bluuebunny/crossref_metadata_2025 huggingface dataset:
Habit Reversal Therapy by Dermatologists to Treat Body‐Focused Repetitive Behaviors: Review and Case Reports
Authors: Sian Clara Michelle Tan Hwei , Yenn Lai Cher , Dua Janet Pei Ling
Published: June 2024

Background

Body‐focused repetitive behaviors (BFRBs) are recurrent, habitual behaviors, such as skin picking, hair pulling, and other compulsions, that can result in distressing cutaneous manifestations of varying severity. Many patients with BFRBs present primarily to dermatologists and a significant proportion subsequently resist engaging with psychological or psychiatric healthcare professionals. Habit reversal therapy (HRT) is one of the most effective evidence‐based management strategies for BFRBs and it can be facilitated by a range of healthcare professionals including general practitioners, dermatologists, and nurses, as well as psychologists. Few dermatologists are comfortable offering HRT, making it a severely underutilized technique in the management of various skin conditions associated with BFRBs.

Objectives

This article aims to highlight strategies that dermatologists can learn to offer to positively influence the patient experience. A practical approach to implementing simplified HRT for patients with BFRBs will be demonstrated through two case studies.
Recovery potential of fish and coral populations following ecological disturbance
Authors: Asbury Mollie , Innes‐Gold Anne A. , Wulstein Devynn M. , Madin Elizabeth M. P. , Madin Joshua S. , McManus Lisa C.
Published: June 2024

The health of coral reef benthic and fish communities is implicitly connected, yet typically studied and managed separately. By developing a coupled reef population model that connects coral populations and reef fish biomass through the habitat complexity that corals build and fish live among, we aim to address this gap by holistically quantifying ecological feedbacks and responses to ecological stressors. We explored the impacts of fishing effort in conjunction with three types of ecological disturbances as they propagated through a coral reef ecosystem: (1) a disturbance that disproportionately affected small, bio‐energetically vulnerable colonies, (2) a disturbance that predominantly affected large, mechanically vulnerable colonies, and (3) a disturbance that affected colonies of all sizes randomly. We found that joint coral and fish population recovery was fastest and most complete under events affecting small colonies, followed by recovery from disturbances affecting random sizes, and lastly large‐colony disturbances. These results suggest that the retention versus loss of large coral colonies with high reproductive potential critically influenced population recovery. Low fishing levels maintained fish and coral populations and allowed for recovery after disturbances, whereas high fishing levels prevented recovery due to greater fish‐dependent coral mortality. Finally, we tested various formulations of the relationship between coral size and habitat complexity (i.e., exponential, linear, logarithmic) that constrain fish carrying capacity. All formulations led to similar population projections in most disturbance scenarios, but there were exceptions where the timing and trajectory of recovery differed, such as faster and greater recovery potential when complexity is logarithmic with respect to coral size. These findings suggest that fishing and habitat complexity mediate the recovery of coral reef populations, emphasizing the importance of describing linkages between coral size distribution and reef habitat structure. Furthermore, our results highlight the utility of the coupled‐model framework for understanding and managing the impact of disturbances at ecosystem scales.
Effects of canagliflozin on total heart failure events across the kidney function spectrum: Participant‐level pooled analysis from the CANVAS Program and CREDENCE trial
Authors: Vaduganathan Muthiah , Cannon Christopher P. , Jardine Meg J. , Heerspink Hiddo J.L. , Arnott Clare , Neuen Brendon L. , Sarraju Ashish , Gogate Jagadish , Seufert Jochen , Neal Bruce , Perkovic Vlado , Mahaffey Kenneth W. , Kosiborod Mikhail N.
Published: June 2024

Aims

People with type 2 diabetes (T2D) face high risks of heart failure (HF) hospitalizations that are often recurrent, especially as kidney function declines. We examined the effects of canagliflozin on total HF events by baseline kidney function in patients with T2D at high cardiovascular risk and/or with chronic kidney disease.

Methods and results

Leveraging pooled participant‐level data from the CANVAS programme (n = 10 142) and CREDENCE trial (n = 4401), first and total HF hospitalizations were examined. Cox proportional hazards models were built for the time to first HF hospitalization, and proportional means models based on cumulative mean functions were used for recurrent HF hospitalizations. Treatment effects were evaluated overall as well as within baseline estimated glomerular filtration rate (eGFR) strata (<45, 45–60, and >60 ml/min/1.73 m2). HF hospitalizations were independently and blindly adjudicated. Among 14 540 participants with available baseline eGFR values, 672 HF hospitalizations occurred over a median follow‐up of 2.5 years. Among participants who experienced a HF hospitalization, 357 had a single event (201 in placebo‐treated patients and 156 in canagliflozin‐treated patients), 77 had 2 events, and 39 had >2 events. Canagliflozin reduced risk of first HF hospitalization (hazard ratio 0.58, 95% confidence interval [CI] 0.48–0.70) consistently across baseline eGFR strata (pinteraction = 0.84). Canagliflozin reduced total HF hospitalizations overall (mean event ratio 0.63, 95% CI 0.54–0.73) and across eGFR subgroups (pinteraction = 0.51). Canagliflozin also reduced cardiovascular death and total HF hospitalizations (mean event ratio 0.72, 95% CI 0.65–0.80) and across eGFR subgroups (pinteraction = 0.82). The absolute risk reductions were numerically larger, and numbers needed to treat were smaller when evaluating total events versus first events alone. These observed HF benefits were highly consistent across the range of eGFR, with larger absolute benefits in participants who had worse kidney function at baseline.

Conclusions

In individuals with T2D at high cardiovascular risk and/or with chronic kidney disease, canagliflozin reduced the total burden of HF hospitalizations, with consistent benefits observed across the kidney function spectrum.

Clinical Trial Registration:
ClinicalTrials.gov Identifier: CANVAS (NCT01032629), CANVAS‐R (NCT01989754), CREDENCE (NCT02065791).
A novel controlled metabolic accelerator for the treatment of obesity‐related heart failure with preserved ejection fraction: Rationale and design of the Phase 2a HuMAIN trial
Authors: Kitzman Dalane W. , Lewis Gregory D. , Pandey Ambarish , Borlaug Barry A. , Sauer Andrew J. , Litwin Sheldon E. , Sharma Kavita , Jorkasky Diane K. , Khan Shaharyar , Shah Sanjiv J.
Published: June 2024

Aims

Compared with those without obesity, patients with obesity‐related heart failure with preserved ejection fraction (HFpEF) have worse symptoms, haemodynamics, and outcomes. Current weight loss strategies (diet, drug, and surgical) work through decreased energy intake rather than increased expenditure and cause significant loss of skeletal muscle mass in addition to adipose tissue. This may have adverse implications for patients with HFpEF, who already have reduced skeletal muscle mass and function and high rates of physical frailty. Mitochondrial uncoupling agents may have unique beneficial effects by producing weight loss via increased catabolism rather than reduced caloric intake, thereby causing loss of adipose tissue while sparing skeletal muscle. HU6 is a controlled metabolic accelerator that is metabolized to the mitochondrial uncoupling agent 2,4‐dinotrophenol. HU6 selectively increases carbon oxidation from fat and glucose while also decreasing toxic reactive oxygen species (ROS) production. In addition to sparing skeletal muscle loss, HU6 may have other benefits relevant to obesity‐related HFpEF, including reduced specific tissue depots contributing to HFpEF; improved glucose utilization; and reduction in systemic inflammation via both decreased ROS production from mitochondria and decreased cytokine elaboration from excess, dysfunctional adipose.

Methods

We describe the rationale and design of HuMAIN‐HFpEF, a Phase 2a randomized, double‐blind, placebo‐controlled, dose‐titration, parallel‐group trial in patients with obesity‐related HFpEF to evaluate the effects of HU6 on weight loss, body composition, exercise capacity, cardiac structure and function, metabolism, and inflammation, and identify optimal dosage for future Phase 3 trials.

Conclusions

HuMAIN will test a promising novel agent for obesity‐related HFpEF.
Widely targeted metabolomics reveal the distribution of primary and secondary metabolites in pomegranate fruit
Authors: Chen Lina , Liu Ruitao , Zhu Juanli , Wang Luwei , Li Haoxian , Liu Junhao , Lu Zhenhua
Published: June 2024

The pomegranate fruit is valued for its nutritional and medicinal properties, and the composition and content of primary and secondary metabolites are the main factors impacting its nutritional and medicinal properties. However, a deep understanding of metabolites in different parts of fruit is still lacking. Here, the peel, aril, and seed of mature pomegranate fruits were analyzed separately to compare metabolic component differences using UPLC/MS–MS. A total of 858 metabolites belonging to 11 classes were identified, of which flavonoids, such as delphinidin‐3‐O‐glucoside and cyanidin‐3‐O‐glucoside; tannins, such as ellagic acid and punicalin; and terpenoids, such as corosolic acid and madasiatic acid, were upregulated in the peel. Lipids, such as punicic acid, methyl linolenate, and linoleic acid; alkaloids, such as indole and choline; nucleotides and derivatives mainly including 2‐deoxyribose‐1‐phosphate and 9‐(arabinosyl)‐hypoxanthine, were upregulated in seeds. Phenolic acids, such as 1‐O‐galloyl‐4,6‐(S)‐HHDP‐β‐D‐glucose and 1,7‐di‐O‐galloyl‐D‐sedoheptulose, and flavonoids, such as cyanidin‐3‐O‐glucoside, cyanidin‐3‐O‐(2″‐O‐xylosyl) galactoside, and delphinidin‐3‐O‐glucoside, were upregulated in aril. The flavone and flavonol biosynthesis (ko00944) pathways were significantly enriched between the peel and seed, as were the anthocyanin biosynthesis (ko00944) pathways between the aril and seed and the flavonoid biosynthesis (ko00941) pathways between the peel and aril. Additionally, functional antioxidants, such as 10,16‐dihydroxypalmitic acid, 3‐O‐methylellagic acid, and 3,3’‐O‐dimethylellagic acid, were first identified in pomegranate fruits. Our results revealed the composition and abundance of primary and secondary metabolites in pomegranate fruit, which can lay the foundation for further elucidation of its nutritional and medicinal properties.
Bipolar Plate Design Assessment: Proton Exchange Membrane Fuel Cell and Water Electrolyzer
Authors: Sarjuni C. T. Aisyah , Shahril Ahmad Adam Danial , Low Hock Chin , Lim Bee Huah
Published: June 2024

Proton exchange membrane fuel cells (PEMFCs) as power generators and proton exchange membrane water electrolyzers (PEMWEs) as hydrogen fuel producers play critical roles in implementing hydrogen energy. The bipolar plates (BPPs) in both PEMFC and PEMWE facilitate the distribution of reactants and products, providing electrical connectivity in a series of singular cells. Although both systems are categorized under the same PEM spectrum, the differing reaction mechanisms require specialized plate properties to achieve optimum performance. This short review analyzes the characteristics of BPPs in both PEMFC and PEMWE, with a focus on the plate material, coating, and flow field. This short review concluded that the polymer composite graphite–based BPPs are the most feasible for PEMFC with no coating needed. PEMWE needs SS316 as a BPP material with a conductive coating to withstand the highly corrosive oxygen evolution reaction at the anode. The serpentine flow field showed dominance in PEMFC stack performance due to even fluid distribution and efficient liquid water drainage. However, its high‐pressure drop contributes to greater parasitic power. PEMWEs commonly adopt the parallel flow field for its lower contact resistance and bubble formation for efficient mass transport toward the cathode.
The physics and the biology of the water balance: A personal journey through the critical zone into the water balance
Authors: Hunt Allen G.
Published: June 2024

The essay describes how a combination of scaling theory from percolation, that relates pore scale flow and transport through catchment scales to global scales (bottom‐up), as well as water fluxes to soil formation and vegetation growth, can be used to support an accurate ecological optimization that (top‐down): solves the central problem of hydrology, that is., “the water balance,” and generates critically important derived quantities, namely streamflow response to climate change, net primary productivity, and plant species richness. Moreover, the essay describes how this particular theoretical approach came to be designed and how it, in retrospect, fits in with the vision of the Committee on Opportunities in the Hydrologic Sciences which met 34 years ago to formulate a research, teaching, and infrastructure guide for the community, and “rebrand our science as a geoscience.” Finally, it demonstrates how the research satisfies the present desires of the community to unite Darwinian and Newtonian scientific methods in the solution of this central problem and how it relates to present research directions in the fields of hydrologic sciences and ecology.
Conceptual approach for a holistic low‐flow risk analysis
Authors: Satzinger Udo , Bachmann Daniel
Published: June 2024

Low‐flow events, characterized by a significant water deficiency in river systems, have profound impacts on various water users and river ecology. Recent low‐flow events in Europe have had severe economic and ecological consequences such as disruptions to hydropower production, irrigation bans, constraints on navigation and complete river drying. These events highlight the urgent need for effective low‐flow risk management and demand a holistic risk analysis as a basis. The existing approaches to low‐flow analysis often focus on hydrological aspects, utilizing indices such as the Standardized Runoff Index (SRI) or Low‐flow Index. However, these indices lack information regarding consequences and impacts. Other approaches consider parts of a risk approach but often focus on special aspects, such as the economy; in general, no holistic assessment is made. This study introduces a conceptual approach to a holistic low‐flow risk analysis. The approach provides a continuous long‐term simulation to capture the special long‐term behaviour of low‐flow events and therefore avoids the complex definition of scenarios. In this conceptual approach, the low‐flow risk is analysed using a combination of various analyses that cover all aspects from occurrence to consequences. Meteorological analysis is used to generate synthetic long‐term weather data time series, which are transformed into runoff time series in hydrological analysis. Based on these results, hydrodynamic analysis quantifies the water levels, water temperatures, and flow velocities along the river. The consequences are analysed in terms of socio‐economic and ecological consequences. The results represent a long‐term series of damage values. Finally, the damage values are summed in the risk analysis and divided by the number of years considered in the analysis. For testing and demonstration purposes, the presented conceptual risk approach is partly applied to a proof‐of‐concept at the Selke catchment, a small river catchment in Germany. Finally, the results are presented, evaluated, and discussed.
To what Extent could Solid‐State Chemistry and Nanotechnology Impact Sustainable Lifestyle of Human Being on Earth in the Years to Come
Authors: Tenne Reshef
Published: June 2024

The lifestyle of mankind has improved significantly since the start of the industrial revolution and the establishment of a science (engineering)‐based society, some 250 years ago. Notwithstanding, the outcome of these advances, a major threat is looming on the future of humanity due to the greenhouse effect produced by fossil fuel effluents and the degradation of the environment on earth. Chemistry and chemical engineering are key players in confronting these challenges and establishing sustainable lifestyle on earth. In particular, the interplay between materials research; solid‐state chemistry and nanoscience (nanotechnology) will be crucial for the future of sustainable life on earth. Education of the population‐at‐large to shift from a consumer‐based society into sustainability‐concerned lifestyle, is mandatory for realization of this paradigm shift. Harmonizing the interplay between entrepreneurs, financing bodies, public agencies, international organizations, legal bodies and research institutes should also play an integral part of this new equation.
High‐accuracy heart rate detection using multispectralIPPGtechnology combined with a deep learning algorithm
Authors: Wang Yu , Ren Yu , Wang Tingting , Li Dongliang , Cai Hongxing , Ji Boyu
Published: June 2024

Image Photoplethysmography (IPPG) technology is a noncontact physiological parameter detection technology, which has been widely used in heart rate (HR) detection. However, traditional imaging devices still have issues such as narrower receiving spectral range and inferior motion detection performance. In this paper, we propose a HR detection method based on multi‐spectral video. Our method combining multispectral imaging with IPPG technology provides more accurate physiological information. To realize real‐time evaluation of HR directly from facial multispectral videos, we propose a new end‐to‐end neural network, namely IPPGResNet18. The IPPGResNet18 model was trained on the multispectral video dataset from which better results were achieved: MAE = 2.793, RMSE = 3.695, SD = 3.707,p = 0.304. The experimental results demonstrate a high accuracy of HR detection under motion state using this detection method. In respect of real‐time monitoring of HR during movement, our method is obviously superior to the conventional technical solutions.
Sarcopenia is independently associated with poor preoperative physical fitness in patients undergoing colorectal cancer surgery
Authors: Rai Jason , Pring Edward T. , Knight Katrina , Tilney Henry , Gudgeon Judy , Gudgeon Mark , Taylor Fiona , Gould Laura E. , Wong Joel , Andreani Stefano , Mai Dinh V.C. , Drami Ioanna , Lung Phillip , Athanasiou Thanos , Roxburgh Campbell , Jenkins John T.
Published: June 2024

Background

Accurate preoperative risk assessment for major colorectal cancer (CRC) surgery remains challenging. Body composition (BC) and cardiopulmonary exercise testing (CPET) can be used to evaluate risk. The relationship between BC and CPET in patients undergoing curative CRC surgery is unclear.

Methods

Consecutive patients undergoing CPET prior to CRC surgery between 2010 and 2020 were identified between two different UK hospitals. Body composition phenotypes such as sarcopenia, myosteatosis, and visceral obesity were defined using widely accepted thresholds using preoperative single axial slice CT image at L3 vertebrae. Relationships between clinicopathological, BC, and CPET variables were investigated using linear regression analysis.

Results

Two hundred eighteen patients with stage I–III CRC were included. The prevalence of sarcopenia, myosteatosis, and visceral obesity was 62%, 33%, and 64%, respectively. The median oxygen uptake at anaerobic threshold (VO2 at AT) was 12.2 mL/kg/min (IQR 10.6–14.2), and oxygen uptake at peak exercise (VO2 peak) was 18.8 mL/kg/min (IQR 15.4–23). On univariate linear regression analysis, male sex (P < 0.001) was positively associated with VO2 at AT. While ASA grade (P < 0.001) and BMI (P = 0.007) were negatively associated with VO2 at AT, on multivariate linear regression analysis, these variables remained significant (P < 0.05). On univariate linear regression analysis, male sex (P < 0.001) was positively associated with VO2 peak, whereas age (P < 0.001), ASA grade (P < 0.001), BMI (P = 0.003), sarcopenia (P = 0.015), and myosteatosis (P < 0.001) were negatively associated with VO2 peak. On multivariate linear regression analysis age (P < 0.001), ASA grade (P < 0.001), BMI (P < 0.001), and sarcopenia (P = 0.006) were independently and negatively associated with VO2 peak.

Conclusions

The novel finding that sarcopenia is independently associated with reduced VO2 peak performance in CPET supports the supposition that reduced muscle mass relates to poor physical function in CRC patients. Further work should be undertaken to assess whether sarcopenia diagnosed on CT can act as suitable surrogate for CPET to further enhance personalized risk stratification.
Assessment of Global and Regional Lung Compliance in Pulmonary Fibrosis With Hyperpolarized Gas MRI
Authors: Zhang Ming , Li Haidong , Xiao Yi , Li Hongchuang , Liu Xiaoling , Zhao Xiuchao , Zheng Yu , Han Yeqing , Guo Fumin , Sun Xianping , Zhao Jianping , Liu Shiyuan , Zhou Xin
Published: June 2024

Background

Lung compliance, a biomarker of pulmonary fibrosis, is generally measured globally. Hyperpolarized 129Xe gas MRI offers the potential to evaluate lung compliance regionally, allowing for visualization of changes in lung compliance associated with fibrosis.

Purpose

To assess global and regional lung compliance in a rat model of pulmonary fibrosis using hyperpolarized 129Xe gas MRI.

Study Type

Prospective.

Animal Model

Twenty Sprague–Dawley male rats with bleomycin‐induced fibrosis model (N = 10) and saline‐treated controls (N = 10).

Field Strength/Sequence

7‐T, fast low‐angle shot (FLASH) sequence.

Assessment

Lung compliance was determined by fitting lung volumes derived from segmented 129Xe MRI with an iterative selection method, to corresponding airway pressures. Similarly, lung compliance was obtained with computed tomography for cross‐validation. Direction‐dependencies of lung compliance were characterized by regional lung compliance ratios (R) in different directions. Pulmonary function tests (PFTs) and histological analysis were used to validate the pulmonary fibrosis model and assess its correlation with 129Xe lung compliance.

Statistical Tests

Shapiro–Wilk tests, unpaired and paired t‐tests, Mann–Whitney U and Wilcoxon signed‐rank tests, and Pearson correlation coefficients. P < 0.05 was considered statistically significant.

Results

For the entire lung, the global and regional lung compliance measured with 129Xe gas MRI showed significant differences between the groups, and correlated with the global lung compliance measured using PFTs (global: r = 0.891; regional: r = 0.873). Additionally, for the control group, significant difference was found in mean regional compliance between areas, eg, 0.37 (0.32, 0.39) × 10−4 mL/cm H2O and 0.47 (0.41, 0.56) × 10−4 mL/cm H2O for apical and basal lung, respectively. The apical‐basal direction R was 1.12 ± 0.09 and 1.35 ± 0.13 for fibrosis and control groups, respectively, indicating a significant difference.

Data Conclusion

Our findings demonstrate the feasibility of using hyperpolarized gas MRI to assess regional lung compliance.

Evidence Level

2

Technical Efficacy

Stage 1
A novel nutritional approach to infants and children with congenital diarrhea due to homozygous DGAT1 mutations
Authors: Millman Peri , Rimon Ramit M. , Toff Chani , Engvall Martin , Shaoul Ron , Wilschanski Michael , Elyashar Hila , Winter Harland S.
Published: June 2024

Objectives

Diacylglycerol acyltransferase (DGAT) catalyzes the final step in triglyceride synthesis. DGAT1 is expressed in human enterocytes and is essential for fat absorption. Homozygous DGAT1 deficiency often presents with severe diarrhea and protein‐losing enteropathy (PLE) in the 1st weeks of life. Because severe restriction of fat intake controls diarrhea and decreases PLE, total parenteral nutrition (TPN) was the initial standard therapy in infants and children. We present tertiary center experience managing infants and children with DGAT1 deficiency resulting in the development of a nutritional approach that minimizes the use of TPN.

Methods

From 2014 to 2020, 12 infants with DGAT1 deficiency were treated. Stool output, growth, and development, as well as essential fatty acid status, were monitored. This retrospective experience formed the basis for treatment recommendations, which include an ultralow fat formula with intermittent peripheral intravenous lipid infusions during the 1st year of life.

Results

All patients with prolonged intestinal fat exposure had PLE, which resolved when treated with the nutrition protocol. Essential fatty acid status as measured by triene:tetraene ratios normalized in all treated patients. Over time, early genetic diagnosis and prompt initiation of an ultralow fat diet with peripheral intravenous lipid infusions replaced the need for TPN.

Conclusions

Children with DGAT1 deficiency respond to dietary restriction of lipids. Management with a novel nutritional approach provides effective treatment for infants with DGAT1 deficiency, treats diarrhea and PLE, promotes growth and development, avoids TPN dependency, and decreases the potential for essential fatty acid deficiency.
Deep Learning Enabled Transmission of Full‐Stokes Polarization Images Through Complex Media
Authors: Pierangeli Davide , Volpe Giovanni , Conti Claudio
Published: June 2024

Polarization images offer crucial functionalities across multiple scientific domains, providing access to physical information beyond conventional measures such as intensity, phase, and spectrum of light. However, the challenge of transmitting polarization images through complex media has restricted their application in optical communication and imaging. Here, a novel approach utilizing deep learning for the transmission of full‐Stokes polarization images through scattering media is presented. It is demonstrated that any input polarization image can be reconstructed in a single shot by employing only an intensity sensor. By supervised training of a deep neural network, high‐accuracy full‐Stokes reconstruction is achieved from the speckle pattern detected by an intensity camera. Leveraging the deep learning based polarization decoder, a polarization‐colored encoding scheme is devised to enable increased‐capacity data transmission through disordered channels. Fast, wavelength‐independent, on‐chip, polarization imaging in complex media enables the utilization of polarization‐structured light in multimode fibres and opaque materials, unlocking new possibilities in optical communication, cryptography, and quantum technology.
Validation, adaptation and application of a multi‐criteria decision analysis‐based framework for chemotherapeutic agents in Egypt
Authors: Eldeib Hend K. , Abbassi Maggie M. , Sabry Nirmeen A.
Published: June 2024

Health technology assessment is a systematic, transparent, robust, and unbiased assessment of healthcare technology that links evidence and decisions. Healthcare decisions usually require trading‐off, and using a structured approach, such as multi‐criteria decision analysis (MCDA), could improve decision quality. This study aimed to adapt an MCDA‐based framework for oncological drug evaluation in an Egyptian clinical setting to explore the perspectives of different stakeholders. The 10th edition of the Evidence and Value: Impact on decision making framework was translated, validated, adapted, and applied to explore key differences between the priorities of different stakeholders for coverage decisions in the oncology field in Egypt. A direct rating scale or hierarchical point allocation was used to elicit criteria weights. Normalized weights were calculated and compared using the preset cut‐off value of 0.008. Understandability, willingness to use the adopted weighting techniques, and cognitive burden were assessed and compared. Ninety participants completed the criteria‐weighting interview for the adapted tool. The elicited criteria weights differed between the two adopted weighting techniques when comparing stakeholders' priorities using the preset cut‐off (0.008). However, there was no significant difference in the weighting technique understandability, future use willingness, and cognitive burden parameters on categorization by either the weighting technique or stakeholder group. This study provides a specially tailored, straightforward procedure for Egyptian stakeholders to evaluate oncologic drugs in a standardized manner by combining various inputs. It also highlights the main variations across Egyptian stakeholder preferences.
Successful treatment with guanfacine in a long‐COVID case manifesting marked cognitive impairment
Authors: Kondo Tsuyoshi , Higa Riki , Kuniba Mariko , Shinzato Hotaka , Takaesu Yoshikazu
Published: June 2024

Background

Persistent cognitive impairment is a serious consequence of the post‐COVID condition. However, there have been no established effective treatments for this pathophysiology supported by sufficient evidence.

Case Presentation

A 32‐year‐old woman became aware of difficulty in word recalling, reading, and writing as well as difficulty in completing various household multitasks 3 weeks after the COVID‐19 infection. Although blood tests, magnetic resonance imaging, electroencephalography, and Kohs block design test were all within normal limits, completion time by trail making test (TMT) A or B was markedly delayed. Finally, she was referred to our hospital 3 months after the infection. At baseline, the THINC integrated tool (THINC‐it), a digital battery consisting of the five‐item version of the perceived deficit questionnaire (PDQ‐5), choice reaction time (CRT), 1‐back test, digit symbol substitution test (DSST), and TMT‐B, revealed poor capability in attention, working memory, and executive function. Also, near‐infrared spectroscopy (NIRS) demonstrated no activation in frontal or temporal regions during verbal fluency task. Extended‐release guanfacine (GXR) 2 mg/day was initiated and a month later was elevated up to 4 mg/day as a maintenance dose. The PDQ‐5, CRT, 1‐back test, DSST, and TMT‐B were dramatically improved 1 month after GXR treatment. NIRS finding was also normalized after 2 months of treatment. These effects were successfully maintained throughout the 6‐month follow‐up period.

Conclusion

GXR may be helpful in improving subjective/objective cognitive functioning and frontotemporal brain activity in long‐COVID patients manifesting apparent cognitive impairment.
Effects of discounting fruits, vegetables, and noncaloric beverages in New York City supermarkets on purchasing, intake, and weight
Authors: Poskute Atene S. , Ang Ian Yi Han , Rahman Nabilah , Geliebter Allan
Published: June 2024

Objective

The objective of this study was to assess purchasing, intake, and weight after discounting fruits and vegetables (F&V) and noncaloric beverages in New York City supermarkets.

Methods

A 16‐week randomized controlled trial was conducted with a 4‐week baseline, an 8‐week intervention with 50% discounts on F&V and noncaloric beverages, and a 4‐week follow‐up. Purchasing was tracked via loyalty cards, and intake was tracked via 24‐h dietary recalls. Weights were measured at five in‐person visits.

Results

Data from 67 participants were analyzed (38 in the experimental group; 29 in the control group). F&V and noncaloric beverage weekly purchasing was greater in the experimental than the control group (mean difference [SD], $4.64 [$1.44], p < 0.0001; $0.53 [$0.39], p = 0.008) during intervention, with F&V purchasing remaining greater in the experimental versus control group during follow‐up (p = 0.005). F&V intake was greater for the experimental than the control group during intervention (142 [105] g/day; p = 0.009) and follow‐up (p = 0.001). Although no difference in noncaloric beverage consumption was observed between groups, there was lower alcohol intake in the experimental than the control group during follow‐up (−85.8 [60.2] g/day; p = 0.004). The experimental group lost weight compared with the control group (−1.33 [0.92] kg; p = 0.006 intervention and p = 0.106 follow‐up). No differences in nutrient composition or high energy‐dense product consumption were found.

Conclusions

A 50% discount on F&V and noncaloric beverages promoted increased purchasing and intake of F&V and induced weight loss.
Acid accumulation is associated with metabolic alterations; higher energy, fat, and protein intake; and energy expenditure
Authors: Treviño‐Alvarez Andrés M. , Cabeza de Baca Tomás , Stinson Emma J. , Gluck Marci E. , Piaggi Paolo , Votruba Susanne B. , Krakoff Jonathan , Chang Douglas C.
Published: June 2024

Objective

The objective of this study was to study how acid accumulation (lower plasma bicarbonate and higher anion gap [AG] and corrected anion gap [CAG]) correlates with metabolic parameters, food intake, and 24‐h energy expenditure (EE).

Methods

Acid accumulation was measured in 286 healthy adults with estimated glomerular filtration rate > 60 mL/min/1.73 m2. Measurements included body composition by dual‐energy x‐ray absorptiometry scan, ad libitum energy intake by a vending machine paradigm over 3 days, and 24‐h EE in a whole‐room indirect calorimeter.

Results

Lower bicarbonate, higher AG, and higher CAG were correlated with higher waist and thigh circumferences, body fat (percentage), fat mass, triglycerides, and lower high‐density lipoprotein cholesterol. Acid accumulation markers were correlated with higher total energy (CAG partial r = 0.17; p = 0.02), fat (CAG partial r = 0.17; p = 0.02), protein intake (CAG partial r = 0.20; p = 0.006), and 24‐h EE (CAG partial r = 0.24; p = 0.0007). A mediation analysis of CAG and total energy intake found that 24‐h EE was a partial mediator (40%), but the association remained significant (β = 0.15; p < 0.0001).

Conclusions

In healthy individuals, acid accumulation was associated with an unfavorable metabolic phenotype; higher 24‐h EE; and increased total energy, fat, and protein intake. Acid accumulation markers, as putative markers of higher dietary acid load (e.g., from protein), may affect energy balance physiology promoting weight gain.
Comparative Performance of ChatGPT 3.5 and GPT4 on Rhinology Standardized Board Examination Questions
Authors: Patel Evan A. , Fleischer Lindsay , Filip Peter , Eggerstedt Michael , Hutz Michael , Michaelides Elias , Batra Pete S. , Tajudeen Bobby A.
Published: June 2024

Objective

Advances in deep learning and artificial intelligence (AI) have led to the emergence of large language models (LLM) like ChatGPT from OpenAI. The study aimed to evaluate the performance of ChatGPT 3.5 and GPT4 on Otolaryngology (Rhinology) Standardized Board Examination questions in comparison to Otolaryngology residents.

Methods

This study selected all 127 rhinology standardized questions from www.boardvitals.com, a commonly used study tool by otolaryngology residents preparing for board exams. Ninety‐three text‐based questions were administered to ChatGPT 3.5 and GPT4, and their answers were compared with the average results of the question bank (used primarily by otolaryngology residents). Thirty‐four image‐based questions were provided to GPT4 and underwent the same analysis. Based on the findings of an earlier study, a pass‐fail cutoff was set at the 10th percentile.

Results

On text‐based questions, ChatGPT 3.5 answered correctly 45.2% of the time (8th percentile) (P = .0001), while GPT4 achieved 86.0% (66th percentile) (P = .001). GPT4 answered image‐based questions correctly 64.7% of the time. Projections suggest that ChatGPT 3.5 might not pass the American Board of Otolaryngology Written Question Exam (ABOto WQE), whereas GPT4 stands a strong chance of passing.

Discussion

The older LLM, ChatGPT 3.5, is unlikely to pass the ABOto WQE. However, the advanced GPT4 model exhibits a much higher likelihood of success. This rapid progression in AI indicates its potential future role in otolaryngology education.

Implications for Practice

As AI technology rapidly advances, it may be that AI‐assisted medical education, diagnosis, and treatment planning become commonplace in the medical and surgical landscape.

Level of Evidence

Level 5.
Seventy five years of public administration teaching and learning in Public Administration and Development: Looking back and looking forward
Authors: Warner Sarah Adele , Brown Prudence Robyn
Published: June 2024

Through a narrative review of 75 years of research in public administration teaching and learning in the journal of Public Administration and Development, this article focusses on the challenges and evolution of approaches for decolonizing countries. These challenges are contextualised within broader debates within the discipline of public administration. Three themes are explored: the assumption of universality of knowledge; appropriate contextualization and the applicability of knowledge; and teaching in and for decolonizing countries. Research interest in this topic has nonetheless declined in recent years, so three areas for future research are suggested: the need to support an empirical agenda which privileges the experiences of managing the tensions between imposed and indigenous systems; the need to support scholars in decolonizing countries to critically reflect on and share their approaches to teaching and learning; and the need to support a research agenda on teaching public administration which embraces more flexible and relational models for public administration and includes diverse ontologies.
Dynamic responses and damage/element composition analysis of thermoplastic polyamide reinforced epoxy composites exposed to HCI environment
Authors: Coskun Taner , Sozen Betul , Sahin Omer Sinan
Published: June 2024

The present study aimed to examine how the corrosive environment affected the low‐velocity impact (LVI) characteristics and damage mechanisms of thermoplastic polyamide fiber‐reinforced polymer (PFRP) composites. In this regard, composite specimens were subjected to corrosive environment containing 10 wt.% diluted HCl for one week and one month before LVI tests. To investigate the hostile effects of the corrosive environment on the composites, scanning electron microscope (SEM) coupled with energy‐dispersive X‐ray system (EDX) analyses were carried out, and thus variations in the elemental composition and damage mechanisms for the composites were determined. According to the examinations, it was discovered that the degradation in LVI responses, such as contact stiffness, bending stiffness, and peak force, increased with longer aging time, as expected. Furthermore, when the aging effect was assessed based on absorbed energy, the specimens exposed to a corrosive environment for one month exhibited the highest energy absorption compared to the control and 1‐week‐immersed ones. The degrading effect of the HCI environment appeared as higher damage severity on the composites, which was also detected from the SEM images. According to the SEM analyses, matrix cracks, corrosion pits, and local surface imperfections caused by ion exchange are detected in 1‐week‐immersed specimens, while more serious damage mechanisms such as fiber breakage and fiber pull‐out are noted in specimens exposed to corrosive environment for 1 month. Furthermore, approximately 6.33 wt.% CI was identified in the composites after 1 month of aging, which was associated with the hydrolysis triggered by rise in the composite's damage severity.

Highlights

Aging effects in mechanical properties of PFRP composites were investigated

LVI tests were conducted to determine dynamic responses of aged composites

Longer aging time led to more severe damages such fiber rupture, delamination etc.

PFRP composites absorbed at least 68% of impact energy.
Improving interfacial and mechanical properties of epoxy resin composites by chemical grafting modification of poly‐ether‐ether‐ketone microparticles with carbon nanotubes
Authors: Zheng Ting , Nan Hongwei , Shang Chunhang , Qiao Yingjie , Wang Xiaodong , Shen Jun
Published: June 2024

The research on epoxy resin toughening is of great significance for its application in aerospace, automotive industries, marine vessels, and other fields. Poly‐ether‐ether‐ketone (PEEK) and carbon nanotubes (CNTs) are ideal candidates for epoxy reinforcement in thermoplastic materials and nanomaterials, respectively. In this study, CNTs were first chemically grafted onto PEEK microparticles using an amidation reaction. These modified hybrid materials were then utilized as fillers in epoxy composites to enhance their strength and toughness. The changes in sample structure, composition, thermal properties, and wettability during the chemical grafting process between CNTs and PEEK were systematically studied. In comparison to pure PEEK, the surface energy of CNTs‐PEEK hybrid materials increased by 11.58% due to CNTs grafting, resulting in improved wettability and enhanced interface bonding between PEEK and the epoxy matrix. Concurrently, the CNTs‐PEEK/epoxy composites exhibited significant enhancements, with the highest tensile strength, tensile elongation at break, flexural strength, and flexural modulus increased by 31.00%, 30.84%, 121.43%, and 23.22%, respectively. The positive reinforcement effect of modified CNTs‐PEEK fillers in epoxy composites and the exploration of CNTs grafting onto PEEK extend the potential applications of epoxy composites.

Highlights

CNTs were bonded to PEEK via an amidation reaction by the chemical grafting method.

CNTs‐PEEK have an 11.58% increase in surface energy compared to pure PEEK.

CNTs‐PEEK/epoxy composites showed improved mechanical properties.

The enhancement mechanisms of CNTs‐PEEK/epoxy composites were analyzed.
An intelligent process analysis method for rapidly evaluating the quality of Chinese medicine with near‐infrared non‐contact hyperspectral imaging: A case study of Weifuchun concentrate
Authors: Zhong Yi , Wen Wu , Fan Xiaohui , Cheng Ningtao
Published: June 2024

Introduction

The quality of Chinese medicine preparations can be greatly influenced by the quality of the intermediates such as extracts or concentrates. However, it is highly challenging to evaluate the quality in a rapid and non‐contact manner during manufacturing. Here, we introduce an intelligent hyperspectral analysis method integrating a self‐built abnormal region removal algorithm with machine learning and demonstrate its utility using the concentrate of Weifuchun (WFC), a traditional Chinese medicine preparation made from Ginseng Radix et Rhizoma Rubra, Rabdosia Amethystoides, and Aurantii Fructus.

Objective

To rapidly and non‐destructively detect quality attributes of the intermediates in the manufacturing processes of Chinese medicine, an intelligent hyperspectral analysis method was developed for simultaneously quantifying the contents of naringin, neohesperidin, rosmarinic acid, and relative density of WFC concentrates.

Methodology

Samples were evenly spread on solid white flat bottom containers, which were batch placed on a horizontal sample stage. Subsequent to the acquisition of near‐infrared (NIR) hyperspectral images, abnormal pixels such as large/small bubbles and fine solids were first removed according to the differential pixel values in the binary grayscale map and the Mahalanobis distance metric. Then, partial least squares (PLS) and support vector machine (SVM) algorithms were used to construct hyperspectral quantitative calibration models for quality attributes. The hyperspectral images were reconstructed based on these models to visually evaluate the quality of the concentrates during manufacturing.

Results

As a case study, quality attributes of the WFC concentrates including contents of naringin, neohesperidin, rosmarinic acid, and relative density were determined simultaneously, and coefficients of determination of these quantitative correction models were 0.900, 0.891, 0.851, and 0.920, respectively.

Conclusion

The method proposed in this study favors real‐time determination of multiple attributes in viscous samples with industrial application prospects.
Periplasmic electron transfer network in Geobacter sulfurreducens revealed by biomolecular interaction studies
Authors: Ferreira Marisa R. , Morgado Leonor , Salgueiro Carlos A.
Published: June 2024

Multiheme cytochromes located in different compartments are crucial for extracellular electron transfer in the bacterium Geobacter sulfurreducens to drive important environmental processes and biotechnological applications. Recent studies have unveiled that for particular sets of electron terminal acceptors, discrete respiratory pathways selectively recruit specific cytochromes from both the inner and outer membranes. However, such specificity was not observed for the abundant periplasmic cytochromes, namely the triheme cytochrome family PpcA‐E. In this work, the distinctive NMR spectroscopic signatures of these proteins in different redox states were explored to monitor pairwise interactions and electron transfer reactions between each pair of cytochromes. The results showed that the five proteins interact transiently and can exchange electrons between each other revealing intra‐promiscuity within the members of this family. This discovery is discussed in the light of the establishment of an effective electron transfer network by this pool of cytochromes. This network is advantageous to the bacteria as it enables the maintenance of the functional working potential redox range within the cells.
The potential role of liquid–liquid phase separation in the cellular fate of the compartments for unconventional protein secretion
Authors: Mendes Luis Felipe S. , Gimenes Carolina O. , da Silva Marília D. O. , Rout Saroj K. , Riek Roland , Costa‐Filho Antonio J.
Published: June 2024

Eukaryotic cells have developed intricate mechanisms for biomolecule transport, particularly in stressful conditions. This interdisciplinary study delves into unconventional protein secretion (UPS) pathways activated during starvation, facilitating the export of proteins bypassing most of the components of the classical secretory machinery. Specifically, we focus on the underexplored mechanisms of the GRASP's role in UPS, particularly in biogenesis and cargo recruitment for the vesicular‐like compartment for UPS. Our results show that liquid–liquid phase separation (LLPS) plays a key role in the coacervation of Grh1, the GRASP yeast homologue, under starvation‐like conditions. This association seems a precursor to the Compartment for Unconventional Protein Secretion (CUPS) biogenesis. Grh1's self‐association is regulated by electrostatic, hydrophobic, and hydrogen‐bonding interactions. Importantly, our study demonstrates that phase‐separated states of Grh1 can recruit UPS cargo under starvation‐like situations. Additionally, we explore how the coacervate liquid‐to‐solid transition could impact cells' ability to return to normal post‐stress states. Our findings offer insights into intracellular protein dynamics and cell adaptive responses to stress.