Background: Despite efforts to advance equity, women face gender-based barriers in research, including fewer senior authorship and grant opportunities. We examined gender disparities in Canadian Institutes of Health Research (CIHR) funding for Canadian neurology divisions and departments. Methods: Data on CIHR grant recipients and metrics (duration, quantity, and contribution) within Canadian neurology divisions and departments (2008-2022) were acquired from the CIHR Funding Decisions Database. Gender-based differences in grant prevalence, duration, and contribution amount within neurology were calculated with subgroup analysis for Canadian neurologists and Project Grant awards. Results: 1604 grants were awarded to Canadian neurology divisions and departments between 2008-2022. Women received fewer grants (41.46%), less funding (p<0.0001), and shorter grant durations (p<0.0001) than men annually. Women comprised the minority of recipients (45.47%) and were less likely to be awarded grants (p<0.001) annually relative to men. Differences were consistent in subgroup analyses, except grant durations were equal across genders in Project Grant awards. Conclusions: Gender disparities persist in CIHR grant funding to Canadian neurology divisions and departments. Women receive fewer grants, lower contribution amounts, and are less likely to be recipients compared to men. Future work includes addressing gender differences and continuing to evaluate CIHR funding to provide equitable opportunities for women.

Background: Surgical delays are in common in Canada. Wait times in elective spine surgery and their impact on outcomes remain uncharacterized. Methods: This was a single-center analysis of elective spine surgery data between 2009-2020. Wait times between referral and consultation (T1), consultation and surgical booking (Ti), and booking and surgery (T2) were assessed. Results: 2041 patients were included. Longitudinal analyses were adjusted for age, sex, diagnosis, surgical volume, while outcomes analyses were age and sex-adjusted. Total T1+Ti+T2 increased 8.1% annually (p<0.001). T1 decreased 4.3% annually (p=0.032). It was not associated with adverse events (AEs) or disposition. Every 100 days of T1 was associated with 1.0% longer hospitalization (p=0.001). Ti increased 21.0% annually (p<0.001). Every 100 days of Ti was associated with 2.9% increased odds of an adverse event (p=0.002), 1.8% longer hospitalization (p<0.001), and 15.9% increased likelihood of discharge home (p<0.001). T2 increased 7.0% annually (p<0.001) and was not associated with AEs. Every 100 days of T2 was associated with 11.6% longer hospitalization (p<0.001) and 76.5% increased likelihood of discharge home (p<0.001). Conclusions: Total wait times for elective spine surgery have increased between 2009-2020. Notably, Ti increased ninefold and was associated with AEs. This study highlights areas of delay and targets for healthcare optimization.

Background: Meningiomas are the most common intracranial tumor with surgery, dural margin treatment, and radiotherapy as cornerstones of therapy. Response to treatment continues to be highly heterogeneous even across tumors of the same grade. Methods: Using a cohort of 2490 meningiomas in addition to 100 cases from the prospective RTOG-0539 phase II clinical trial, we define molecular biomarkers of response across multiple different, recently defined molecular classifications and use propensity score matching to mimic a randomized controlled trial to evaluate the role of extent of resection, dural marginal resection, and adjuvant radiotherapy on clinical outcome. Results: Gross tumor resection led to improved progression-free-survival (PFS) across all molecular groups (MG) and improved overall survival in proliferative meningiomas (HR 0.52, 95%CI 0.30-0.93). Dural margin treatment (Simpson grade 1/2) improved PFS versus complete tumor removal alone (Simpson 3). MG reliably predicted response to radiotherapy, including in the RTOG-0539 cohort. A molecular model developed using clinical trial cases discriminated response to radiotherapy better than standard of care grading in multiple cohorts (ΔAUC 0.12, 95%CI 0.10-0.14). Conclusions: We elucidate biological and molecular classifications of meningioma that influence response to surgery and radiotherapy in addition to introducing a novel molecular-based prediction model of response to radiation to guide treatment decisions.

Background: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of subsequent stroke is uncertain. Methods: Electronic databases were searched for observational studies reporting subsequent stroke during a minimum follow-up of 1 year in patients with TIA or minor stroke. Unpublished data on number of stroke events and exact person-time at risk contributed by all patients during discrete time intervals of follow-up were requested from the authors of included studies. This information was used to calculate the incidence of stroke in individual studies, and results across studies were pooled using random-effects meta-analysis. Results: Fifteen independent cohorts involving 129794 patients were included in the analysis. The pooled incidence rate of subsequent stroke per 100 person-years was 6.4 events in the first year and 2.0 events in the second through tenth years, with cumulative incidences of 14% at 5 years and 21% at 10 years. Based on 10 studies with information available on fatal stroke, the pooled case fatality rate of subsequent stroke was 9.5% (95% CI, 5.9 – 13.8). Conclusions: One in five patients is expected to experience a subsequent stroke within 10 years after a TIA or minor stroke, with every tenth patient expected to die from their subsequent stroke.

Background: Liquid biopsy represents a major development in cancer research, with significant translational potential. Similarly, the integration of multiple molecular platforms has yielded novel insights into disease biology and heterogeneity. We hypothesise that applying contemporary multi-omic approaches to liquid biopsies will improve the power of current models. Methods: We have compiled a cohort of 51 patients with glioblastoma, brain metastasis, and primary CNS lymphoma who underwent CSF sampling as part of clinical care. Cell free methylated DNA and shotgun proteomic profiling was obtained from the CSF of each patient and used to build tumour-specific classifiers. Integrated classifiers were compared with single platform classifiers using multiple approaches. Results: In this study, we show that the DNA methylation and protein profiles of cerebrospinal fluid can be combined to fully discriminate lymphomas from their major diagnostic counterparts with perfect AUCs of 1 (95% confidence interval 1-1) and 100% specificity. Each integrated lymphoma classifier significantly outperforms single-platform classifiers, suggesting synergistic biology is obtained using multiple molecular platforms. Conclusions: We present the most specific and accurate CNS lymphoma classifier to date by integrating the methylome and proteome of CSF. This has important implications for the future of cancer diagnostics and generates immediate utility for patients with CNS lymphoma.

Background: Meningiomas have significant heterogeneity between patients, making prognostication challenging. For this study, we prospectively validate the prognostic capabilities of a DNA methylation-based predictor and multiomic molecular groups (MG) of meningiomas. Methods: DNA methylation profiles were generated using the Illumina EPICarray. MG were assigned as previously published. Performance of our methylation-based predictor and MG were compared with WHO grade using generalized boosted regression modeling by generating time-dependent receiver operating characteristic (ROC) curves and computing area under the ROC curves (AUCs) along with their 95% confidence interval using bootstrap resampling. Results: 295 meningiomas treated from 2018-2021 were included. Methylation-defined high-risk meningiomas had significantly poorer PFS and OS compared to low-risk cases (p<0.0001). Methylation risk increased with higher WHO grade and MG. Higher methylome risk (HR 4.89, 95%CI 2.02-11.82) and proliferative MG (HR 4.11, 95%CI 1.29-13.06) were associated with significantly worse PFS independent of WHO grade, extent of resection, and adjuvant RT. Both methylome-risk and MG classification predicted 3- and 5-year PFS and OS more accurately than WHO grade alone (ΔAUC=0.10-0.23). 42 cases were prescribed adjuvant RT prospectively although RT did not significantly improve PFS in high-risk cases (p=0.41). Conclusions: Molecular profiling outperforms conventional WHO grading for prognostication in an independent, prospectively collected cohort of meningiomas.

The purpose of this study was to explore the electroencephalogram (EEG) features sensitive to situation awareness (SA) and then classify SA levels. Forty-eight participants were recruited to complete an SA standard test based on the multi-attribute task battery (MATB) II, and the corresponding EEG data and situation awareness global assessment technology (SAGAT) scores were recorded. The population with the top 25% of SAGAT scores was selected as the high-SA level (HSL) group, and the bottom 25% was the low-SA level (LSL) group. The results showed that (1) for the relative power of $\beta$1 (16–20Hz), $\beta$2 (20–24Hz) and $\beta$3 (24–30Hz), repeated measures analysis of variance (ANOVA) in three brain regions (Central Central-Parietal, and Parietal) × three brain lateralities (left, midline, and right) × two SA groups (HSL and LSL) showed a significant main effect for SA groups; post hoc comparisons revealed that compared with LSL, the above features of HSL were higher. (2) for most ratio features associated with $\beta$1 ∼ $\beta$3, ANOVA also revealed a main effect for SA groups. (3) EEG features sensitive to SA were selected to classify SA levels with small-sample data based on the general supervised machine learning classifiers. Five-fold cross-validation results showed that among the models with easy interpretability, logistic regression (LR) and decision tree (DT) presented the highest accuracy (both 92%), while among the models with hard interpretability, the accuracy of random forest (RF) was 88.8%, followed by an artificial neural network (ANN) of 84%. The above results suggested that (1) the relative power of $\beta$1 ∼ $\beta$3 and their associated ratios were sensitive to changes in SA levels; (2) the general supervised machine learning models all exhibited good accuracy (greater than 75%); and (3) furthermore, LR and DT are recommended by combining the interpretability and accuracy of the models.

The sophisticated relationship between the intake of dietary carbohydrates and host immunity is mediated in large part by the gut microbiota. This comprehensive review explores the multifaceted connections linking human gut microbiota with nondigestible carbohydrate metabolism and immune responses, highlighting the critical importance of this symbiotic relationship in maintaining overall host health. Understanding the mechanisms by which gut microbiota act as a bridge between carbohydrate intake and host immunity has significant implications for precision nutrition strategies and the development of therapeutic interventions.

The catalytic power of Ca-nontronite (0.2–2 μm) for the polycondensation of phenols and glycine and the associated reactions that involve the ring cleavage of phenols and the decarboxylation and deamination of glycine was studied in systems free of microbial activity. At the end of a 90-hr reaction period, the amount of CO2 released from the Ca-nontronite-glycine-pyrogallol, Ca-nontronite-glycine-eatechol, and Ca-nontronite-glycine-hydroquinone systems were 5.1, 8.7, and 11.6 times higher, respectively, than those from the respective nontronite-free systems, showing the catalytic role of Ca-nontronite in the ring cleavage of phenols and the decarboxylation of glycine. The release of CO2 and NH3 from the Ca-nontronite-glycine system revealed that Ca-nontronite can catalyze decarboxylation and deamination of glycine. The ability of Ca-nontronite to catalyze the deamination of glycine was substantially enhanced by the presence of a phenol. The visible absorbances at both 472 and 664 nm of the supernatants, the total yields of N-containing humic polymers, and the fractions of glycine converted to nitrogenous polymers indicated that polycondensation of glycine and phenol was greatly catalyzed by Ca-nontronite. The total N-containing humic polymers formed in the systems decreased in the order: Ca-nontronite-glycine-pyrogallol > Ca-nontronite-glycine-cateehol > Ca-nontronite-glycine-hydroquinone > glycine-pyrogallol > glycine-hydroquinone > glycine-catechol. The infrared and electron spin resonance spectra of humic acid (HA) and fulvic acid (FA) formed in the supernatants of the reaction systems were quite similar to those of soil HA and FA. The catalytic power of Ca-nontronite in affecting the ring cleavage of phenols, deamination and decarboxylation of amino acids, and formation of humic substances derived from phenols with amino acids in soils and the related environments thus merits attention.

The catalytic power of Ca-nontronite, Ca-bentonite, and Ca-kaolinite in promoting the abiotic ring cleavage of pyrogallol (1,2,3-trihydroxybenzene) and the associated formation of humic polymers was studied in systems free of microbial activity. The presence of Ca-kaolinite and especially Ca-nontronite in the pyrogallol solutions at pH 6.00 greatly enhanced the absorbance at both 472 and 664 nm of the supernatants. At an initial pH of 6.00 and at the end of a 90-hr reaction period, the amounts of CO2 released from the ring cleavage of pyrogallol and the yields of the resultant humic polymers formed in the reaction systems followed the same sequence: Ca-nontronite > Ca-kaolinite > Ca-bentonite. The data indicate that the catalytic power of Fe(III) on the edges and in the structure of nontronite was substantially greater than that of Al on the edges of kaolinite and montmorillonite and of a small amount of Fe(III) in the structure of montmorillonite in promoting the reactions. The infrared and electron spin resonance spectra and the solid-state, cross-polarization magic-angle-spinning 13C nuclear magnetic resonance spectra of humic polymers formed in the reaction systems resembled those of natural humic substances.

Broad-spectrum antimicrobials are commonly used without indication and contribute to antimicrobial resistance (AMR). We implemented a syndrome-based stewardship intervention in a community hospital that targeted common infectious syndromes and antipseudomonal beta-lactam (APBL) use. Our intervention successfully reduced AMR, C. difficile rates, use of APBLs, and cost.

The non-archosauriform archosauromorph Dinocephalosaurus orientalis was first described from the Upper Member of the Guanling Formation (late Anisian, Middle Triassic) of Guizhou Province by Li in 2003 on the basis of a complete articulated skull and the first three cervical vertebrae exposed in dorsal to right lateral view. Since then, additional specimens have been discovered in southwestern China. Here, five newly discovered specimens are described for the first time, and redescriptions of the holotype IVPP V13767 and another referred specimen, IVPP V13898, are provided. Together, these permit the description of the complete skeleton of this remarkable long-necked marine reptile. The postcranial skeleton is as much as 6 metres long, and characterised by its long tail and even longer neck. The appendicular skeleton exhibits a high degree of skeletal paedomorphosis recalling that of many sauropterygians, but the skull and neck are completely inconsistent with sauropterygian affinities. The palate does not extend back over the basisphenoid region and lacks any development of the closed condition typical of sauropterygians. The arrangement of cranial elements, including the presence of narial fossae, is very similar to that seen in another long-necked archosauromorph, Tanystropheus hydroides, which at least in part represents a convergence related to an aquatic piscivorous lifestyle. The long and low cervical vertebrae support exceptionally elongate cervical ribs that extend across multiple intervertebral joints and contribute to a ‘stiffening bundle of ribs’ extending along the entire ventral side of the neck, as in many other non-crocopodan archosauromorphs. The functional significance of the extraordinarily elongate neck is hard to discern but it presumably played a key role in feeding, and it is probably analogous to the elongate necks seen in pelagic, long-necked plesiosaurs. Dinocephalosaurus orientalis was almost certainly a fully marine reptile and even gave birth at sea.

Recently released Moderate-Resolution Imaging Spectroradiometer (MODIS) land surface temperature (LST) collection 6.1 (C6.1) products are useful for understanding ice–atmosphere interactions over East Antarctica, but their accuracy should be known prior to application. This study assessed Level 2 and Level 3 MODIS C6.1 LST products (MxD11_L2 and MxD11C1) in comparison with the radiance-derived in situ LSTs from 12 weather stations. Significant cloud-related issues were identified in both LST products. By utilizing a stricter filter based on automatic weather station cloud data, despite losing 29.4% of the data, accuracy of MODIS LST was greatly improved. The cloud-screened MODIS LST exhibited cold biases (−5.18 to −0.07°C, and root mean square errors from 2.37 to 6.28°C) than in situ LSTs at most stations, with smaller cold biases at inland stations, but larger ones at coastal regions and the edge of plateau. The accuracy was notably higher during warm periods (October–March) than during cold periods (April–September). The cloud-screened MODIS C6.1 LST did not show significant improvements over C5 (Collection 5) version across East Antarctica. Ice-crystal precipitation occurring during temperature inversions at the surface (Tair-Tsurface) played a crucial role in MODIS LST accuracy on inland plateau. In coastal regions, larger MODIS LST biases were observed when the original measurements were lower.

Cost-share contracts, offered through working lands programs, are instrumental in addressing environmental externalities from agriculture and generating ecosystem services. However, the persistent trend of noncompliance with cost-share contractual terms has become a problem for funding agencies and policymakers. This paper aims to study noncompliance issues within the US working lands programs using historical county-level panel data (1997–2019) from Louisiana. The results show that noncompliance is attributed more to cancellations than terminations due to flexible provisions within the cancellation option. The significant incentive effect of payment obligations reveals that revisiting payment rates could reduce contract noncompliance and mitigate moral hazard.