Dietary Macronutrient Composition and Protein Concentration for Weight Loss Maintenance

ABSTRACT Objective To examine the association between dietary macronutrient composition and 12‐month weight loss maintenance (WLM) in adults who achieved initial weight loss (≥ 5%). Methods This prospective cohort analysis used 12‐month follow‐up data from the Navigating to a Healthy Weight trial. Macronutrient composition (%) was assessed using a 4‐day, 24‐h dietary recall. Food sources were categorized as discretionary foods, lean meat, vegetables, fruit, grains, and dairy. Primary outcomes included 12‐month changes in body weight, fat mass index (FMI), waist‐to‐height ratio (WHtR), and hip‐to‐height ratio (HHtR). A nutritional geometry approach was used to examine individual and interactive associations of macronutrient intake, visualizing as response surfaces. Results Among 1518 participants (69.8% women; mean age 45 ± 12 years), mean macronutrient composition was 20.6% protein, 33.8% fat, and 43.1% carbohydrate. Protein energy percentage was inversely associated with energy intake (β: −0.33; 95% CI: −0.39, −0.27). Response surfaces revealed that lower proportional energy from protein, diluted by high fat and/or carbohydrate, was associated with higher total energy intake and greater 12‐month increases in body weight, WHtR, and HHtR, but not FMI. Consumption of discretionary food, not other food sources, increased energy intake by reducing proportional energy from protein. Conclusions Maintaining dietary proportional energy from protein, particularly by limiting discretionary food consumption, was associated with reduced energy intake and improved WLM.

Inter‐population variation in demographic responses to environmental changes: insights from four seabird populations

The variability in responses to environmental change between populations remains poorly quantified and understood. This shortcoming has major consequences, as variation and flexibility of life‐history traits between populations contribute to the estimation of the adaptive potential, which is necessary for predicting the responses of interconnected populations to environmental change. Here, we use 20–50 years of capture‐mark‐recapture data from four populations of two closely related species in the southern Indian Ocean, the sooty albatross Phoebetria fusca and the light‐mantled sooty albatross Phoebetria palpebrata , to analyze their demographic responses to environmental changes across an oceanic basin scale. We assessed the role of climate and oceanographic conditions as bottom–up forcings and fisheries bycatch as a top–down forcing on survival and three reproductive parameters in each population. We found expected demographic responses: negative effects of fishing effort on survival and breeding success, positive effects of wind velocity on breeding success, negative effects of warm sea surface temperature anomalies, and positive effects of sea ice concentration. Furthermore, our results highlight differences between populations, revealing three main outcomes. First, the two populations situated at the edge of their distribution seemed more affected by variations in oceanographic conditions than counterparts situated within the core of their ranges. Second, the two northernmost populations experiencing lower wind speed, had their breeding success affected by meridional wind speed. Third, a large‐scale climate index had opposite effects on demographic parameters of the two populations situated in the western and eastern parts of the southern Indian Ocean. This comparison of the variation in demographic responses to environmental conditions at the inter‐population level, sheds light on our limited understanding of the processes that account for life‐history trait variation between populations and suggests that local environmental conditions and large‐scale climate patterns may drive the diversity of local ecological responses across species' ranges.

Detached Eddy Simulation (DES) of a Turbulent Premixed Flame Stabilized on a Bluff Body

ABSTRACT As the demand for net‐zero emissions intensifies, low‐emission fuels (LEFs) are increasingly explored for their potential to reduce pollutants in combustion systems. The present study investigates the flame dynamics and pollutant emissions (CO and NOx) of different LEFs using detached eddy simulations (DES), a method that offers better predictions of turbulent flames compared to Reynolds‐averaged Navier–Stokes (RANS) approaches in reacting flows. DES is closed by the k $k$ ‐ ω $\omega$ Shear Stress Transport (SST) and conventional Smagorinsky subgrid‐scale (SGS) models. The turbulence‐chemistry interaction scheme is treated using the Eddy Dissipation Concept (EDC) model in combination with a skeletal mechanism. It assumes that reactions occur in small dissipative eddies, which are on the order of the Kolmogorov scale. Three different reduced reaction mechanisms, for propane‐air, methanol‐air, and hydrogen‐air, are used within the industrial code ANSYS‐Fluent. To validate the model, the propane‐air mechanism was first taken as a benchmark, analyzing in detail velocity, temperature, and some post‐flame products. The velocity and temperature profiles show significant differences among the flame types, with hydrogen exhibiting higher velocities and more intense chemical reactions. The analysis reveals that NOx and CO concentrations increase with a higher inlet temperature. Propane flames have higher emissions, while methanol flames lead to the lowest pollutant level.

The Influence of Hydrocarbon Additives on Laminar Burning Velocity and NOx Emissions in Hydrogen‐Air Combustion

ABSTRACT Hydrogen is a promising carbon‐free fuel but faces challenges due to combustion instability and nitrogen oxide ( NO x ${\rm NO}_x$ ) emissions during combustion. This study investigates the potential of blending hydrocarbons (methane, propane) or ammonia with hydrogen‐air flames in order to minimize these challenges. Simulations were performed using a one‐dimensional, freely‐propagating, adiabatic premixed flame (FPPF) model in Cantera, incorporating detailed kinetic and thermodynamic modeling. Updated, detailed, and reduced reaction mechanisms were utilized to accurately represent the chemical kinetics of the selected fuel blends. We analyzed laminar flame velocity (LFV), flame structure, and emissions ofNO x ${\rm NO}_x$ and CO across a range of inlet pressures, temperatures, equivalence ratios, and blend ratios ofH 2 ${\rm H}_2$ / NH 3 ${\rm NH}_3$ ,H 2 ${\rm H}_2$ / CH 4 ${\rm CH}_4$ , andH 2 ${\rm H}_2$ /C 3 H 8 ${\rm C}_3{\rm H}_8$ . The results were validated against experimental data. Propane addition (10% –60% vol.) was found to be the most effective solution to reduceNO x ${\rm NO}_x$ emissions by promoting reburning pathways that convert NO toN 2 ${\rm N}_2$ , while moderately reducing LFV. Methane exhibits a comparable effect in suppressing thermalNO x ${\rm NO}_x$ while slightly reducing LFV. Ammonia drastically lowersNO x ${\rm NO}_x$ via fuel‐bound nitrogen pathways but sharply increases CO emissions and destabilizes flames at high concentrations. By identifying key reaction pathways governingNO x ${\rm NO}_x$ formation (thermal, prompt,N 2 O ${\rm N}_2{\rm O}$ , NNH, and reburning), propane is finally selected as the optimal additive for achieving low‐ NO x ${\rm NO}_x$ hydrogen combustion, despite its trade‐off with LFV, providing critical insights for designing cleaner and more stable combustion systems.

Rationale for irradiation of persisting oligo‐skeletal metastases to improve survival of metastatic neuroblastoma patients with a poor response to chemotherapy: A retrospective study

Abstract Background Persistent metaiodobenzylguanidine (mIBG)‐positive skeletal metastases post induction in high‐risk neuroblastoma correlate with a poor outcome. The aim of this study was to investigate the potential rationale for a prospective randomized study evaluating the impact on event‐free survival of the irradiation of residual oligo‐skeletal metastases. Procedure Patients over 1 year with a stage M neuroblastoma treated between 2000 and 2020 at Gustave Roussy were identified. Patients with a positive mIBG scan at diagnosis and persistent skeletal metastases after high‐dose chemotherapy (HDC) were included. Data were retrospectively collected and mIBG scans reviewed by two nuclear medicine physicians. Results Persistent skeletal uptake after HDC was observed in 30/201 patients (15%). Four patients reached a complete response at the end of maintenance treatment and did not relapse (median follow‐up [FU] 8 years [1.8–11.8]), while two patients had progressive disease during maintenance. Among the 24 patients with persistent skeletal uptakes at the end of treatment, seven had a persistent response (median FU 8.2 years [4–15.6]). Median SIOPEN (International Society of Paediatric Oncology European Neuroblastoma) scores post consolidation and at the end of treatment were, respectively, 2 [1–6] and 2 [0–4] for patients with persistent responses compared to 4 [1–28] and 2 [1–17] for patients with progressive diseases. Median SIOPEN score at progression was 34 [2–56]. Conclusions Our study underlines that only a minority of patients had persistent skeletal mIBG‐positive scans after HDC. Recurrence mainly occurred in disease sites present at diagnosis that cleared with chemotherapy. On‐therapy control of the disease is the main challenge. These results highlight the complexity of conducting a randomized study exploring this strategy.

Centralized Investigator Review of Radiological and Functional Imaging Reports in Real‐World Oncology Studies: The SACHA‐France Experience

ABSTRACT SACHA‐France (NCT04477681) is a prospective real‐world study that collects clinical safety and efficacy data of novel anticancer therapies prescribed off‐label or on compassionate use to patients <25 years. From March 2020 until February 2024, 640 patients with solid tumors or lymphomas were included, with 176 (28%) reported objective tumor responses. Centralized medical monitoring of local radiological/functional imaging reports by the SACHA coordinating investigator led to response modification in 45 out of 176 cases (26%), highlighting the relevance of the medical review of study data. We suggest this pragmatic approach for improving clinical trial data when centralized radiological review is not performed.

Hemoglobin Richmond Masquerading as Fetal Hemoglobin in a Child With Sickle Cell Disease: A Case Report and Review of the Literature

Pediatric Head and Neck Germ Cell Tumors: Current Management and Risk of Malignant Transformation

ABSTRACT Background and aims Head and neck germ cell tumors (HN‐GCTs), excluding the central nervous system, are rare and frequently contain mature or immature teratoma (MIT) compounds. The aims of this study were to analyze the risk of malignant transformation after MIT HN‐GCTs, to describe treatments and sequelae, and to propose recommendations for the follow up of these patients. Methods National multicentric retrospective study of all patients aged from birth to 17 years, treated in France between 2000 and 2021 for a HN‐GCT of all histotypes. Patients were selected from various sources: French National Registry of Childhood Cancers, SFCE ( Société Française des Cancers de l'Enfant ) centers and pediatric ENT (ear, nose and throat) surgical centers. Results A total of 152 patients were selected. Median age at diagnosis was 9 months (range, 0–190), with 34 diagnosed antenatally. Overall, 150 tumors contained MIT and two were malignant yolk sac GCT (YST). All patients, except for two cases with early postpartum death, underwent surgery, preceded in 12 cases by an EXIT (Ex Utero Intra Partum) procedure. After a median follow‐up of 47 months (range, 11–124), four patients with MIT developed a localized mature teratoma relapse, three developed a localized secreting malignant HN‐GCT (including two malignant degenerations after MIT), and one had a thoracic neuroblastoma. All patients survived. 9% of survivors developed moderate to severe sequelae. Conclusions Due to the low rate of malignant degeneration (two out of 148, 1.3%), this study does not support systematic oncologic long‐term monitoring after neonatal MIT HN‐GCT. However, regular clinical examination is required to detect and treat locoregional sequelae.

Neuroblastoma in Infants: Long‐Term Survival From INES Protocols A SIOPEN Study

ABSTRACT Objectives Neuroblastoma is the most common extracranial solid tumor in infants, with a possibility of spontaneous regression even in disseminated disease. Despite an overall good prognosis, relapse can worsen the outcome for some patients. A long‐term analysis is crucial to identify subgroups of patients with poorer prognosis, assessing the risks of late relapse, progression or long‐term toxicity associated with multimodal treatment in very young children. Methods Estimation of the 10‐year event‐free and overall survivals in 750 infants under 12 months with neuroblastoma, enrolled in the prospective INES protocols between 1999 and 2004. Follow‐up data from INES patients were updated, and survival analyses were performed in order to determine prognostic factors such as age, stage, genomic profile, or MYCN amplification. Results Overall, 10‐year overall survival was 91.1% ± 1.0%, and 10‐year event‐free survival was 82.4% ± 1.4%, with significantly better outcomes in infants under 6 months compared with those aged 6–12 months, even considering the MYCN‐amplified tumors only. MYCN amplification was the strongest prognostic factor and was correlated with lower survival in patients with metastatic disease. Discussion Survival in patients less than 12 months remains excellent and stable even at long term, as a 10‐year follow‐up did not change the number of events. However, survival in MYCN‐amplified tumors remained poor. Patients with metastatic tumors require accurate risk stratification. For each treatment group, there was no significant difference in long‐term outcomes compared with previous publications from INES. No lethal toxicity affecting long‐term survival occurred.

A Case of Pigmented Mesoblastic Nephroma With Melanocytic Features