Background: COMISA (comorbid insomnia and obstructive sleep apnea) is associated with daytime functioning and cognitive impairments. This post hoc analysis assessed the impact of lemborexant (LEM), a dual-orexin-receptor-antagonist approved to treat insomnia in adults, on morning sleepiness/alertness in participants with COMISA. Methods: Of the overall population (n=1006), 410 (40.8%) adults (≥55 years) with comorbid insomnia disorder and mild obstructive sleep apnea (apnea-hypopnea-index, 5–≤15 events/h) from Study E2006-G000-304 (NCT02783729), a 1-month, randomized, placebo- and active-controlled study, were analyzed. Participants received placebo (PBO), LEM 5mg (LEM5), LEM 10mg (LEM10), or zolpidem tartrate 6.25mg (not reported). A daily sleep diary assessed morning sleepiness/alertness (1, extremely sleepy to 9, extremely alert). Participants (%) shifting from baseline mild/moderate sleepiness (≤3) towards greater alertness (4, 5, or >5) during the first/last 7 mornings of the study were analyzed. Results: At baseline, 17/75 (22.7%), 36/112 (32.1%), and 28/104 (26.9%) participants with COMISA receiving PBO, LEM5, or LEM10, respectively, reported mild/moderate sleepiness. Across the first/last 7 mornings, more participants shifted from mild/moderate sleepiness towards alertness with LEM5 (66.7%, 82.9%) and LEM10 (64.3%, 75.0%) versus PBO (47.1%, 64.7%), respectively. Conclusions: A greater percentage of participants with COMISA experienced improvements in morning sleepiness across the treatment period with LEM versus PBO.

Premised on the Developmental Origins of Health and Disease theory and on the limited effectiveness of antenatal interventions, interventions in the preconception period are being conducted to potentially improve intergenerational health and non-communicable disease burdens. The Healthy Life Trajectories Initiative (HeLTI) is an international health research consortium primarily investigating the intergenerational effects of behavioural interventions on obesity via a complex four-phase intervention initiated preconceptionally, through pregnancy, and into early childhood. HeLTI, in partnership with the World Health Organization, aims to generate evidence that will shape health policy focused on preconception as part of a life course approach to population health. It is necessary to ensure that a renewed public health focus on preconception prioritises justice and equity in its framing. This article presents collaborative interdisciplinary work with HeLTI-South Africa. It applies a feminist bioethics methodology, which is empirical, situated, intersectional, and fundamentally concerned with justice, to investigate what South African HeLTI community health workers, or ‘Health Helpers’, who deliver the complex behavioural intervention, think about preconception health and responsibility. Seven semi-structured interviews were conducted with HeLTI-SA Health Helpers, and data were analysed using reflexive thematic analysis. Our findings show that Health Helpers’ perceptions of preconception health and related responsibility were significantly gendered, heteronormative, and concerned with child-bearing intentionality and desires. These themes were inflected with Health Helpers’ perceptions about how attributions of responsibility are shaped by culture, demonstrating the situated nature of epistemologies. Their ideas also highlight how preconception health knowledge can distribute responsibility unjustly. Understanding the contextual impact and relevance of values around responsibility is critical to prospectively design preconception health interventions that promote equity and fairness. This understanding can then be used for effective policy translation, with the goal that public health policy is founded upon contextual responsivity and justice for the public it aims to serve.

Recent governmental figures have demonstrated that the number of students taking an examination in A-Level Music across England has fallen by 41% in eleven years (Ofqual, 2023a). Furthermore, areas with lower POLAR ratings (i.e. historical rates of participation in higher education) and greater levels of deprivation correlate with lower uptake of A-Level Music (Whittaker et al., 2019). These findings have profound implications for equitable access to music education, especially at advanced levels. Against this challenging background, Sandbach School, the Love Music Trust and the Royal Northern College of Music have sought to respond by creating a new partnership approach to A-Level Music. Since September 2019, this specialist course has drawn students together from all over Cheshire whose access to A-Level Music has been geographically limited. Specifically aiming to facilitate progression into higher education, this course provides the young musicians with musical enrichment activities that are additional to the core curriculum, including performance opportunities, advanced musicianship classes, chamber music and instrumental tuition at the Royal Northern College of Music. This article presents a critical discourse analysis of data collected from these students and their teachers, contextualising their experiences within a broader analysis of recent socio-cultural trends and the associated political climate that has impacted on the provision of music education within English schools. Findings point to an important rearticulation of the meaning of ‘Music Hub’, where putting schools at the centre and enriching this provision through strategic partnerships with local ensembles, music services and higher education institutions can build musical cultures and communities that better enable equitable access to high-level music education and progression pathways into higher education.

Based on fieldwork with two related Afro-Brazilian religions, Umbanda and Quimbanda, this article explores the value of Donald Davidson’s semantic theory for making sense of ethnographic fieldwork. Specifically, we look at the role of scriptedness in communication, including religious ritual. We first clarify the role of social externalities in Davidson’s view of communicative interpretation, which is broader than his initial framework of radical interpretation. We then offer an account of what constitutes communicative and interpretational success, by drawing on Davidson’s account of prior and passing theory. Prior theories are interpreters’ initial hypothetical frameworks, ranging from general (e.g., the rational, intentional nature of self and other, and a shared perceivable world) to local (e.g., assumptions about cultural, social, and institutional contexts). Passing theories are tactical, on-the-fly modifications that we hypothesize in order to get mutual understanding back on track. We introduce the concept of ‘semantic reduction’ to operationalize the view that specific, local social externalities provide clues that help keep interpretation on track. In the case of religious ethnography, these include ritual, doctrinal, narrative, symbolic, material, temporal, and spatial frames that constrain the generation of passing theories. Examples from fieldwork illustrate the potential value of our appeal to Davidson’s ideas.

Effective ex situ conservation of plants in botanic gardens requires sufficient wild accessions to represent wild diversity. In Rhododendron L. (Ericaceae), c. 64% of the taxa are threatened or require field investigation. As a case study of the analysis of ex situ conservation gaps we used ecogeographical representation as a proxy for genetic representation in ex situ collections of the 65 taxa of Rhododendron subsection Maddenia. We compiled the first list profiling both wild distributions and ex situ wild collections of all taxa in subsection Maddenia. Our results reveal that 55 Maddenia taxa are in cultivation. Of the 18 threatened taxa all are in cultivation but nine require further collection to capture adequate wild diversity. There are 12 Data Deficient taxa: these await further field investigation of wild populations and nine of them require wild collections to conserve genetic diversity. The UK, the USA, Australia, New Zealand and China are the top five countries holding ex situ collections of subsection Maddenia; in these countries nearly 66% of the ex situ sites hold > 86% of the global living collections of subsection Maddenia. We recommend that wild collections of endemic species of subsection Maddenia should be established in all 10 countries of origin and that data should be shared internationally for metacollections. In addition to proposing priorities, our case study highlights the challenges facing data and collection management to help achieve effective ex situ conservation for Rhododendron species.

The modern marine megafauna is known to play important ecological roles and includes many charismatic species that have drawn the attention of both the scientific community and the public. However, the extinct marine megafauna has never been assessed as a whole, nor has it been defined in deep time. Here, we review the literature to define and list the species that constitute the extinct marine megafauna, and to explore biological and ecological patterns throughout the Phanerozoic. We propose a size cut-off of 1 m of length to define the extinct marine megafauna. Based on this definition, we list 706 taxa belonging to eight main groups. We found that the extinct marine megafauna was conspicuous over the Phanerozoic and ubiquitous across all geological eras and periods, with the Mesozoic, especially the Cretaceous, having the greatest number of taxa. Marine reptiles include the largest size recorded (21 m; Shonisaurus sikanniensis) and contain the highest number of extinct marine megafaunal taxa. This contrasts with today’s assemblage, where marine animals achieve sizes of >30 m. The extinct marine megafaunal taxa were found to be well-represented in the Paleobiology Database, but not better sampled than their smaller counterparts. Among the extinct marine megafauna, there appears to be an overall increase in body size through time. Most extinct megafaunal taxa were inferred to be macropredators preferentially living in coastal environments. Across the Phanerozoic, megafaunal species had similar extinction risks as smaller species, in stark contrast to modern oceans where the large species are most affected by human perturbations. Our work represents a first step towards a better understanding of the marine megafauna that lived in the geological past. However, more work is required to expand our list of taxa and their traits so that we can obtain a more complete picture of their ecology and evolution.

No one would think of denying that literary texts lend themselves to “plural” readings, as we say today: the studies collected in this issue are one more proof, as is the title of the collection. Tens of thousands of pages have already been written on Shakespeare and on Montaigne, which does not preclude the enjoyment of those that are offered us here; and the idea would not occur to anyone that this process of re-writing could ever come to an end, aside from the apocalyptic end of all human things, written and unwritten.

The UK food system is distorted by inequalities in access, failing the people most in need, yet it should provide access to safe, nutritious affordable food for all citizens. Dietary patterns are associated with socio-demographic characteristics, with high levels of diet-related disease mortality attributed to poor dietary habits. Disadvantaged UK communities face urgent public health challenges, yet are often treated as powerless recipients of dietary and health initiatives. The need for food system transformation has been illustrated within recent UK government policy drivers and research funding. The Food Systems Equality project is a research consortium that aims to ‘co-produce healthy and sustainable food systems for disadvantaged communities’. The project focusses on innovating food products, supply chains and policies, placing communities at the centre of the change. Tackling the above issues requires new ways of working. Creative approaches in food research are known to empower a wider range of individuals to share their ‘lived food experience’ narratives, building relationships and corroborating co-production philosophies, thus promoting social justice, and challenging more traditional positivist/reductionist ‘biomedical’ approaches for nutrition and food studies. This review paper critiques the use of community-centric approaches for food system transformation, focusing on one, a community food researcher model(1) as an exemplar, to highlight their utility in advocating with rather than for less affluent communities. The potential for creative methods to lead to more equitable and lasting solutions for food system transformation is appraised, consolidating the need for community-driven systemic change to foster more progressive and inclusive approaches to strengthen social capital. The paper closes with practice insights and critical considerations offering recommendations for readers, researchers, and practitioners, enabling them to better understand and apply similar approaches.

Rabies virus (RABV) is a deadly zoonosis that circulates in wild carnivore populations in North America. Intensive management within the USA and Canada has been conducted to control the spread of the raccoon (Procyon lotor) variant of RABV and work towards elimination. We examined RABV occurrence across the northeastern USA and southeastern Québec, Canada during 2008–2018 using a multi-method, dynamic occupancy model. Using a 10 km × 10 km grid overlaid on the landscape, we examined the probability that a grid cell was occupied with RABV and relationships with management activities (oral rabies vaccination (ORV) and trap-vaccinate-release efforts), habitat, neighbour effects and temporal trends. We compared raccoon RABV detection probabilities between different surveillance samples (e.g. animals that are strange acting, road-kill, public health samples). The management of RABV through ORV was found to be the greatest driver in reducing the occurrence of rabies on the landscape. Additionally, RABV occupancy declined further with increasing duration of ORV baiting programmes. Grid cells north of ORV management were at or near elimination ($\hat{\psi }_{{\rm north}}$ = 0.00, s.e. = 0.15), managed areas had low RABV occupancy ($\hat{\psi }_{{\rm managed}}$ = 0.20, s.e. = 0.29) and enzootic areas had the highest level of RABV occupancy ($\hat{\psi }_{{\rm south}}$ = 0.83, s.e. = 0.06). These results provide evidence that past management actions have been being successful at the goals of reducing and controlling the raccoon variant of RABV. At a finer scale we also found that vaccine bait type and bait density impacted RABV occupancy. Detection probabilities varied; samples from strange acting animals and public health had the highest detection rates. Our results support the movement of the ORV zone south within the USA due to high elimination probabilities along the US border with Québec. Additional enhanced rabies surveillance is still needed to ensure elimination is maintained.

We define a new family of spectral invariants associated to certain Lagrangian links in compact and connected surfaces of any genus. We show that our invariants recover the Calabi invariant of Hamiltonians in their limit. As applications, we resolve several open questions from topological surface dynamics and continuous symplectic topology: We show that the group of Hamiltonian homeomorphisms of any compact surface with (possibly empty) boundary is not simple; we extend the Calabi homomorphism to the group of hameomorphisms constructed by Oh and Müller, and we construct an infinite-dimensional family of quasi-morphisms on the group of area and orientation preserving homeomorphisms of the two-sphere.

Our invariants are inspired by recent work of Polterovich and Shelukhin defining and applying spectral invariants, via orbifold Floer homology, for links composed of parallel circles in the two-sphere. A particular feature of our work is that it avoids the orbifold setting and relies instead on ‘classical’ Floer homology. This not only substantially simplifies the technical background but seems essential for some aspects (such as the application to constructing quasi-morphisms).

Antarctic and Southern Ocean environments are facing increasing pressure from multiple threats. The Antarctic Treaty System regularly looks to the Scientific Committee on Antarctic Research (SCAR) for the provision of independent and objective advice based on the best available science to support decision-making, policy development and effective environmental management. The recently approved SCAR Scientific Research Programme Ant-ICON - ‘Integrated Science to Inform Antarctic and Southern Ocean Conservation‘ - facilitates and coordinates high-quality transdisciplinary research to inform the conservation and management of Antarctica, the Southern Ocean and the sub-Antarctic in the context of current and future impacts. The work of Ant-ICON focuses on three research themes examining 1) the current state and future projections of Antarctic systems, species and functions, 2) human impacts and sustainability and 3) socio-ecological approaches to Antarctic and Southern Ocean conservation, and one synthesis theme that seeks to facilitate the provision of timely scientific advice to support effective Antarctic conservation. Research outputs will address the most pressing environmental challenges facing Antarctica and offer high-quality science to policy and advisory bodies including the Antarctic Treaty Consultative Meeting, the Committee for Environmental Protection and the Scientific Committee of the Commission for the Conservation of Antarctic Marine Living Resources.