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This study aims to optimize the performance of CrN coatings deposited on WC cutting tools for machining Ti6Al4V alloy, where the formation of built-up edge (BUE) is a prevalent and critical issue. In-house CrN coatings were developed using the PVD (Physical Vapor Deposition) process, with variations in deposition parameters including nitrogen gas pressure, bias voltage, and coating thickness. A comprehensive experimental approach encompassing deposition, characterization, and machining performance evaluation was employed to identify the optimal deposition conditions. The results indicated that CrN coatings deposited at a nitrogen gas pressure of 4 Pa, a bias voltage of -50 V, and a thickness of 1.81 µm exhibited superior performance, significantly reducing BUE formation and tool wear. These optimized coatings demonstrated enhanced properties, such as a higher elastic modulus and a lower coefficient of friction, which contributed to improved tool life and machining performance. Comparative studies with commercial CrN coatings revealed that the in-house developed coatings outperformed the commercial variants by approximately 65% in tool life, owing to their superior mechanical properties and reduced friction. This research highlights the potential of tailored CrN coatings for advanced machining applications and emphasizes the importance of optimizing deposition parameters to achieve high-performance tool coatings.

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The erosion process of a 4 µm monolayer CrN coating deposited on 316L stainless steel due to cavitation was investigated using finite element analysis (FEA). To estimate load parameters from cavitation pit geometry resulting from high impact velocity and high strain rate, the explicit dynamic solver was employed. Water microjet impacts at velocities of 100, 200 and 500 m/s were simulated to recreate different cavitation erosion intensities observed in the experiment. The resulting damage characteristics were compared to previous studies on uncoated 316L steel. The relationship between impact velocity and postimpact geometry was examined. Simulations revealed that only impact at 500 m/s can exceed the maximum yield stress of the substrate without penetrating the coating. Subsequent impacts on the same zone deepen the impact pit and penetrate the coating, leading to direct substrate degradation. The influence of impact velocity on the coating degradation process is discussed.

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BACKGROUND: In significant events like chemical, biological, radiological, nuclear, and explosive (CBRNE) incidents, additional expertise in specific chemical substances becomes essential. Train-the-trainer programmes are used to increase knowledge and skills in a variety of fields and have been shown to be a cost-effective training method, eliminating the necessity of bringing in external experts or requiring participants to travel outside their region. Care in Hazardous Environments (CiHE) is one example of a course which comprises basic multi-disciplinary training together with personnel from rescue, police, and emergency medical services to prepare them to handle chemical and radioactive nuclear incidents. The train-the-trainer programme described in this study contains both theoretical and practical components, intended for instructors who will lead training on CiHE incidents. This study aimed to evaluate trainers' level of knowledge before and after a train-the-trainer programme, as well as their thoughts about becoming an instructor i.e. the pedagogical competence for the Care in Hazardous Environments course. METHODS: A pre- and post-test, along with an evaluation of open-ended response options were employed to assess the effectiveness of the train-the-trainer programme for teaching the basic course (CiHE). A total of 49 participants were enrolled in the programme. RESULTS: Participants showed significant improvement in chemical, radiological and nuclear (CRN) response knowledge in two of the eight questions between the pre- and post-tests. The two questions that improved pertained to chemical substances and basic principles of radiation protection. Instructors trained in the train-the-trainer programme are intended to bring new knowledge, incorporate a rarely discussed topic into instruction regularly, and de-stigmatise CRN incidents by helping raise the minimum competency levels in their respective organisation. CONCLUSION: An effective response to CBRNE events begins with readiness. First responders must be prepared and possess knowledge of both CRN components as well as protective gear to keep themselves and others safe at the incident scene. This study shows the importance of the train-the-trainer programme in continuing to educate police, and personnel from rescue and emergency medical services in CiHE, enable them to collaboratively prepare to handle CRN incidents.

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Plasma membrane intrinsic proteins (PIPs), a subclass of aquaporins (AQPs), play an important role in plant immunity by acting as H2O2 transporters. Their homeostasis is mostly maintained by C-terminal serine phosphorylation. However, the kinases that phosphorylate PIPs and manipulate their turnover are largely unknown. Here, we found that Arabidopsis thaliana PIP2;7 positively regulates plant immunity by transporting H2O2. Arabidopsis CALCIUM-DEPENDENT PROTEIN KINASE 28 (CPK28) directly interacts with and phosphorylates PIP2;7 at Ser273/276 to induce its degradation. During pathogen infection, CPK28 dissociated from PIP2;7 and destabilized, leading to PIP2;7 accumulation. As a counter, oomycete pathogens produce the conserved kinase effectors that stably bind and mediate the phosphorylate of PIP2;7 to induce its degradation. Our study identifies PIP2;7 as a novel substrate of CPK28 and its protein stability is negatively regulated by CPK28. Such phosphorylation could be mimicked by Phytophthora kinase effectors to promote infection. Accordingly, we developed a strategy to combat oomycete infection by using a phosphorylation-resistant PIP2;7S273/276A mutant. The strategy only allows accumulation of PIP2;7S273/276A during infection to limit potential side effects on normal plant growth.

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OBJECTIVES: This manuscript presents a comprehensive framework for the assessment of the value of real-world evidence (RWE) in healthcare decision-making. While RWE has been proposed to overcome some limitations of traditional, one-off studies, no systematic framework exists to measure if RWE actually lowers the burden. This framework aims to fill that gap by providing conceptual approaches for evaluating the time and cost efficiencies of RWE, thus guiding strategic investments in RWE infrastructure. METHODS: The framework consists of four components: (114th Congress. 21st Century Cures Act.; 2015. https://www.congress.gov/114/plaws/publ255/PLAW-114publ255.pdf .) identification of stakeholders using and producing RWE, (National Health Council. Glossary of Patient Engagement Terms. Published 2019. Accessed May 18. 2021. https://nationalhealthcouncil.org/glossary-of-patient-engagement-terms/ .) understanding value propositions on how RWE can benefit stakeholders, (Center for Drug Evaluation and Research. CDER Patient-Focused Drug Development. U.S. Food & Drug Administration.) defining key performance indicators (KPIs), and (U.S. Department of Health and Human Services - Food and Drug Administration: Center for Devices and Radiological Health and Center for Biologics Evaluation and Research. Use of Real-World Evidence to Support Regulatory Decision-Making for Medical Devices - Guidance for Industry and Food and Drug Administration Staff. 2017. http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guida .) establishing metrics and case studies to assess value. KPIs are categorized as 'better, faster, or cheaper" as an indicator of value: better focusing on high-quality actionable evidence; 'faster,' denoting time-saving in evidence generation, and 'cheaper,' emphasizing cost-efficiency decision compared to methodologies that do not involve data routinely collected in clinical practice. Metrics and relevant case studies are tailored based on stakeholder value propositions and selected KPIs that can be used to assess what value has been created by using RWE compared to traditional evidence-generation approaches and comparing different RWE sources. RESULTS: Operationalized through metrics and case studies drawn from the literature, the value of RWE is documented as improving treatment effect heterogeneity evaluation, expanding medical product labels, and expediting post-market compliance. RWE is also shown to reduce the cost and time required to produce evidence compared to traditional one-off approaches. An original example of a metric that measures the time saved by RWE methods to detect a signal of a product failure was presented based on analysis of the National Cardiovascular Disease Registry. CONCLUSIONS: The framework presented in this manuscript offers a comprehensive approach for evaluating the value of RWE, applicable to all stakeholders engaged in leveraging RWE for healthcare decision-making. Through the proposed metrics and illustrated case studies, valuable insights are provided into the heightened efficiency, cost-effectiveness, and improved decision-making within clinical and regulatory domains facilitated by RWE. While this framework is primarily focused on medical devices, it could potentially inform the determination of RWE value in other medical products. By discerning the variations in cost, time, and data utility among various evidence-generation methods, stakeholders are empowered to invest strategically in RWE infrastructure and shape future research endeavors.

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Jobs for clinical research professionals (CRPs) have grown increasingly complex over the past 20+ years. This is due largely to additional administrative burden for investigators, study teams, sponsors, Clinical Research Organizations (CROs), and sites, particularly Academic Medical Centers (AMCs). Furthermore, National Institutes of Health (NIH) has reduced capacity to effectively fund research recognizing this is dependent on the overall congressional budget, which creates greater pressure for clinician scientists to secure external support. It is widely known clinical research will continue to become increasingly more complex for clinician scientists. This manuscript explores adoption of a clinical research competency-based job classification framework from the Joint Task Force for Clinical Trial Competency (JTFCTC) across several AMCs and the role of Human Resources (HR) in facilitating this process. This collaboration focuses on fostering successful projects tied to the business case in order to address equity and improve support for the clinical research enterprise.

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We examine whether math anxiety is related to altered response monitoring in an arithmetic task. Response-locked event-related brain potentials (ERPs) were evaluated in 23 highly (HMA) and 23 low math-anxious (LMA) individuals while they performed an arithmetic verification task. We focused on two widely studied ERPs elicited during error processing: error-related negativity (ERN) and error positivity (Pe). Correct-related negativity (CRN), an ERP elicited after a correct response, was also studied. The expected ERN following errors was found, but groups did not differ in its amplitude. Importantly, LMA individuals showed less negative CRN and more positive Pe amplitudes than their more anxious peers, suggesting more certainty regarding response accuracy and better adaptive behavioral adjustment after committing errors in an arithmetic task in the LMA group. The worse control over response performance and less awareness of correct responses in the HMA group might reduce their ability to 'learn from errors'.

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Oomycete pathogens secrete numerous crinkling and necrosis proteins (CRNs) to manipulate plant immunity and promote infection. However, the functional mechanism of CRN effectors is still poorly understood. Previous research has shown that the Phytophthora sojae effector PsCRN108 binds to the promoter of HSP90s and inhibits their expression, resulting in impaired plant immunity. In this study, we found that in addition to HSP90, PsCRN108 also suppressed other Heat Shock Protein (HSP) family genes, including HSP40. Interestingly, PsCRN108 inhibited the expression of NbHSP40 through its promoter, but did not directly bind to its promoter. Instead, PsCRN108 interacted with NbCAMTA2, a negative regulator of plant immunity. NbCAMTA2 was a negative regulator of NbHSP40 expression, and PsCRN108 could promote such inhibition activity of NbCAMTA2. Our results elucidated the multiple roles of PsCRN108 in the suppression of plant immunity and revealed a new mechanism by which the CRN effector hijacked transcription factors to affect immunity. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

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For exploring advanced Zn-ion batteries (ZIBs) with long lifespan and high Coulombic efficiency (CE), the critically important point is to limit the undesired Zn dendrite and parasitic reactions. Among the coating for electrode is a promising strategy, relying on the trade-off between its thickness and stability to achieve the ultra-stable Zn anodes in ZIBs. Herein, a submicron-thick (≈0.4 µm) zincophilic CrN coatings are fabricated by a facile and industry-compatible magnetron sputtering approach. It is exhilarating that the ultrathin and dense CrN coatings with strong adsorption ability for Zn2+ exhibit an impressive lifespan up to 3700 h with ≈100% CE at 1 mA cm-2. Along with the experiments and theoretical calculations, it is verified that the introduced CrN coatings cannot only effectively suppress the dendrite growth and notorious parasitic reactions, but also allow the uniform Zn deposition due to the reduced nucleation energy. Moreover, the as-assembled Zn@CrN‖MnO2 full cell delivers a high specific capacity of 171.1 mAh g-1 after 1000 cycles at 1 A g-1, much better than that of Zn‖MnO2 analog (97.8 mAh g-1). This work provides a facile strategy for scalable fabrication of ultrathin zincophilic coating to push forward the practical applications of ZIBs.

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The Nuss procedure for pectus excavatum (PE) is both less invasive and very simple compared to the Ravitch procedure. However, it may be difficult to perform the Nuss procedure in cases of severe PE. Therefore, we developed a Combined Ravitch and Nuss (CRN) procedure and examined its effectiveness in patients with severe PE. Nine patients with severe PE underwent the CRN procedure. Data on patient characteristics and perioperative results were collected retrospectively. The median Haller index (HI) was 15.4 (range, 6.3-29.3). No significant intraoperative adverse events were noted. Postoperatively, marked improvements in HI were seen in all cases (3.29, range, 2.72-4.96). Two surgical site infections on the shallow layer and one wound seroma occurred. No recurrences were observed during the observation period. Our novel CRN procedure is useful for achieving adequate and sustainable sternal elevation with less invasiveness for patients with severe PE.

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Chromium Nitride (CrN) coatings have widespread utilization across numerous industrial applications, primarily attributed to their excellent properties. Among the different methods for CrN coating synthesis, direct current magnetron sputtering (DCMS) has been the dominant technique applied. Nonetheless, with the expanded applications of CrN coatings, the need for enhanced mechanical performance is concurrently escalating. High-power impulse magnetron sputtering (HiPIMS), an innovative coating deposition approach developed over the past three decades, is gaining recognition for its capability of yielding coatings with superior mechanical attributes, thereby drawing significant research interest. Considering that the mechanical performance of a coating is fundamentally governed by its microstructural properties, a comprehensive review of CrN coatings fabricated through both techniques is presented. This review of recent literature aims to embark on an insightful comparison between DCMS and HiPIMS, followed by an examination of the microstructure of CrN coatings fabricated via both techniques. Furthermore, the exploration of the underlying factors contributing to the disparities in mechanical properties observed in CrN coatings is revealed. An assessment of the advantages and potential shortcomings of HiPIMS is discussed, offering insight into CrN coating fabrication.

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BACKGROUND: While Lynch syndrome (LS) is a highly penetrant colorectal cancer (CRC) syndrome, there is considerable variation in penetrance; few studies have investigated the association between microbiome and CRC risk in LS. We analyzed the microbiome composition among individuals with LS with and without personal history of colorectal neoplasia (CRN) and non-LS controls. METHODS: We sequenced the V4 region of the 16S rRNA gene from the stool of 46 individuals with LS and 53 individuals without LS. We characterized within community and in between community microbiome variation, compared taxon abundance, and built machine learning models to investigate the differences in microbiome. RESULTS: There was no difference within or between community variations among LS groups, but there was a statistically significant difference in both within and between community variation comparing LS to non-LS. Streptococcus and Actinomyces were differentially enriched in LS-CRC compared to LS-without CRN. There were numerous differences in taxa abundance comparing LS to non-LS; notably, Veillonella was enriched and Faecalibacterium and Romboutsia were depleted in LS. Finally, machine learning models classifying LS from non-LS controls and LS-CRC from LS-without CRN performed moderately well. CONCLUSIONS: Differences in microbiome composition between LS and non-LS may suggest a microbiome pattern unique to LS formed by underlying differences in epithelial biology and immunology. We found specific taxa differences among LS groups, which may be due to underlying anatomy. Larger prospective studies following for CRN diagnosis and microbiome composition changes are needed to determine if microbiome composition contributes to CRN development in patients with LS.

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Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease globally and in India. The already high burden of NAFLD in India is expected to further increase in the future in parallel with the ongoing epidemics of obesity and type 2 diabetes mellitus. Given the high prevalence of NAFLD in the community, it is crucial to identify those at risk of progressive liver disease to streamline referral and guide proper management. Existing guidelines on NAFLD by various international societies fail to capture the entire landscape of NAFLD in India and are often difficult to incorporate in clinical practice due to fundamental differences in sociocultural aspects and health infrastructure available in India. A lot of progress has been made in the field of NAFLD in the 7 years since the initial position paper by the Indian National Association for the Study of Liver on NAFLD in 2015. Further, the ongoing debate on the nomenclature of NAFLD is creating undue confusion among clinical practitioners. The ensuing comprehensive review provides consensus-based, guidance statements on the nomenclature, diagnosis, and treatment of NAFLD that are practically implementable in the Indian setting.

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In this study, Co, Cr, and Ni were selected as the equal-atomic medium entropy alloy (MEA) systems, and Si was added to form CoCrNiSi0.3 MEA. In order to further improve its wear and corrosion properties, CrN film was sputtered on the surface. In addition, to enhance the adhesion between the soft CoCrNiSi0.3 substrate and the super-hard CrN film, a Cr buffer layer was pre-sputtered on the CoCrNiSi0.3 substrate. The experimental results show that the CrN film exhibits a columnar grain structure, and the film growth rate is about 2.022 µm/h. With the increase of sputtering time, the increase in CrN film thickness, and the refinement of columnar grains, the wear and corrosion resistance improves. Among all CoCrNiSi0.3 MEAs without and with CrN films prepared in this study, the CoCrNiSi0.3 MEA with 3 h-sputtered CrN film has the lowest wear rate of 2.249 × 10-5 mm3·m-1·N-1, and the best corrosion resistance of Icorr 19.37 µA·cm-2 and Rp 705.85 Ω·cm2.

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This study successfully deposited Si-doped CrN coatings onto Si (100) substrate by direct current magnetron sputtering. The concentration of Si in the CrSiN coatings was varied by changing the Si target current during deposition. The microstructural and mechanical properties were determined by employing X-ray diffraction, X-ray photoelectron spectroscopy, atomic force microscopy, and nanoindentation test. According to the results, the coating with 3.3 at.% Si contents (CrSiN-2) show an increase and decrease in the crystallite size and coating surface roughness, respectively, leading to solid solution hardening with an optimum hardness and elastic modulus of 21.37 GPa and 205.68 GPa, respectively. With continued Si addition, the coating roughness increased and the mechanical properties gradually decreased and attained 184.08 GPa and 18.95 GPa for the elastic modulus and hardness of the coating with a maximum Si concentration of 9.2 at.% (CrSiN-5).

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Introduction: In the Danish National Colorectal Cancer (CRC) screening program, participants with screen-detected low-risk adenomas are invited to a new faecal immunochemical test (FIT) screening after two years. However, participation rate in next FIT screening is unknown. We aimed to investigate this subsequent participation rate within the Danish CRC screening program. Methods: This nationwide register-based study included participants aged 50-72 years registered with FIT screening in the Danish CRC screening program between January 1, 2016, and June 30, 2017. Participants were included if their index FIT was negative or if it was positive and the subsequent colonoscopy detected low-risk adenomas. Invitees were categorized as subsequent participants if they returned a FIT within 135 days following the invitation to screening. We estimated the relative risk for participation depending on screening outcome, age, and sex. Result: 415,107 with a negative result and 5,550 with low-risk adenomas were included. 86.0% (85.9;86.1) of the invitees with a negative result participated in the subsequent screening, while 71.8% (70.6;73.0) of the invitees with low-risk adenomas participated subsequently. The risk of participation in the subsequent screening was significantly lower among all age groups of men and women with low-risk adenomas compared to similar groups with negative results. Conclusion: Invitees with low-risk adenomas detected at their initial colonoscopy are less likely to participate in the subsequent screening than invitees with negative results. This association was found in all age groups and for both sexes. Further studies are necessary to assess whether non-attendance is more pronounced in specific subgroups.

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Hard coatings can be applied onto microstructured molds to influence wear, form filling and demolding behaviors in microinjection molding. As an alternative to this conventional manufacturing procedure, "direct processing" of physical-vapor-deposited (PVD) hard coatings was investigated in this study, by fabricating submicron features directly into the coatings for a subsequent replication via molding. Different diamondlike carbon (DLC) and chromium nitride (CrN) PVD coatings were investigated regarding their suitability for focused ion beam (FIB) milling and microinjection molding using microscope imaging and areal roughness measurements. Each coating type was deposited onto high-gloss polished mold inserts. A specific test pattern containing different submicron features was then FIB-milled into the coatings using varied FIB parameters. The milling results were found to be influenced by the coating morphology and grain microstructure. Using injection-compression molding, the submicron structures were molded onto polycarbonate (PC) and cyclic olefin polymer (COP). The molding results revealed contrasting molding performances for the studied coatings and polymers. For CrN and PC, a sufficient replication fidelity based on AFM measurements was achieved. In contrast, only an insufficient molding result could be obtained for the DLC. No abrasive wear or coating delamination could be found after molding.

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It is known that measurement parameters can significantly influence the elemental composition determined by atom probe tomography (APT). Especially results obtained by laser-assisted APT show a strong effect of the laser pulse energy on the apparent elemental composition. Within this study laser-assisted APT experiments were performed on Cr0.51N0.49 and thermally more stable (Cr0.47Al0.53)0.49N0.51, comparing two different base temperatures (i.e. 15 and 60 K), laser wavelengths (i.e. 532 and 355 nm) and systematically modified laser pulse energies. Absolute chemical compositions from laser-assisted APT were compared to data obtained from ion beam analysis. The deduced elemental composition of CrN exhibited a strong increase of the Cr content when the laser pulse energy was increased for both laser wavelengths. For low laser pulse energies Cr, CrN, N and N2 ions were identified, while the amount of detected Cr ions increased and the amount of N ions strongly decreased at higher laser pulse energies. Further, increased detection of more complex Cr-containing ions such as Cr2N at the expense of CrN was observed at higher pulse energies. At the highest pulse energy levels used within this work, the resulting Cr content was > 80 at%, dominated by the amount of detected elemental Cr ions. The change of the mass spectrum of the detected ions with increasing laser pulse energy provides evidence that high laser pulse energies initiate the decomposition of CrN during the APT measurement, consistent with the known thermal decomposition path into Cr2N and subsequently into Cr and gaseous N. In contrast, variation of the laser pulse energy for the thermally more stable CrAlN resulted only in a slight increase of Cr and a decrease of the resulting concentrations of Al and N with increasing laser pulse energy and no change in the type of detected ions. In conclusion, within the present study, the decomposition of a coating material with low thermal stability induced by laser-assisted APT was reported for the first time, emphasizing the importance of the selection of suitable measurement parameters for metastable materials, which are prone to thermal decomposition.

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OBJECTIVE: "Subsyndromal" obsessive-compulsive disorder symptoms (OCDSs) are common and cause impaired psychosocial functioning. OCDSs are better captured by dimensional models of psychopathology, as opposed to categorical diagnoses. However, such dimensional approaches require a deep understanding of the underlying neurocognitive drivers and impulsive and compulsive traits (ie, neurocognitive phenotypes) across symptoms. This study investigated inhibitory control and self-monitoring across impulsivity, compulsivity, and their interaction in individuals (n = 40) experiencing mild-moderate OCDSs. METHODS: EEG recording concurrent with the stop-signal task was used to elicit event-related potentials (ERPs) indexing inhibitory control (ie, N2 and P3) and self-monitoring (ie, error-related negativity and correct-related negativity (CRN): negativity following erroneous or correct responses, respectively). RESULTS: During unsuccessful stopping, individuals high in both impulsivity and compulsivity displayed enhanced N2 amplitude, indicative of conflict between the urge to respond and need to stop (F(3, 33) = 1.48, P < .05, 95% Cl [-0.01, 0.001]). Individuals high in compulsivity and low in impulsivity showed reduced P3 amplitude, consistent with impairments in monitoring failed inhibitory control (F(3, 24) = 2.033, P < .05, 95% CI [-0.002, 0.045]). Following successful stopping, high compulsivity (independent of impulsivity) was associated with lower CRN amplitude, reflecting hypo-monitoring of correct responses (F(4, 32) = 4.76, P < .05, 95% CI [0.01, 0.02]), and with greater OCDS severity (F(3, 36) = 3.32, P < .05, 95% CI [0.03, 0.19]). CONCLUSION: The current findings provide evidence for differential, ERP-indexed inhibitory control and self-monitoring profiles across impulsive and compulsive phenotypes in OCDSs.

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