs maintain olfactory function and are repaired or replenished following inflammatory environmental exposures. We hypothesized that acute nasal aeroallergen exposure alters immune cell function in the MOE to elicit a neuroprotective response, thereby preserving OSN function. We developed an environmental aeroallergen exposure consisting of one week of daily intranasal house dust mite extract (HDM) instillations. Spectral flow cytometry indicated only subtle changes in resident immune cells proportions and phenotypes in the MOE. Immunohistochemical evaluation did not reveal extensive changes in immune cell distribution in the sensory epithelium or lamina propria, but instead we observed increases in axonal olfactory marker protein (OMP) expression in the lamina propria, where resident immune cells are most abundant. To evaluate the effects of HDM exposure on OSN function, we performed live ex vivo Ca2+ imaging of MOEs from HDM- and sham-exposed transgenic mice using objective-coupled planar illumination (OCPI) microscopy. OSN responses to multiple odorants revealed increased chemosensory sensitivity and decreased across-trial adaptation in HDM-treated epithelia. These results indicate that short-term nasal aeroallergen exposure minimally alters immune cell phenotypes, and instead induces functional changes in OSN physiology that preserve olfactory function.

Humans and other animals often act in environments that are at least partly familiar, where aspects of the spatial layout are known. Although such knowledge is known to support navigation and spatial cognition, its role in the online control of action remains unclear. We investigated whether drivers use knowledge of road layout to guide steering in high and low visibility and, if so, the form of such knowledge. In two simulated driving experiments (total N = 90), participants repeatedly drove winding roads containing segments with and without fog. Drivers who repeatedly experienced the same road exhibited more stable steering and lane positioning than drivers encountering novel roads, but only when visibility was reduced. These advantages were accompanied by superior performance on post-tests assessing knowledge of road geometry. We next examined the form of such knowledge by dissociating global knowledge of road layout from local associations between landmarks and road segments. Disrupting landmark-road segment associations produced the largest impairment in steering performance. The benefits of prior experience were largely preserved when road-segment order was scrambled but landmark associations remained intact. These findings show that spatial knowledge can support moment-to-moment steering control when visibility is reduced. Rather than relying on a globally coherent representation of the environment, drivers use local associations between landmarks and upcoming road geometry to anticipate future demands. More broadly, the results elucidate how familiarity with environmental structure contributes to the control of action when visual information is degraded, revealing a close interplay between spatial knowledge and visual control. Significance StatementPeople routinely act within surroundings they have encountered before, from commuting on the same streets to walking familiar hallways. Whether the spatial knowledge acquired from such experience actually shapes online visual control remains an open question. Using a simulated driving task, we show that familiarity with a road improves steering stability specifically when visibility is reduced, and that this benefit depends on learned associations between landmarks and upcoming road geometry rather than a global cognitive map. The results indicate that spatial knowledge plays a key role in moment-to-moment control, letting drivers anticipate road segments they cannot yet see. Unfamiliar roads and impaired spatial learning may compound the risks of poor visibility, suggesting a role for driver-assistance systems that leverage landmarks.

Background: Randomized controlled trials have shown that computed tomographic (CT) screening reduces lung cancer mortality. Improved identification of at-risk groups, by leveraging non-smoking risk factors, could help refine screening selection. Aim: To evaluate polygenic risk scores (PRSs) and ambient air pollution (AAP) exposure for risk stratification in the NELSON lung cancer screening cohort. Methods: Two PRSs (PRS-McKay/PRS-Byun) and several AAPs (including nitrogen dioxide, ozone, and particulate matter [PM]) were assessed in the NELSON lung cancer screening trial (N=7,364). PRSs were validated in the Rotterdam Study (N=11,493). Associations with lung cancer, mortality, screening results, and discriminative ability to distinguish lung cancer were evaluated. Results: PRS-McKay and PRS-Byun were associated with lung cancer (odds ratio [OR] per SD [95%CI]: 1.22 [1.08-1.37] and 1.28 [1.13-1.44], respectively) and lung cancer-specific mortality (OR [95%CI]: 1.24 [1.05-1.47], for both), but not with non-lung cancer mortality (OR [95%CI]: 1.01 [0.94-1.10] and 1.03 [0.95-1.12], respectively). Exposure to PM2.5 was associated with lung cancer (OR [95%CI]: 1.11 [1.01-1.22]). PM constituents were associated with adenocarcinoma, particularly PM10 (OR [95%CI]: 1.16 [1.01-1.32]) and ultra-fine particles (OR [95%CI]: 1.16 [1.04-1.30]). PRS and AAP added modestly to the discriminative ability for lung cancer on top of pack-years, age, and sex (area under the curve [95%CI]: 0.659 [0.624-0.695] vs. 0.643 [0.608-0.679]). Conclusions: PRSs and exposure to PM were associated with lung cancer in a high-risk screening population. The primary potential of PRSs may reside in refining lung cancer screening selection toward individuals at higher risk of dying from lung cancer specifically.

Analyses of human breast carcinomas (BCs) and premalignant breast lesions show that the loss of RASSF1A is an early event in the development of ER+ BCs, which correlates linearly with malignant progression. This observation suggests that RASSF1A inhibition is important for the development and progression of ER+ BCs. In addition to RASSF1A, concurrent caveolin-1 (Cav-1) inhibition may further promote ER+ breast carcinogenesis. In the present study, transgenic Rassf1a-/- and Cav-1(-/-) single as well as Rassf1a-/-, Cav-1(-/-) double knockout mice were used to investigate the impact of single or combined Rassf1a and Cav-1 inactivation on BC initiation. Loss of either one or both proteins led to different, pre-malignant histopathological alterations within the mammary glands of the mice, but not to fully developed BC, confirming that Rassf1a and Cav-1 are both important for maintaining the integrity of mammary gland epithelial structure, but suggesting that further intracellular changes or extracellular factors are required for the development of luminal BC when both genes are lost.

Air pollution exposure has been associated with increased risk of developing mental health problems. It is possible that individuals at high genetic risk for psychopathology may be more vulnerable to these effects; however, this question remains to be investigated. We leveraged longitudinal data from n=10,620 participants from the Adolescent Brain Cognitive Development Study to first investigate sex-stratified associations of particulate matter (PM2.) exposure and genetic risk with mental health trajectories across 9-16 years including internalizing symptoms and psychotic like experiences (PLEs). Additionally, we tested whether genetic risk for schizophrenia (PRS-SCZ) and major depressive disorder (PRS-MDD) exacerbate the association with PM2. exposure and change in symptoms over time. PM2. exposure was associated with lower decreases in PLEs over time in females (p-FDR=0.005), with no effects on internalising symptom trajectories in either sex. Genetic influences were sex-specific, with higher PRS-SCZ and PRS-MDD linked to greater increases in internalising symptoms in females (p-FDR=0.009; p-FDR=0.022) and higher PRS-MDD associated with greater decreases in PLEs in males (p-FDR=0.001). In females we also observed an interaction between PM2. and PRS-MDD on PLEs trajectories (p-FDR=0.048) such that those with high genetic risk and high PM2.5 exposure demonstrated increases in PLEs over time. Our results suggest that PM2. exposure and polygenic risk for depression jointly shape mental health during adolescence. This underscores the potential of interventions aimed at lowering air pollution during sensitive periods of neurodevelopment in improving adolescent mental health.

AO_SCPLOWBSTRACTC_SCPLOWThere is a gap between neuroscientific theories of learning and the speed of learning observed in many experiments. Since the Cognitive Revolution of the 1950s, compositionality has played a central role in efforts to bridge this gap. Roughly, a compositional system is one where distinct modules are combined according to a set of rules in order to accomplish complex tasks. Recently, significant progress has been made in understanding the emergence of modules in both biological and artificial neural systems. How, and under what conditions, the rules of module recombination are represented in these systems remains an open question. Here we present a neural model that can leverage these rules to dramatically speed up learning. We first show that when faced with multiple tasks which share subcomponents, models learn a low-dimensional representation that captures how subcomponents are reused across the task set. These low-dimensional spaces encode the structure that governs how modules should be recombined. Restricting learning to these subspaces greatly reduces the amount of experience needed to acquire a novel task, even when learning from reinforcement on single trials. In some cases, we can leverage the geometric regularities of these representations to reduce learning to a form of hypothesis testing over a small set of discrete points. Finally, we use this theory to model both behavioral and neural data from non-human primates performing a compositional task, and show that key features in this data are consistent with a model in which exploration during learning is restricted to these low-dimensional spaces. Overall, this work shows that the advantages of modularity in neural systems can be greatly improved upon when models represent the structure of module reuse. Both these features working in tandem lead to learning on timescales similar to biological intelligences, and hence provide a model for how such fast, adaptable behavior can emerge from systems of neurons.

Patients and caregivers seek informational and emotional support throughout medical care, especially when interpreting unfamiliar laboratory test results. Although resources such as patient portals and online health communities (OHCs) help address questions, gaps remain. The emergence of large language models (LLMs) offers the potential to be a complementary source of support to assist patients and caregivers in understanding and using their test results. The objective of our study is to empirically compare LLM responses to patients online questions containing their laboratory test results to responses written by peers in an OHC. We compared the 519 peer replies to 122 laboratory test-related posts from an OHC to 488 responses generated from four LLMs using mixed computational and qualitative methods. LLMs frequently provided clear explanations of medical terminology and structured interpretations of numeric results but were longer and less readable. Peers offered more personalized, context-specific emotional support. Overall, LLMs have the potential to complement peer responses in OHCs, but require greater emotional depth, reasoning transparency, and alignment with community norms.

White matter lesion (WML) identification, assessment, and characterization using magnetic resonance imaging (MRI) are fundamental for diagnosis and monitoring of multiple sclerosis (MS). Portable ultra-low field (pULF) MRI at 64 millitesla (mT) has been shown to visualize WML with at least one dimension greater than 4 mm. An automated WML segmentation tool catered to pULF-MRI can provide standardized and accurate quantitative measurements of WML volume. In this study, we sought to investigate and compare the accuracy of machine-learning (ML) and deep-learning (DL) pULF MRI segmentation tools. Same-day paired pULF (64mT) and high-field (HF, 3T) MRI scans from 84 adults with MS or suspected-MS (mean age {+/-} SD: 48 {+/-} 13, 62 females) included T2-FLAIR and T1w images. Reference WML segmentations were manually annotated on pULF T2-FLAIR for all scans, with WML confirmed with registered HF T2-FLAIR. HF reference WML segmentations were created. Four automated segmentation methods were applied to pULF scans: Method for Inter-Modal Segmentation Analysis (MIMoSA), an ML algorithm trained on HF WML masks; WMH-SynthSeg, a convolutional neural network model with flexible segmentation capabilities across field strengths and resolution; nnU-Net, a DL algorithm trained on pULF reference WML masks; and Pseudo-Label Assisted nnU-Net (PLAn), a DL algorithm pre-trained on HF reference WML masks and refined with 64mT reference WML masks. Two models were trained with nnU-Net, one using T2-FLAIR images only (nnU-Net-FL) and one using T1w and T2-FLAIR images (nnU-Net-FL/T1). The same was done with PLAn, creating PLAn-FL and PLAn-FL/T1. The six automated WML segmentation outputs were compared to the manual segmentations to determine Dice Similarity Coefficient (DSC) scores. Associations of WML volume estimates with clinical measures were investigated. DSC scores with pULF reference WML masks from PLAn-FL (DSC mean {+/-} SD: 0.50 {+/-} 0.24) outperformed MIMoSA (0.24 {+/-} 0.20, p < 0.0001), WMH-SynthSeg (0.30 {+/-} 0.18, p < 0.0001), nnU-Net-FL (0.41 {+/-} 0.24, p < 0.0001), and nnU-Net-FL/T1 (0.41 {+/-} 0.26, p = 0.0004). Worse Expanded Disability Status Scale (EDSS) and Scripps Neurologic Rating Scale (SNRS) scores were correlated with higher WML volumes in the pULF and HF reference masks. They were also correlated with WML volumes derived from WHM-SynthSeg, nnU-Net-FL, nnU-Net-FL/T1, PLAn-FL, and PLAn-FL/T1, but not MIMoSA. After adjusting for age, WHM-SynthSeg, nnU-Net FL, nnU-Net-FL/T1, PLAn-FL, and PLAn-FL/T1 had significant associations with EDSS and SNRS scores. nnU-Net and PLAn performed best in segmenting WML on pULF-MRI at 64 mT, providing accurate quantitative estimates of WML burden. Moreover, WML volumes estimated by these algorithms were associated with clinical measures of disability, underscoring their utility for reflecting clinical and radiological disease severity. Given pULF-MRI's mobility and lower cost, these findings highlight its relevance in clinical trials, particularly in involving more participants who face logistical constraints and barriers.

Prenatal alcohol exposure (PAE) is a major cause of neurodevelopmental disorders, yet most children are diagnosed late or misdiagnosed. Neuroplacentology suggest that placental factors released into maternal and/or umbilical cord blood contribute to fetal brain development. Consistently, a preclinical inter-organ transcriptomic database revealed that PAE disrupts the expression ratio of angiogenic and inflammatory factors suggesting an angio-inflammatory response. This study aimed i) to assay, by multiplex immunoassay, angiogenic and inflammatory factors in maternal and umbilical cord blood from alcohol-consuming women and ii) to perform a maternofetal analysis according to neonatal sex. Afterwards, dysregulated factors from mothers who gave birth to females or males were submitted to STRING and ShinyGO analyses. Results showed that PAE differently altered the distribution profiles of dysregulated angiogenic and inflammatory factors in maternal and umbilical cord blood. Moreover, sex-specific differences were observed, with 36% of dysregulated proteins specific to males, 48% to females, and 16% common to both. STRING analysis revealed robust functional protein-protein interactions linking together inflammatory and angiogenic clusters while the ShinyGO analysis identified enriched pathways related to vascular shear stress. These findings provide the first maternofetal analysis of combined angiogenic and inflammatory factors from alcohol-consuming mothers.

Background. UK clinical guidance recommends that structured risk prediction tools and risk stratification should not be used in self-harm, to predict suicide or determine who is offered treatment. Underpinning this position is the premise that routinely collected health data contain no useful predictive signal, which has received little direct scrutiny. Objective. To test whether routinely collected electronic health record data can distinguish groups at higher and lower risk of severe outcomes following paracetamol overdose. Methods. We analysed 4,095 adults presenting to NHS Lothian emergency departments with paracetamol overdose (2017-2023). Elastic-net logistic regression was fitted to 37 routinely collected electronic health record features to predict a composite of death or mental health inpatient admission at 0-7, 8-30 and 31-365 days following attendance, evaluated on a held-out 20% test set with bootstrapping. Findings. Events occurred in 5.5% of patients at 0-7 days, 2.0% at 8-30 days and 7.9% at 31-365 days, dominated by mental health admission. Bootstrap AUROC 95% confidence intervals lay above 0.5 in every window (0.65-0.82, 0.63-0.90, 0.71-0.85): models ranked patients better than chance. Calibration slopes (1.04, 1.14, 1.07) were close to one. Ranking drew primarily on mental health-related features. Conclusions. Routinely collected health data carried predictive signal for severe outcomes after paracetamol overdose, although discrimination fell short of what is needed for individual-level clinical use. Clinical implications. These models are not proposed for clinical deployment; however, treating risk prediction as a settled question will redirect research efforts, potentially excluding this patient population from machine learning advances driving improvements in care in other medical specialties.

Background: Actigraphy-derived rest-activity rhythm (RAR) features are widely used to characterize clinical states in bipolar disorder (BD). Both mean levels and temporal variability of these features have been associated with mood episodes; however, variability measures are often statistically coupled with the mean, particularly in skewed distributions. This raises a question as to whether variability reflects a separate characteristic of the data or whether the observed association arises from statistical properties of the data. Objective: In this study, we aim to determine whether temporal variability of actigraphy-derived RAR features provides standalone information on mood episodes in BD beyond mean activity levels after accounting for mean-variance dependence. Methods: We analyzed actigraphy data from a subset of 72 participants with BD drawn from a larger longitudinal study, extracting 22 daily RAR features aggregated weekly as sample mean (MEAN) and within-week temporal variability computed as sample standard deviation (VAR). Variance-stabilizing transformations (Box-Cox or Yeo-Johnson) were applied to the entire study cohort to reduce mean-variance dependence. Associations with mood episodes and remission (mania: n=34; depression: n=58 annotated participants) were evaluated using generalized linear mixed-effects models with a logistic link function, including univariate (MEAN or VAR) and multivariate (MEAN+VAR) specifications, assessed by likelihood-based metrics and the area under the receiver operating characteristic curve (AUC). Results: Transformations reduced mean-absolute correlations from 0.43 to below 0.06. Temporal variability remained significantly associated with clinical state for 11/22 RAR features in mania and 16/22 features in depression, with all significant associations remaining after false discovery rate correction (p<0.05). Joint models showed modest incremental gains (AUC 3%-4% overall; up to 12% in mania, 7% in depression), with absolute performance remaining limited (AUC 0.50-0.66). In both mania and depression, nearly all significant variability-based regressors contributed incremental information beyond mean-based models. Only sleep duration and activity changes around wake time (+-1 hour), did not improve discrimination between mania and remission. Conclusions: Temporal variability in RAR features can be considered a standalone state marker of mood episodes not captured by mean activity. We found it to be more consistently associated with depression than mania. Its incremental discriminative contribution is modest, suggesting greater utility within multivariate or multimodal frameworks.