Optimal Method Research Articles

Preparation for Rural Practice with a Multimodal Rural Emergency Medicine Curriculum

Rural regions face emergency medicine (EM) physician shortages. Most training programs are located in cities and lack rural clinical experiences, didactics, and mentorship to excite and prepare residents for rural EM practice. There is limited data on optimal training methods for preparing residents for rural practice. To address this need for rural EM training and workforce, we developed a rural EM curriculum. We began with a two-year case review from critical access emergency departments. Rural EM skills were defined and taught using lectures, simulation cases, and clinical rotations. We obtained quantitative and qualitative feedback from the first ten residents participating in the curriculum. Qualitatively, 10/10 residents gained new skills and found these experiences valuable to their training and career choice, with 100% expressing interest in rural practice and 75% choosing a rural practice. Quantitatively, residents managed a greater variability in patient acuity and volume and performed a greater variety of procedures compared to their academic center rotations, all while gaining unique skills from the challenges of a rural environment. Focused rural emergency medicine clinical experience and didactic training during residency are a promising approach to bridge the gap between urban tertiary care training programs and rural emergency care needs.

Identification of Land Use Conflict Based on Multi-Scenario Simulation—Taking the Central Yunnan Urban Agglomeration as an Example

Land use conflict is an inevitable and objective phenomenon during regional development, with significant impacts on both regional economic growth and ecological security. Scientifically assessing the spatiotemporal evolution of these conflicts is essential to optimize land use structures and promote sustainable resource utilization. This study employs multi-period land use/land cover remote sensing data from China to develop a model for the measurement of land use conflict from the perspective of the landscape ecological risk. By applying the optimal landscape scale method to determine the most appropriate analysis scale, this research investigates the spatiotemporal evolution characteristics of land use conflicts in the Central Yunnan Urban Agglomeration from 2000 to 2020. Furthermore, by integrating the Patch-Generating Land Use Simulation (PLUS) model with the Multi-Objective Programming (MOP) algorithm, this study simulates the spatial patterns of land use conflict in 2030 under four scenarios: Natural Development (ID), Economic Development (ED), Ecological Conservation (PD), and Sustainable Development (SD). The findings reveal that, from 2000 to 2020, the proportion of areas with strong and moderately strong conflict levels in the Central Yunnan Urban Agglomeration increased by 2.19%, while the proportion of areas with weak and moderately weak conflict levels decreased by 1.45%, underscoring the growing severity of land use conflict. The predictions for 2030 suggest that the spatial pattern of conflict under various scenarios will largely reflect the trends observed in 2020. Under the ID scenario, areas with weak and moderately weak conflict levels constitute 57.5% of the region; this increases by 0.85% under the SD scenario. Conversely, areas experiencing strong and moderately strong conflict levels, which stand at 33.02% under the ID scenario, decrease by 1.04% under the SD scenario. These projections indicate that the SD scenario, which aims to balance ecological conservation with economic development, effectively mitigates land use conflict, making it the most viable strategy for future regional development.

Multipotent mesenchymal stromal cell therapy for a neonate with congenital diaphragmatic hernia and adhesive small bowel obstruction

Background. In the last decade, therapy using multipotent mesenchymal stromal cells (MSCs) has offered hope for regenerating the lungs of preterm babies with chronic lung disease. Due to similar disease mechanisms, it is logical to explore the potential impact of MSC therapy on pulmonary hypoplasia in congenital diaphragmatic hernia. Furthermore, MSCs may also contribute to the regeneration of the intestines affected by adhesive small bowel obstruction in patients with congenital diaphragmatic hernia. Case presentation. A female newborn, delivered at 32 weeks and six days gestational age, was diagnosed with a left congenital diaphragmatic hernia. After surgical repair and respiratory/nutritional support for 39 days, she was still dependent on a ventilator and total parenteral nutrition. Two MSC treatments were given a week apart: 10 million cells/kg intratracheally and 5 million cells/kg intravenously. She was extubated, and her enteral nutrition improved after the treatment. No side effects were detected. We present the first documented case using MSCs derived from the umbilical cord to simultaneously treat pulmonary hypoplasia and adhesive small bowel obstruction of congenital diaphragmatic hernia. Conclusion. Although MSC treatment is very promising for pulmonary hypoplasia and adhesive small bowel disease of congenital diaphragmatic hernia, much more needs to be learned about potential side effects, appropriate dosage, and the optimal method of administration.

Effects of different exercise modalities on pediatric and adolescent populations with developmental disorders: a network meta-analysis of randomized controlled trials.

Combat sports, ball sports, neurodevelopmental motor training, and aquatic exercise may be effective exercise modalities for improving symptoms in children and adolescents with developmental disorders. However, the degree of improvement can vary among individuals with specific developmental disorders. Therefore, precise assessment of the individual symptoms of children or adolescents is crucial before selecting specific exercise interventions. PROSPERO (CRD42024545673). • Many studies indicate that exercise as an intervention can have positive effects on individuals with developmental disorders, such as ADHD and autism. However, reported effects vary, and there is no clear consensus on the optimal exercise intervention method yet. • Through a comprehensive network meta-analysis, various exercise interventions for children and adolescents with developmental disorders were compared to determine the optimal approach. The study found that combat sports, ball sports, neurodevelopmental motor training, and aquatic exercise could potentially be effective modalities for improving symptoms in this population.

Optimization and application of renal depth measurement method in the cadmium-zinc-telluride‑based SPECT/CT renal dynamic imaging.

This study aims to evaluate the accuracy of four kidney depth measurement methods-nuclear medicine tomography, nuclear medicine lateral scanning, ultrasound, and Tonnesen's formula-based estimation-using CT measurements as the reference standard. Additionally, it investigates the feasibility of utilizing nuclear medicine tomography and lateral scanning for measuring kidney depth in 99mTc-DTPA renal dynamic imaging. Hollow kidney phantoms mimicking the shape and volume of adult kidneys were 3D printed and filled with 99mTcO4- solution. These phantoms were then subjected to lateral scanning and nuclear medicine tomography using CZT (cadmium-zinc-telluride) SPECT/CT to determine the optimal post-processing method. Forty patients who underwent renal dynamic imaging were recruited for the study. Renal depths were derived from ultrasound, lateral imaging, nuclear medicine tomography, formula-based estimation, and CT measurements. The renal depths obtained through these four methods were for correlation with CT-measured renal depths. Additionally, the absolute differences between renal depths obtained by each method and the CT standard were analyzed and compared across groups. Using kidney phantoms, nuclear medicine tomography images were processed with a Butterworth filter (cutoff frequency = 0.6), and renal outlines in lateral images was manually delineated. In the clinical validation phase, correlation coefficients indicated strong associations between renal depths measured by nuclear medicine tomography (left kidney: R = 0.885, P < 0.05; right kidney: R = 0.927, P < 0.05) and lateral scanning (left kidney: R = 0.933, P < 0.05; right kidney: R = 0.956, P < 0.05) compared to CT measurements. The difference in kidney depth between nuclear medicine tomography and CT measurements were the smallest and statistically significant (left kidney: 0.69 ± 0.51; right kidney: 0.58 ± 0.41, P < 0.05). Using ordered subset expectation maximization (OSEM) in conjunction with a Butterworth filter (fc = 0.6) as the post-processing method, nuclear medicine tomography enables more accurate renal depth measurements without increasing the radiation dose to patients.

Metal stent versus plastic stent in endoscopic ultrasound-guided hepaticogastrostomy for unresectable malignant biliary obstruction: Large single-center retrospective comparative study.

Whether metal stents (MS) or plastic stents (PS) yield better outcomes for malignant biliary obstruction in endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is controversial. We aimed to compare outcomes of initial EUS-HGS performed with MS or PS. In this single-center retrospective study, we included patients (MS/PS groups: n = 151/72) with unresectable malignant biliary obstruction and performed multivariable analysis. The landmark date was defined as day 100 and used to evaluate the time to recurrent biliary obstruction (TRBO). The clinical success rate was similar in both groups. The mean total bilirubin percentage decrease at week 2 was significantly higher in the MS group than in the PS group (-45.1% vs. -23.7%, P = 0.016). Median TRBO was significantly different between the MS and PS groups (183 and 92 days, respectively; P = 0.017). TRBO within 100 days was comparable in both groups but was significantly shorter only after 100 days in the PS group (adjusted hazard ratio 12.8, P < 0.001). Adverse events were significantly more common in the MS group (23.8% vs. 9.7%, P = 0.012), although they occurred relatively frequently even with PS in the cholangitis subgroup (Pinteraction = 0.034). After endoscopic re-intervention, TRBO tended to be longer with revision PS (hazard ratio 0.40, P = 0.47). Although MS provided early improvement of jaundice and long stent patency, PS provided a better safety profile and comparable stent patency until 100 days. PS might also be an adequate and optimal palliation method in EUS-HGS.

A new paradigm for optimized experimental design in cIEF platforms aimed at an accurate robust and reliable mAbs charge-variant assessment.

The success of therapeutic monoclonal antibodies (mAbs) and their biosimilars, highlights the challenge to control their purity, identity, and stability. For this purpose, among several orthogonal methodologies, imaged capillary Iso Electric Focusing (icIEF) is one of the leading techniques. Despite the isoelectric point (pI) being a univocal parameter relying on the protein's primary sequence and its post-translational modifications (PTMs), the current Charge Variants Profile Assessment (CVPA) carried out by cIEF relies on relative comparisons with corresponding reference standards, this is because the inconsistent outputs for the same sample across different instruments preclude the uniqueness of the measured parameters. We demonstrate that refining the current calibration approach in the iciEF method allows for obtaining more reliable and objective pIs, and a deeper understanding of the pH gradients along the capillaries. We are confident our advancements will enhance CVPA, by exploring the concept of univocal charge identity. This is crucial for constructing biobanks and developing algorithms to quickly identify divergences from the originators, thus ensuring drug quality, efficacy, and safety. Moreover, our method allows an experimental design optimized to minimize bias ("Unbiased" Experimental Design-UED) to study resolution as a multivariate function of different input variables. This endeavor aims to develop optimal methods tailored to specific pH ranges.

Tracing human influence on rising surface air temperature in Venezuela.

The rise in surface air temperature (SAT) in Venezuela, leading to the loss of all its glaciers, underscores the urgency of understanding human contributions to this phenomenon. This study investigates the impact of anthropogenic climate forcings on SAT across Venezuela, employing observational data, multi-model simulations, and optimal fingerprinting method. Anthropogenic forcings have driven a 0.40-0.85 C SAT rise during the industrial era, with land use (LU) emerging as a significant driver (0.36-0.68 C), surpassing greenhouse gases (GHGs) (0.10-0.62 C). Conversely, anthropogenic aerosols (Aaer) exhibit a cooling effect (- 0.93 to - 0.25 C) on SAT. Projections under Representative Concentration Pathways 4.5 indicate substantial SAT increases by the 21st century's end, underscoring human-induced SAT rise. Effective management of regional Aaer and LU changes in Venezuela holds the potential for mitigating current and future warming and its subsequent impacts on the fragile ecosystem of this region.

Hormonal interventions in skin wounds - a mini review.

The ability to heal from wounds is perhaps the most important biological function that ensures our survival and perpetuation. Cutaneous wound healing typically consists of four characteristic stages, namely hemostasis, inflammation, proliferation, and remodeling, which are carefully carried out by coordinated actions of various cells, cytokines, and hormones. Incoordination of these steps may impede complete and efficient reconstruction and functional recovery of wounds or even lead to worsened outcomes. Hormones, as powerful modulators of organ functions, participate in multiple steps of the wound healing process and play a pivotal role by choreographing the complex interplay of cellular and molecular events. Leveraging the regulatory effects of hormones to enhance the healing process, hormonal therapy has emerged as a promising approach in the clinical treatment of wounds. Current research has focused on determination of the optimal dosages, delivery methods, and combinations of hormonal therapies to maximize their therapeutic benefits while minimizing potential side effects. This review highlights the molecular mechanisms, clinical benefits and side effects of the most commonly used hormones in clinical treatment of wounds.

Utilization and Outcomes of Temporary Percutaneous Right Ventricular Assist Devices in Cardiogenic Shock

Acute right ventricular failure (RVF) is a common finding in cardiogenic shock (CS), yet the optimal method of supporting the failing RV remains unclear. This study aimed to describe CS patients receiving percutaneous right ventricular assist devices (pRVADs) using the multicenter Cardiogenic Shock Working Group (CSWG) registry. Among 6,201 patients with CS, 152 (2.4%) received pRVADs, with ProtekDuo and Impella RP being used in 71% and 29% of cases, respectively. The average age of this group was 58.5 years, with a higher proportion of men (66.4%). Heart failure–associated CS (HF-CS) was observed in 48% of patients, while myocardial infarction–associated CS (MI-CS) was seen in 27% (HF-CS versus MI-CS: 52.8% vs. 21.3% for ProtekDuo; 36.4% vs. 40.9% for Impella RP; p = 0.01). The overall in-hospital mortality rate was 54.6%, bleeding complications were more prevalent among ProtekDuo recipients (64.8% vs. 43.2%, p = 0.008), whereas Impella RP recipients had shorter hospital stays (20.4 ± 18.7 vs. 41.9 ± 31.5 days, p &lt; 0.001). ProtekDuo was more commonly used in patients with HF-CS and was associated with higher rates of bleeding and longer hospital stays compared with Impella RP, although overall mortality was similar. Further investigation is required to determine the ideal timing and clinical conditions warranting pRVAD deployment in CS.

Contagious Bovine Pleuropneumonia: A Review

Contagious bovine pleuropneumonia (CBPP) is a bacterial disease, the causative agent of which is Mycoplasma mycoides subsp. Mycoides. The CBPP disease is one of important disease to be given attention because it is causing heavy mortality in bovines all over the world with African continent being hardly hit due to vagaries of bacteria. Air droplets is primary source of infection. Colonization in lower respiratory tract, Mmm invades arteries cause vasculitis. Many pathways of Mmm organism to cause destruction in host animal, presence of Gts ABC is one such mechanism. In CBPP we see pulmonary sequestra in chronic cases, severe fibrinous bronchopneumonia and pleural effusion during the acute to subacute phases. For confirmatory diagnosis, laboratory investigation and use of molecular techniques is recommended. Isolation of causative agent is also optimal method for diagnosis. The use of danofloxacin, tetracycline, flufenicol etc have been documented with varying degree of efficiency. Control over movement of bovine species, adequate space (where droplet spread is prevented) for each animal and vaccination are recommendatory steps. Though India has been declared CBPP free in 2007 we still need cautious approach and continue surveillance because north east of India seems very vulnerable to CBPP. Also, the fact that animal husbandry and agriculture drive economy of some of our most populous states it is all the more important that we give due consideration and focus on CBPP.

PLACENTA ACCRETA SPECTRUM: CLINICAL PATHWAY OF A PATIENT IN THE PERINATAL CENTRE OF KYIV

There is no doubt about the danger of obstetric hemorrhage. For many years, the main preventable cause of maternal mortality has been peripartum hemorrhage. Pathology of the placenta – its location and attachment – is one of the main reasons for the development of obstetric hemorrhage, the frequency of which continues to increase, mainly due to the increase in the proportion of abdominal deliveries. For this reason, these conditions receive constant attention from scientists all over the world: there is a constant review of recommendations for the management of pregnant women with these pathologies, as well as the search for the optimal method and timing of delivery to ensure the best health of the mother and the newborn. To date, it has not been possible to reach an unequivocal consensus among diff erent world schools on these issues. Recently, there has been an increase in the number of cases of the placenta growing into the uterine wall – a condition called placenta accreta spectrum, as well as its special form, when the chorionic villi grow into the lower segment of the uterus – placenta previa accreta. These are particularly dangerous conditions that carry a double risk of massive obstetric hemorrhage. The article presents the latest views on the possibilities of organ- preserving surgery for these pathologies and reviews the recommendations of various major world schools of obstetrics and gynecology. We also present our own algorithms for the management and delivery of women withpathologically invasive placenta.

Integrating Friction Noise for In Situ Monitoring of Polymer Wear Performance: A Machine Learning Approach in Tribology

Abstract Friction and wear between mating surfaces significantly affect the efficiency and performance of mechanical systems. Traditional tribological research relies on post-observation methods, limiting the understanding of dynamic friction behavior. In contrast, in situ monitoring provides real-time insights into evolving friction dynamics. This study employs machine learning to monitor polymer wear performance through friction noise. The predictive accuracy of various machine learning methods, including Extremely Randomized Trees, Gradient-Boosting Decision Trees, AdaBoost, LightGBM, Deep Forest, and Deep Neural Networks, is compared for wear-type classification. Additionally, the LSBoost regression is selected as the optimal method for predicting polymer wear-rates across various temperatures. The results underscore the potential of using friction noise and machine learning for real-time wear monitoring, offering valuable insights for tribological system maintenance and failure prediction.

An optimal transformation method for inferring ocean tracer sources and sinks

Abstract. The geography of changes in the fluxes of heat, carbon, freshwater and other tracers at the sea surface is highly uncertain and is critical to our understanding of climate change and its impacts. We present a state estimation framework wherein prior estimates of boundary fluxes can be adjusted to make them consistent with the evolving ocean state. In this framework, we define a discrete set of ocean water masses distinguished by their geographical, thermodynamic and chemical properties for specific time periods. Ocean circulation then moves these water masses in geographic space. In phase space, geographically adjacent water masses are able to mix together, representing a convergence, and air–sea property fluxes move the water masses over time. We define an optimisation problem whose solution is constrained by the physically permissible bounds of changes in ocean circulation, air–sea fluxes and mixing. As a proof-of-concept implementation, we use data from a historical numerical climate model simulation with a closed heat and salinity budget. An inverse model solution is found for the evolution of temperature and salinity that is consistent with “true” air–sea heat and freshwater fluxes which are introduced as model priors. When biases are introduced into the prior fluxes, the inverse model finds a solution closer to the true fluxes. This framework, which we call the optimal transformation method, represents a modular, relatively computationally cost-effective, open-source and transparent state estimation tool that complements existing approaches.

Preparation of Powder from Butterfly Pea Plant (Clitoria Ternatea) for Pharmaceutical Applications

The butterfly pea plant, scientifically known as Clitoria ternatea, is valuable medicinal herb with long history of traditional use in various cultures. This research focuses on the preparation of powder from the butterfly pea plant, exploring the optimal methods for drying, grinding, and storing the plant material. The study also evaluates the phytochemical content, physical properties, and potential pharmaceutical applications of the resulting powder. The findings suggest that standardized preparation techniques can enhance the medicinal value of the butterfly pea plant, making it a viable option for use in various pharmaceutical formulations

Analysis of the effectiveness of two-stage and one-stage surgical treatment for idiopathic scoliosis in children using various methods for deformity mobilization

Introduction. The correction potential of modern systems is limited by the natural mobility of scoliotic deformities, which sometimes require multiple discectomy and osteotomy. Choosing the optimal method of treatment for scoliosis in the thoracic and lumbar regions is difficult due to the variety of approaches and options available for osteotomies. There is no single algorithm for the treatment of idiopathic scoliosis, making it necessary to develop a differentiated approach and treatment strategies. Purpose of the study. To optimize the choice of surgical treatment tactics for children with idiopathic scoliosis based on a compa­rative analysis of the use of one-stage and two-stage surgical treatment. Materials and methods. The study subjects were ninety four patients with idiopathic scoliosis (Lenke type 1–4), operated on between 2017 and 2023. They were divided into three groups: group I (control) — 30 patients underwent one-stage dorsal correction with G1 osteotomy, group II — 31 patients who received two-stage treatment, and group III — 33 patients who underwent a one-stage correction with apical G2 osteotomy. Depending on the initial thoracic kyphotic angle, subgroups were defined as A (hypokyphosis), B (normokyphosis) and C (hyperkyphosis). The minimum follow-up period was 12 months. Results. The frontal balance in all examined patients was in a state of relative compensation, both before surgical treatment and in the postoperative period. When comparing the results in patients from the second and third groups, we found no significant differences (p &gt; 0.05). The second group showed a higher degree of correction of the main arch of spinal deformity (p &lt; 0.05) in the frontal plane compared to the control and third group patients. When analyzing the results of thoracic kyphosis formation, we obtained reliable results in formation more significant indices in patients after surgery in Group II (subgroups A and B), for whom a two-stage applied surgical method was supplemented with anterior release and halo pelvic traction. In Group III (subgroup C), we obtained significant results in thoracic kyphosis indices when using single-stage surgery performed from the dorsal approach supplemented with G2 osteotomy. Conclusion. The condition of the sagittal profile, including the severity of thoracic kyphosis, is an important criterion for choosing the tactics of surgical treatment of scoliotic deformities of the thoracic and lumbar spine. Two-stage treatment, including ventral release and halo-pelvic traction, is recommended for rigid deformities of the thoracic or thoracolumbar spine, under conditions of initial normal kyphosis or hypokyphosis. Severe deformities with initial hyperkyphosis should be corrected preferably in a single stage using posterior surgery, supplemented by G2-osteotomy. The use of G2-osteotomies in patients with initial normal- or hypokyphoses is impractical due to the risk of neurological complications, development of pseudoarthroses, and increase in volume of perioperative bleeding.

The Sustainability Coefficient of Urban Open Space Illumination Compliance as a Subjective Indicator of Environmental Comfort

Smart lighting of public open spaces plays a crucial role in creating sustainable cities. Investing in optimal methods for improving the energy efficiency of urban lighting systems has become strategic for the economic, technological, and social development of cities. In addition to technical considerations such as energy efficiency and photometric measurements, lighting design should also take into account the subjective aspect of visual safety. However, measuring lighting efficiency in terms of human perception can be challenging because people’s perceptions vary and depend on the urban and architectural context. To address this issue, a sustainability coefficient of outdoor lighting ambiences (Sn) is presented to quantify the compliance of urban open spaces with sustainable lighting design. This coefficient combines two subjective factors: illumination likability and perceived illuminance intensity. The study uses the SEC methodology (suitable for everyone, environmentally accepted, cost-effective), which provides insight into the factors that influence the Sn value. The results showed significant correlations between psychological and aesthetic-functional factors and the Sn, while sociological factors had little influence. The validity of the Sn in a realistic environment can be confirmed. The main reasons for certain Sn levels were identified and possible solutions were proposed, ranging from changes in lighting intensity to architectural redesigns, to improve environmental comfort in urban environments. This study paves the way for a deeper understanding of the role of urban lighting in shaping environmental comfort and human behavior.

System-level Prognostics and Health Management for Complex Industrial Systems

Prognostics and health management (PHM) has become essential to guarantee aware and safe system operation and to inform economic decision-making. However, due to the nature of detection, diagnostics, and prognostic methods, applications have mainly been limited to the component level. In practice, most industrial systems consist of multiple interacting components whose partial degradation could lead to the system's failure (or subsystems).This research addresses the limitations of traditional component-level PHM techniques by proposing a novel system-level framework. By implementing a hierarchical structure of components and subsystems, we will select an optimal method for each subsystem to aggregate its component health assessments. The overall system health can then be estimated by further combining the obtained estimates. The research considers simplified and holistic modeling techniques, margin-based methods, and hybrid graphical models. This approach aims to provide reliable system health predictions and online components' sensitivity measures to enhance maintenance decision-making. We consider an application in the context of the nuclear industry, characterized by strict safety and economic requirements. Using a SIMULINK model to approximate a Pressurized Water Reactor (PWR) with real industrial inputs, we plan to add component degradation modules and use simulated sensor data and reliability information to test the proposed framework. Initial results on artificial case studies show the feasibility of integrating component-level health predictions.

Nonlinear Dynamics of an Electromagnetically Actuated Cantilever Beam Under Harmonic External Excitation

The present work is devoted to the study of nonlinear vibrations of an electromagnetically actuated cantilever beam subject to harmonic external excitation. The soft actuator that controls the vibratory motion of such components of a robotic structure led to a strongly nonlinear governing differential equation, which was solved in this work by using a highly accurate technique, namely the Optimal Auxiliary Functions Method. Comparisons between the results obtained using our original approach with those of numerical integration show the efficiency and reliability of our procedure, which can be applied to give an explicit analytical approximate solution in two cases: the nonresonant case and the nearly primary resonance. Our technique is effective, simple, easy to use, and very accurate by means of only the first iteration. On the other hand, we present an analysis of the local stability of the model using Routh–Hurwitz criteria and the eigenvalues of the Jacobian matrix. Global stability is analyzed by means of Lyapunov’s direct method and LaSalle’s invariance principle. For the first time, the Lyapunov function depends on the approximate solution obtained using OAFM. Also, Pontryagin’s principle with respect to the control variable is applied in the construction of the Lyapunov function.

Conducting water-energy-food nexus studies: what, why, and how

The increasing pressure on resources and the persistent failure to address global malnutrition are evident challenges. A significant contributing factor is the decline in the quality of production resources, particularly water. As a result, many countries and their experts have prioritized the need to balance resource consumption. To address the research gap regarding balanced and optimal resource use, various methodologies have been developed over time, culminating in nexus studies. This study aimed to investigate the what, why, and how of conducting water-energy-food nexus (WEFN) studies. The research employed a sequential mixed-methods approach, integrating content analysis with the Analytical Network Process (ANP). The findings reveal that the objectives of WEFN studies encompass a wide range of interests, which can be systematically categorized into seven principal domains: system sustainability assessment, integration of planning and decision-making processes related to resource consumption, optimization of resource use, management of resource consumption systems, development of theoretical frameworks for the nexus, evaluation of the impacts of resource consumption, and assessment of associated risks. Notably, the results indicate that system sustainability assessment is the most critical reason for conducting WEFN studies. Furthermore, the analysis of WEFN methodologies identified simulation as the most effective technique within the Analytical Hierarchy Process (AHP) framework. In the context of the ANP technique, statistical analysis and simulation emerged as the most important methods. This research advocates for using a diagram to facilitate the selection of the optimal method for conducting a WEFN study.