bluuebunny/crossref_metadata_2025 huggingface dataset:
A spectral machine learning approach to derive central aortic pressure waveforms from a brachial cuff
Authors: Tamborini Alessio , Aghilinejad Arian , Gharib Morteza
Published: February 2025

Analyzing cardiac pulse waveforms offers valuable insights into heart health and cardiovascular disease risk, although obtaining the more informative measurements from the central aorta remains challenging due to their invasive nature and limited noninvasive options. To address this, we employed a laboratory-developed cuff device for high-resolution pulse waveform acquisition and constructed a spectral machine learning model to nonlinearly map the brachial wave components to the aortic site. Simultaneous invasive aortic catheter and brachial cuff waveforms were acquired in 115 subjects to evaluate the clinical performance of the developed wave-based approach. Magnitude, shape, and pulse waveform analysis on the measured and reconstructed aortic waveforms were correlated on a beat-to-beat basis. The proposed cuff-based method reconstructed aortic waveform contours with high fidelity (mean normalized-RMS error = 11.3%). Furthermore, continuous signal reconstruction captured dynamic aortic systolic blood pressure (BP) oscillations (r = 0.76,
P
< 0.05). Method-derived central pressures showed strong correlation with the independent invasive measurement for systolic BP (R
2
= 0.83; B [LOA] = −0.3 [−17.0, 16.4] mmHg) and diastolic BP (R
2
= 0.58; B [LOA] = −0.7 [−13.1, 11.6] mmHg). Shape-based features are effectively captured by the spectral machine learning method, showing strong correlations and no systemic bias for systolic pressure–time integral (r = 0.91,
P
< 0.05), diastolic pressure–time integral (r = 0.95,
P
< 0.05), and subendocardial viability ratio (r = 0.86,
P
< 0.05). These results suggest that the nonlinear transformation of wave components from the distal to the central site predicts the morphological waveform changes resulting from complex wave propagation and reflection within the cardiovascular network. The proposed wave-based approach holds promise for future applications of noninvasive devices in clinical cardiology.
Multiscale toughening mechanisms in biomimetic tendon-like hydrogels
Authors: Guo Xiao , Dong Xinyu , Zou Guijin , Zhang Haoqi , Zeng Kaiyang , Gao Huajian , Zhai Wei
Published: February 2025

Mimicking hierarchical structures found in nature, such as nacre and tendon, has led to remarkable successes in the creation of biomimetic materials with exceptional properties. The depth of knowledge derived from nature extends far beyond mere trial-and-error fabrication by providing deep insights into the toughening mechanisms that are integral to natural materials. A key challenge is understanding how these toughening mechanisms can be effectively translated into biomimetic materials. Here, we characterize the multiscale mechanical behavior of tendon-like fibrous hydrogels, unraveling the intricate toughening mechanisms at play across multiple scales—from dynamic molecular interactions and nanoscale fibril sliding, to anisotropic microscale characteristics and macroscopic performance—using a combination of experimental and simulation approaches. Additionally, we address the open question of how hierarchical structures exhibit mechanical properties at different scales, demonstrating that hydrogels, fibrils, and chains take up successively lower levels of strain in a ratio of 11.5:3.2:2. This work establishes a comprehensive framework for exploring nature-inspired materials, marking a significant step forward in the advancement of biomimetic technology.
“The rock of stability?”
Authors: Bonnet Alma-Pierre
Published: February 2025

Within the fields of narratology and discourse analysis, this paper proposes a critical narrative analysis of Sir
Keir Starmer’s storytelling at the four party conferences he attended as opposition leader. The objective is to assess how Starmer
attempted to create the image of a strong and stable leader, in discourse, in a bid, arguably, to differentiate himself from his
predecessor, to rebrand his party as an inclusive organisation and to establish his ethos as a credible leader. Maybe more
importantly, this paper posits that the narratives at the heart of his keynote speeches served a self-promotional purpose to show
that, by focusing on the notion of stability, he could bring to a close a fourteen-year period of electoral and ideological
domination by the Conservative Party.
DNA barcodes narrow down the possible sources of introductions of an invasive banana skipper,
Erionota torus
Evans (Lepidoptera, Hesperiidae)
Authors: Cock Matthew J.W. , Buddie Alan G. , Cafa Giovanni , Chiba Hideyuki , Girish Kizhakke Athulya , Yu-Feng Hsu , Kunte Krushnamegh
Published: February 2025

The banana skipper,
Erionota torus
Evans (Lepidoptera, Hesperiidae, Hesperiinae, Erionotini) is a South-east Asian pest of banana that, in the last 60 years, has spread to the southern Philippines, Taiwan, Japan, India, Sri Lanka, Mauritius and La Réunion, and potentially threatens Africa and Tropical America. A partial library of DNA barcodes from the indigenous and introduced ranges was built. Based on our analysis, the indigenous populations can be divided into an ‘East’ group, in China and Vietnam, and a ‘West’ group in India, Nepal, Myanmar and west Malaysia. Further, within the ‘West’ group, there is a coherent ‘Malaysia’ subgroup from west Malaysia. Introduced populations in south India, La Réunion and Taiwan showed almost no variation in barcodes, suggesting they are each based on a single homogenous introduction. We conclude that the introduced populations in Taiwan and Japan match the ‘East’ group, the introduced populations in Mauritius and La Réunion match the ‘Malaysia’ subgroup and the introduced population in south India matches the ‘West’ group. These results are discussed in the context of existing ideas regarding the source of each introduction, and the implications in terms of pathways of entry.
Unique Carrollian manifolds emerging from Einstein spacetimes
Authors: Blitz Samuel , McNutt David , Nurowski Paweł
Published: February 2025

We explicitly determine all shear-free null hypersurfaces embedded in an Einstein spacetime, including vacuum asymptotically flat spacetimes. We characterize these hypersurfaces as oriented 3-dimensional manifolds where each is equipped with a coframe basis, a structure group and a connection. Such manifolds are known as null hypersurface structures (NHSs). The coframe and connection one-forms for an NHS appear as solutions to the projection of the Cartan structure equations onto the null hypersurface. We then show that each NHS corresponds to a Carrollian structure equipped with a unique pair of Ehresmann connection and affine connection.
Washable, transparent and self-sustained sensor based on transparent stretchable electrodes
Authors: Wang Yan , Zhang Haonan , Jin Shichao , Wang Mingyong , Zhang Xiao-Sheng
Published: February 2025

With the continuous advancement of technology, flexible electronic devices are gradually becoming integrated into our daily lives. These devices exhibit remarkable properties such as flexibility, bending capability, and resilience in harsh environments. One particular challenge in the development of these devices is achieving a balance between transparency and conductivity for flexible transparent stretchable electrodes. In this article, we use thermoplastic polyurethane (TPU), silver nanowires (AgNW), and polydimethylsiloxane (PDMS) to fabricate a stretchable, transparent and self-sustained multifunctional sensor, which retains its functionality even after being washed in water for 16 minutes with stirring speed of 100 r/min. The TPU/AgNW electrode has a high transparency (85.26 %) and conductivity (7.04 Ω/sq) with third spin-coating process. When it stretch up to 80%, it also sustain excellent conductivity (6.4 kΩ). The flexible self-powered pressure sensor has high transparency, and it maintains excellent sensing performance of high pressure sensitivity (0.01499 V/kPa) and has fast response time (20 ms), demonstrating excellent pressure sensing characteristics. The sensing performance decreases by only 24% when the deformation reaches 100%.
Mechanical fault diagnosis method based on binary neural network with adaptive depth-to-width ratio
Authors: Liu Chenyu , Li Zhinong , Wang Fengtao , Li Zhe , Yang Wenxian
Published: February 2025

Deep neural network (DNN) has powerful feature extraction and classification abilities and is extensively used in mechanical fault diagnosis. However, in the DNN-based fault diagnosis method, too many model parameters, high computational complexity, and occupying a large amount of storage space make it very difficult to optimize and retrain the DNN model. To overcome this deficiency, a binary neural network (BNN) is introduced into fault diagnosis. In the proposed BNN-based fault diagnosis method, the floating-point weights and activations are binarized as ‘+1’ and ‘-1’ to save storage space, and the floating-point multiply-accumulate operations are replaced by bitwise operations to reduce the computational complexity. The BNN-based fault diagnosis method effectively compresses the structure of DNNs and accelerates model inference. However, the binarization operation may bring about the quantization error and gradient error, which will accumulate with the increase of the network depth, and lead to a degradation in model performance. To solve these deficiencies in the proposed BNN-based fault diagnosis method, an improved BNN fault diagnosis method based on adaptive depth-to-width ratio (ADTWR) is proposed. For the convenience in description, the proposed method is called the BNN-ADTWR method. In the proposed BNN-ADTWR method, the network structure is reshaped by the comparison of the gains brought by the depth and width of the backbone network, and the backbone network is further optimized by the pruning technique. To evaluate the effectiveness of the proposed method, the comparative experiments, such as ablation, anti-noise, and computational complexity, had successfully completed on several rolling bearing datasets. The experiment results show that the proposed BNN-ADTWR method significantly reduces computational complexity and helps with rapid fault diagnosis. The constructed ADTWR backbone network decreases activations in the traditional backbone network and improves absolute accuracy while the computational cost is equivalent.
Design of an integrated ultrasonic guided wave structural health monitoring system based on multi-channel high-speed synchronous acquisition
Authors: Li Zehua , Xue Wendong , Yang Zhenhai , Huang Xin , Qing Xinlin , Wang Yishou
Published: February 2025

Structural health monitoring (SHM) technology based on ultrasonic guided wave (UGW) has been widely researched and applied. The SHM instrument development has become a current research hotspot. Existing UGW SHM systems typically use the single-actuation-single-reception (SASR) mode and require an external computer for data processing and analysis. This results in a large system size and low scanning efficiency, making it difficult to meet the requirements for airborne applications. In response to the SHM requirements for airborne applications, this paper designs an architecture with FPGA for synchronous high-speed acquisition and an ARM embedded system for asynchronous analysis and processing. A core control module for real-time UGW acquisition was developed, featuring 4-channel 14-bit 100 MSPS high-speed synchronous sampling. At the FPGA level, a high-throughput FIFO (First In, First Out) data buffer was designed, achieving average read and write speeds of 330 MByte/s and 1.6 GByte/s, respectively. Data is asynchronously transferred to the ARM embedded system via the PCIe bus for analysis and processing, thereby implementing functions with a low-power CPU. The acquisition control module uses the single-actuation-multiple-simultaneous-reception (SASMR) mode, which improves scanning efficiency by up to 4 times compared to the SASR mode used in traditional monitoring systems. While improving system integration and reducing weight, the system's power consumption is also reduced, achieving a standby power consumption of less than 20 W. Experiments based on the core control module developed in this paper involved constructing an UGW SHM integrated system with 64 piezoelectric sensor channels. System performance tests and damage localization experiments on composite materials were conducted, achieving an error within 2 cm.
Application of variational Bayesian-based cubature information filter for UWB/INS tightly coupled positioning system
Authors: Wang Sen , Dai Peipei , Xu Tianhe , Nie Wenfeng , Cong Yangzi , Gao Fan , Xing Jianping
Published: February 2025

Accurate and reliable positioning is a crucial foundation for achieving sufficient autonomy and intelligence in positioning systems. The ultra-wideband (UWB) technology has significant potential for applications in the challenging and complex field of indoor positioning, and is often integrated with the inertial navigation system (INS) to enhance the overall performance of integrated positioning system. This paper proposes a novel variational Bayesian-based cubature information filter that enhances the positioning accuracy of tightly coupled UWB/INS navigation system. This approach aims to provide continuous and reliable navigation and positioning across various scenarios. The proposed integrated system applies the non-holonomic constraint to positioning in the elevation direction, thereby enhancing the system’s overall positioning accuracy and performance. Real-world experimental results demonstrate that the proposed system delivers continuous, accurate, and stable positioning. In UWB line-of-sight scenario, the proposed system achieves root mean square errors of 0.085 m, 0.091 m, and 0.125 m in the east, north, and horizontal directions, respectively; the corresponding errors in non-line-of-sight scenario are 0.286 m, 0.237 m, and 0.372 m. Furthermore, when integrated with a scheme for mitigating non-line-of-sight errors, the proposed system demonstrates a significant enhancement in positioning accuracy. In conclusion, the experimental results effectively validate the proposed system’s effectiveness in achieving accurate and continuous positioning across various environments, demonstrating its application potential in complex scenarios.
Investigating the layered structure of HfNBr and HfNCl0.5Br0.5: A DFT+U approach to optoelectronic and thermoelectric application
Authors: Shirvani Fatemeh , Jafari Mohammad Reza , Shokri Aliasghar
Published: February 2025

Layered materials have attracted considerable attention due to their distinctive properties. In this study, the optoelectronic and thermoelectric characteristics of HfNBr and its alloy with Cl, where Br atoms are partially replaced, were investigated using density functional theory (DFT), while incorporating the Hubbard correction (U) in the calculations. The structural and dynamic stability of these compounds was confirmed through cohesive energy and phonon results analysis. The electronic density of states (DOS) revealed semiconducting band gaps of 2.275 eV (using the GGA method) and 2.744 eV (with GGA+U) for HfNBr, while for the alloy HfNCl0.5Br0.5, the band gaps were calculated as 2.31 eV (GGA) and 2.781 eV (GGA+U). The highest optical conductivity was observed for pure HfNBr, reaching 6.519  × 1015 s−1 at a photon energy of 5.03 eV along the x-direction, as calculated with GGA+U. For the alloy compound, the maximum optical conductivity was also along the x-direction, with a value of 5.549  × 1015 s−1 at the same photon energy (5.03 eV), using the GGA+U method. Additionally, the peak absorption coefficient for HfNBr was found to be 3.348  × 108 m−1 at a photon energy of 4.91 eV using the GGA method. For the alloy, the maximum absorption coefficient, obtained using GGA+U, was 1.104  × 108 m−1 at a photon energy of 5.61 eV. At temperature of 300 K, corresponding to room temperature, the maximum of thermoelectric power factors per relaxation time for HfNBr and HfNCl0.5Br0.5 were 60.82  × 1016
μW.m−1.K−2.s−1 at a chemical potential of −1.37 eV (GGA) and 58.38  × 1016
μW.m−1.K−2.s−1 at −1.56 eV (GGA+U), respectively. These findings provide valuable insights into the potential applications of these materials in optoelectronic and thermoelectric devices.
Asymmetric warm dark matter: from cosmological asymmetry to chirality of life
Authors: Yin Wen , Nakagawa Shota , Murokoshi Tamaki , Hattori Makoto
Published: February 2025

We investigate a novel scenario involving asymmetric keV-range dark matter (DM) in the form of right-handed (sterile) neutrinos. Based on the Fermi-Dirac distribution, we demonstrate that asymmetric fermionic DM forms a Fermi degenerate gas, making it potentially colder than symmetric fermionic DM. This setup simultaneously accounts for the Universe's baryon asymmetry through tiny Yukawa interactions with Standard Model leptons and the Higgs field, and the homochirality of amino acids via decay into circularly polarized photons. This scenario can be investigated through soft X-ray searches conducted by current and upcoming space missions.
The helical X-rays is a smoking-gun signal of our scenario. Additionally, we propose a new mechanism to suppress thermalization by introducing a light modulus, which may also benefit cosmology involving generic right-handed neutrinos with large mixing.
Influence of cooling atmosphere on the structure, magnetization, and dielectric properties of CaBaCo4O7
Authors: Gong Gaoshang , Wang Minghao , Liu Ruoshui , Wu Yang , Wang Lichen , Wang Yongqiang , Shen Baogen
Published: February 2025

CaBaCo4O7 has been widely studied because of its distinctive structure and magnetic properties. This study examined the influence of different cooling atmospheres on the structure, magnetic properties, and dielectric behavior of CaBaCo4O7. Samples were cooled under different atmospheric conditions to assess these influences. Our findings indicate that reduced oxygen content leads to increased lattice distortion. Since oxygen atoms play a crucial role in mediating magnetic exchange, oxygen deficiency disrupts long-range magnetic order and promotes short-range antiferromagnetic interactions. Additionally, the cooling atmosphere significantly impacts grain size, thereby affecting the dielectric constant and dielectric loss. In the argon-cooled CaBaCo4O7 (Ar) sample, oxygen deficiency reduced dielectric permittivity and increased dielectric loss.
A framework for discrete optimization of stellarator coils
Authors: Hammond Kenneth
Published: February 2025

Designing magnets for three-dimensional plasma confinement is a key task for advancing the stellarator as a fusion reactor concept. Stellarator magnets must produce an accurate field while leaving adequate room for other components and being reasonably simple to construct and assemble. In this paper, a framework for coil design and optimization is introduced that enables the attainment of sparse magnet solutions with arbitrary restrictions on where coils may be located. The solution space is formulated as a "wireframe" consisting of a mesh of interconnected wire segments enclosing the plasma. Two methods are developed for optimizing the current distribution on a wireframe: Regularized Constrained Least Squares (RCLS), which uses a linear least-squares approach to optimize the currents in each segment, and Greedy Stellarator Coil Optimization (GSCO), a fully discrete procedure in which loops of current are added to the mesh one by one to achieve the desired magnetic field on the plasma boundary. Examples are presented of solutions obtainable with each method, some of which achieve high field accuracy while obeying spatial constraints that permit easy assembly.
Generalized arcsine laws for a sluggish random walker with subdiffusive growth
Authors: Del Vecchio Del Vecchio Giuseppe , Majumdar Satya N.
Published: February 2025

We study a simple one dimensional sluggish random walk model with subdiffusive growth. In the continuum hydrodynamic limit, the model corresponds to a particle diffusing on a line with a space dependent diffusion constant

D
(
x
)
=

|

x

|

−
α

and a drift potential

U
(
x
)
=

|

x

|

−
α

, where

α
⩾
0

parameterizes the model. For α = 0 it reduces to the standard diffusion, while for α > 0 it leads to a slow subdiffusive dynamics with the distance scaling as

x
∼

t

μ

at late times with

μ
=
1

/

(
α
+
2
)
⩽
1

/

2

. In this paper, we compute exactly, for all

α
⩾
0

, the full probability distributions of three observables for a sluggish walker of duration T starting at the origin: (i) the occupation time

t
+

denoting the time spent on the positive side of the origin, (ii) the last passage time

t
l

through the origin before T, and (iii) the time tM
at which the walker is maximally displaced on the positive side of the origin. We show that while for α = 0 all three distributions are identical and exhibit the celebrated arcsine laws of Lévy, they become different from each other for any α > 0 and have nontrivial shapes dependent on α. This generalizes the Lévy’s three arcsine laws for normal diffusion

(
α
=
0

) to the subdiffusive sluggish walker model with a general

α
⩾
0

. Numerical simulations are in excellent agreement with our analytical predictions.
Commissioning of Extended Electron Beam Ion Source at Brookhaven National Laboratory
Authors: Kondrashev S. , Beebe E. , Coe B. , Ikeda S. , Kanesue T. , Landon G. , Okamura M. , Raparia D. , Ritter J. , Rodowicz T. , Schoepfer B. , Vorbach R.
Published: February 2025

The Extended Electron Beam Ion Source (EEBIS) has been installed and commissioned at Brookhaven National Laboratory (BNL) hadron accelerator complex in the spring of 2023. EEBIS has replaced its predecessor, RhicEBIS, which provided ions for BNL hadron facilities for over a decade since 2009. The motivations for the source upgrade are to provide higher intensities of the Au32+ ion beam for the Relativistic Heavy Ion Collider (RHIC) and to provide of an intense source of polarized 3He2+ ions for the future Electron Ion Collider (EIC) at BNL. EEBIS is and will continue to be the primary source for a variety of different ion species for the NASA Space Radiation Laboratory (NSRL) at BNL. EEBIS utilizes two identical, two-meter-long unshielded 5T warm bore superconducting solenoids, and it is operated with electron beam current up to 10 A, providing a high-capacity ion traps to fulfill the requirement for high intensity ion beams. The upstream solenoid contains a “short ion trap” with a length of 95 cm, while the “long ion trap” with a length of 178 cm is located inside the downstream solenoid bore. The main features of EEBIS are:

* A Gas injection and ionization cell equipped with a Lorenz pulse valve

* High-capacity ZAO non-evaporable getter (NEG) custom linear pumping units

* In situ apparatus for pumping speed measurements to monitor NEG activation and saturation

* “External drift tube” construction with differential pumping stages to provide space for Lorentz pulse valve and 3He high-field polarization cell

* A Ba oxide electron gun cathode.

The design of EEBIS as well as the results of its commissioning and first-year operation are presented and discussed.
Investigation of the burst phenomenon in SiPMs in liquid nitrogen
Authors: Guarise M. , Andreotti M. , Balboni A. , Calabrese R. , Casazza D. , Cotta Ramusino A. , Corallo A. , Chiozzi S. , D'Amico R. , Fiorini M. , Giammaria T. , Luppi E. , Pierini L. , Tomassetti L.
Published: February 2025

Burst effect of Silicon Photomultiplier (SiPM) at cryogenic
temperatures have been discovered few years ago looking at the dark
count rate of SiPMs at liquid nitrogen temperatures. Bursts are
trains of single signals that happen randomly and are clearly
distinguishable from the primary DCR and correlated noise because of
their particular time distribution. In this article we describe a
detailed study related to both the external causes that triggers
bursts and to the phenomenon, internal to the sensor, that produces
this dark signals. We related the burst occurrence to the
luminescence produced by some trapping centers in the SiPMs when
they are excited by ionizing radiation that impinges on the sensor.
Effect of overlap rates on forming quality and properties of laser cladding Ni40A-WC composite coatings
Authors: Xu Liangjie , Sun Shengyuan , Xu Jihao , Liu Zihan , Li Jiaxin , Wang Jiale , Cao Yang , Jiao Junke
Published: February 2025

To investigate the effect of the overlap rates on quality, microstructure and mechanical properties of the cladding layer, the Ni40A-WC composite coating on the surface of H13 steel was prepared by laser cladding technology, and the surface morphology, crack defects, microstructure, microhardness, friction and wear of composite coatings with different overlap rates was detailed characterized and analyzed. The results show that the overlap rates is a key parameter that affects the quality and performance of coatings, and Ni40A-WC coating with flat surface, compact structure and significantly improved mechanical properties can be obtained by appropriate overlap rates. With the increase of the overlap rates, the WC particles in the coating increased, the hard phase diffraction peak intensity of Cr7C3, W2C and Cr23C6 in the microstructure increased, and the microhardness and wear resistance also increased. The mean hardness of the coating at 50%, 60%, 70% and 80% overlap rates increases 1.01, 1.16, 1.17 and 1.71 times of the hardness of H13 substrate, respectively, and the wear rate decreases by about 57%, 65%, 74% and 83%, respectively.
Sharp Boundary Trace Theory and Schrödinger Operators on Bounded Lipschitz Domains
Authors: Behrndt Jussi , Gesztesy Fritz , Mitrea Marius
Published: February 2025

We develop a sharp boundary trace theory in arbitrary bounded Lipschitz domains which, in contrast to classical results, allows “forbidden” endpoints and permits the consideration of functions exhibiting very limited regularity. This is done at the (necessary) expense of stipulating an additional regularity condition involving the action of the Laplacian on the functions in question which, nonetheless, works perfectly with the Dirichlet and Neumann realizations of the Schrödinger differential expression

−
Δ
+
V

-\Delta +V

. In turn, this boundary trace theory serves as a platform for developing a spectral theory for Schrödinger operators on bounded Lipschitz domains, along with their associated Weyl–Titchmarsh operators. Overall, this pushes the present state of knowledge a significant step further. For example, we succeed in extending the Dirichlet and Neumann trace operators in such a way that all self-adjoint extensions of a Schrödinger operator on a bounded Lipschitz domain may be described with explicit boundary conditions, thus providing a final answer to a problem that has been investigated for more than 60 years in the mathematical literature. Along the way, a number of other open problems are solved. The most general geometric and analytic setting in which the theory developed here yields satisfactory results is that of Lipschitz subdomains of Riemannian manifolds and for the corresponding Laplace–Beltrami operator (in place of the standard flat-space Laplacian). In particular, such an extension yields results for variable coefficient Schrödinger operators on bounded Lipschitz domains.
Predictors of NCLEX-RN Failure in Prelicensure Nursing Students
Authors: Rogers Meagan , Koomey Cynthia , Fontenot Rachael
Published: February 2025

AIM

The aim of this study was to identify predictors of NCLEX-RN® failure and guide nursing program support and resources for at-risk students.

BACKGROUND

Prelicensure nursing programs have adopted stringent admission and progression policies and often delay student testing based on known predictors of NCLEX-RN success. Students also delay scheduling the exam based on their perceived level of test readiness. There is a gap in the literature associated with predictors of NCLEX-RN failure.

METHOD

A retrospective predictive analysis was conducted on 3,396 graduates for the period 2018 through 2022 using demographic characteristics and academic metrics as variables.

RESULTS

Students who were men and students with increased lag time to take the NCLEX-RN (>45 days between graduation and initial attempt) were significantly more likely to fail.

CONCLUSION

Nursing programs using only known predictors of success for admission and progression decisions exclude students who could be successful if given the opportunity.
Alterations of diffusion kurtosis measures in gait-related white matter in the “ON–OFF state” of Parkinson’s disease
Authors: Wei Xuan , Wang Shiya , Zhang Mingkai , Yan Ying , Wang Zheng , Wei Wei , Tuo Houzhen , Wang Zhenchang
Published: February 2025

Background:

Gait impairment is closely related to quality of life in patients with Parkinson’s disease (PD). This study aimed to explore alterations in brain microstructure in PD patients and healthy controls (HCs) and to identify the correlation of gait impairment in the ON and OFF states of patients with PD, respectively.

Methods:

We enrolled 24 PD patients and 29 healthy controls (HCs) from the Movement Disorders Program at Beijing Friendship Hospital Capital Medical University between 2019 and 2020. We acquired magnetic resonance imaging (MRI) scans and processed the diffusion kurtosis imaging (DKI) images. Preprocessing of diffusion-weighted data was performed with Mrtrix3 software, using a directional distribution function to track participants’ main white matter fiber bundles. Demographic and clinical characteristics were recorded. Quantitative gait and clinical scales were used to assess the status of medication ON and OFF in PD patients.

Results:

The axial kurtosis (AK), mean kurtosis (MK), and radial kurtosis (RK) of five specific white matter fiber tracts, the bilateral corticospinal tract, left superior longitudinal fasciculus, left anterior thalamic radiation, forceps minor, and forceps major were significantly higher in PD patients compared to HCs. Additionally, the MK values were negatively correlated with Timed Up and Go Test (TUG) scores in both the ON and OFF in PD patients. Within the PD group, higher AK, MK, and RK values, whether the patients were ON or OFF, were associated with better gait performance (i.e., higher velocity and stride length).

Conclusions:

PD exhibits characteristic regional patterns of white matter microstructural degradation. Correlations between objective gait parameters and DKI values suggest that dopamine-responsive gait function depends on preserved white matter microstructure. DKI-based Tract-Based Spatial Statistics (TBSS) analysis may serve as a tool for evaluating PD-related motor impairments (e.g., gait abnormalities) and could yield potential neuroimaging biomarkers.
Tadalafil Use in Cardiovascular Disease
Authors: Kallash Mohammed , Frishman William H.
Published: February 2025

Tadalafil is a phosphodiesterase inhibitor currently approved for use in erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH). While tadalafil’s benefits in ED and BPH have been well-established for years, its benefits in PAH were identified only recently in major clinical trials, resulting in the recent approval of a single-tablet, combination therapy of tadalafil with an endothelin receptor antagonist for PAH. With Tadalafil’s cardiovascular benefits in ED, BPH, and PAH, clinical researchers have begun investigating whether tadalafil’s use extends to other cardiovascular diseases, especially heart failure (HF), an emerging epidemic in medicine. Recent research in animal models has demonstrated a potential benefit of tadalafil use in ischemic cardiomyopathy and HF, as numerous studies in mice and sheep demonstrated improved left ventricular function and contractility, with reduced adverse remodeling and hypertrophy. A retrospective cohort study identified that tadalafil use in patients with ED and coronary artery disease was associated with a significant decrease in the incidence of HF, acute myocardial infarction, and mortality compared with sildenafil or no treatment. However, a randomized controlled trial in patients with comorbid PAH and HF with preserved ejection fraction demonstrated no significant benefit with the use of tadalafil. Unfortunately, there is limited evidence from clinical trials investigating the impact of tadalafil in patients with HF with reduced or preserved ejection fraction without comorbid PAH. Further studies are needed on this topic to better identify whether tadalafil has a role in the prevention or treatment of HF.
Cardiac Immunotherapy, Immuno-Cardiology and the Future of Cardiovascular Pharmacology
Authors: Biondi-Zoccai Giuseppe , Weber Brittany N. , Abbate Antonio , Booz George W.
Published: February 2025

Immuno-cardiology is an emerging field that explores the interplay between the immune system, inflammation and cardiovascular health/disease, aiming to develop innovative therapies for preventing and treating cardiac diseases. Indeed, chronic inflammation and immune dysregulation play pivotal roles in most cardiovascular conditions, including arrhythmias, atherothrombosis, ischemic heart disease, heart failure, and valve disease. Recent advances in immune-based therapies, including chimeric antigen receptor (CAR)-T and CAR-macrophage (CAR-M) technologies, have demonstrated potential in impacting on cardiac fibrosis and thus improving surrogate endpoints in preclinical studies. Immune checkpoint inhibitors (ICIs), while already established as an effective intervention in oncology, present challenges in their cardiovascular applications due to cardiotoxic side effects, highlighting the need for dedicated cardioprotective strategies or further molecular refinements. Nanoparticle-based delivery systems and cytokine-targeted therapies may offer precise modulation of immune responses, while gut microbiota interventions could exploit the systemic impact of inflammation on cardiovascular health. Despite these quite promising advances, barriers such as safety, scalability, and patient-specific responses must be addressed, and thus precision and personalized approaches will be crucial to overcoming these challenges and ensuring safe and also equitable access. By leveraging interdisciplinary collaboration and technological innovations, immuno-cardiology holds the promise of transforming the prevention and treatment landscape for cardiac diseases, paving the way for improved outcomes and quality of life for patients worldwide.
Human Papillomavirus Infections and Sequela in Women
Authors: Stokes Mary J. , Ramirez Paulina R. , Spencer Nicole M. , Nelson Erin L.
Published: February 2025

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with up to 90% of females infected at some point in their lifetime. While most HPV infections will be cleared by the immune system within 2 years, persistent HPV infection may result in anogenital warts, dysplasia of the cervix, vagina, vulva, and squamous cell carcinoma. This chapter will review the epidemiology, microbiology, progression, and treatment of HPV-related genital disease in women.
A novel KEAP1 inhibitor, tiliroside, activates NRF2 to protect against acetaminophen-induced oxidative stress and acute liver injury
Authors: Cai Fangfang , Zhou Kaiqian , Wang Peipei , Zhang Wen , Liu Lei , Yang Yunwen
Published: February 2025

Background:

Acetaminophen-induced acute liver injury (AILI) is one of the common causes of abrupt liver failure in numerous nations. Several previous studies revealed that tiliroside, a glycoside flavonoid, exerts neuroprotective and renal protective effects. However, whether it has hepatoprotective effects is not known. The objective of this research is to examine whether tiliroside can protect against AILI.

Methods:

AILI mouse and cell models were performed to evaluate the protective effects of tiliroside. Molecular docking, cellular thermal shift assay, immunoprecipitation, and RNA-seq were performed to analyze the possible mechanisms of tiliroside.

Results:

In vivo, tiliroside attenuated AILI in mice significantly, as evidenced by lower ALT and AST levels. Molecular docking, cellular thermal shift assay, and RNA-seq analysis revealed that tiliroside promoted the activation of nuclear factor erythroid 2-related factor 2 (NRF2) and the expression of its downstream genes through disruption of the NRF2-KEAP1 protein-protein interaction to inhibit KEAP1-mediated ubiquitination and degradation of NRF2, thereby inhibiting oxidative stress in the livers of AILI mice. Furthermore, hepatocyte-specific knockout of NRF2 greatly attenuated the hepatic-protective effects of tiliroside in mice. In vitro, tiliroside protected against acetaminophen-induced oxidative stress on cultured hepatocytes through activation of NRF2. In addition, NRF2 knockout markedly blunted the protection effects of tiliroside, suggesting that NRF2 mediates the hepatic-protective effects of tiliroside.

Conclusions:

Our study demonstrated that tiliroside could protect against AILI by activating the KEAP1/NRF2 pathway, which primarily inhibits the processing of oxidative stress and cell death. Our results suggest that tiliroside could serve as a potential agent for the clinical treatment of AILI.
Integrative single-cell and spatial transcriptome analysis reveals heterogeneity of human liver progenitor cells
Authors: Liu Chuanjun , Wang Kai , Mei Junpu , Zhao Ruizhen , Shen Juan , Zhang Wei , Li Liangyu , Roy Bhaskar , Fang Xiaodong
Published: February 2025

Background:

Liver progenitor cells (LPCs) with bipotential differentiation capacities are essential for restoring liver homeostasis and hepatocyte population after damage. However, the low proportion and shared markers with epithelial cells make studying LPC heterogeneity difficult, especially in humans. To address this gap, we explored over 259,400 human liver single cells across 4 conditions (fetal, healthy, cirrhotic, and HCC-affected livers).

Methods:

Human liver tissue samples were analyzed using spatial transcriptomics sequencing technologies to describe the heterogeneity of LPCs. Liver tissue was characterized by LPC heterogeneity at single-cell resolution by employing cellular modules, differentiation trajectories, and gene co-expression patterns.

Results:

We annotated and identified 1 LPC cluster, 3 LPC subpopulations, and 4 distinct cellular modules, indicating the heterogeneity within LPC and the diversity between LPCs and epithelial cells. LPCs showed spatial colocalization with cholangiocytes and comprised a small proportion (2.95±1.91%) within the merged epithelial cells and LPC populations, exhibiting marked differences in marker expression patterns compared to those in mice. LPCs exhibited distinct cellular states in functional restoration, activation, proliferation, and cell transition. Additionally, the gene co-expression network of LPCs exhibited 3 unique modules, reflecting the distinct connectivity of genes encoding apolipoproteins and heat shock proteins in the gene co-expression network modules.

Conclusions:

Our study provides valuable insights into the multifaceted heterogeneity of human LPCs. Future studies focusing on spatial gene expression dynamics will contribute to our understanding of the spatial arrangement of liver regeneration.
Cardiac Rehabilitation Among Veterans
Authors: Varghese Merilyn S. , Wu Wen-Chih , Drwal Kariann R. , Burg Matthew M. , Kazi Dhruv S. , Gaffey Allison E. , Mattocks Kristin M. , Brandt Cynthia A. , Bastian Lori A. , Gandhi Parul U.
Published: February 2025

Purpose:

Cardiac rehabilitation (CR) is a valuable secondary preventive intervention for Veterans given their increased risk of cardiovascular disease. Adults cared for in the Veterans Affairs (VA) healthcare system are a unique population that receives healthcare from the largest integrated care network in the United States. Yet, this group faces distinct challenges in utilizing CR. In this review, we evaluated the existing data regarding CR utilization and outcomes among U.S. Veterans.

Review methods:

A literature search was conducted using PubMed and Scopus for cardiac rehabilitation and U.S. Veterans.

Veterans have 3 potential options for attending CR: in-person at their local VA medical centers, home-based CR through their local VA medical centers, and in-person at community CR centers. However, participation remains low. A significant barrier to participation is transportation to in-person CR. Home-based CR shows promise in addressing this barrier and has demonstrated resilience in the face of pandemic restrictions. Cardiac rehabilitation outcomes among Veterans who participate include improved exercise capacity, fewer depressive symptoms, and decreased mortality. Despite its benefits for secondary prevention among Veterans, there remains a paucity of data about the current uptake of CR, the impact of mental health on uptake, possible sex-based or racial disparities, and long-term outcomes.
New Keratoconus Grading System Based on OCT: Threshold Adjustment for a Swept-Source OCT
Authors: Lu Nan-Ji , Raiskup Frederik , Pillunat Lutz E. , Wang Qin-Mei , Cui Le-Le , Herber Robert
Published: February 2025

Purpose:

To assess the performance of the STEP keratoconus (KC) grading system using swept-source (SS)-OCT, and to compare the relative performance of SS-OCT and spectral domain (SD)-OCT for thickness measurements.

Setting:

University hospitals in Germany and China.

Designs:

Retrospective case-control study.

Methods:

Rotating Scheimpflug Tomography (RSC, Pentacam) and SS-OCT (ANTERION) were used to examine 152 normal and 314 KC eyes from a German cohort; The STEP system (stroma thinnest thickness [ST] and epithelium standard deviation [EP]) was generated in SS-OCT and compared with RSC ABC system. Pentacam and SD-OCT (RTVue-XR) data from a Chinese cohort of 236 normal and 331 KC eyes were utilized to indirectly assess inter-device agreement between SS-OCT and SD-OCT using Bland-Altman plots and linear regression. Optimized thresholds for STEP ‘ST’ were determined for SS-OCT.

Results:

In normal eyes, STEP ‘ST’ agreement with RSC ‘C’ was 91.45%, dropping to 28.98% in KC eyes. STEP ‘EP’ showed 58.55% and 60.53% agreement with RSC ‘A’ and ‘B’ in normal eyes, and 36.62% and 52.87% in KC eyes, respectively. SS-OCT’s ST values were estimated to be higher than those of SD-OCT (estimated mean difference = 23.18 and 20.91 μm in the normal and KC eyes, respectively). Adjusted threshold of STEP ‘ST’ for SS-OCT was proposed.

Conclusions:

SS-OCT’s STEP ‘EP’ aligned well with RSC ABC system, while thresholds for SS-OCT’s STEP 'ST' required adjustment for more accurate clinical application. These findings highlight important considerations for thickness measurement discrepancies between SS-OCT and SD-OCT, with broader implications for future clinical practice and research.
Validation of the CONTEC08A upper-arm blood pressure monitor in adult Chinese
Authors: Zhou Yi , Zhou Yi , Zou Ruo-Yi , Li Yan , Wang Ji-Guang
Published: February 2025

Objective

The aim of this study was to evaluate the accuracy of the CONTEC08A oscillometric upper-arm blood pressure (BP) monitor for BP measurement in adults according to the International Organization for Standardization (ISO) 81060-2:2018 and amendment (Amd)1:2020 standard.

Methods

Eighty-five subjects (male 40 and female 45) were recruited to fulfill the age, sex, BP, and cuff distribution criteria of the ISO standard in the general population, and had a mean age of 40.2 years. The same arm sequential BP measurement method was used with three differently sized cuffs for the arm circumference ranging from 18 to 26 cm (small), 22–32 cm (medium), and 22–43 cm (large), respectively, for the test device, and two differently sized cuffs for the arm circumference ≤32 cm (standard) and >32 cm (large), respectively, for the mercury sphygmomanometer.

Results

Two hundred and fifty-five comparison pairs were obtained for analysis. For validation criterion 1, the mean ± SD of the differences between the test device and reference SBP/DBP readings was 1.1 ± 6.7/3.0 ± 5.3 mmHg. For validation criterion 2, the SD of the averaged SBP/DBP differences between the test device and reference BP per subject was 5.63/4.68 mmHg.

Conclusion

The automated upper-arm BP monitor CONTEC08A has passed the requirements of the ISO Universal Standard in the general population, and can be recommended for BP measurement in adults.
Clinical evaluation of the iHealth BP7 wrist blood pressure monitor in general population according to the ISO 81060-2:2018/Amd 1:2020
Authors: Li Yiming , Zhu Zizhuo , Li Jiaheng , Gu Yuan , Wan Yi
Published: February 2025

Objective

The objective of this study is to evaluate the accuracy of the iHealth BP7 wrist blood pressure (BP) monitor for clinical use and self-measurement in general population according to the International Organization for Standardization (ISO) 81060-2:2018/Amendment (Amd) 1:2020 protocol.

Methods

Same arm BP was sequentially measured in 95 qualified participants and compared with a standard mercury sphygmomanometer. A total of 285 comparison pairs were obtained and analyzed according to the ISO 81060-2:2018/Amd 1:2020.

Results

For the validation Criterion 1 of the protocol, the mean ± SD of the differences between the test device and reference BP readings was 0.62 ± 6.18 and −0.20 ± 5.59 mmHg for SBP and DBP, respectively. For Criterion 2, the SDs of the averaged BP differences between the test device and reference BP per subject were 5.79 and 5.28 mmHg (with maximum allowed SDs of 6.90 and 6.95 mmHg) for SBP and DBP, respectively.

Conclusion

The iHealth BP7 wrist BP monitor satisfied all the validation requirements according to the ISO 81060-2:2018/Amd 1:2020 protocol and can be recommended for clinical use and self-measurement in the general population.
Time is spine: critical updates for the intensivist
Authors: Sandarage Ryan , Nashed Joseph Y. , Tsai Eve C.
Published: February 2025

Purpose of review

The concept of ‘time is spine’ emphasizes early or ultra-early surgical decompression within 24 or 12 h, respectively, after spinal cord injury (SCI) to maximize recovery. This review updates the latest findings on the timing of surgical decompression and hemodynamic management in acute SCI, focusing on neurological outcomes and complications.

Recent findings

While early decompression may improve neurological outcomes, factors like injury severity, comorbidities, and system resources affect surgical timing. Recent studies question the benefits of ultra-early decompression, finding no significant improvement at 12 months, suggesting earlier analyses may have overstated its benefits. Current recommendations include tailoring decompression timing to individual cases, considering patient-specific and systemic factors. New techniques like spinal cord pressure monitoring, intraoperative ultrasound, and advanced imaging are advancing targeted intervention and hemodynamic management in SCI.

The timing of spinal decompression and hemodynamic management may impact neurological function, however, because of the deficiencies of current studies, individualized, patient-tailored decision-making is critical. A multidisciplinary approach that considers injury severity and patient characteristics is essential for optimal management. Further research is required to refine the timing of surgical intervention and explore additional factors influencing recovery.