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Paradigm shift is a significant modification of the core assumptions and methods of experimentation in a scientific discipline. The field of education, at all levels, has undergone tremendous change recently, precipitated by extraordinary demand for high quality and meaningful sustainable education at all levels across the globe. The national education system is segregated into five main categories: primary, junior secondary, senior secondary, collegiate (higher education) and tertiary. In Sri Lanka, basic and higher education levels are compulsory for students; however tertiary education is an optional level. Recent data show that just 20% of students who pass the GCE Advanced Level Test can be admitted into the government university system, leaving the remaining students with few options for higher education. The framework or for determining students' university choice based on their qualifications, talents, demand and supply characteristics, or their willingness to select an appropriate degree program is somewhat non-existent in Sri Lanka's existing educational system. To determine the steps that can be taken for a paradigm shift in higher education, this study aims to highlight the need for one in Sri Lankan post-secondary education while also proposing a relevant conceptual framework. The Marketing Mix Model for Higher Education, Hossler, Kotler and Fox, and the Integrated Complex Decision Model was the framework used to identify the demand pull and supply push factors affecting the university choice in Sri Lanka. Both qualitative and quantitative techniques were used. The study sample was drawn using stratified sampling technique and clustered into several sub-clusters such as state university, private university, technological campus and vocational Institute. Both descriptive and essential inferential statistics tools were used for the data analysis. This study identified the measures that can be used for a paradigm shift in the tertiary education.

Education boosts any nation's economy. Sri Lankan higher education is competitive. Because only 15% of students who take the General Certificate Examination in Advanced Level (G.C.E A/L) are qualified to enter public universities, every student struggles to get into university. Some ineligible public college students attend private universities, vocational schools, or are migrant students. 15% of students qualify for public colleges, but their abilities and skills may limit their possibilities. These characteristics show that Sri Lanka doesn't assess students' talents, qualifications, and program interests when picking a university. Thus, this study seeks to understand how Sri Lankan students choose universities. The study uses student selection dimensional variables. Hossler (1999), Kotler and Fox (1995), Marketing Mix model for higher education, and Combined Complex Decision model (Holdswoth and Nind, 2005) to quantify student university choice. Convenient sampling selected 139 students from 150. Methods were quantitative and qualitative. Descriptive and inferential statistics examined data to attain study aims. HEM majors lost students due to employability. HEM programs' flexible financing options are the biggest factor in students' undergraduate choices. Female HEM majors are unemployed. According to the findings, Sri Lanka's tertiary education system needs a paradigm shift to properly select university students.

Recently, many researchers have found that education systems in many nations are very comprehensive and competitive. They revealed that the primary goal of many universities is to increase the number of students' enrolment as much as possible. In students' perspective, they also consider different factors when they make their higher education decision. Therefore, this article aims to investigate the factors affecting for students' university choice and satisfaction. Relevant literature reviews explained in terms of four models which link to students' university choice process: economic model, sociological model, combined complex decision model and the marketing mixed model. Then, the study investigated the other main factors that are affecting to the university choice of students from empirical evidence. In terms of students' university satisfaction, this paper has described several models and other factors influencing on students' university satisfaction.

Objectives: Large language models such as ChatGPT have been used to generate text in a conversational manner, and may be of use in providing patient information in a urological setting. This study evaluated the accuracy, presence of omissions, and preferability of traditional patient information to the large language models ChatGPT and Bing Chat. Methods: Eight common questions regarding urolithiasis and prostate cancer were selected from traditional patient information and posed to ChatGPT and Bing Chat. Responses from all sources were then evaluated by seven urologists in a blinded fashion for accuracy, omissions, and preferability. Results: We found that 96.43% of ratings of traditional patient information sources were rated accurate, compared to 94.6% for ChatGPT and Bing Chat; 7.1% of ratings of traditional patient information were rated as containing harmful omissions, compared to 10.71% for ChatGPT and 21.4% for Bing Chat; and 55.4% of rater first preferences were given to ChatGPT, compared to 35.7% for traditional patient information and 8.9% for Bing Chat. Conclusions: ChatGPT provided responses of a similar accuracy and preferability to traditional sources, highlighting its potential as a supplementary tool for urological patient information. However, concerns remain regarding omissions and complexity in model-generated responses.

Introduction: The contemporary management of patients with colorectal cancer and synchronous liver metastases is complex. This study appraises the recommendations made by national/international guidelines for the diagnosis and management of patients with synchronous liver metastases from colorectal cancer. Methods: A systematic review of national and international guidelines published between 2011 and 2024 was carried out using PubMed, OvidSP and Guidelines International Network databases. The quality of guidelines was evaluated using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. Guidelines were assessed for the quality of advice for specific scenarios. The protocol was registered with PROSPERO (CRD42021243744). Results: The search strategy returned ninety unique articles with 11 guidelines eligible for inclusion. Of these, one (9 %) guideline defined ‘synchronous disease’ at outset, eight (73 %) recommended neoadjuvant chemotherapy as first intervention. Seven (64 %) guidelines supported synchronous hepatic resection with colectomy. One (9 %) recommended against synchronous surgery. Conclusions: This study demonstrates important variations between international clinical guidelines on diagnostic workup and management of synchronous liver metastases in colorectal cancer. [167 words].

BACKGROUND: The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2). METHODS: RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4 hours of onset. The primary outcome was a shift in scores on the modified Rankin scale (mRS) at day 90. Secondary outcomes included death; a global analysis (Wei-Lachin test) containing Barthel Index, EuroQol-5D, mRS, telephone interview for cognitive status-modified and Zung depression scale; and neuroimaging-determined brain frailty markers. Data were reported as n (%), mean (SD), median [IQR], adjusted common OR (acOR), mean difference or Mann-Whitney difference (MWD) with 95% CI. RESULTS: 597 of 1149 (52%) patients had a final diagnosis of ischaemic stroke; age 75 (12) years, premorbid mRS>2 107 (18%), Glasgow Coma Scale 14 (2) and time from onset to randomisation 67 [45, 108] min. Neuroimaging brain frailty was common: median score 2 [2, 3] (range 0-3). At day 90, GTN did not influence the primary outcome (acOR for increased disability 1.15, 95% CI 0.85 to 1.54), death or global analysis (MWD 0.00, 95% CI -0.10 to 0.09). In subgroup analyses, there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1 hour of symptom onset and in those with more severe stroke. CONCLUSIONS: In patients who had an ischaemic stroke, ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital trials.

Background Each year in England, 450,000 children and young people (CYP) under 18 years of age are transported by ambulance to emergency departments. Approximately 20% of these suffer acute pain caused by illness or injury. Pain is a highly complex sensory and emotional experience. The intersection between acute pain, unwell CYP and the unpredictable pre-hospital environment is convoluted. Studies have shown that prehospital pain management in CYP is poor, with 61% of those suffering acute pain not achieving effective pain relief (abolition or reduction of pain score by 2 or more out of 10) when attended by ambulance. Consequences of poor acute pain management include altered pain perception, post-traumatic stress disorder and the development of chronic pain. This realist review will aim to understand how ambulance clinicians can provide improved prehospital acute pain management for CYP. Methods A realist review will be conducted in accordance with the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidance. A five-stage approach will be adopted; 1) Developing an Initial Programme Theory (IPT): develop an IPT with key stakeholder input and evidence from informal searching; 2) Searching and screening: conduct a thorough search of relevant research databases and other literature sources and perform screening in duplicate; 3) Relevance and rigour assessment: assess documents for relevance and rigour in duplicate; 4) Extracting and organising data: code relevant data into conceptual “buckets” using qualitative data analysis software; and 5) Synthesis and Programme Theory (PT) refinement: utilise a realist logic of analysis to generate context-mechanism-outcome configurations (CMOCs) within and across conceptual “buckets”, test and refine the IPT into a realist PT. Conclusion The realist PT will enhance our understanding of what works best to improve acute prehospital pain management in CYP, which will then be tested and refined within a realist evaluation. Registration PROSPERO Registration: CRD42024505978

Summary: The implantation of the mouse blastocyst initiates a complex sequence of tissue remodeling and cell differentiation events required for morphogenesis, during which the extraembryonic primitive endoderm transitions into the visceral endoderm. Through single-cell RNA sequencing of embryos at embryonic day 5.0, shortly after implantation, we reveal that this transition is driven by dynamic signaling activities, notably the upregulation of BMP signaling and a transient increase in Sox7 expression. Embryos deficient in Hepatocyte nuclear factor-1-beta (Hnf1b−/−), a gene critical for visceral endoderm differentiation, showed an interaction between visceral endoderm and epiblast, crucial for epiblast survival. Single-cell RNA profiling of Hnf1b−/− visceral endoderm shows developmental delays and severe dysregulation in several nutrient transport pathways. Impaired glucose uptake in Hnf1b−/− embryos suggests that the activation of nutrient transport mechanisms during the primitive-to-visceral endoderm transition may be vital for post-implantation epiblast development. These findings offer new insights into the molecular regulation of early mammalian development.

Abstract 1,1,1‐trifluoroethyl methyl carbonate (FEMC) is a popular non‐flammable solvent for lithium‐ion battery electrolytes, although its high irreversible capacity means it can only be used with film‐forming additives like fluoroethylene carbonate (FEC). This work studies the origin of the high irreversible capacity of FEMC‐containing cells. Scanning electron microscopy and Raman spectroscopy of graphite anodes after charging and discharging in an FEMC electrolyte show evidence of significant physical and chemical graphite degradation, likely caused by solvent co‐intercalation, which is probably responsible for a large portion of the capacity loss. X‐ray photoelectron spectroscopy analysis of the anodes shows very low graphite signals, a sign of graphite degradation, formation of a thick solid electrolyte interphase (SEI), or both. When a small amount of FEC is added to FEMC, co‐intercalation does not occur. FEC reduction occurs at a higher potential versus Li/Li+ than FEMC co‐intercalation. It also forms a significantly different and thinner SEI containing more carbon, less fluorine, and no apparent FEMC decomposition products.

Background: Distal pancreatectomy (DP) is a well-established minimally invasive procedure. However, feasibility and technical details when using Versius robotic surgical system are still unexplored. Method: This is a prospective stage 2a development IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) case series. All consecutive robotic DP (RDP), including both splenectomy (DPS) and spleen-preserving DP (SPDP), were analysed. Pre- intra- and post-operative details were prospectively recorded. Results: 6 DPS and 3 SPDP were performed between May 2022 and May 2024. Conversion to open was recorded in one case. The average operating time and robot docking time were 185 ​min (range: 118–300) and 9.3 ​min (range: 3–15), respectively. No reoperation or 90-days mortality were recorded. Ports placement, instruments used, and surgical strategy are described in detail. Conclusion: We present the first series on RDP performed by Versius robotic surgical system. The procedure is safe and feasible, and careful patient selection is required for the first cases.

Tertiary education is a turning point in anybody's life. Students' choice of tertiary education is crucial for them, their family members, and the country. All parents would like to see their children reach the heights in education and develop many career prospects. In Sri Lanka, critical job profiles are limited to medical doctors, engineers, accountants, and lawyers. However, the fact remains that this type of lean job market is not realistic or sustainable. Firstly, a country needs not have many professionals from a handful of fields. Secondly, not all students have the capacity to complete the coursework of their respective programs. On the other hand, many vacancies in different fields must be filled consistently, and a country cannot be sustained otherwise. Making a shift in students' psychological paradigm is essential in this scenario. This paper introduces a new concept called vertical education integration (E.V.I.). E.V.I. provides a strategic solution to bridge various gaps in the current education system. This concept has been tested and proved for successful results in Sri Lanka.

This paper investigates the potential influence of socioeconomic factors in the students' choice for tertiary education. The approach of this study combines an opinion survey, desk research and a case study. Shifting of a psychological paradigm is easier said than done. It may need social awareness about the existing problems, gaps, significance and negative/positive impact of different scenarios, and availability of potential solution. The data analysis and discussions have been done under identified key socioeconomic factors relevant to education. Parental levels of education, income, and financial status have been given priority in the discussion. Parents' involvements in education and material support have been recognized as influential factors in students' choice in university education. The language of instruction and peer group in school environment was considered finally. However, none of these factors are within the control of a person or an institute. The objective of the study is to explore factors required to establish favourable socioeconomic conditions providing students with right direction while implementing necessary policy changes to create suitable pathways in the tertiary education. The paper recommends vertical integration of teaching majors from school, to the university, to the industry which would provide many benefits.

Runjie Li,1,2,* Rongna Lian,1,3,* Hiruni T Siriwardena,4 Jiaojiao Jiang,5 Ming Yang1,3 1National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Department of Geriatrics, Ya ‘an People’s Hospital, Ya ‘an, People’s Republic of China; 3Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 4West China School of Medicine, Sichuan University, Chengdu, People’s Republic of China; 5Rehabilitation Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ming Yang, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, People’s Republic of China, Tel\Fax +86 28 8542 2321, Email yangmier@gmail.com; yangmier@scu.edu.cn Jiaojiao Jiang, Rehabilitation Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, People’s Republic of China, Tel\Fax +86 28 8542 2313, Email jiangjiaojiao1997@163.comAbstract: Despite over 30 years of microbiome and skeletal muscle research, no quantitative analysis of sarcopenia and the microbiome literature had been conducted. Our bibliometric study examined research status, hotspots, and future trends. We utilized bibliometric techniques to search the Science Citation Index Extended Database on February 27, 2023, using the Bibliometrix package in R to create a map displaying scientific production and subject categories. Collaborative network maps between countries/regions were visualized using Scimago Graphica, while VOSviewer explored collaboration modes among individuals and institutions. We analyzed the top 25 emerging keywords, top co-occurring keyword networks, and co-occurring keyword clusters using CiteSpace. A total of 997 articles were retrieved for sarcopenia and microbiome, of which 633 papers were analyzed. Both the number of publications and total citation frequency had been continuously increasing. The United States had the highest total citation frequency, while China had the highest number of publications. Research on the impact of the microbiome on sarcopenia was in its nascent stage and spans multiple disciplines, including nutrition, microbiology, geriatrics, immunology, endocrinology and metabolism, molecular biology, and sports medicine. The University of Copenhagen contributed the most to the number of publications (n=16), with Tibbett M (n=7) and Hulver MW (n=7) among the top authors. The most published journal was “Nutrients” (n=24). Analysis of keywords and clusters revealed new research hotspots in microbes and sarcopenia, such as malnutrition, dietary fiber, signaling pathways, frailty, and intestinal permeability. Research on the impact of the microbiome on sarcopenia is in its infancy and spans multiple disciplines. Malnutrition, dietary fiber, signaling pathways, frailty, and intestinal microbes are currently research hotspots. Furthermore, the visual atlas analysis of research on microbes and sarcopenia helps to track the knowledge structure in research fields related to sarcopenia and microbes, providing direction for future research. Keywords: bibliometric analysis, microbes, skeletal muscle, scientometrics, muscle wasting

Introduction Research has found differences in processes and outcomes of care between people in ethnic minorities and White British populations in some clinical conditions, although findings have been mixed. The Building an understanding of Ethnic minority people’s Service Use Relating to Emergency care for injuries study is investigating differences in presentation, experience and health outcomes between people from ethnic minorities and White British people who seek emergency health care for injury. Objective Our aim was to consult with stakeholders to define measurable outcomes available in routine ambulance and emergency department data; to assess the appropriateness of existing outcome measures for ethnic minorities and White British people; and to identify any gaps. Method Clinicians, public contributors, researchers, people from the third sector, public health, healthcare inclusion were invited to join an online workshop to discuss routine outcomes. Results Twenty participants attended the stakeholder consultation, with only one being a public contributor, a limitation. Eleven were from a minority ethnic background and seven were female. The integrated list of outcomes included 25 items, combining routine outcomes from the Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries protocol and literature (n = 17) with additional outcomes (n = 8). Notably, the initial list lacked provisions for safeguarding referrals and cases of treatment refusal, which were new additions. Safety concerns arose due to the lack of safeguarding referrals, treatment refusal and self-discharge. Factors such as pre-existing health conditions, injury location and experiences of discrimination were identified as possible influences on care quality and waiting times for ethnic minority patients. Conclusion Although the number of stakeholders taking part in our consultation was low, their participation identified outcomes not found in routine data, supporting the adoption of a mixed-methods approach to answer our research questions. A future consultation could look to include more public members and wider range of clinicians including those who work in safeguarding and rehabilitation services. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132744. Plain language summary Research has shown that people from ethnic minorities often have less favourable healthcare experiences and outcomes than white British people. Our BE SURE study aims to establish whether there are differences between these groups and whether this can be seen in routinely available health outcome data or through patients’ own words through questionnaires and interviews. Before starting data collection, we wanted to consult with people who may deliver or receive emergency health care for injuries, about what routinely available healthcare measures and outcomes we should include in the study. Twenty stakeholders joined the meeting: clinicians, paramedics, researchers and representatives from healthcare organisations, the third sector and a public contributor. We firstly explained what the study was about, and what we hoped to achieve during the online consultation meeting. We presented examples of measurable outcomes that we had included in our original research proposal for injuries. We broke into small groups to discuss these outcome measures and identify gaps. We also asked for comments and suggestions to check the appropriateness of these measures. Participants agreed that the proposed measures were mostly appropriate; these included tests, treatments, waiting times, referrals to other doctors, leaving the hospital against medical advice and time spent in the emergency department. They identified two new outcomes, which were safeguarding referrals and refusal of treatment. The final agreed list of outcomes was 25. Participants also discussed disparities in medication and treatments provided to ethnic minorities compared to white British people, such as pain relief. Additionally, they explored various factors that could affect care differently across these groups. For instance, ethnic minorities may experience discrimination, have distinct health issues or experience variations in the location, nature and severity of injuries. These factors could influence waiting times, pain management and overall quality of care.

Purpose This paper aims to describe the study design and baseline characteristics of the Sri Lanka Child Growth Cohort (SLCGC), which was established to assess the timing, pattern and determinants of growth faltering in infants and young children in Sri Lanka.Participants A retrospective cohort study was conducted among term-born babies (≥37-week gestation), currently aged between 12 and 24 months. A sample of 1875 mother–child pairs were recruited using two-stage stratified cluster sampling method. Data on sociodemographic characteristics, pregnancy care, feeding practices, childhood illnesses and home risk factors were collected through direct interviews with the caregivers. Pregnancy-related data were obtained from the pregnancy record. Birth weight, serial weight and length records and growth pattern were extracted from the Child Health and Development Record. Current weight and length of the children were measured directly.Findings to date The SLCGC serves as a comprehensive cohort study with a countrywide distribution in Sri Lanka, covering the three main residential sectors, namely the urban, rural and estate sectors in equal proportions. The majority of mothers were housewives (76.8%) and aged

Background Each year in England, 450,000 children and young people (CYP) under 18 years of age are transported by ambulance to emergency departments. Approximately 20% of these suffer acute pain caused by illness or injury. Pain is a highly complex sensory and emotional experience. The intersection between acute pain, unwell CYP and the unpredictable pre-hospital environment is convoluted. Studies have shown that prehospital pain management in CYP is poor, with 61% of those suffering acute pain not achieving effective pain relief (abolition or reduction of pain score by 2 or more out of 10) when attended by ambulance. Consequences of poor acute pain management include altered pain perception, post-traumatic stress disorder and the development of chronic pain. This realist review will aim to understand how ambulance clinicians can provide improved prehospital acute pain management for CYP. Methods A realist review will be conducted in accordance with the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidance. A five-stage approach will be adopted; 1) Developing an Initial Programme Theory (IPT): develop an IPT with key stakeholder input and evidence from informal searching; 2) Searching and screening: conduct a thorough search of relevant research databases and other literature sources and perform screening in duplicate; 3) Relevance and rigour assessment: assess documents for relevance and rigour in duplicate; 4) Extracting and organising data: code relevant data into conceptual “buckets” using qualitative data analysis software; and 5) Synthesis and Programme Theory (PT) refinement: utilise a realist logic of analysis to generate context-mechanism-outcome configurations (CMOCs) within and across conceptual “buckets”, test and refine the IPT into a realist PT. Conclusion The realist PT will enhance our understanding of what works best to improve acute prehospital pain management in CYP, which will then be tested and refined within a realist evaluation. Registration PROSPERO Registration: CRD42024505978

Mica waste, a type of commercial waste produced in bulk quantities by the mica mining industry, was processed and added to Natural Rubber Latex Foams (NRLF) made of centrifuged and creamed latex. Following the Dunlop method, NRLF composites with various Processed Mica Waste (PMW) loadings (0, 2, 4, 6, 8, and 10 Phr) were prepared, and the thermo-physical characteristics were compared. Thermal conductivity, electrical resistivity of NRLF against the latex type and mica loading were compared for the first time. NRLFs prepared using creamed latex exhibit 33 and 50 μm (width and height) cell diameter, 3 ibf hardness, 281 % swelling index improvements and 0.05 Wm−1K−1 thermal conductivity, and 1 °C glass transition temperature (Tg) reductions than centrifuged NRLF and indistinguishable electrical resistivity. With the addition of mica (0–10 Phr), both NRLF types showed a similar ascending trend in hardness (42 ibf), water absorption (16 %), Tg (7 °C), thermal conductivity (0.54 Wm−1K−1), electrical resistivity (69 × 103 Ω m) with decreasing gel time (3 min) and swelling index (550 %). The key objective of this research was to prepare PMW-filled NRLF and compare structural, electrical and thermo-physical properties, for the first time, against mica content and latex type.

Wildlife management can generate social conflict when stakeholder perceptions of the target species are not considered. Introduced Ring-necked Parakeets (RNP) are established in the UK and have been added to the ‘general licence’ of birds that can be killed to prevent serious economic damage. We aimed to better understand perceptions of RNPs on a nationwide scale to inform mitigation actions for potential future conflict over RNP management. We surveyed 3,947 UK residents to understand awareness of, knowledge of and attitudes towards the RNP across the UK. We found that most respondents (90.2%) were aware of the RNP. Almost half of respondents (45.9%) held negative opinions, particularly against the RNP in rural areas (64.7%), suggesting landscape contexts influence attitudes. Respondent preference for the RNP was low in local neighbourhoods (7.80%) although the species was considered aesthetically pleasing by most (83.0%). Many respondents knew the species’ name (54.9%), but underestimated current population numbers in the UK (82.6%) and few knew its full native range (10.0%). We identified respondents’ ecological interest, age, education, preference for, awareness of and knowledge of the RNP as significant factors associated with perceptions. Our findings suggest that the RNP presents a complex socio-environmental challenge, with respondent awareness, knowledge and attitudes each forming an important component of perceptions towards this species. We recommend that wildlife managers utilise our findings and cohesive approach to enhance future RNP perception research in the UK and abroad and towards the success of any proposed management initiatives under the UK general licence.

The melon fly, Bactrocera cucurbitae, poses a severe threat to the country’s agricultural productivity, particularly in the cultivation of cucurbitaceous crops. This study was conducted to determine the ideal irradiation dose to be used to set up a Sterile Insect Technique (SIT)-based strategy to control B. cucurbitae outbreaks in Sri Lanka. A B. cucurbitae colony was established and maintained under standard laboratory conditions. Male pupae (100 pupae per treatment) were exposed to different radiation doses, namely 0 (control), 50, 60, 70, 80, 90, 100, and 110 Gy. The effect of irradiation on selected performance parameters such as survival, flight ability, fecundity, fertility, and adult longevity was evaluated under laboratory conditions. In addition, mating competitiveness was evaluated for irradiated male B. cucurbitae. Significant differences were observed in percentage pupal survival, flight ability, and fertility rates (p < 0.05) at a 95% level of confidence. Further, the 50% and 75% adult longevity periods of irradiated B. cucurbitae males significantly decreased with the increasing irradiation dosage (p < 0.05). B. cucurbitae exposed to 70 Gy radiation reported a mean pupal survival rate of 94.0 ± 1.25, flight ability of 93.3 ± 1.88, and fertility 0.2 ± 0.05%, along with a mean longevity of 38 ± 1.5 days until 50% reduction in the population. The competitiveness of B. cucurbitae exposed to 70 Gy with respect to wild males was 0.56 under laboratory conditions, which reduced up to 0.5 in semi-field settings. The 70 Gy dose could be recommended as the optimal radiation dose for the production of sterile B. cucurbitae males with an acceptable level of fitness and sterility to be used in SIT-based melon fly control programmes in Sri Lanka.

Background Insomnia is a prevalent and distressing sleep disorder. Multicomponent cognitive–behavioural therapy is the recommended first-line treatment, but access remains extremely limited, particularly in primary care where insomnia is managed. One principal component of cognitive–behavioural therapy is a behavioural treatment called sleep restriction therapy, which could potentially be delivered as a brief single-component intervention by generalists in primary care. Objectives The primary objective of the Health-professional Administered Brief Insomnia Therapy trial was to establish whether nurse-delivered sleep restriction therapy in primary care improves insomnia relative to sleep hygiene. Secondary objectives were to establish whether nurse-delivered sleep restriction therapy was cost-effective, and to undertake a process evaluation to understand intervention delivery, fidelity and acceptability. Design Pragmatic, multicentre, individually randomised, parallel-group, superiority trial with embedded process evaluation. Setting National Health Service general practice in three regions of England. Participants Adults aged ≥ 18 years with insomnia disorder were randomised using a validated web-based randomisation programme. Interventions Participants in the intervention group were offered a brief four-session nurse-delivered behavioural treatment involving two in-person sessions and two by phone. Participants were supported to follow a prescribed sleep schedule with the aim of restricting and standardising time in bed. Participants were also provided with a sleep hygiene leaflet. The control group received the same sleep hygiene leaflet by e-mail or post. There was no restriction on usual care. Main outcome measures Outcomes were assessed at 3, 6 and 12 months. Participants were included in the primary analysis if they contributed at least one post-randomisation outcome. The primary end point was self-reported insomnia severity with the Insomnia Severity Index at 6 months. Secondary outcomes were health-related and sleep-related quality of life, depressive symptoms, work productivity and activity impairment, self-reported and actigraphy-defined sleep, and hypnotic medication use. Cost-effectiveness was evaluated using the incremental cost per quality-adjusted life-year. For the process evaluation, semistructured interviews were carried out with participants, nurses and practice managers or general practitioners. Due to the nature of the intervention, both participants and nurses were aware of group allocation. Results We recruited 642 participants (n = 321 for sleep restriction therapy; n = 321 for sleep hygiene) between 29 August 2018 and 23 March 2020. Five hundred and eighty participants (90.3%) provided data at a minimum of one follow-up time point; 257 (80.1%) participants in the sleep restriction therapy arm and 291 (90.7%) participants in the sleep hygiene arm provided primary outcome data at 6 months. The estimated adjusted mean difference on the Insomnia Severity Index was −3.05 (95% confidence interval −3.83 to −2.28; p 65 years), sex, baseline insomnia severity [Insomnia Severity Index (ISI) score