Background: The consistency of effects of lemborexant (LEM), a dual orexin-receptor antagonist, on sleep maintenance variables across 2 phase 3 studies with contrasting populations was compared. Methods: E2006-G000-304 (Study 304; NCT02783729) and E2006-J086-311 (Study 311; NCT04549168) were 1-month, randomized, double-blind, placebo (PBO)-controlled studies evaluating LEM 10mg (LEM10) in adults with insomnia disorder. Global Study 304 (N=1006; PBO, n=208; LEM10, n=269) enrolled participants of any race (≥55y); Study 311 (N=193; PBO, n=100; LEM10, n=93) participants were exclusively Chinese (≥18y). Pairs of polysomnograms were conducted at baseline and after the first/last 2 doses of the 1-month treatment. Change from baseline in sleep efficiency (SE [%]), wake-after-sleep-onset (WASO [min]), and total-sleep-time (TST [min]) were analyzed. Results: Mean baseline sleep parameters: Study 304: SE, 67.9–68.9; WASO, 111.8–114.8; TST, 325.1–330.7; Study 311: SE, 69.4–70.3; WASO, 79.3-–85.8; TST, 333.2–336.7. Least squares mean [standard error] increases from baseline were significantly larger with LEM10 vs PBO (P<0.001) for SE (Study 304, 8.0 [0.7]; Study 311, 7.1 [1.4]) and TST (38.9 [3.7]; 32.8 [6.9]), as were decreases in WASO (-25.4 [3.1]; -17.8 [4.8]). Most treatment-emergent adverse events were mild–moderate. Conclusions: Short-term LEM10 treatment consistently improved objective sleep maintenance in patients with insomnia of different races.

Background: Canadian neurosurgery residency programs have an alarming 28.4% attrition rate—seven times higher than the average for most other specialties (1–4%) and double that of US neurosurgery programs. Canadian data for this issue is over 30 years old, highlighting the need for updated research. This study identifies factors contributing to Canadian neurosurgery attrition rates. Methods: Using critical constructivist theory, virtual interviews were conducted with current program directors (PDs) from Canada’s 14 neurosurgery programs and neurosurgery residents who left training between 2013–2023. Interviews were recorded, transcribed, anonymized, and iteratively coded through descriptive thematic analysis to construct an analytical framework. Results: We conducted interviews with 7 PDs and 7 former neurosurgery residents, representing 7 neurosurgery programs across Canada. The average attrition rate was 14.11% (0%–28.6%) from 2013–2023. Contributing factors include poor job prospects in Canada, resource constraints leading to high workloads, poor work-life balance, moral distress due to high levels of patient mortality, and a lack of teaching and support from staff and senior residents. Conclusions: Neurosurgery residents are the future of neurosurgery. Our study uncovers factors contributing to high attrition rates in neurosurgery training, indicating that change must come from provincial governments and within training programs to retain residents.

Background: Accurate aquaporin-4 (AQP4) and Myelin Oligodendrocyte Glycoprotein (MOG) assays are essential for effectively diagnosing neuromyelitis Optica spectrum disorder and MOG antibody-associated disease. The Live Cell-Based Assay (L-CBA) is the gold standard laboratory test for detecting these antibodies. We studied the profiles of these antibodies, in samples of patients with relevant neurological conditions. Methods: Between January 2021 and December 2024, a total of 6673 samples of serum and/ or CSF were tested at BC Neuroimmunology Lab, Vancouver. We performed in-house L-CBA for the AQP4 and MOG Abs identification. We analyzed the demographics and characteristics of the positive Abs results. Results: We identified 7.8% positive results for anti-MOG and 2.7% for anti-AQP4 antibodies. Both antibodies were more frequent in females (AQP4: 76.9%, MOG: 65.1%). The average age of patients was 49.2 ± 18.8 years, ranging from 9 to 88 years for AQP4 antibodies, and 40.9 ± 19.5 years, ranging from 10 months to 89 years for MOG antibodies. Conclusions: Both anti-MOG and anti-AQP4 Abs are prevalent in females. Moreover, anti-MOG Abs are present across a wider age range from infancy to the elderly, and anti-AQP4 Abs are typically found in later ages, between 10 and 90 years.

Background: Neurosurgery is a long and arduous training program, and the demands of neurosurgical training have led to resident burnout prevalence ranging from 11-67%, attrition, and suicide. We aimed to assess whether implementation of a weekly self-assessment tool with optional psychological counselling improves neurosurgical resident quality of life. Methods: We performed a one year prospective cohort study including 14 Calgary (intervention group) and 12 Toronto/Winnipeg residents (control group). Calgary residents utilized a mobile application (“HONE”) weekly, and all residents responded to questionnaires at baseline, midpoint and endpoint: EQ-5D-5L, Maslach Burnout Inventory (MBI), and Mayo Clinic Well-being Index (WBI). Between and within group results were compared using two-tailed t-tests. Results: Pooled baseline scores were comparable to population norms, with increased mean MBI depersonalization scores (10.28 versus 7.12, p=0.033), and more WBI “at risk” scores compared to normative data. There were no baseline differences between cohorts. EQ-5D-5L, MBI, and WBI scores were comparable between and within cohorts at all three time points. Three intervention group residents accessed psychological counselling, totalling ten sessions. Conclusions: Weekly use of the HONE application did not impact resident quality of life, although multiple residents displayed help-seeking behaviours. HONE provided tangible data for the program director to track trends in team well-being.

Background: Meningiomas are the most common intracranial extra-axial lesion. Reports of meningioma regression exist, often in the context of known hormonal or vascular fluctuations, though very few describe complete resolution. Though rare, extra-axial mimics such as lymphoma and chloroma may also spontaneously regress. Methods: Electronic medical records were used to access patient information in accordance with our local ethics review board. Results: A 29-year-old male presenting with new onset seizures was found to have a 22.7 x 26.6 mm left temporal extra-axial lesion, radiologically consistent with meningioma. Due to wait times and patient preference, repeat pre-operative imaging was not available prior to surgical resection 13 months later, though an interim CT had confirmed persistence of the tumour’s size 1 month after diagnosis. Decision was made to proceed with resection; however, intraoperatively, no lesion was identified. Post-operative imaging demonstrated complete disappearance of the lesion, and follow-up imaging has shown no recurrence. Conclusions: This case highlights the possibility of spontaneous resolution of extra-axial lesions and emphasizes the importance of serial imaging prior to resection.

Background: We aim to assess the resting state functional connectivity (RSFC) and reactivity with functional near-infrared spectroscopy (fNIRS) in patients with acute stroke compared to age, sex and comorbidity-matched subjects. Methods: Patients with acute anterior circulation stroke syndrome localizing to the right (RH) or left hemisphere (LH) were enrolled. RSFC was assessed using group-level seed-based (Primary Motor cortex,PMC) correlation analysis. Finger-tapping-associated relative oxygen Hemoglobin (ΔHbO) changes were analyzed with generalized linear model regression. Results: 127 participants (RH stroke, 51; LH stroke, 43; control, 33) enrolled at a median of 21 (15,29) hours after symptom onset. Compared to the control group, the RSFC with the affected PMC (LH stroke) was reduced over the affected somatosensory cortex (SSC) in the minor ischemic stroke (IS) (r = -0.14 (-0.3,-0.01)), minor intracerebral hemorrhage (ICH) (-0.48 (-0.78,-0.18)) and major ICH groups (-0.2 (-0.4,-0.01). In the FT task compared to the control groups in LH stroke, ΔHbO was increased over the affected SSC in minor IS (β11.2(1.9,20.5)) and major ICH group (β11.7 (1.4,22.1)). In the FT task in RH stroke, ΔHbO was increased over the unaffected PMC in minor IS (β12.1(2.3,21.8)), major IS (β14.9 (0.3,29.5)), minor ICH (β25.7 (10.1,41.2)) and major ICH (β13.4 (1.1,25.6). Conclusions: Motor cortex dysconnectivity may be worse over the LH stroke. In RH stroke, there is early compensatory increased neuronal activity over the unaffected PMC. These results suggest differential acute remodelling in RH and LH strokes.

The application of a tube combustion system (pyrolyzer) for the batch combustion of low carbon content environmental matrices, such as soil and sediment, for determining 14C specific activity is examined. The samples were combusted at 600°C, and the CO2 species produced were trapped in 3N NaOH, precipitated as BaCO3 by adding BaCl2, and subjected to acid-hydrolysis to transfer the CO2 species to the absorber-scintillator mixture for liquid scintillation counting (LSC). The method was validated by analyzing the samples by accelerator mass spectrometry (AMS) method. The minimum detectable activity (MDA) for the method, at 2σ confidence level, was 10 Bq kg–1C (4 pMC) for a counting time of 500 min and 7 Bq kg–1C (3 pMC) for 1000 min. The capability of the method to quantify a small excess of 14C specific activity (a few Bq kg–1C or pMC) in the environment of a nuclear facility, when compared to the ambient natural background level, was demonstrated by analyzing a total of 23 soil and 7 sediment samples from the vicinity of a pressurized heavy water reactor (PHWR) nuclear power plant (NPP) at Kaiga, India. The maximum excess 14C specific activity values recorded for soil and sediment matrices were 37 ± 7 Bq kg–1C and 11 ± 7 Bq kg–1C, respectively, confirming minimal radioecological impact of the operation of the NPP on the environment. The 14C specific activity ratio for the recently fallen leaf litter and the soil underneath at most of the sampling points in the vicinity of the NPP had a mean value of 1.03 with an associated standard deviation of 0.07. Statistical tests confirm that the mean values of the data set of 14C specific activity of leaf litter and underlying soil are not significantly different.

The mass balance of lake-terminating glaciers responds to annual atmospheric variations, while calving-induced ice loss at the front is driven by local ice–water interactions. The current glaciological studies underestimate glacier response by neglecting the significant annual ice loss at the terminus through calving processes. This study integrates field measurements with remote sensing data to investigate the glaciological characteristics and proglacial lake evolution of the Gepang Gath glacier in the Chandra basin, Western Himalaya, India. Long-term observations reveal a continuous expansion of the proglacial lake from 0.21 ± 0.06 km2 (1962) to 1.21 ± 0.05 km2 (2023), along with terminus retreat of ∼2.76 km, attributed to calving at the ice–water interface. The glacier’s surface exhibits complex debris cover, with thicknesses up to 35 cm, creating significant spatial variations in surface mass balance. In-situ, glaciological measurements reveal a highly negative glacier-wide mass balance of −0.90 ± 0.30 m w.e. a−1 between the years 2014 and 2023. The geodetic estimates also reveal a negative mass balance of −0.61 ± 0.1 m w.e. a−1 over the past decade (2013–2023). The frontal area change (0.42 km2) and geodetic mass balance show a total volumetric ice loss of −21.77 × 106 m3 w.e. during the same period. Overall, the yearly frontal ice loss exacerbates the mass loss by 17–22%. These findings suggest that the presence of proglacial lakes plays a significant role in intensifying ice mass loss from Himalayan glaciers, strongly regulating their overall evolution.

The broad-band direct combustion noise is an important problem for industrial and domestic burners. The power spectral density (PSD) of this noise is related to the local spectral density of fluctuating heat release rate (HRR) ($\psi _{\dot {q}}$), which is challenging to measure but is readily available from large eddy simulations (LES) results. The behaviour of $\psi _{\dot {q}}$ for a wide range of thermochemical and turbulence conditions is investigated. Three burners are studied, namely a dual-swirl burner, a bluff-body burner and a jet in cross-flow burner, operating at atmospheric conditions with $\textrm {CH}_4$–air and $\textrm {H}_2$–air mixtures. In contrast to the classical $f^{-5/2}$ scaling, the far-field sound pressure level and volume-integrated HRR ($\psi _{\dot {Q}}$) spectra reveal a universal $f^{-5}$ scaling for high frequencies. This differing spectral decay rate for $\psi _{\dot {Q}}$ compared to the classical scaling is due to multi-regime combustion, related to either partial premixing or the local turbulence intensity. The dependence of $\psi _{\dot {q}}$ on the chosen spatial locations, flame configuration and its relation to velocity spectra are studied. A simple model for $\psi _{\dot {q}}$ involving the velocity spectra is found that compares well with LES results. The characteristic frequency involved in this model is related to the time scale of the coherent structures of the flow.

The therapeutic effects of soya consumption on adipokine concentrations have yielded inconsistent results in previous meta-analyses. This umbrella meta-analysis aims to investigate the impact of soya and its isoflavones on serum adiponectin and leptin levels in adults. We searched the Cochrane Central, Web of Science, PubMed and Scopus databases until October 10, 2024. The articles were restricted to those written in English. We included meta-analysis studies that evaluated the effects of soya and its isoflavones on levels of adiponectin and leptin and reported effect sizes (ES) and corresponding CI. Two independent reviewers screened all articles based on eligibility criteria and extracted the required data from the included meta-analyses. The meta-analysis was performed using a random-effects model in STATA software. Six meta-analyses of randomised controlled trials meeting the inclusion criteria were included in the current umbrella meta-analysis. The findings indicated that soya and its isoflavones did not have a significant effect on adiponectin (ES = 0·10; 95 % CI: −0·22, 0·41; P = 0·55; I2 = 51·8 %) and leptin (ES = −0·37; 95 % CI: −1·35, 0·61; P = 0·46; I2 = 71·2 %) concentrations. Subgroup analysis based on participants’ mean age, total sample size and duration was conducted. Results showed that the effect is not statistically significant in any of the subgroups. In conclusion, soya and its isoflavones could not improve the adipokines mentioned above. However, further high-quality research in different countries is required to substantiate these findings.

The magnificent shrimp, Ancylomenes magnificus (Bruce, 1979), is a sea anemone associated marine ornamental organism exploited from Indo-Pacific waters, for the marine aquarium trade, as it has attractive coloration. However, there are no reports available yet on its population and reproductive characteristics (population structure, length–weight relationship, fecundity, sexual dimorphism, sex ratio and maturity stages). The present investigation provides information for the first time on the population and reproductive parameters of A. magnificus. In this study, a total of 158 individuals were collected from the intertidal regions of the Gulf of Mannar, Tamil Nadu, India from August 2021 to April 2022, out of which 61.4% (97 individuals) were females and 38.6% (61 individuals) were males. The estimated mean size (CL ± SD) of females was 4.93 ± 0.78 mm, while that of males was 3.22 ± 0.56 mm. The estimated mean body weight was 0.091 and 0.219 g in males and females, respectively. The study indicated strong sexual dimorphism in this species and considerable variation appeared in the carpus and chela of the second major pereopod, carapace and total length. The carapace length and weight showed a negative allometric relationship with a significant coefficient. Fecundity was relatively lower and embryo volume increased with size groups. Interestingly, the study revealed year-round breeding activity with a peak in the post-monsoon (January to March) and monsoonal period (October to December) for this species. The present investigation provides the first baseline information on the population and reproductive parameters of A. magnificus.

With wide-field phased array feed technology, the Australian Square Kilometre Array Pathfinder (ASKAP) is ideally suited to search for seemingly rare radio transient sources that are difficult to discover previous-generation narrow-field telescopes. The Commensal Real-time ASKAP Fast Transient (CRAFT) Survey Science Project has developed instrumentation to continuously search for fast radio transients (duration $\lesssim$ 1 s) with ASKAP, with a particular focus on finding and localising fast radio bursts (FRBs). Since 2018, the CRAFT survey has been searching for FRBs and other fast transients by incoherently adding the intensities received by individual ASKAP antennas, and then correcting for the impact of frequency dispersion on these short-duration signals in the resultant incoherent sum (ICS) in real time. This low-latency detection enables the triggering of voltage buffers, which facilitates the localisation of the transient source and the study of spectro-polarimetric properties at high time resolution. Here we report the sample of 43 FRBs discovered in this CRAFT/ICS survey to date. This includes 22 FRBs that had not previously been reported: 16 FRBs localised by ASKAP to $\lesssim 1$ arcsec and 6 FRBs localised to $\sim 10$ arcmin. Of the new arcsecond-localised FRBs, we have identified and characterised host galaxies (and measured redshifts) for 11. The median of all 30 measured host redshifts from the survey to date is $z=0.23$. We summarise results from the searches, in particular those contributing to our understanding of the burst progenitors and emission mechanisms, and on the use of bursts as probes of intervening media. We conclude by foreshadowing future FRB surveys with ASKAP using a coherent detection system that is currently being commissioned. This will increase the burst detection rate by a factor of approximately ten and also the distance to which ASKAP can localise FRBs.

Glacier and snow melt are the primary sources of water for streams, and rivers in upper Indus region of the western Himalaya. However, the magnitude of runoff from this glacierized basin is expected to vary with the available energy in the catchment. Here, we used a physically based energy balance model to estimate the surface energy and surface mass balance (SMB) of the upper Chandra Basin glaciers for 7 hydrological years from 2015 to 2022. A strong seasonality is observed, with net radiation being the dominant energy flux in the summer, while latent and sensible heat flux dominated in the winter. The estimated mean annual SMB of the upper Chandra Basin glaciers is −0.51 ± 0.28 m w.e. a−1, with a cumulative SMB of −3.54 m w.e during 7 years from 2015 to 2022. We find that the geographical factors like aspect, slope, size and elevation of the glacier contribute towards the spatial variability of SMB within the study region. The findings reveal that a 42% increase in precipitation is necessary to counteract the additional mass loss resulting from a 1°C increase in air temperature for the upper Chandra Basin glaciers.

Residual blood specimens collected at health facilities may be a source of samples for serosurveys of adults, a population often neglected in community-based serosurveys. Anonymized residual blood specimens were collected from individuals 15 – 49 years of age attending two sub-district hospitals in Palghar District, Maharashtra, from November 2018 to March 2019. Specimens also were collected from women 15 – 49 years of age enrolled in a cross-sectional, community-based serosurvey representative at the district level that was conducted 2 – 7 months after the residual specimen collection. Specimens were tested for IgG antibodies to measles and rubella viruses. Measles and rubella seroprevalence estimates using facility-based specimens were 99% and 92%, respectively, with men having significantly lower rubella seropositivity than women. Age-specific measles and rubella seroprevalence estimates were similar between the two specimen sources. Although measles seropositivity was slightly higher among adults attending the facilities, both facility and community measles seroprevalence estimates were 95% or higher. The similarity in measles and rubella seroprevalence estimates between the community-based and facility serosurveys highlights the potential value of residual specimens to approximate community seroprevalence.

Residual blood specimens provide a sample repository that could be analyzed to estimate and track changes in seroprevalence with fewer resources than household-based surveys. We conducted parallel facility and community-based cross-sectional serological surveys in two districts in India, Kanpur Nagar District, Uttar Pradesh, and Palghar District, Maharashtra, before and after a measles-rubella supplemental immunization activity (MR-SIA) from 2018 to 2019. Anonymized residual specimens from children 9 months to younger than 15 years of age were collected from public and private diagnostic laboratories and public hospitals and tested for IgG antibodies to measles and rubella viruses. Significant increases in seroprevalence were observed following the MR SIA using the facility-based specimens. Younger children whose specimens were tested at a public facility in Kanpur Nagar District had significantly lower rubella seroprevalence prior to the SIA compared to those attending a private hospital, but this difference was not observed following the SIA. Similar increases in rubella seroprevalence were observed in facility-based and community-based serosurveys following the MR SIA, but trends in measles seroprevalence were inconsistent between the two specimen sources. Despite challenges with representativeness and limited metadata, residual specimens can be useful in estimating seroprevalence and assessing trends through facility-based sentinel surveillance.

A knowledge, attitudes and control practices (KAP)-based study on ticks and tick-borne diseases (TTBD) and resistance development in ticks was conducted in Dhar district of Madhya Pradesh covering 200 livestock owners using a questionnaire. Based on our scoring criteria, results indicated only 25% (19.16–31.60) respondents possessing basic knowledge of TTBDs while 75% (68.40–80.84) respondents were not aware of TBDs. Due to lack of proper awareness of TTBDs, about 1.28 times more respondents (OR 95% CI 0.42–3.86) were having heavy tick infestations in their animals. However, about 36.5% (29.82–43.58) respondents showed a favourable attitude towards the adoption of different tick control practices; consequently, their animals showed low-level infestation. Amongst various feeding systems for animals, a mixed type of feeding system was mostly adopted by 57.5% respondents followed by manger system (37.5%) while grazing was the least adopted method (5%). Results indicated that the grazing animals were 6 times (OR 95% CI 2.93–12.28) more susceptible to ticks and possessed heavy tick infestation. Resistance status of collected tick isolates of Rhipicephalus microplus and Hyalomma anatolicum was assessed and revealed that both tick species were found resistant to deltamethrin. The goals of this study were to assess some of the underlying causes of ticks and TBD in livestock in Dhar district of Madhya Pradesh state using the KAP survey and resistance characterization of ticks.