Rigorous Studies Research Articles

Rinse, gel, and foam – is there any evidence for a difference in their effectiveness in preventing infections?

BackgroundFollowing publication of the 2009 World Health Organizations Guidelines for Hand Hygiene in Health Care, a debate has emerged regarding the relative antimicrobial efficacy of the different formats (rinse, gel, foam) of ABHRs and their ability to contribute to reduction of healthcare-associated infections (HAIs).MethodsData regarding the in-vivo antimicrobial efficacy of ABHRs and other factors that likely affect their effectiveness in reducing HAIs were reviewed, and a comprehensive review of studies that reported the effectiveness of each of the three ABHR formats to improve hand hygiene compliance and reduce HAIs was conducted.ResultsThe amount of rubbing time it takes for hands to feel dry (dry time) is the major driver of ABHR antimicrobial efficacy. ABHR format is not a major factor, and several studies found that rinse, gel, and foam ABHRs have comparable in-vivo antimicrobial efficacy. Other factors that likely impact the ability of ABHRs to reduce transmission of healthcare-associated pathogens and HAIs include ABHR formulation, the volume applied to hands, aesthetic characteristics, skin tolerance, acceptance by healthcare personnel, and hand hygiene compliance rates. When accompanied by complementary strategies, promoting the use of each of the three ABHR formats has been associated with improvements in hand hygiene compliance rates. A review of 67 studies failed to identify an ABHR format that was significantly more effective in yielding statistically significant reductions in transmission of healthcare-associated pathogens or HAIs.ConclusionsCurrent evidence is insufficient to definitively determine if one ABHR format is more effective in reducing transmission of healthcare-associated pathogens and HAIs. More rigorous studies such as multicenter randomized controlled trials comparing the different formats are needed to establish if one format is significantly more effective in reducing HAIs.

Association between ABO blood groups and risk of COVID-19 infection: An umbrella review

Numerous primary studies, systematic reviews, and meta-analyses have been conducted to examine the association between ABO blood groups and susceptibility to coronavirus disease 2019 (COVID-19) infection. The findings, however, are preliminary and contentious. As a result, the following umbrella review examines the relationship between ABO blood groups and the risk of COVID-19 infection. From December 9, 2020, to December 29, 2020, relevant articles were searched using Google Scholar, Google, and Cochrane systematic review databases. After eliminating duplicates and screening records based on article titles, abstracts, and full texts, four full article texts met the inclusion criteria. The data were analyzed using a narrative approach. This umbrella review suggests that blood group A may be a risk factor for COVID-19 infection and blood group O may be a protective factor; however, all studies included in this umbrella review reported significant heterogeneity across primary studies, which may explain inconsistent and discordant findings regarding the relationship between ABO blood groups and risk of COVID-19 infection, severity, and mortality outcomes, thereby limiting the findings. Thus, additional methodologically rigorous and experimental research and prospective cohort studies are warranted.

Prescribing Patterns of Nonrecommended Medications for Children With Acute COVID-19.

Repurposed medications for acute coronavirus disease 2019 (COVID-19) continued to be prescribed after results from rigorous studies and national guidelines discouraged use. We aimed to describe prescribing rates of nonrecommended medications for acute COVID-19 in children, associations with demographic factors, and provider type and specialty. In this retrospective cohort of children <18 years in a large United States all-payer claims database, we identified prescriptions within 2 weeks of an acute COVID-19 diagnosis. We calculated prescription rate, performed multivariable logistic regression to identify risk factors, and described prescriber type and specialty during nonrecommended periods defined by national guidelines. We identified 3 082 626 COVID-19 diagnoses in 2 949 118 children between March 7, 2020 and December 31, 2022. Hydroxychloroquine (HCQ) and ivermectin were prescribed in 0.03% and 0.14% of COVID-19 cases, respectively, during nonrecommended periods (after September 12, 2020 for HCQ and February 5, 2021 for ivermectin) with considerable variation by state. Prescription rates were 4 times the national average in Arkansas (HCQ) and Oklahoma (ivermectin). Older age, nonpublic insurance, and emergency department or urgent care visit were associated with increased risk of either prescription. Additionally, residence in nonurban and low-income areas was associated with ivermectin prescription. General practitioners had the highest rates of prescribing. Although nonrecommended medication prescription rates were low, the overall COVID-19 burden translated into high numbers of ineffective and potentially harmful prescriptions. Understanding overuse patterns can help mitigate downstream consequences of misinformation. Reaching providers and parents with clear evidence-based recommendations is crucial to children's health.

The alterations of oral, airway and intestine microbiota in chronic obstructive pulmonary disease: a systematic review and meta-analysis

BackgroundIncreasing evidence indicates the microbial ecology of chronic obstructive pulmonary disease (COPD) is intricately associated with the disease’s status and severity, and distinct microbial ecological variations exist between COPD and healthy control (HC). This systematic review and meta-analysis aimed to summarize microbial diversity indices and taxa relative abundance of oral, airway, and intestine microbiota of different stages of COPD and HC to make comparisons.MethodsA comprehensive systematic literature search was conducted in PubMed, Embase, the Web of Science, and the Cochrane Library databases to identify relevant English articles on the oral, airway, and intestine microbiota in COPD published between 2003 and 8 May 2023. Information on microbial diversity indices and taxa relative abundance of oral, airway, and intestine microbiota was collected for comparison between different stages of COPD and HC.ResultsA total of 20 studies were included in this review, involving a total of 337 HC participants, 511 COPD patients, and 154 AECOPD patients. We observed that no significant differences in alpha diversity between the participant groups, but beta diversity was significantly different in half of the included studies. Compared to HC, Prevotella, Streptococcus, Actinomyces, and Veillonella of oral microbiota in SCOPD were reduced at the genus level. Most studies supported that Haemophilus, Lactobacillus, and Pseudomonas were increased, but Veillonella, Prevotella, Actinomyces, Porphyromonas, and Atopobium were decreased at the genus level in the airway microbiota of SCOPD. However, the abundance of Haemophilus, Lactobacillus and Pseudomonas genera exhibited an increase, whereas Actinomyces and Porphyromonas showed a decrease in the airway microbiota of AECOPD compared to HC. And Lachnospira of intestine microbiota in SCOPD was reduced at the genus level.ConclusionThe majority of published research findings supported that COPD exhibited decreased alpha diversity compared to HC. However, our meta-analysis does not confirm it. In order to further investigate the characteristics and mechanisms of microbiome in the oral-airway- intestine axis of COPD patients, larger-scale and more rigorous studies are needed.Systematic review registrationPROSPERO (https://www.crd.york.ac.uk/prospero/), identifier CRD42023418726.

The Clinical Translation of α-humulene - A Scoping Review.

α-humulene, a sesquiterpene found in essential oils of various plant species, has garnered interest due to its potential therapeutic applications. This scoping review aims to consolidate α-humulene's evidence base, informing clinical translation, and guiding future research directions. A scoping review was conducted of EMBASE, MEDLINE, and PubMed databases up to 14th July 2023. All studies describing original research on α-humulene extraction, as well as pre-clinical and clinical research, were included for review. Three hundred and forty articles were analysed. α-humulene yields ranged from negligible to 60.90% across plant species. In vitro experiments demonstrated cytotoxicity against adenocarcinomas (such as colorectal, pulmonary, breast, prostatic, lung, and ovarian), with varying responses in other cell models. Mechanistic insights revealed its involvement in mitochondrial dysfunction, diminished intracellular glutathione levels, and the induction of oxidative stress. In rodent studies, oral administration of α-humulene at 50 mg/kg reduced inflammation markers in paw oedema and ovalbumin-induced airway inflammation. Intraperitoneal administration of α-humulene (50 - 200 mg/kg) exhibited cannabimimetic properties through cannabinoid 1 and adenosine A2a receptors. α-humulene also exhibited a multitude of properties with potential scope for therapeutic utilisation. However, there is a paucity of studies that have successfully translated this research into clinical populations with the associated disease. Potential barriers to clinical translation were identified, including yield variability, limited isolation studies, and challenges associated with terpene bioavailability. Consequently, rigorous pharmacokinetic studies and further mechanistic investigations are warranted to effectively uncover the potential of α-humulene.

Optimized energy management of a solar battery microgrid: An economic approach towards voltage stability

As the adoption of renewable energy sources (RESs) continues to surge, and the concept of microgrids (MGs) gains widespread recognition, the need for efficient battery energy storage system (BESS) management within MGs has become increasingly prominent. This paper introduces a novel Energy Management System (EMS) designed for grid-connected MGs, with the primary objectives of enhancing the energy economics of the MG, minimizing BESS degradation, and ensuring that the point of common coupling (PCC) voltage remains within prescribed limits. The proposed EMS utilizes a finite-horizon Model Predictive Control (MPC) framework to seamlessly coordinate BESS operations, encompassing charging, discharging, and reactive power provision. This coordination is done in conjunction with solar power generation, load demand, electricity pricing, and feed-in tariffs. Furthermore, the EMS accounts for uncertainties related to load and solar demand using a Monte Carlo simulation approach. The optimization goal of the proposed EMS is to minimize the expected total operational cost of the MG over a 24-hour prediction horizon. This cost encompasses both economic costs and battery degradation costs. The optimization process adheres to a set of constraints that consider BESS limitations, such as state of charge (SoC) constraints and charging/discharging limits, as well as inverter capacity limits and PCC voltage requirements. Conducting rigorous case studies on the MATLAB Simscape Electrical platform and validating them in real-time using the OPAL-RT simulator demonstrate the effectiveness of the proposed EMS across diverse operational scenarios and pricing models. The findings of these case studies provide valuable insights into the effectiveness of the EMS in real-world MG applications.

Challenges and directions for digital twin implementation in otorhinolaryngology.

Digital twin technology heralds a transformative era in Otorhinolaryngology (ORL), merging the physical and digital worlds to offer dynamic, virtual models of physical entities or processes. These models, capable of simulating, predicting, and optimizing real-world counterparts, are evolving from static replicas to intelligent, adaptive systems. Fueled by advancements in communication, sensor technology, big data analytics, Internet of Things (IoT), and simulation technologies, artificial intelligence (AI), digital twins in ORL promise personalized treatment planning, virtual experimentation, and therapeutic intervention optimization. Despite their potential, the integration of digital twins in ORL faces challenges including data privacy and security, data integration and interoperability, computational demands, model validation and accuracy, ethical and regulatory considerations, patient engagement, and cost and accessibility issues. Overcoming these challenges requires robust data protection measures, seamless data integration, substantial computational resources, rigorous validation studies, ethical transparency, patient education, and making the technology accessible and affordable. Looking ahead, the future of digital twins in ORL is bright, with advancements in AI and machine learning, omics data integration, real-time monitoring, virtual clinical trials, patient empowerment, seamless healthcare integration, longitudinal data analysis, and collaborative research. These developments promise to refine diagnostic and treatment strategies, enhance patient care, and facilitate more efficient and tailored ORL research, ultimately leading to more effective and personalized ORL management.

Novel Hydrogen and Biomethanol Production From Pinecone Biomass Using an Integrated Steam Gasification System

This study develops a new biomass-based integrated energy system where a steam gasification process is considered for hydrogen and biomethanol production in a viable manner using woody bioresources from pinecones. The modeling and simulation studies are performed using both The Aspen Plus and Matlab software packages in a combined manner to practically investigate the integrated system's operating and management conditions and potential performance for a strategically identified location in British Columbia where bioresources are widely available, and there is a strong need to create a value out of these. The emphasis is on three main stages: gasification, syngas post-treatment, and methanol production. This comprehensive approach ensures an in-depth understanding of the production process, from resource extraction to end-product progress. A key aspect of the study is estimating essential flow rates, notably CO2, H2, and CH4O, in various operational conditions. The analysis goes beyond product yields, providing a thorough evaluation of mass flow rates for all streams in the system. This enables a more sophisticated evaluation of performance under various operating situations and component varieties. The integrated system's performance is evaluated using rigorous thermodynamic studies. This analytical technique provides details on the efficiencies and environmental impacts of the proposed system. The simulation findings show that the existing system can produce 0.17 kg/s methanol and 0.025 kg/s hydrogen. These findings establish a foundation for further improvement and scalability of the integrated system for practical applications. The study not only helps advance the field of renewable energy era but also provides a practical and sustainable solution to the pressing issue of pine beetle infestation, demonstrating the possibility of combining technology and ecology to benefit the environment.

Short-term Non-invasive Ventilation for Children with Palliative Care Needs

Objectives: Non-invasive ventilation (NIV), namely continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP), delivers mechanical ventilation without endotracheal intubation. Short-term NIV (planned for &lt;21 days during initiation) can be used for the management of acute respiratory distress (ARD) among paediatric palliative patients with “Do Not Resuscitate or Intubate” (DNI) as the ceiling of care. This study aimed to describe the usage of short-term NIV among paediatric palliative patients in a woman and child hospital with a paediatric palliative subspecialty. Materials and Methods: A retrospective and observational study was conducted on all paediatric palliative patients who received short-term NIV in Tunku Azizah Hospital Kuala Lumpur, Malaysia, from March 2020 to May 2022. Results: During the study period, short-term NIV was offered on 23 occasions for 20 different children. Indications for short-term NIV include 16 (69.6%) occasions of potentially reversible ARD (NIV Category 1) and 7 (30.4%) occasions of comfort care at the end of life (NIV Category 2). The main cause of ARD was pneumonia (90.3%) due to either aspiration or infection. The modality of NIV used was BiPAP only (14 occasions, 60.9%), CPAP only (three occasions, 13%) and both BiPAP and CPAP (six occasions, 26.1%). The median duration of NIV usage was four days (minimum one day and maximum 15 days). NIV was initiated as an escalation from nasal prong, Ventimask or high-flow mask oxygen on 22 occasions and as weaning down post-extubation on one occasion. For the 22 occasions of escalating therapy, there was significant improvement at six hours compared to pre-NIV in the median heart rate (136 to 121, P=0.002), respiratory rate (40 to 31, P=0.002) and oxygen saturation (96% to 99%, P=0.025). All 17 documented parental impressions of the child’s condition post six hours of NIV were that the child had improved. Adverse events during short-term NIV include five episodes (21.7%) of stomach distension, four episodes (17.4%) of skin sores on the face and one episode (4.3%) of excessive drooling. Three patients passed away while on NIV in the hospital. For the other 20 (87%) occasions, patients were able to wean off NIV. Post-weaning off NIV, three patients passed away during the same admission. On 17 occasions, patients were discharged home after weaning off NIV. Conclusion: Usage of short-term NIV in paediatric palliative care, where children have an advanced directive in place indicating DNI, as seen in our study, can be a valuable modality of management for distressing symptoms, in addition to the pharmacological management of breathlessness. This is shown through our study to be of benefit in potentially reversible ARD as well as comfort care at the end of life. Further rigorous studies will need to be conducted for a clearer understanding of short-term NIV that would enable the formulation of guidelines to improve the quality of life and death in children.

Efficacy of adjunctive inhaled colistin and tobramycin for ventilator-associated pneumonia: systematic review and meta-analysis

IntroductionVentilator-associated pneumonia (VAP) presents a significant challenge in intensive care units (ICUs). Nebulized antibiotics, particularly colistin and tobramycin, are commonly prescribed for VAP patients. However, the appropriateness of using inhaled antibiotics for VAP remains a subject of debate among experts. This study aims to provide updated insights on the efficacy of adjunctive inhaled colistin and tobramycin through a comprehensive systematic review and meta-analysis.MethodsA thorough search was conducted in MEDLINE, EMBASE, LILACS, COCHRANE Central, and clinical trials databases (www.clinicaltrials.gov) from inception to June 2023. Randomized controlled trials (RCTs) meeting specific inclusion criteria were selected for analysis. These criteria included mechanically ventilated patients diagnosed with VAP, intervention with inhaled Colistin and Tobramycin compared to intravenous antibiotics, and reported outcomes such as clinical cure, microbiological eradication, mortality, or adverse events.ResultsThe initial search yielded 106 records, from which only seven RCTs fulfilled the predefined inclusion criteria. The meta-analysis revealed a higher likelihood of achieving both clinical and microbiological cure in the groups receiving tobramycin or colistin compared to the control group. The relative risk (RR) for clinical cure was 1.23 (95% CI: 1.04, 1.45), and for microbiological cure, it was 1.64 (95% CI: 1.31, 2.06). However, there were no significant differences in mortality or the probability of adverse events between the groups.ConclusionAdjunctive inhaled tobramycin or colistin may have a positive impact on the clinical and microbiological cure rates of VAP. However, the overall quality of evidence is low, indicating a high level of uncertainty. These findings underscore the need for further rigorous and well-designed studies to enhance the quality of evidence and provide more robust guidance for clinical decision-making in the management of VAP.

Patterns of sedentary behavior among older women with urinary incontinence and urinary symptoms: a scoping review

BackgroundIndependent of physical activity, sedentary behavior has emerged as a significant risk factor for health. Particularly, older adults spent as high as 13 h daily on sedentary activities, which account for 98% of their awake times. Although there is growing evidence revealing the potential association between sedentary behavior and urinary incontinence (UI) across populations of different ages, the relationship between sedentary behavior and urinary symptoms in older women, who are twice as likely to have UI than older men, has not been reviewed. This scoping review aimed to synthesize available evidence of the relationship between sedentary behavior and urinary symptoms in noninstitutionalized older women.MethodsSix electronic databases (PubMed, Web of Science, SPORTDiscus, Ovid Nursing Database, EMBASE, and MEDLINE) were searched from their inception to April 2023. Observational and experimental studies that measured sedentary behavior using objective and/or self-reported methods in older women aged 60 + years having any type of UI, with English full texts available, were included. Relevant data, including sedentary patterns (types, definitions, measurements, and daily patterns) and UI types were tabulated. A narrative synthesis of the findings was also conducted.ResultsA total of seven studies (n = 1,822) were included for review and reporting. Objective measurement showed that older women with UI were engaged in > 8 h sedentary activities daily (493.3–509.4 min/day), which accounted for 73% of their awake times. The duration of self-reported sedentary behavior was lower than the time measured objectively, and the average weekday sitting time was 300–380 min/day. With or without adjustment for confounding factors (e.g., age and number of vaginal deliveries), the daily proportion of sedentary time and average duration of sedentary bouts were positively associated with the prevalence of urgency UI. Notably, sedentary patients with UI were more likely to have lower urinary tract symptoms, including bothersome incontinence, to use incontinence products, and to have nocturia episodes, than their age-matched counterparts who were less sedentary.ConclusionOur findings suggest a potential relationship between sedentary behavior and UI in older women, but the causality of the relationship remains unclear. To further inform the clinical role of sedentary behavior in the context of UI, a greater number of rigorous studies with a prospective study design is urgently needed.

Student Dropout: The Case of Government Schools in South Ethiopia Region

Attainment of targets set to control dropout was by far behind in the government schools in Ethiopia. Thus, this study was designed in order to address student dropout experienced in the study area. The study employed mixed research method and parallel convergent design. Data were collected from students, teachers, parents and related stakeholders. The quantitative data were analyzed using mean, independent samples t-test and pearson’s correlation, whereas the qualitative ones through narration. The study revealed that the overall dropout status was moderate yet varying with the types of the community’s economic activity. Factors of dropout among the pastoralist community and that of agrarian and cash crop production areas also vary accordingly. Thus, developing community engagement project involving essential collaborators was suggested for intervening with the challenges identified. Further rigorous studies need also be conducted to intensify and scale up the impact.

Realizing the Promise of Artificial Intelligence in Hepatocellular Carcinoma through Opportunities and Recommendations for Responsible Translation

This study aims to provide an overview of the current state-of-the-art applications of artificial intelligence (AI) and machine learning in the management of hepatocellular carcinoma (HCC), and to explore future directions for continued progress in this emerging field.  This study is a comprehensive literature review that synthesizes recent findings and advancements in the application of AI and machine learning techniques across various aspects of HCC care, including screening and early detection, diagnosis and staging, prognostic modeling, treatment planning, interventional guidance, and monitoring of treatment response. The review draws upon a wide range of published research studies, focusing on the integration of AI and machine learning with diverse data sources, such as medical imaging, clinical data, genomics, and other multimodal information.  The results demonstrate that AI-based systems have shown promise in improving the accuracy and efficiency of HCC screening, diagnosis, and tumor characterization compared to traditional methods. Machine learning models integrating clinical, imaging, and genomic data have outperformed conventional staging systems in predicting survival and recurrence risk. AI-based recommendation systems have the potential to optimize personalized therapy selection, while augmented reality techniques can guide interventional procedures in real-time. Moreover, longitudinal application of AI may enhance the assessment of treatment response and recurrence monitoring. Despite these promising findings, the review highlights the need for rigorous multicenter prospective validation studies, standardized multimodal datasets, and thoughtful consideration of ethical implications before widespread clinical implementation of AI technologies in HCC management.

Exploring Electrical Neuromodulation as an Alternative Therapeutic Approach in Inflammatory Bowel Diseases

Background and Objectives: This review systematically evaluates the potential of electrical neuromodulation techniques—vagus nerve stimulation (VNS), sacral nerve stimulation (SNS), and tibial nerve stimulation (TNS)—as alternative treatments for inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s Disease (CD). It aims to synthesize current evidence on the efficacy and safety of these modalities, addressing the significant burden of IBD on patient quality of life and the limitations of existing pharmacological therapies. Materials and Methods: We conducted a comprehensive analysis of studies from PubMed, focusing on research published between 1978 and 2024. The review included animal models and clinical trials investigating the mechanisms, effectiveness, and safety of VNS, SNS, and TNS in IBD management. Special attention was given to the modulation of inflammatory responses and its impact on gastrointestinal motility and functional gastrointestinal disorders associated with IBD. Results: Preliminary findings suggest that VNS, SNS, and TNS can significantly reduce inflammatory markers and improve symptoms in IBD patients. These techniques also show potential in treating related gastrointestinal disorders during IBD remission phases. However, the specific mechanisms underlying these benefits remain to be fully elucidated, and there is considerable variability in treatment parameters. Conclusions: Electrical neuromodulation holds promise as a novel therapeutic avenue for IBD, offering an alternative to patients who do not respond to traditional treatments or experience adverse effects. The review highlights the need for further rigorous studies to optimize stimulation parameters, understand long-term outcomes, and integrate neuromodulation effectively into IBD treatment protocols.

Looking to the future: Agendas, directions, and resources for nutrition research.

The development and progression of nutrition as a scientific field is ever evolving and complex. Although the history of nutrition research began by exploring specific food components, it has evolved to encompass a more holistic view that considers the impact of dietary patterns over time, interactions with the environment, nutrition's role in disease processes, and public policy related to nutrition health. To guide the future direction of nutrition science, both federal and other professional organizations have established agendas and goals. The Strategic Plan for National Institutes of Health Nutrition Research outlines four goals and five cross-cutting research areas that are priorities to explore between 2020 and 2030. Similarly, the American Society for Parenteral and Enteral Nutrition and other governmental and professional organizations have identified priority areas in their research agendas. Rigorous research studies are needed to explore these areas of interest while also considering practical implementation strategies for translating research into practice. Nutrition clinicians are uniquely positioned to lend expertise in the areas of research design, implementation, advocacy and evidence-based practice; there are numerous resources to support practitioners in these endeavors.

Numerical Approximation of a Nonequilibrium Model of Gradient Elution Chromatography Considering Different Functional Relationships between Model Parameters and Solvent Composition.

In this paper, a rigorous theoretical study is conducted to analyze the influence of varying solvent compositions on the retention characteristics of elution profiles within a fixed-bed liquid chromatographic column. In gradient chromatography, the propagation speed of elution profiles is manipulated through a progressive variation in the mobile-phase composition. Consequently, enhanced separation of the mixture components can be achieved together with a reduction in the requisite recycling times for subsequent injections. In other words, both the efficiency and the selectivity of the column can be enhanced. The lumped kinetic model coupled with the convection-diffusion equation for the volume fraction of the solvent is applied to simulate the process. The resulting nonlinear model equations are numerically solved by applying a semidiscrete second-order finite-volume method. The numerical solutions are utilized to quantify the effects of gradient starting and ending times, solvent composition, solvent strength parameters, and gradient slope on the concentration profiles. Additionally, temporal numerical moments are plotted versus the starting and ending times of the gradient, and standard performance criteria are presented for evaluating the process performance. The outcomes of this investigation will contribute to further enhancements in gradient elution chromatography.

A conceptual framework for a neurophysiological basis of art therapy for PTSD.

Post-traumatic stress disorder (PTSD) is a heterogeneous condition that affects many civilians and military service members. Lack of engagement, high dropout rate, and variable response to psychotherapy necessitates more compelling and accessible treatment options that are based on sound neuroscientific evidence-informed decision-making. Art therapy incorporates elements proven to be effective in psychotherapy, such as exposure, making it a potentially valuable treatment option. This conceptual paper aims to inform the neurophysiological rationale for the use of art therapy as a therapeutic approach for individuals with PTSD. A narrative synthesis was conducted using literature review of empirical research on the neurophysiological effects of art therapy, with supporting literature on neuroaesthetics and psychotherapies to identify art therapy factors most pertinent for PTSD. Findings were synthesized through a proposed framework based on the triple network model considering the network-based dysfunctions due to PTSD. Art therapy's active components, such as concretization and metaphor, active art engagement, emotion processing and regulation, perspective taking and reframing, and therapeutic alliance, may improve symptoms of PTSD and prompt adaptive brain functioning. Given the scarcity of rigorous studies on art therapy's effectiveness and mechanisms of alleviating PTSD symptoms, the suggested framework offers a neurophysiological rationale and a future research agenda to investigate the impact of art therapy as a therapeutic approach for individuals with PTSD.

SCALiR: A Web Application for Automating Absolute Quantification of Mass Spectrometry-Based Metabolomics Data.

Quantitative liquid chromatography-mass spectrometry (LC-MS)-based metabolomics is becoming an important approach for studying complex biological systems but presents several technical challenges that limit its widespread use. Computing metabolite concentrations using standard curves generated from standard mixtures of known concentrations is a labor-intensive process that is often performed manually. Currently, there are few options for open-source software tools that can automatically calculate metabolite concentrations. Herein, we introduce SCALiR (standard curve application for determining linear ranges), a new web-based software tool specifically built for this task, which allows users to automatically transform LC-MS signals into absolute quantitative data (https://www.lewisresearchgroup.org/software). SCALiR uses an algorithm that automatically finds the equation of the line of best fit for each standard curve and uses this equation to calculate compound concentrations from the LC-MS signal. Using a standard mix containing 77 metabolites, we show a close correlation between the concentrations calculated by SCALiR and the expected concentrations of each compound (R2 = 0.99 for a y = x curve fitting). Moreover, we demonstrate that SCALiR reproducibly calculates concentrations of midrange standards across ten analytical batches (average coefficient of variation 0.091). SCALiR can be used to calculate metabolite concentrations either using external calibration curves or by using internal standards to correct for matrix effects. This open-source and vendor agnostic software offers users several advantages in that (1) it requires only 10 s of analysis time to compute concentrations of >75 compounds, (2) it facilitates automation of quantitative workflows, and (3) it performs deterministic evaluations of compound quantification limits. SCALiR therefore provides the metabolomics community with a simple and rapid tool that enables rigorous and reproducible quantitative metabolomics studies.

A roadmap for therapeutic discovery in pulmonary hypertension associated with left heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on Pulmonary Circulation & Right Ventricular Function.

Pulmonary hypertension (PH) associated with left heart failure (LHF) (PH-LHF) is one of the most common causes of PH. It directly contributes to symptoms and reduced functional capacity and negatively affects right heart function, ultimately leading to a poor prognosis. There are no specific treatments for PH-LHF, despite the high number of drugs tested so far. This scientific document addresses the main knowledge gaps in PH-LHF with emphasis on pathophysiology and clinical trials. Key identified issues include better understanding of the role of pulmonary venous versus arteriolar remodelling, multidimensional phenotyping to recognize patient subgroups positioned to respond to different therapies, and conduct of rigorous pre-clinical studies combining small and large animal models. Advancements in these areas are expected to better inform the design of clinical trials and extend treatment options beyond those effective in pulmonary arterial hypertension. Enrichment strategies, endpoint assessments, and thorough haemodynamic studies, both at rest and during exercise, are proposed to play primary roles to optimize early-stage development of candidate therapies for PH-LHF.

Observation or Insight? Unraveling the Impact of Characters' Image on Interpersonal Communication in Contemporary Chinese TV Series

A salient determinant of effective interpersonal communication resides in the cultivation of a positive personal image. The intricate interplay between self-image, individual behaviors, and communication abilities highlights the far-reaching influence of personal perception on social interactions. In the contemporary landscape of Chinese television series, exemplified by the production ‘Nothing but Thirty’, a deliberate effort is made to depict characters that embody the evolving roles of women in modern society. Drawing from relevant literature, this study conducts a comprehensive analysis of characters’ image in ‘Nothing but Thirty’, examining content such as appearance, language, non-verbal cues (body language), and varied scene settings. Adopting a rigorous qualitative case study methodology and leveraging content analysis grounded in the coordinated management of meaning theory and social exchange theory, the research aims to dissect the nuanced dynamics of interpersonal communication as portrayed in the series. The findings illuminate that the dynamic characterizations in contemporary Chinese TV series function as reflective mirrors, capturing the intricate layers of modern interpersonal communication and societal intricacies. This narrative analysis extends beyond the purview of conventional storytelling, offering a scholarly exploration of the intricate fabric of human interaction.