University College Dublin

Maternal perception of reduced fetal movements is a frequent reason for referral to maternity services and may signal risk of adverse outcomes, particularly stillbirth. To identify contemporary maternal and pregnancy-related risk factors for RFM and to examine associations between RFM and perinatal outcomes. A prospective case-control study in a large urban maternity hospital in Ireland was conducted. Women with singleton pregnancies with RFM at ≥24 weeks' gestation between 1 January and 30 September 2020 (cases) were compared with randomly selected women without RFM during pregnancy (controls) from the same population and timeframe. Associations were assessed using univariate and multivariable logistic regression analyses. A total of 850 women with RFM were compared with 1743 controls. Women with RFM were younger (mean age [SD] 33.8 [5.04] vs 34.4 [4.93] years; p = 0.004), had a higher body mass index (BMI) (mean [SD] 26.6 [5.76] v 25.89 [5.10]; p < 0.05) and more likely nulliparous (68 % vs 43.8 %; p < 0.001). Multivariable analyses identified anterior placenta (OR 1.24 95 %CI 1.05-1.46; p = 0.01), a prior history of neonatal death (OR 4.65, 95 % CI 1.43-15.15; p = 0.01), and recurrent miscarriage (OR 1.64, 95 % CI 0.99-2.72; p = 0.05) as independent risk factors for RFM. RFM was not associated with stillbirth, preterm birth or neonatal death but was significantly associated with small for gestational age (SGA) infants (OR 1.48, 95 % CI 1.09-2.02). Women with RFM were more likely to undergo induction of labour (aOR 1.44 95 %CI 1.20-1.74) but not emergency caesarean section (aOR 1.20 95 % CI 0.80-1.80), or neonatal intensive care admission. RFM is influenced by maternal and pregnancy characteristics and is associated with SGA but not severe adverse perinatal outcomes. Careful assessment of women presenting with RFM, targeted growth surveillance, antenatal education and standardised care pathways are essential to optimise maternal and fetal well-being, inform clinical practice, and guide policy in contemporary maternity care.

There is increasing interest to develop Bayesian inferential algorithms for point process models with intractable likelihoods. A purpose of this paper is to illustrate the utility of using simulation based strategies, including Approximate Bayesian Computation (ABC) and Markov Chain Monte Carlo (MCMC) methods for this task. Shirota and Gelfand (2017) proposed an extended version of an ABC approach for Repulsive Spatial Point Processes (RSPP), but their algorithm was not correctly detailed. In this paper, we correct their method and, based on this, we propose a new ABC-MCMC algorithm to which Markov property is introduced compared to a typical ABC method. Though it is generally impractical to use, Monte Carlo approximations can be leveraged for intractable terms. Another aspect of this paper is to explore the use of the exchange algorithm and the noisy Metropolis–Hastings algorithm ( Alquier et al., 2016 ) on RSPP. Comparisons to ABC-MCMC methods are also provided. We find that the inferential approaches outlined above yield good performance for RSPP in both simulated and real data applications and should be considered as viable approaches for the analysis of these models.

Psychological trauma is an increasingly prominent construct in contemporary culture, invoked across diverse contexts of policy, practice, and public discourse. However, little is known about how laypeople conceptualise trauma in everyday life. This qualitative study explored social representations of trauma among residents of the Republic of Ireland. Twenty participants completed interviews that elaborated their associations with the term ‘trauma’. Thematic analysis identified three overarching themes, which represented trauma as (a) an individual journey, (b) a byproduct of social ills, and (c) a cultural construct. More specifically, participants viewed trauma as highly subjective, shaped by individual differences in experiences, responses and outcomes. In parallel, trauma was linked to societal-level phenomena such as war and violence, with social support positioned as key to coping and recovery. Participants were highly sensitive to the growing cultural prominence and widening uses of trauma and expressed ambivalence regarding this trend, welcoming trauma’s de-stigmatisation but decrying its potential trivialisation. These findings offer original insights into how trauma is understood beyond clinical settings, informing responsible uses of the concept and ongoing debates about its cultural significance. • Psychological trauma is an increasingly prominent construct in contemporary culture • Qualitative interviews explored lay associations with the concept of trauma • Trauma was construed as an individual journey, byproduct of social ills, and cultural construct • Lay understandings of trauma have potential implications for clinical, personal and societal contexts

Deer abundances and distributions have expanded at increasing rates in several regions across the globe due to human-driven land use change, uncontrolled (re)introductions, and insufficient top-down control by human or natural predators. Yet, the impact of unsustainable deer density on the belowground component of ecosystems is understudied. Ireland is a good model for anthropogenic environmental context, where populations of large herbivores are not regulated by large predators nor by structured hunting management. Using a combination of camera trapping, soil and vegetation surveys, with phospholipid fatty acid (PLFA) and bioinformatic approaches, we monitored 50 sites in Irish woodlands. The effects of varying sika deer ( Cervus nippon ) disturbances on soil biota were then assessed using structural equation modelling. Site-level deer intensity of use correlated with vegetation through an increase in litter and moss quantity and reduction in understory vegetation. We also found that variation in deer intensity of use directly affect vertebrate communities, which shifted towards a dominance of foxes, squirrels, cats and dogs – species more commonly associated to human-dominated landscapes – and a reduction in birds and mustelids, which also cascaded on soil biota. Our results thus support the hypothesis that deer overabundance has a potential to drive the structure of soil biota but mostly through indirect effects via vertebrate fauna and vegetation, acting as an ecosystem engineer. Future studies will have to experimentally tease apart the mechanisms underpinning the patterns documented in this study.

Childhood maltreatment and FKBP5 CATT haplotypes increase identity dissociation risk. While maltreatment often fosters disorganized attachment, the specific role of the FKBP5 CATT haplotype within this developmental pathway remains unknown. In 310 trauma-exposed adults, we assessed childhood maltreatment, disorganized attachment, and identity dissociation. FKBP5 CATT haplotype status was dichotomized (present/absent). Regression models were estimated to examine the pathway Childhood Maltreatment → Disorganized Attachment → Identity Dissociation, comparing two competing hypotheses: 1) The Formation Hypothesis (Maltreatment × CATT → Disorganization), and 2) The Translation Hypothesis (Disorganization × CATT → Identity Dissociation). Model fit was compared using BIC, and simple slopes were examined. Disorganized attachment predicted identity dissociation (β = 0.143, z = 3.83, p < .001), and childhood maltreatment predicted disorganization (β = 0.007, z = 4.46, p < .001). The Formation hypothesis was not supported, as the Maltreatment × CATT interaction did not predict disorganization (β = -0.004, z = -1.18, p = .24). However, the Translation hypothesis was supported by three pieces of evidence: a significant Disorganization × CATT interaction predicting identity dissociation (β = 0.133, z = 2.22, p = .027), model fit (∆BIC = 265.3), and simple slopes showing a strong effect of disorganization on identity dissociation for CATT carriers (β = 0.15, p < .001; +16.5 % per unit) but not for non-carriers (β = 0.02, p = .65). The FKBP5 CATT haplotype does not promote disorganized attachment but amplifies the translation of disorganized attachment into identity dissociation. This result highlights a genetically influenced failure of identity development following disorganized attachment.

To determine the safety and efficacy of taselisib, a selective PI3K inhibitor, in combination with tamoxifen. POSEIDON is a phase II, randomized, placebo-controlled trial conducted from June 2016 to March 2020. Eligible patients were refractory upon prior endocrine therapy. Prior treatment with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors and everolimus was allowed. Patients were randomized (1:1) to receive either taselisib (4 mg) + tamoxifen (20 mg) or placebo + tamoxifen. The primary endpoint of the trial was investigator-assessed progression-free survival (PFS) in the intention-to-treat (ITT) population (two-sided α 0.2, 90% power). Exploratory biomarker analysis with regards to prognosis and treatment resistance was conducted in circulating tumor (ct)DNA. POSEIDON met its primary endpoint, in which patients treated with taselisib + tamoxifen had improved PFS compared with patients treated with placebo + tamoxifen in the ITT population (median PFS 4.8 months vs. 3.2 months; stratified hazard ratio 0.69; 80% confidence interval, 0.49-0.98, P = 0.17). However, toxicity of taselisib was significant, with diarrhea (40% any grade) as the most common adverse event. Exploratory analyses indicated that high tumor fraction (TF) determined in ctDNA at baseline is associated with worse PFS and overall survival (P < 0.0001). Our findings suggest efficacy of PI3K inhibition + tamoxifen beyond second-line treatment and after prior targeted therapies, including CDK4/6 inhibition in metastatic HR+/HER2- breast cancer, although the magnitude of benefit did not outweigh the tolerability of this combination. Exploratory biomarker analysis indicates that TF determined in ctDNA differentiates patients based on prognosis and may help optimize patient selection for targeted treatment strategies.

• Large nutrient exports are infrequent and short-lived depending on heavy rainfalls. • Heavy rainfalls regulate nutrient and ion concentrations by a dilution effect. • Effluent water quality varies seasonally as controlled by climatic factors. • The pond assures particle retention but fails to treat soluble components. • Downstream aquatic communities are subject to harmful effects year-round. Peatlands are important stores of carbon and nutrients, but drainage for peat extraction disrupts hydrology and water quality, enhancing leaching of organic matter and nutrients. This study examined the seasonal dynamics of water quality from a 16.4 ha industrial cutaway peatland catchment in Ireland following storm events and evaluated the influence of an on-site sedimentation pond. Water quality, including carbon, nitrogen and major ions, was monitored over three years using automated storm-event sampling, grab sampling and continuous flow measurements to assess seasonal variability, pond treatment effects and relationships with climatic drivers (flow and temperature). High flows (≥25 L/s) were infrequent, whereas low flows (≤5 L/s) were common. Carbon and nitrogen concentrations varied markedly between storm events, with increasing flow generally causing dilution. Despite their rarity, short-lived high flows accounted for a large proportion (>70–85%) of annual nutrient export. Effluent water quality exhibited clear seasonal patterns and was strongly related to flow and temperature. Warm, dry periods produced more neutral, nutrient-rich effluents, whereas colder, wetter conditions generated more acidic waters with lower concentrations, regulated by pH. Oxygen availability within the catchment appeared to influence carbon production in effluents concurrently with ammonia production. The pond received subsurface inflows low in dissolved oxygen and exhibited highly variable hydraulic retention times (mean ± standard deviation 90 ± 551 days; median 15 days). While the pond retained particulate material, its influence on dissolved constituents was limited. These effluents pose risks to receiving waters, highlighting the need for improved mitigation strategies in extracted peatland catchments.