bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring time-resolved heat transfer fluctuations on a heated-thin foil in a turbulent channel airflow
Authors: Cuellar Martin Antonio , Amico Enrico , Serpieri Jacopo , Cafiero Gioacchino , Baars Woutijn J , Discetti Stefano , Ianiro Andrea
Published: February 2025

We present an experimental setup to perform time-resolved convective heat transfer measurements in a turbulent channel flow with air as the working fluid. We employ a heated thin foil coupled with high-speed infrared thermography. The measurement technique is challenged by the thermal inertia of the foil, the high frequency of turbulent fluctuations, and the measurement noise of the infrared camera. We discuss in detail the advantages and drawbacks of all the design choices that were made, thereby providing a successful implementation strategy to obtain high-quality data. This experimental approach could be valuable for studies employing wall-based measurements of turbulence, such as flow control applications in wall-bounded turbulence.
Magnetic mesh generation and field line reconstruction for scrape-off layer and divertor modeling in stellarators
Authors: Frerichs Heinke , Boeyaert Dieter , Feng Yuhe , Garcia Kelly Adriana
Published: February 2025

The design of divertor targets and baffles for optimal heat and particleexhaust from magnetically confined fusion plasmas requires a combination of fast,low-fidelity models (such as EMC3-Lite [1]) for scoping studies and high-fidelity ones(such as EMC3-EIRENE [2]) for verification. Both of those approaches benefit from amagnetic flux tube mesh for fast interpolation and mapping of field line segments [3]. Anew automated mesh generator for unstructured quadrilateral flux tubes with adaptiverefinement is presented and integrated into FLARE [4]. For HSX with an extended firstwall, it is found that several layers of flux tubes can span the entire half field periodbefore splitting is required. This is an advantage over the traditional setup of theEMC3-EIRENE mesh where careful construction of several sub- domains is requiredalready for the much tighter present first wall. In particular, there is no longer theneed to manually construct a suitable outer boundary for the mesh. The divide andconquer paradigm with unstructured mesh layout offers a powerful alternative for fasthead load approximation that is suitable for integration into optimization workflows.Further examples for W7-X and CTH demonstrate the versatile application range.
Design, simulation, and fabrication of high-gain microstrip patch antenna arrays for 28 GHz millimeter-wave 5G applications
Authors: Khouyaoui Ibrahim , Elbathaoui Mouhssine , Hamdaoui Mohamed , Foshi Jaouad
Published: February 2025

This study focuses on the design, simulation, and fabrication of microstrip patch antenna arrays optimized for 28 GHz 5G applications. The work progresses from a single patch antenna to 2x1 and 4x1 patch arrays, showcasing significant performance improvements. Using CST simulations, the single patch antenna achieved a gain of 6.83 dB and a return loss of -26.2 dB. The 2x1 array further enhanced performance, reaching a gain of 11.1 dB and a return loss of -31 dB. The 4x1 array demonstrated superior performance with a gain of 13.8 dB and an exceptionally low return loss of -41.4 dB, making it well-suited for 5G applications requiring high gain, efficient impedance matching, and compact design.The methodology involved employing a Rogers RT5880 substrate and a microstrip line feeding technique, ensuring ease of fabrication and cost-effectiveness. A fabricated 2x1 array was tested using a Vector Network Analyzer, confirming close alignment with simulation results. Compared to prior studies, the proposed arrays address critical challenges such as achieving high performance while maintaining simplicity in design and fabrication. These results position the 4x1 array as a practical and efficient solution for next-generation mmWave communication systems.
Optimization design of warhead fragment initial velocity
Authors: Zheng Minghui , Zhao Hongzhi , Li Jianan , Liang Zhengang
Published: February 2025

The thickness of the end cover is a key factor in the precise design of the warhead power. Therefore, the initial velocity distribution of the fragments of the cylindrical charge shell under different thickness end cover conditions was studied. Through theoretical analysis and SPH numerical simulation, the corresponding numerical model is constructed, and the theoretical calculation formula of the axial distribution of the initial velocity of the debris is proposed. The results show that with the increase of the thickness of the end cover, the influence of the axial sparse wave is weakened, which leads to the increase of the debris velocity at both ends of the shell. Compared with the detonation end, the debris acceleration at the non-detonation end is more significant. The formula obtained is more suitable for the conditions of different end cover thicknesses and materials in engineering, and the error is significantly reduced, which can provide a reference for the accurate design of warhead debris parameters.
Experimental study on the fastening method of shipborne equipment
Authors: Liu Jingqiao , Wang Guo , Jiang Xin , Ge Junbo , Li Mengxiang , Liu Kun , Liu Shiye
Published: February 2025

In order to solve the safety problem of equipment fastening during the transit of the mother ship, the scale model test technology of the shipborne equipment fastening system is studied in this paper. This paper designed and carried out scaling tests of equipment safety fastening under different sea conditions and various motion states (single-freedom and multi-freedom motion), revealed the changing rules of equipment safety fastening loads, formed the analysis and evaluation techniques of equipment fastening methods, and the research results can provide guidance methods for the design of phase relation fastening equipment.
Path optimization model of manipulator based on d-h parameter method and genetic algorithm
Authors: He Peiqi , Zhao Yaqin , Tan Min , Liao Bingquan
Published: February 2025

The Denavit-Hartenberg (D-H) parametric method is extensively utilized in the industrial machinery domain. This research explores the application of the D-H parametric method to enhance the functionality of six-degree-of-freedom manipulators, leveraging their notable flexibility and versatility to improve productivity and execution accuracy in highly automated industrial and service environments. In this research, the forward kinematics model of the manipulator is developed using the D-H parametric method. Subsequently, an optimization model is formulated with the objective of minimizing end-effector error and optimized through a genetic algorithm. Following single-objective optimization, the study incorporates energy consumption minimization as an additional objective. A dual-objective optimization model, which considers both end-effector error and energy consumption, is then constructed and optimized using a genetic algorithm. The results demonstrate a reduction in energy consumption of the six-degree-of-freedom manipulator and optimization of joint angle paths while ensuring that the end-effector error remains within an acceptable range. This research offers valuable insights for achieving efficient and precise operations in complex industrial applications and contributes to the advancement of automation technology.
Analysis of fatigue damage of frame under different influence parameters
Authors: Wu Canyan , Zhang Jiangyao , Zheng Renbin
Published: February 2025

The subway vehicle’s frame is crucial to its operational integrity. However, it faces potential fatigue damage due to the transmission of wheel-rail impact loads. To address this, a comprehensive study is conducted, establishing a dynamic model that considers the interaction between the vehicle and the track. This model incorporates the irregularities present in welded joints as the primary source of impact load excitation. The research is carried out from two aspects, welded joint irregularity and running speed. The results show that the wheel-rail impact force can be transmitted upward to the frame and excite the 46.3 Hz mode and 55.5 Hz mode of the frame, resulting in vibration fatigue damage. Lowering the vehicle’s running speed has been proven effective in mitigating damage caused by impact on the frame. Additionally, it reduces the maximum wheel-rail vertical force, diminishes the wheel unloading rate, and enhances the overall wheel-rail vibration environment. Reducing the fastener stiffness can effectively reduce the damage caused by wheel-rail impact on the frame.
Research on pulse induction metal detector probe based on finite element simulation
Authors: Liu Anqi , Wang Zhan , Zhang Yong
Published: February 2025

Metal detection technology based on the principle of electromagnetic induction has always played an important role in the field of mine detection. In metal detectors, the probe coil is an essential component, and its performance affects the overall performance of the system. This paper introduces the basic principles of pulsed electromagnetic induction and constructs a model of the metal detector probe using the finite element electromagnetic simulation software Ansys Maxwell. The study explores the impact of the coil shape and radius, the number of turns, and the coil current on the primary field generated by the probe coil, as well as the influence of different metallic target materials on the secondary field received by the coil. Finally, the effectiveness of the simulation is verified by the experiments. The research findings have certain reference significance for optimizing the best parameter configuration of the probe coil.
An automatic fuzzy neighbourhood cutting algorithm for attribute reduction
Authors: Qian Yuan , Tan Anhui , Gu Shenming
Published: February 2025

Neighbourhood information represents a local component of granular information and is employed to describe the distribution of neighbourhoods surrounding a given sample. Automatically choosing the proper size to determine the granularity of neighborhoods is a challenging problem. To address these issues, we introduce a cutting mechanism from fuzzy set theory to generate fuzzy neighbourhoods with automatic parameters, these parameters are the confidence level determining which samples are selected into the fuzzy neighborhood of the sample. Misclassified samples are identified by their diverse category labels within the fuzzy neighbourhood, and their distributions can reflect the performance of a classification task. Additionally, we propose a reduction algorithm (CFE) to choose a pertinent subset of attributes from the dataset. Experimental findings on actual datasets reveal the algorithm’s superiority over baseline approaches and its efficiency in eliminating misclassified neighbours.
Eigenvalue inverse the problem with generalized arrow matrices with linear relations
Authors: Huang Yi , Wang Yiyi , Li Zhibin
Published: February 2025

The inverse problem of eigenvalues of matrices is nowadays a popular topic in numerical algebra and is widely used in mathematical physics inverse problems. This paper studies the eigenvalue inverse of generalized arrow matrices with linear relations, in which the concept of an eigenpair is used and the existence and unambiguousness of the solution of the equation generated by the problem are shown. Recursive expressions are given according to the laws. The validity of the algorithm will be verified with exact conditions. Finally, the conclusion is drawn.
Numerical solution of elliptic partial diffe rential equations and their optimal control problems
Authors: Yu Xuemei
Published: February 2025

The mathematical theory of optimal control has emerged rapidly in the past few decades as an essential and independent field in applied mathematics. This theory not only has a profound theoretical foundation in the field of mathematics, but also shows strong application value in many practical application fields such as physical engineering, biological engineering and social science. In these problems, it is necessary to solve the minimization problem of a given cost function under satisfying differential equations and certain constraints. The optimal control problem studied in this paper is constrained by elliptic partial differential equations.
Convergence of compactly supported L
p

solutions of the dilation equation
Authors: Wang Min , Wu Xia , Tian Daping
Published: February 2025

This paper discusses the existence of compact Lp
solutions for the dilation equation. We use Iterative Function Schemes to analyze the solutions of the equation under different conditions. In d-dimensional space, the existence of the solution of the dilation equation and the necessary and sufficient conditions are discussed, and some conclusions are obtained.
New extended sidon spaces with dimension k+1
Authors: Wu Lingling , Li Yu , Fang Lin , Niu Yongfeng
Published: February 2025

In recent years, Sidon spaces have gained great popularity and applications in various fields such as multi-antenna communication systems, distributed storage systems, multimedia transmission, and network coding. With our further research into this field, it becomes evident that Sidon spaces are crucial in the field of constructing cyclic subspace codes. Currently, lots of papers focuse on how to construct Sidon spaces. Researchers find that through using the roots of irreducible polynomials and primitive elements over finite fields, we can sucessfully construct them. Based on the significant research conducted by previous scholars, we obtain several Sidon spaces which have new cardinality. Moreover, these Sidon spaces is beneficial to help us obtain better-performance subspace codes.
Finite element analysis of LWI-100 heat insulation block
Authors: Fu Qiang , Guo Fenyang
Published: February 2025

The ultimate tensile strain and fracture energy of LWI-100 were obtained by a four-point pure bending moment test and a three-point bending beam test. The finite element analysis of the heat insulation block is carried out by using fracture theory. The experimental results show that when the maximum tensile strain exceeds the ultimate tensile strain, the fracture energy of the material does not exceed the critical energy.
Optimization of out-of-plane polarization calculations for two-dimensional ferroelectric metals
Authors: Chen Jianfei , Wei Yi-Wen , Ma Yu-Quan , Lai Wenxi , Huang Wenqi
Published: February 2025

Due to the screening effect of conduction electrons, ferroelectricity and metallicity typically do not coexist. However, recent studies have discovered metallic ferroelectricity in two-dimensional (2D) transition metal dichalcogenides, which show potential applications in ferroelectric tunneling junctions and ferroelectric memory. During the numerical calculations of the out-of-plane polarization using the classical dipole moment method, we find that significant inaccuracies arise when the reference point is chosen beyond a certain range, due to the unreasonable cut of the periodic charge density. The resulting computational inaccuracies can be suppressed by shifting the center of the two-dimensional materials to the lattice center. Furthermore, we show that asymmetry can be introduced when the real-space grid is not symmetrically distributed around the lattice center. Since the calculated charge density is the result of the real-space grid sampling, it is advisable to ensure that the grid is symmetrically distributed around the lattice center to avoid inaccuracies. The enhancement in precision of out-of-plane polarization calculations is helpful for the prediction of new ferroelectric metals (FEMs).
Convex combination of quantum states and characterization of correlation
Authors: Liu Guangrong , Liu Yang , Li Xiangrong
Published: February 2025

In the study of optical quantum information, quantum teleportation can be realized by preparing multiphoton entangled states. Entanglement is a special quantum correlation, and there is also a quantum correlation in separable quantum States, which comes from the measurement of quantum states. Convex combinations of arbitrary quantum states are still quantum states. From the spectral decomposition of a quantum state, an ensemble formed by a complete eigenvector system can be determined, which corresponds to an orthogonal projection operator family with rank 1, and the convex combination of the operator family will correspond to a quantum state. The characterization of quantum correlation is an important issue in the study of quantum information theory. A Quantum state that remains unchanged under local orthogonal projection is a classical correlation state, which is not affected by decoherence. Based on the standard orthogonal basis, this paper considers the correlation of the quantum states formed by the convex combination of the operator family. According to the separability and entanglement of the ground state and the mutual dissimilarity of the corresponding non-zero eigenvalues, it is concluded that the convex combination of the operator family formed by the separable standard orthogonal basis in the composite system must be a classical correlation state. When the entangled pure state is an eigenvector, it is a quantum correlation state if the corresponding eigenvalue is a non-zero single value. In the case of multiple roots, we can illustrate that both are possible. For the correlation of unitary evolution of quantum states under different standard orthogonal bases, the evolution law is revealed by considering important quantum gates.
The static elastoplastic analysis of new multi-layer frame-bent industrial building structure
Authors: Yu Xiaoqi , Ye Jingui
Published: February 2025

This study aims to evaluate the seismic performance of a new type of multi-layer frame-bent structure industrial plant through the static elastoplastic analysis method. The study provides a detailed design description of the frame structure, including its basic structural characteristics, load effects, and seismic design requirements. A numerical model was established by using static elastoplastic analysis techniques, taking into account the non-uniformity of the structure’s mass and stiffness distribution, as well as the complexity of the system. Simulating the structural response under different earthquake actions, the relationship between base shear force and vertex displacement was analyzed, and the weak links of the structure were identified. The results indicate that under high-intensity earthquake action, the structure exhibits complex behavior patterns, and the top layer becomes weak due to the whip effect and sudden changes in lateral stiffness. The study emphasizes the importance of reasonably setting up top-level lateral support to enhance the stability and seismic performance of the structure.
A fixed point result involving BSS-type cyclic mapping
Authors: Wu Dingping , Weng Shengquan
Published: February 2025

In this manuscript, based on extended b-metric spaces, we propose a new structure of cyclic mapping, that is, BSS-type cyclic mapping. The fixed-point theorem for BSS-type cyclic mapping is established. A concrete example of BSS-type cyclic mapping is given to show the reasonability and correctness of the obtained results. The result proposed by this manuscript extends known conclusions in some references.
Analysis of the explosion venting holes in the cabin explosion on the structural response
Authors: Yang Di , Li Fei , Pan Weibo , Yu Banhai , Li Sheng
Published: February 2025

Firstly, the damaging effect of the internal explosion in a closed cabin by numerical simulation has been evaluated, which indicates that the pressure peak of the shock wave and the duration of positive pressure in the closed cabin has been increased at a large scale compared with the free field, and the corner-structures of the cabin have been damaged seriously under the shock wave at the same time. Then the explosion response effect of the hull superstructure which has an explosion venting hole has been analysed, and the pressure peak of the shock wave in a different location and the superstructure which has a different explosion venting hole size has been compared, which shows that the explosion venting holes have a strong impact on cabin explosion shock wave propagation, the scope and ratio of the venting explosion depend linearly on the characteristic length of explosion venting holes, and the explosion venting holes can protect the cabin corner structure within certain TNT limits. It is concluded that setting a reasonable size and proper location of the explosion venting holes can achieve the purpose of protecting the important compartments.
Heat Transfer and Flow Distribution Characteristics of Liquid Hydrogen in Parallel Channels under Non-uniform Heat Fluxes
Authors: Zou Sihan , Pei Xinyan , Liu Shanlin , Hou Lingyun
Published: February 2025

Efficient heat exchange technology is crucial for optimizing hydrogen-fueled engines, particularly with liquid hydrogen as the cold-side medium. This study investigates the heat transfer characteristics of liquid hydrogen in parallel channels, focusing on flow and temperature distributions. The analysis of flow resistance within these channels reveals mechanisms responsible for temperature and flow deviations in dual-channel systems. Various scenarios with different heat flux ratios and total flow rate conditions are examined to elucidate their impacts on temperature and flow deviations. Additionally, a sensitivity analysis examines the impact of variations in thermophysical properties, listed as density, specific heat at constant pressure, thermal conductivity, and viscosity—on temperature and flow deviations, highlighting the principal factors that drive these changes. This research provides a comprehensive analysis and mechanistic insights into the heat transfer behavior of liquid hydrogen in parallel channels, establishing a theoretical framework for the design of efficient liquid hydrogen heat exchangers in hydrogen-fueled engines.
The Latest Development of Powering Aircraft (Aviation) with Hydrogen and Assessing the Technology Readiness
Authors: Rakhshani B. , Murmu T. , Leslie T. , Gopalasingam D. , Zhang W.
Published: February 2025

To meet the aviation emissions reduction targets, the performance characteristics in terms of power output, fuel consumption and propulsive efficiencies of hydrogen-powered aircraft have been reviewed and assessed. The design performance of an aircraft model (regional turboprop ATR 72-600) retrofitted with hydrogen-based propulsive systems was investigated, and comparisons are made against the conventional jet-fuelled propulsion. The hydrogen retrofit constituted two configurations; a fuel cell (FC) powered and direct combustion design. The power characteristics of the three propulsive configurations along with the fuel consumption and efficiencies have been numerically modelled and evaluated. The hydrogen retrofits in both architectures (FC and direct combustion) have been found to perform in line with required operational parameters. They have also demonstrated high level of efficiency in terms of reduced fuel consumption up to 50% for the FC retrofit and 80% for direct combustion design. The weight factor, however, poses a significant challenge to the feasibility of the hydrogen technology.
Design of a single-phase bidirectional charger for power flow control in electric vehicles
Authors: Eti SRI LATHA ETI , Rama Sudha K
Published: February 2025

Environmentally friendly and a carbon neutral future highly rely on the use of Electric Vehicles for commute. The ease of charging and the accessibility of vehicle infrastructure, however, remain key factors in the mainstream adoption of Electric Vehicles. The paper focuses on the design, analysis and control of a bidirectional single ended primary inductor type converter (SEPIC). The dynamic behaviour of the converter with load variations were presented along with performance parameters which explains the operation of the bidirectional charger in Vehicle-to-X charging modes. Also, a review on the bidirectional DC-DC converter topologies is covered in this paper. Simulations were performed in MATLAB environment and the results were presented under various operating scenarios of the converter topology.
Bayesian optimization of hybrid quantum LSTM in a mixed model for precipitation forecasting
Authors: Dong Yumin , Ding Huanxin
Published: February 2025

Precipitation forecasting has important applications in meteorological research. Accurate forecasting is of great significance for reducing the impact of floods, optimizing crop planting plans, rationally allocating water resources, and ensuring traffic safety. However, the factors affecting precipitation are complex and nonlinear, and have spatiotemporal variability, making rainfall forecasting extremely challenging. In response to these challenges, this paper proposes a hybrid model based on temporal convolutional network (TCN), quantum long short-term memory network (QLSTM), and random forest regression (RFR) to achieve more accurate rainfall forecasting. The hyperparameters of the model are optimized using the Bayesian optimization algorithm to obtain the best performance. Experiments are conducted on meteorological datasets from Seattle and Ukraine, and the results are verified using mean absolute error (MAE), root mean square error (RMSE), and bias evaluation indicators. The results show that the proposed hybrid model outperforms traditional models such as RFR, SVM, KNN, LSTM, and QLSTM in terms of MAE, RMSE, and bias. The proposed model achieves improvements of 1.89%MAE, 2.65% RMSE, and 31% Bias, respectively. These results highlight the improved forecast accuracy and robustness of the proposed hybrid model. This research provides a new approach to weather forecasting and demonstrates the potential of combining quantum computing with traditional machine learning techniques.
Photocatalytic degradation of dye contaminants using ZnO-Hematene composite under UVA and visible light exposure
Authors: Aviles-Monreal Raul , Borbon-Nuñez Hugo , Nava-Ramos Jesus , Farías M.H. , Castillón-Barraza Felipe
Published: February 2025

A novel Hematene 2D nanosheets-ZnO (ZnO-Hm) composite was successfully synthesized via a facile liquid exfoliation method. AFM, TEM and UV-vis techniques confirmed the successful exfoliation of Hematene and the formation of the composite. The ZnO-Hm composite exhibited enhanced visible light absorption compared to pure ZnO, attributed to the synergistic interaction between the two materials, leading to improved photocatalytic activity for the degradation of methylene blue and rhodamine B under visible or UVA irradiation. ZnO-Hm composite exhibited complete degradation of dyes under UVA light and significantly improved degradation under visible light. Kinetic analysis revealed improved degradation rate and half-life constants for the ZnO-Hm composite compared to pure ZnO. These results suggest the potential of ZnO-Hm composite for efficient and economical water treatment applications.
Imaging-based screen identifies novel natural compounds that perturb cell and chloroplast division in Chlamydomonas reinhardtii
Authors: Clark-Cotton Manuella R. , Chen Sheng-An , Gomez Aracely , Mulabagal Aditya , Perry Adriana , Malhotra Varenyam , Onishi Masayuki
Published: February 2025

Successful cell division requires faithful division and segregation of organelles into daughter cells. The unicellular alga Chlamydomonas reinhardtii has a single, large chloroplast whose division is spatiotemporally coordinated with furrowing. Cytoskeletal structures form in the same plane at the midzone of the dividing chloroplast (FtsZ) and the cell (microtubules), but how these structures are coordinated is not understood. Previous work showed that loss of F-actin blocks chloroplast division but not furrow ingression, suggesting that pharmacological perturbations can disorganize these events. In this study, we developed an imaging platform to screen natural compounds that perturb cell division while monitoring FtsZ and microtubules and identified 70 unique compounds. One compound, curcumin, has been proposed to bind to both FtsZ and tubulin proteins in bacteria and eukaryotes, respectively. In C. reinhardtii, where both targets coexist and are involved in cell division, curcumin at a specific dose range caused a severe disruption of the FtsZ ring in chloroplast while leaving the furrow-associated microtubule structures largely intact. Time-lapse imaging showed that loss of FtsZ and chloroplast division failure delayed the completion of furrowing but not the initiation, suggesting that the chloroplast-division checkpoint proposed in other algae requires FtsZ or is absent altogether in C. reinhardtii.

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Landscape of Consensus-Based Entity-Endorsed Perioperative Quality Measures
Authors: Harris Alex H.S. , Davis-Lopez Kristen , Schmidt Eric , Nieser Kenneth , Massarweh Nader N.
Published: February 2025

Objective:

Healthcare quality measures have a central role in monitoring and incentivizing the quality of surgical care. Payors and other stakeholders rely on consensus-based entities (CBEs) for the rigorous, independent evaluation and endorsement of quality measures. The aim of this study is to catalog current CBE-endorsed, surgery-related quality measures and to assess measure characteristics, gaps, and redundancies to inform prioritization of measure development efforts.

Methods:

The National Quality Forum Quality Positioning System and Battelle Partnership for Quality Measurement were reviewed to identify CBE-endorsed quality measures related to perioperative care. Identified measures were characterized in terms of their type (eg, structure, process and outcome), quality domain (eg, effectiveness and efficiency), focus (eg, complications, cost and improvement in functioning), and perioperative specialty (eg, general surgery and anesthesia).

Results:

A total of 172 perioperative measures were identified, of which 79 were currently CBE-endorsed and 93 were previously endorsed. Among currently endorsed measures, 43 (54%) were clinical outcomes measures (eg, mortality and/or complications, readmissions), 8 (10%) were patient-reported outcomes measures, 20 (26%) were process measures, 4 (5%) were cost measures, and 4 (5%) were measures of structure. Measures specific to cardiothoracic (n = 40) and orthopedic (n = 11) surgery were the most common while 12 measures were relevant to multiple specialties.

Conclusions:

Despite the large number of surgery-related quality measures, most are concentrated on a small sample of quality domains for a few surgical specialties. Fewer measures are focused on patient-reported outcomes or experiences, low-value care (eg, unnecessary testing or imaging), healthcare structures, or processes that may lead to better outcomes.
Impact of Skin Tone on Skin Tolerance to Shear in the Context of Pressure Injuries: Theory and Computer Modeling
Authors: Katz Tomer , Gefen Amit
Published: February 2025

OBJECTIVE

To investigate the impact of darker skin tones on skin tolerance to shear forces in the context of pressure injuries (PIs) and explore the mechanobiological hypothesis that people with darker skin may be at an increased PI risk due to altered biomechanical skin properties resulting from a lower water content (WC) as some literature suggests.

METHODS

The authors developed a computational modeling framework simulating skin with varying Poisson ratios to represent different WC levels in the stratum corneum (SC), focusing on the effects of ethnicity and WC on mechanical stresses in superficial skin during weightbearing postures. Mechanical properties of the tissues were based on literature values. Pure compression and compression with shear were applied to the skin model.

RESULTS

A lower Poisson ratio in the SC, indicating lower WC, is associated with higher tissue stresses and more intense stress concentrations, especially under combined compression and shear loading. The initial reduction in the Poisson ratio had the most significant impact on increased tissue loading. These results support the hypothesis that the lower WC in darker skin, associated with increased transepidermal water loss, may lead to altered biomechanical behavior and increased PI risk.

CONCLUSIONS

The modeling suggests that reduced WC and increased transepidermal water loss, notably present in darker skin tones, lead to higher stress concentrations within the SC, thus elevating the PI risk. Comprehensive clinical and biomechanical data across various skin tones are needed to improve the practice of PI prevention in individuals with darker skin.
Incidence of Multiple Revision Cervical Surgeries After Single-Level Anterior Cervical Discectomy and Fusion
Authors: Durand Wesley M. , Hoveidaei Amir Human , Raad Micheal , Khanna Rajan , Jain Amit
Published: February 2025

Study Design.

Retrospective analysis using the MarketScan private insurance database from 2010-2020.

Objective.

Determine the incidence of multiple revision cervical surgeries at 5 years following primary, single-level ACDF and assess the risk of subsequent revisions after the first and second surgeries.

Summary of Background Data.

The rate of revision surgery after ACDF is well-documented, but data on multiple revision surgeries is limited.

Methods.

Adult patients ≤65 years undergoing primary, single-level ACDF were identified. Patients with infectious, traumatic, or neoplastic etiologies were excluded. The primary endpoint was any revision cervical surgery with follow-up ending at 5 years. Kaplan-Meier and Cox proportional hazards regression were used, adjusting for sex, age, CCI, and region.

Results.

A total of 42,845 patients undergoing primary, single-level ACDF (P) were included, with a mean age of 48.9 years (SD 9.0); 52.8% were female. The “first revision” (R1) group included 2,374 patients, and the “second revision” (R2) group had 195 patients. The mean revision-free follow-up was significantly different across the P, R1, and R2 groups, though with small absolute differences (P 2.2 years, R1 2.0 years, R2 2.0 years; P<0.0001). At 5-years post-operatively, the incidence of revision surgery was 10.8% after primary surgery, 24.1% after one revision, and 42.5% after two revisions. In multivariable Cox regression, the risk of subsequent revision surgery was significantly higher after one revision (HR 1.6 vs. primary, P<0.0001) and even more so after two revisions (HR 2.6 vs. primary, P<0.0001). Interval hazard analysis showed a significantly higher incidence of revision from 2-5 years with each subsequent revision (all P<0.05).

Conclusion.

After primary ACDF in patients <65 years, approximately 10% underwent revision at 5 years post-operatively. The occurrence of subsequent revision surgery was higher; >20% after one revision, and >40% after two revisions, which is critical for patient decision-making.

Level of Evidence.

III
Identification of Hypoplastic Left Heart Genotypes and Phenotypes; The Window toward Future Cell-Based Therapy: A Narrative Review
Authors: Shahidi Mohsen
Published: February 2025

Hypoplastic left heart syndrome (HLHS) is a prevalent and lethal type of single ventricle anomaly. During early prenatal evaluations, left heart hypoplasia may be neglected due to its progressive features. It is a heterogeneous congenital heart disease with different phenotypes. Currently, there is no definite treatment for HLHS. This is in part due to its heterogeneous phenotypes that require different management. In addition, hindrances in recognizing the etiologic factors do not allow early preventive or therapeutic procedures. Phenotypic determination is fundamental to identifying the etiologic factors and therapeutic strategies. This review article introduces comprehensive information about different phenotypes and genotypes of HLHS and their novel molecular strategy. Genetic defects and flow-mediated mechanisms are the main known factors of HLHS. Recent studies reported additional data about its nonmendelian genetic origins associated with heterogeneous phenotypes. The genetic defects influence endocardium or cardiomyocyte development to yield early or late valve deformities and myocardial malformations. The new molecular therapeutic methods are essentially based on genetic etiologies. The principal therapeutic purpose is reinforcing the function of the right ventricle in patients with nonfunctional left ventricles. The ultimate desire is to create a biventricular heart in selected cases.
Volume of Aerobic Exercise to Optimize Outcomes in Cardiac Rehabilitation: An Official Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation
Authors: Savage Patrick D. , Beckie Theresa M. , Kaminsky Leonard A. , Lavie Carl J. , Ozemek Cemal
Published: February 2025

Exercise training is a core component of cardiac rehabilitation (CR) programming. Exercise and, more broadly, physical activity are critical elements to secondary prevention of cardiovascular disease. The central components of the exercise prescription are well-defined and include frequency (how many bouts of exercise per week), intensity (how hard to exercise), time (duration of exercise session), type (modality of exercise), and progression (rate of increase in the dose of exercise). Specific targets for the volume (total amount) of exercise, however, are less well-defined. This Position Statement provides a general overview of the specific goals for the volume of aerobic exercise to optimize long-term outcomes for participants in CR. Additionally, examples are provided to illustrate how to integrate the various aspects of the exercise
Invasive Haemophilus influenzae Disease at a US Children’s Hospital in the SARS-CoV-2 Era
Authors: McNeil J. Chase , McDonald David R. , Dunn James J. , Kaplan Sheldon L. , Hulten Kristina G. , Vallejo Jesus G.
Published: February 2025

Background:

National data previously demonstrated an increase in invasive disease due to non-type b Haemophilus influenzae from the 2000s to the 2010s. Significant shifts in the epidemiology of respiratory pathogens in children have occurred in the post-SARS-CoV-2 era. We examined pediatric invasive H. influenzae disease in the pre- and post-SARS-CoV-2 years.

Methods:

Invasive H. influenzae infections were identified from culture records of the Texas Children’s Hospital microbiology laboratory from January 2011 to December 2023. Invasive cases were considered those with isolation of H. influenzae from a sterile site. The annual number of cases/1000 admissions was used as a surrogate for incidence.

Results:

One hundred twenty-four cases of invasive disease were identified. The median age was 1.9 years, and 57% had pre-existing comorbidities. The most common diagnosis was bacteremia without a focus (50%), followed by pneumonia (27%). An increase in invasive disease occurred from 2011 to 2019 (P < 0.001) followed by a decline from 2020 to 2021 (P = 0.04) and a subsequent resurgence (P < 0.001). Bacteremia declined in 2020 followed by an increase in 2022 (P = 0.003); 50% of pneumonia cases occurred in the final 2 study years. The most common strain types were nontypeable H. influenzae (NTHi, 52.4%), type a (17.5%) and type f (15.9%). NTHi declined in 2020 followed by a peak in 2022, exceeding prepandemic rates (P = 0.001). Respiratory viruses were codetected in 52.9% of those tested.

Conclusions:

The frequency of pediatric invasive H. influenzae has undergone change throughout the SARS-CoV-2 pandemic. Recent increases in disease activity are driven by NTHi presenting as bacteremia and pneumonia. Given the high burden of disease, these trends should continue to be monitored.
Knowledge, attitude, and practice regarding cardiovascular diseases in Saudi Arabia: A cross-sectional study
Authors: Alaamri Shalan , Naser Abdallah Y.
Published: February 2025

Cardiovascular diseases (CVDs) are the primary contributors to mortality and morbidity on a global scale. The aim of this study is to examine knowledge, attitude and practices of the general public regarding CVDs in Saudi Arabia. This is a cross-sectional survey study that was conducted in Saudi Arabia to examine KAP of the general public regarding CVDs between January and February 2024. There were 605 participants in total enrolled in this study. The mean knowledge score for the study participants was 7.1 (2.5) out of 11 (64.5%); which indicates moderate level of knowledge of CVD. A considerable proportion of participants (61.5%) report engaging in vigorous physical activity for a minimum of 30 minutes per day throughout the week, including activities like running, lifting large loads, or drilling. In terms of knowledge, there is no significant difference between males and females across gender categories (odds ratio = 0.92, P = .603). Within the age group category, those between the ages of 24 and 30 (odds ratio = 0.44, P < .001) and 31 and 40 (odds ratio = 0.39, P < .001) demonstrate noticeably diminished probabilities of possessing superior knowledge in comparison to those between the ages of 18 and 23. In relation to marital status, the odds of possessing superior knowledge are considerably lower for married individuals (odds ratio = 0.43, P < .001), divorced individuals (odds ratio = 0.39, P = .003), and widowed individuals (odds ratio = 0.11, P = .004) in comparison to singles. The survey found moderate level of awareness of cardiovascular diseases and strong recognition of preventive measures including physical activity and a healthy diet. There are gaps in CVD symptom knowledge. Participants are typically favorable about CVD prevention and willing to adopt healthy lifestyles. Decision-making recommendations include targeted teaching efforts on symptom awareness, physical activity, and healthy diets. Further research is needed to determine how educational interventions improve knowledge across demographic groups. Longitudinal studies could also evaluate lifestyle treatments for CVD risk reduction.
The impact of the moon cycles’ in different seasons on heart failure patients’ hospitalization and length of stay
Authors: Khiatah Bashar , Jazayeri Sam , Diep Brian , Yamamoto Naofumi , Belikova Anna , Diaz Graal , Frugoli Amanda , Mansour Craig
Published: February 2025

The natural forces of the lunar cycle and seasonal solstice variation on the water surfaces have been studied extensively but not on patients with fluid problems such as heart failure (HF). This retrospective review investigates these temporal effects on admission rates of patients with heart failure and length of stay. In this study, we try to answer the following questions: Do moon cycles (full moon vs new moon) significantly affect the number of patients admitted? and Do moon cycles significantly affect the patient’s hospital length of stay (LOS?). All patients with HF exacerbation admission between January 1, 2016 to December 31, 2019, were filtered according to admission date based on the lunar calendar. Patients admitted on the day of, the day before, and the day after a new and full moon were included. Question 1, Poisson regression models were employed. The overdispersion obtained from the AER package was 1.63. All analyses were performed using R (R Core Team). A total of 758 patients were admitted during lunar cycles, 50.1% (N = 380) were admitted during the new moon and 49.4% (N = 378) during the full moon. The mean age is 78.4 (SD 7.2), the mean BMI is 28.8 (SD 6.7), and the mean LOS is 5.6 (SD 3.4) with no significant differences in patients admitted during both of the moon cycles. The seasons variable showed statistically significant coefficients, with the summer season (S2) having the highest impact (coefficient 0.85, P = .001). Some interaction between Moon-Cycle, summer season, and BMI influenced patient admissions during lunar cycles (coefficient = 0.49 P ≤ .001). This study showed that the moon cycle may impact patients with HF during the summer season only. Prospective studies are needed on a national level to investigate further the impact of the moon cycle on HF patients. This will help improve patient outcomes and pathogenesis, and there is excellent potential for reducing medical costs.
Comparison of the effects of endobutton continuous loop and adjustable zip loop devices on bone tunnel enlargement and clinical results in arthroscopic anterior cruciate ligament reconstruction: A retrospective observational study
Authors: Doğar Fatih , Dere Kadir Ismail , Bilal Okkeş , Topak Duran , Altun Ibrahim , Kuşcu Burak , Özdemir Mustafa Abdullah , Gültekin Muhammed Zeki , Kizildağ Betül
Published: February 2025

It was aimed to reveal the effects of 2 different techniques [Endobutton Continuous Loop (CL), ZipLoop technique] used for graft fixation in anterior cruciate ligament (ACL) reconstruction on bone tunnel enlargement and clinical results. Patients who underwent arthroscopic ACL reconstruction using hamstring tendon graft due to ACL rupture between January 2016 and December 2020 were retrospectively analyzed. The study included 80 patients who were operated on by the same surgical team in the same clinic. Forty patients who underwent repair using the suspension system ZipLoop technique were classified as Group 1, and 40 patients who underwent repair using the Endobutton CL technique were classified as Group 2. Plain radiography and MRI were used to evaluate bone tunnel widening. Visual analog scale (VAS), International Knee Documentation Committee (IKDC) knee assessment score, and Lysholm scores were evaluated at the last follow-up to evaluate clinical outcomes. When bone tunnel enlargement was evaluated between the groups, femoral and tibial tunnel enlargement was found to be greater and statistically significant in Group 2 patients in direct radiography measurements. No statistically significant difference was found in tunnel enlargement in MRI measurements (P > .05). However, in MRI measurements, the graft apex–tunnel apex distance was found to be greater and statistically significant in Group 2 patients (P < .05). When the clinical results of both groups were compared, no statistically significant difference was found in VAS, IKDC and Lsyholm scores (P > .05). The graft fixation method affects bone tunnel enlargement. However, it was observed that this had no effect on clinical results.