bluuebunny/crossref_metadata_2025 huggingface dataset:
Parameter estimation for the weibull general log-linear model in accelerated life testing
Authors: Yuan Fuqing , Lu Jinmei
Published: February 2025

Uncertainty is commonly present in accelerated life test (ALT) data. The combination of a general log-linear model with a statistical distribution model—using the Weibull distribution in this paper—allows for addressing both multiple operational factors and uncertainty within a single model. This paper interprets the Weibull General Log-Linear (WGLL) model from the ALT perspective. Two parameter estimation methods—maximum likelihood estimation and least squares method—are proposed to address the parameter estimation problem. A simulation study demonstrates that both methods are effective, while the least squares method generally provides better results. The approaches proposed in this paper can be used to develop more general ALT models.
Numerical methods for inverse problems in quadratic programming
Authors: Wang Min , Li Lidan
Published: February 2025

This paper addresses a quadratic programming inverse problem that minimizes the distance between the parameters of the objective function and the right-side parameters of the constraints and their estimated values under the condition that the feasible solution is the optimal solution to the original quadratic programming problem. By employing duality theory, we first transform this problem into an optimization problem with complementarity constraints. Subsequently, we utilize the smooth Fischer-Burmeister function to handle the complementary constraints, converting the problem into a convex optimization framework. The first-order optimality conditions are then applied to reformulate the problem as a generalized equation. We also demonstrate that the generalized Jacobian elements at the solution point are non-singular, enabling the use of an inexact Newton method for solving the problem. Numerical experiments are conducted, comparing our approach with previous methods, and the results indicate that our method exhibits significantly higher computational efficiency.
The comparative study of vector wave equation solutions based on dyadic Green’s function
Authors: Luo Xiangdong , Li Yongning
Published: February 2025

Based on the dyadic Green’s function, this paper analyzes four Green function methods for solving vector wave equations, obtains the relations of electromagnetic field quantities expressed by dyadic Green’s function, and compares several methods. It is found that the expression of the third method is the same as that of the second method. If

G

=

m

=

G

=

m
2

is chosen for the fourth method, the expression of the solution is the same as that of the first method.
Coxeter elements and Coxeter plane: A programming guide
Authors: Wang Ying , Zhao Liang
Published: February 2025

In a finite Coxeter group, the product of its generating elements in any given sequence is called a Coxeter element. The Coxeter element acts on a two-dimensional plane P as a rotation, and the rotation’s order is precisely the order of the Coxeter element itself. When projecting the root system onto P, the result is a beautifully symmetric pattern that exhibits rotational symmetry. This paper takes the exceptional Lie algebra E8 as an example to demonstrate how to compute such a projection using the Python programming language. We also discuss some properties of Coxeter elements, such as their conjugacy, orders, characteristic polynomials, and eigenvalues. This contribution opens up new avenues for a deeper understanding of Lie algebras and Coxeter groups, enriching the reader’s comprehension of these beautiful structures.
Acyclic coloring of two operations of graphs
Authors: Jin Xinze , Tian Shuangliang
Published: February 2025

The coloring theory of graphs is a very important direction in graph theory. The graph coloring problem has a strong application background. Many practical problems such as timetabling problems, frequency allocation problems, traffic arrangements, circuit design, and storage problems can be transformed into graph coloring problems. A substantial amount of scholarly work has been dedicated to the exploration of acyclic coloring, resulting in a plethora of significant findings that significantly contribute to the theoretical framework of vertex coloring in graphs. An acyclic coloring of a graph G refers to a proper vertex coloring where the subgraph resulting from any pair of color classes does not encompass any cycles. We analyze acyclic coloring in splitting graphs and Cartesian products of paths and cycles by using the method of structural coloring, reductive proof, and mathematical induction. Moreover, we present the precise acyclic chromatic numbers for splitting graphs of cycles and Cartesian products of paths and cycles.
Meshless method for solving nonlinear Sine-Gordon equation
Authors: Su Lingde , Wang Zhenli
Published: February 2025

Sine-Gordon is a classical wave equation with a nonlinear sine source term. In this article, the method of approximate particular solution is applied to solve the nonlinear sine-Gordon equation. In the algorithm, the primary operator Laplacian is kept on the left, and other terms are placed on the right, regarded as forcing term. Therefore, the original equation can be regarded as a standard Poisson equation. Then, based on the theory of radial basis function interpolation, the solution of the original problem can be obtained by solving the operator equation. This method is meshless with advantages such as ease of implementation and high accuracy.
Existence of solutions for a fractional m&n-Laplacian system with Hardy-Sobolev exponents
Authors: Zhang Rumao , Deng Zhiying
Published: February 2025

In this article, our purpose is to study weak solutions for a fractional m&n-Laplacian system with Hardy-Sobolev critical exponents. It is hard to find a classical solution for our system, so we will discuss a weak solution for its energy function. We will also study the Sobolev spaces that can be used in compact embedding. With the help of some inequalities, we show that the sequence we used is bounded in our Sobolev spaces. Finally, we can prove that our system has a nontrivial solution.
Matching energy and hosoya index on the complements of unicycle graphs
Authors: Ma Haicheng , He Xianghong
Published: February 2025

The matching energy of a graph is defined as the sum total of the absolute values of all the zeros of its matching polynomial, which is a quantity of significance in chemical applications. Since the study of extreme matching energy is an interesting work, some authors have given some vastly amusing elementary results on this topic. For example, Gutman, Ji, Chen, etc. characterized the unicycle, bicycle, and tricycle graphs with extremal matching energy. In this article, we focus on the matching energy of the complements of graphs, and four relevant graph transformations are given, from which we completely determine the graphs with extremal matching energy, among all complements of trees and all complements of unicycle graphs, respectively. As a byproduct, we also find that there exist the same results for the extremal Hosoya index.
Variance estimation in high dimensional truncated linear models
Authors: Pan Cheng , Zi Xuemin
Published: February 2025

This paper focuses on the problem of variance estimation in high-dimensional truncated linear models. In ultra-high-dimensional regression models, variance estimation is crucial for statistical inference and model selection. Traditional variance estimation techniques are no longer applicable when the number of samples is fewer than the number of variables. This paper proposes an improved variance estimation method that combines Refitted Cross-validation (RCV) with three semiparametric truncated linear regression estimators: Symmetric Trimmed Least Squares (STLS), Quadratic Mode Estimation (QME), and Left Truncation (LT) estimators. Theoretical analysis and simulation studies show that these combined methods not only mitigate the impact of high spurious correlations from irrelevant variables but also improve the accuracy and robustness of variance estimation. We further conducted detailed numerical simulations, which serve as concrete evidence of their effectiveness.
Study on measurement method of average pore radius of organic and inorganic matters in shale reservoirs
Authors: Sun Xin , Zhang Ran , Du Huanfu , Du Shuyan , Liu Guihua
Published: February 2025

Oil and natural gas resources are important strategic materials for guaranteeing national energy security and play an irreplaceable role. In recent years, the foreign dependence on oil has greatly affected China’s energy security. Shale oil/gas, as an important unconventional oil/gas resource with wide distribution and large reserves, has become a key area for breakthroughs in oil/gas exploration and increased reserves and production in the future. Shale oil/gas exists in both organic and inorganic pores in shale, and there is a big difference between organic and inorganic pores in terms of the crude oil occurrence state and starting ability. However, due to the constraints of geological understanding and engineering technology, it is currently difficult to distinguish between organic and inorganic pores in shale reservoirs, resulting in the inability to distinguish and measure the corresponding pore radius, which greatly restricts the evaluation of shale oil/gas reservoirs and oil/gas-bearing possibilities, the selection of development layers and the evaluation of shale oil/gas productivity. In this study, a method for measuring the average pore radius of organic and inorganic matter in shale reservoirs is proposed. This method can quickly and accurately distinguish organic and inorganic pores in shale reservoirs, and is of high application value for evaluating shale oil/gas reservoirs and oil/gas-bearing possibilities, selection of development layer as well as oil/gas productivity.
A moving mesh method for analyzing dual-phase-lag heat transfer in silicon substrate heated by a moving laser pulse source
Authors: Fan Longkun
Published: February 2025

We investigated the thermal characteristics of silicon substrate under the effect of a moving laser source using the 2D dual-phase-lag heat transfer theory. A moving mesh technique that is effective has been proposed to address the physical issue mentioned above. Specifically, the 1D moving mesh partial differential formulation is used to build the 2D adaptable mesh dimension by dimension using a suitable monitor operation of the area of temperature. The finite difference approach is then used to resolve the model issue on the adaptable mesh. The algorithm’s efficiency is confirmed by the numerical findings. Furthermore, research has been conducted to investigate the impact of pulse duration and phase lag factors on the silicon substrate’s thermal response.
Damaged acoustic-deformation response characteristics of layered soft rock under water-rock coupling
Authors: Sun Yinhao
Published: February 2025

To explore the damaged acoustic-deformation response characteristics of layered soft rock under water-rock coupling, the structural anisotropy of wave velocity and micro-fracture morphological characteristics were studied. The results show that the wave velocity of soft rock has significant structural anisotropic characteristics. The water-rock process has a significant strengthening effect on the wave transmission of vertical layering. The wave-velocities Vc
(parallel layering) and Vp
(vertical layering) of saturated soft-rock increased by 4.52%–35.76% and 52.28%–113.53%. The structural specificity coefficients of saturated soft-rock are significantly weakened, which was 46.02%–78.44% of that of dry soft-rock. The structural anisotropy of soft-rock is significantly weakened by water-rock interaction, the structural heteromorphic coefficient of saturated soft-rock is 46.02%–78.44% of that of dry soft-rock, and its compaction path is prolonged, the elastic deformation is shortened and the average strength decreases by 42.44%. The wave velocity Vc
of dry soft-rock goes through the stages of steady development, slow decay, and sharp decay. The soft rock is mainly damaged by splitting, the tension cracks increase and the degree of rupture is intensified after the water saturation, and the micro-sections are mainly dissolution fractures. The research can provide a theoretical reference for the stability analysis of hydraulic rock mass.
Generalized solitons: Resize the amplitudes of solitons
Authors: Wang Dikai
Published: February 2025

A classical soliton is a solitary wave whose amplitude, shape, and velocity remain unchanged. The letter discovers a novel property of a soliton to change its amplitude. Simulations show that: (1) The amplitude of each soliton can be changed by exerting a function on it. The classical soliton affected by the function is extended to a generalized soliton. (2) The generalized soliton retains the properties of the function. (3) Many generalized solitons can be easily constructed by using different functions.
Optimal decay rate of solutions to compressible quantum Navier-Stokes-Poisson system
Authors: Deng Qinqin
Published: February 2025

In this paper, we investigate the optimal decay-in-time rate of solutions to the Cauchy problem of the compressible quantum Navier-Stokes-Poisson (abbr. QNSP) equations, which had been used to model the motion of electrons in the semiconductor devices on the nanometer scale. Since the quantum effect in the QNSP equations is described by the third-order spatial derivatives of density, this fact results in some essential difficulties in the investigation of the optimal decay-in-time rate of solutions by the spectral analysis method. To avoid the essential difficulties, we use the method of pure energy estimates to substitute the spectral analysis method as in [1], and thus establish the decay-in-time rates of solutions. We believe that the decay-in-time rates obtained in this paper are optimal, since they are consistent with the ones of the linear equations.
Characterization of energy absorption of metal rubber based on SHPB test
Authors: Sun Xiaoting , Wang Yi , Su Xujun , Che Jinli , Wang Wei
Published: February 2025

In order to protect the weak parts from being damaged, it is a common method to choose the appropriate buffer material to resist the impact. In this article, metal rubber is the object of study, and the energy absorption characteristics of the buffer material based on the separated Hopkinson bar test under the same impact load are studied. The test results show that, under the same impact load, the thickness of the metal rubber more energy is greater, and the value of energy absorption efficiency also increases. The maximum energy absorption efficiency of the metal rubber with a thickness of 15 mm is 5.81 J, and the energy absorption efficiency is 9.7%.
Optimized thermal power prediction model for Heliostat fields accounting for meteorological conditions
Authors: He Jialei , Feng Yingyin
Published: February 2025

A specific computational model and procedure for the output thermal power of a Heliostat field under Stochastic weather patterns are proposed for a conical light scenario characterized by non-uniform radiation. To lessen the associated processing complexity, a radial staggered layout is implemented in the meantime. Numerical experiments show the best scheduling plan with probabilistic weather occurrences and demonstrate the output thermal power unit area of the Heliostat under random to clear weather conditions. This research contributes to the practical prediction of thermal power output fluctuations in Concentrating Solar Power (CSP) systems under uncertain weather circumstances. Its findings have the potential to facilitate the real-time control of ancillary equipment, thereby ensuring the stability and efficiency of heat collection capabilities.
Demonstration of a RRAM-CMOS Random Number Generator Circuit for Flexible Hybrid Electronics
Authors: Dwivedi Anurag , Agarwal Harshit , Tiwari Shree Prakash
Published: February 2025

A hybrid random number generator circuit is designed by utilizing the stochastic switching variation, an inherent property arising from the randomness in formation and dissolution of the conductive filament, of a flexible resistive random access memory (RRAM) devices. Initially, a widely accepted simple 1-D RRAM compact model is calibrated with the experimental data from a fabricated flexible RRAM device, with less than 5% of RMS error. Then, two model parameters reflecting the cyclic variations are identified and incorporated in the compact model by using simple mathematical functions. Moreover, the effect of random variation of these two physical parameters, (a) initial gap length of the conductive filament from the opposite electrode, and (b) activation energy, on the switching characteristics of the device has been investigated. Furthermore, a simple 4-bit random number generator (RNG) circuit is proposed that utilizes the switching variations of RRAM device as source of entropy or randomness. A CMOS based circuit is designed using XOR, AND, and 4-bit counter blocks to produce a 4-bit random number utilizing 65 nm UMC PDK. The output of this flexible hybrid circuit have been tested for randomness by utilizing the benchmark test suite of NIST SP 800-22, and it is found that the output has passed most of the applicable tests without incorporating any post processing scheme, indicating the presence of randomness. These results indicate that the incorporation of variation in a simple 1-D model can be qualitatively achieved with the above discussed parameters, and a simple flexible hybrid random number generator circuit may be implemented for hardware security applications.
Highly sensitive directional torsion sensor based on a helical-tapered panda fiber
Authors: xuelan he , Liu Mengyun , jian xing , Li Wenchao , Bai Yan , Cui Shuanglong
Published: February 2025

A directional torsion sensor based on Panda-type polarization-maintaining fiber (PMF) was experimentally demonstrated by using the arc technique, the helical-tapered modulates the PMF periodically, forming the helical-tapered long-period fiber gratings (Ht-LPFGs), in which torsion sensitivity was significantly enhanced by helical tapered structure. The experimental results show that the torsional sensitivity of Ht-LPFGs is 154.5pm/(rad/m) and -0.008737dB/rad/m. Ht-LPFGs’ sensitivity is one order of magnitude higher than that of tapered long-period fiber gratings (t-LPFGs) without helical structure. The torsion sensor proposed in this paper has the advantages of high sensitivity, low cost and small size, which provides a promising method for torsion measurement.
Influence of tilted geometry formation on dimensional accuracy and energy consumption using micro-single point incremental sheet forming
Authors: kumar rupesh , Kumar Vikas
Published: February 2025

Miniature sheet metal part found their applications in variety of field like medial implants, tooth crowning, electronic parts and for making small drones and there housing. Recently research was focused on producing small scale parts using micro-incremental sheet forming to reduce high investment cost and making it viable for micro-forming industries. Since, no research work was found which examine the energy consumption and dimensional accuracy simultaneously at micro level. AA6061 which has wide range of applications in aerospace engineering, drone industry and biomedical field due to its high strength, durability and malleability has not been formed using micro-single point incremental sheet forming (SPIF). The main objective of current study was to form a miniature tilted geometry of AA 6061using micro-SPIF technique and assess power and energy consumption during the process. Additionally, the impact of tilt angle on dimensional accuracy was examined. The maximum deviation in roundness and flatness observed at 10º tilt angle were 29 µm and 5 µm respectively. However, the minimum profile accuracy was measured at 2º tilt angle and the tilt angle was found an insignificant parameter regarding deformation energy in micro-SPIF with contribution of only 0.13% of total energy consumption.
Comparing the economic, environmental, and exposure impacts of options for coming into compliance with drinking water regulations in very small water systems in the US
Authors: Lane Kaycie , Tobiason John , Reckhow David , Kumpel Emily
Published: February 2025

Very small drinking water systems in the United States can face challenges in complying with the Safe Drinking Water Act, resulting in a need to improve existing infrastructure. This study applied a triple bottom-line approach to compare modeled health, environmental, and economic impacts of improving existing centralized water treatment systems to using point-of-use/point-of-entry (POU/POE) devices in four very small community water systems serving 40-450 people. We found that POU/POE systems could be implemented 1-3 years faster than centralized improvements and achieve higher removal efficiencies (up to 99% removal for arsenic, compared to 80% for some centralized options), resulting in larger decreases in human exposure to arsenic or nitrate. Treatment options using adsorptive media or ion exchange resins had larger overall environmental impacts than reverse osmosis devices, and the total 30-year cost of POUs/POEs were more expensive in 3 of the 4 modeled systems than centralized improvements due to high replacement frequencies and populations. An “ideal” option in each community water system was not selected; rather, we contextualized our results as tradeoffs.
Getting Ready for Residency: A Qualitative Analysis of Fourth-Year Medical Student Learning Plans Mapped to Accreditation Council for Graduate Medical Education Residency Competencies
Authors: Mallaro Hannah L. , O’Brien Celia Laird , Sanguino Sandra M. , Dolan Brigid M.
Published: February 2025

Purpose

Undergraduate medical education (UME) to graduate medical education (GME) transition gaps may limit opportunities for learner improvement along each individual’s learning trajectory. Additional information regarding learner perspectives on skill-based learning goals in preparation for the residency transition is needed. The authors hypothesized that fourth-year medical student (MS4) learning plans may provide information to fill the gap in understanding learner perspectives on the knowledge, skills, and opportunities they consider important in supporting their residency readiness.

Method

Directed thematic analysis informed by a constructivist analytical approach was used to review readiness for residency reflections as part of a portfolio assessment system at a large, urban, research-intensive medical school during academic years 2021 and 2022. The authors identified student-selected Accreditation Council for Graduate Medical Education (ACGME) competencies and subcompetencies, iteratively identified non–subcompetency-based themes, refined the codes, and achieved consensus. They then analyzed the frequency of competencies and subcompetencies within learner reflections and explored additional themes.

Results

In the final set of 291 reflections, the ACGME competencies selected for MS4 learning plans were patient care (227 learning plans), medical knowledge (144 learning plans), interpersonal and communication skills (94 learning plans), practice-based learning and improvement (79 learning plans), system-based practice (67 learning plans), and professionalism (63 learning plans). The top 3 ACGME subcompetencies identified as growth areas by MS4s were practice-based learning and improvement: evidence-based and informed practice, patient care: clinical reasoning, and interpersonal and communication skills: interprofessional and team communication. Teaching was the most common learning goal outside the ACGME subcompetencies.

Conclusions

The MS4 readiness for residency reflections offered important insight into student perspectives on UME to GME transition preparation. Learners’ reflections yielded a diverse set of learning goals for the fourth year of medical school, highlighting the importance of individualized approaches in addition to standardized curricula at the time of transition.
Evaluation of Caregivers’ Experiences in the Management of Pressure Injuries in Palliative Care Patients: A Phenomenologic Study
Authors: Pamuk Cebeci Sevil , Duru Pınar , Kaya Zeynep Irmak , Topçu Mihraç
Published: February 2025

OBJECTIVE

To evaluate the experiences of caregivers (patients’ companions and nurses) in managing pressure injuries (PIs) in patients in palliative care.

METHODS

Included in this qualitative phenomenologic study were 10 caregivers (five patient companions and five nurses) involved in the care of five patients hospitalized in the palliative care unit of a single facility between January and March 2023. The research data were collected through face-to-face, in-depth interviews using semistructured interviews.

RESULTS

Two main themes emerged from the interviews: “approach to care” and “factors affecting the care of PIs.” Regarding “approach to care,” subsidiary analytic themes included “management of PIs” and “feelings.” For "factors affecting the care of PIs,” analytic themes were “level of knowledge,” “facilitators,” “difficulty in caregiving,” and “experience of care.”

CONCLUSIONS

The interviewed nurses and patients’ companions identified factors facilitating and complicating the effective management of PIs, knowledge of which may steer the development of strategies by healthcare providers and administrators that meet the needs of healthcare personnel. These findings may contribute to creating interventions and policies for managing PIs, potentially increasing the patients’ quality of life.
Evaluation of the Effect of Massage on Pressure Injury Prevention among Intensive Care Patients: A Randomized Controlled Study
Authors: Özkan Esra , Çilingir Dilek
Published: February 2025

BACKGROUND

Few studies have investigated the application of massage to bony prominences, and international guidelines do not currently recommend additional massage in these areas.

OBJECTIVE

To investigate the impact of the effleurage technique, a component of classical massage known for its clinical applicability and practicality, in preventing pressure injuries (PIs).

METHODS

The study focused on bedridden patients in the ICU of a state hospital. The sample included patients admitted between July 1, 2021, and November 30, 2021, without preexisting PIs. Using a randomized controlled trial design with simple randomization, routine nursing care was provided to the control group of 30 patients, and the experimental group of 30 patients received classical massage (effleurage technique) in addition to routine care. Both groups were followed up for an average of 12 days using various assessment tools, including a patient information form, the Braden Risk Assessment Scale, the Pressure Wound Staging Form, and an experimental/control group follow-up form.

RESULTS

The research results revealed a statistically significant impact of massage application on preventing PIs (P < .05). The average day of PI development was 10.93 ± 2.31 in the experimental group and 6.79 ± 4.42 in the control group.

CONCLUSIONS

The study findings suggest that the effleurage technique, as part of classical massage, can be integrated into nursing practices to effectively prevent PIs.
Exploring the Extent and Depth of Clinical Education on Sepsis SEP-1 Core Measure and the Reported Impact on Outcomes and Compliance rate: A Scoping Review
Authors: Wells Alexis J. , Sapp Alysha , Walker Danielle K. , Baker Kathy A.
Published: February 2025

OBJECTIVES:

This scoping review aimed to understand the extent and depth of education provided on the severe sepsis and septic shock management bundle quality measure (SEP-1) to frontline clinicians to elicit insight regarding the impact on patient outcomes, the compliance rate, and any efforts to alleviate concerns about clinical judgment challenges with SEP-1.

DATA SOURCES:

Seven databases were used: ProQuest, EBSCO Host, Embase, Web of Science, PubMed, MEDLINE, and CINAHL for studies published in 2015 and later using key terms related to sepsis and SEP-1 quality measure.

STUDY SELECTION:

Two independent reviewers selected studies that mentioned the Centers for Medicare and Medicaid Services SEP-1 and included education to frontline clinicians on the quality measure as one of the interventions.

DATA EXTRACTION:

Data extraction included study design, publication type, what was educated to frontline clinicians, Bennet and Bennet’s “depth of knowledge” through education provided, and any mention of patient outcomes and change in SEP-1 compliance rate from the study.

DATA SYNTHESIS:

The initial search yielded 493 articles. After screening for eligibility criteria, 20 studies were ultimately included. When evaluating what details of SEP-1 are being educated, 95% (19/20) of the studies focused on how to identify sepsis as well as the bundle elements required to pass the measure (19/20); however, the deeper details of the measure that allow clinical judgment and still pass the measure are severely lacking.

CONCLUSIONS:

Multiple education opportunities not currently addressed in the literature may lead to improvement of the national SEP-1 compliance rate and alleviate clinician concern that the quality measure does not allow for clinical judgment. Without deeper education, this knowledge gap could be a key factor in why the quality measure national compliance rate has halted, raising calls to retire the measure prematurely.
Mpox and the impact on people with HIV
Authors: Lima Mauricio Teixeira , Kroon Erna Geessien , Campos Marco Antônio
Published: February 2025

Purpose of review

This review explores the intersection of Mpox and HIV, highlighting clinical manifestations, immune evasion mechanisms, epidemiological challenges, and prevention strategies. People with HIV (PWH), particularly those with low CD4+ cell count, face severe Mpox outcomes. Prevention relies on education, vaccination, and early detection. Integrating Mpox management into HIV care systems is vital.

Recent findings

Since May 2022, Mpox caused by Orthopoxvirus monkeypox (MPV) Clade IIb, has affected 126 countries. In 2024, Clade Ib emerged in the Democratic Republic of Congo, leading to its declaration as a Public Health Emergency of International Concern (PHEIC). Research on MPV-HIV co-infections has provided genomic insights and protective strategies for PWH. Antivirals like tecovirimat show promise despite emerging resistance concerns.

The global Mpox outbreak caused by Clade IIb and the emergence of Clade Ib underscores its growing threat. Mpox disproportionately impacts PWH, leading to severe outcomes and higher fatality rates. This review emphasizes clinical challenges, genomic advances, and prevention strategies. Enhanced surveillance, vaccination, and tailored therapies are essential to addressing this evolving health crisis.
Central/mixed venous oxygen saturation and lactate levels might be of limited use as physiologic transfusion triggers in cardiac surgery
Authors: Noitz Matthias , Brooks Roxane , Schlömmer Christine , Tschoellitsch Thomas , Mahečić Tina Tomić , Baronica Robert , Maletzky Alexander , Zierer Andreas , Dünser Martin W. , Meier Jens
Published: February 2025

BACKGROUND

Current guidelines differ in their recommendations regarding the use of physiologic transfusion triggers to guide transfusion practice. Data on the interaction between haemoglobin (Hb) and physiologic transfusion triggers, or their response to packed red blood cell (pRBC) transfusions are limited.

OBJECTIVES

This study aimed to evaluate the interactions between Hb, mixed/central venous oxygen saturation (SvO2) and lactate levels as well as their changes (ΔSvO2, Δlactate) in response to pRBC transfusion in cardiac surgery patients.

DESIGN

Retrospective exploratory data analysis.

SETTING

A 22-bed intensive care unit (ICU) at a single tertiary academic centre and university hospital in Austria.

PATIENTS

Adult (age ≥ 18 years) patients who underwent cardiac surgery.

MAIN OUTCOME MEASURES

Pearson correlation coefficients (r) and coefficients of determination (r
2) between Hb, mixed/central venous oxygen saturation (SvO2), and lactate levels. Pearson correlation coefficients (r) and coefficients of determination (r
2) between ΔSvO2, Δlactate and pretransfusion Hb.

RESULTS

A total of 5025 cardiac surgery patients, in whom 20 542 blood gas analyses were performed, were included in the final analysis. Correlations between Hb levels and SvO2 (r
2 = 0.026, P < 0.001) and between Hb and lactate levels (r

2
 = 0.001, P < 0.001) were statistically significant but weak overall. No correlations were found between ΔSvO2 (r

2
 = 0.002, P = 0.13) or Δlactate (r

2
 = 0.003, P = 0.087) and pretransfusion Hb levels.

CONCLUSIONS

Hb, SvO2 and lactate levels were only weakly correlated with each other, and changes in SvO2 and lactate levels in response to pRBC transfusion did not correlate with pretransfusion Hb. Our findings question the usefulness of SvO2 and lactate levels as physiologic transfusion triggers to guide transfusion practice in cardiac surgery patients.

TRIAL REGISTRATION

Johannes Kepler University Ethics Committee Study Reference Number 1063/2023.
Effect of neuraxial anaesthesia or analgesia on postpartum relapse rates in multiple sclerosis
Authors: Ioannopoulos Dimitrios , Manika Kleanthi , Lykoudis Panagis M. , Papadopoulou Marianna , Lelekaki Eleftheria , Tsani Zoi , Kouki Pinelopi
Published: February 2025

BACKGROUND

Multiple sclerosis (MS) is a chronic autoimmune disease affecting primarily women of childbearing age. Recent advancements in treatment have led to more women with MS pursuing motherhood. Despite much new evidence on the safety of neuraxial anaesthesia/analgesia, many anaesthetists are still reluctant to provide neuraxial anaesthesia/analgesia to these patients.

OBJECTIVE

The present systematic review aimed to evaluate the safety of administrating neuraxial anaesthesia/analgesia to parturients with MS.

OUTCOME

The incidence of MS relapses occurring up to 1 year after childbirth was the main outcome of interest.

DESIGN

A systematic review of randomised and non-randomised controlled trials.

DATA SOURCES

MEDLINE (PubMed), Library of Congress and LiSTA (EBSCO) were searched to identify eligible trials.

ELIGIBILITY CRITERIA

Randomised or nonrandomised prospective studies and retrospective comparative studies, comparing MS relapses following caesarean section or vaginal delivery were included.

RESULTS

Eight studies involving 1315 parturients were included. There was no statistically significant difference in the incidence of postpartum relapses between women who received neuraxial anaesthesia/analgesia and those who did not (P > 0.05). A statistically significant increase in the probability of a relapse was consistently observed across the majority of studies in women who had experienced relapses during pregnancy or during the year preceding the pregnancy (P < 0.05).

CONCLUSION

Neuraxial analgesia/anaesthesia does not increase the risk of postpartum relapse in MS parturients in the year following delivery. The risk of postpartum relapse is related to symptom exacerbation during the year before pregnancy or during pregnancy. Adequately powered, prospective, studies are strongly recommended to confirm the above results.
Prospective Validation of a Nomogram for Determining the Optimal Dose of Lamotrigine for Augmentation Therapy in Patients With Treatment-Resistant Depression
Authors: Suzuki Takeshi , Nagai Goyo , Mihara Kazuo , Tomori Yoko , Kagawa Shoko , Nakamura Akifumi , Nemoto Kenji , Kondo Tsuyoshi
Published: February 2025

Background:

Previous research has shown that a plasma lamotrigine concentration of 12.7 µmol/L may be a threshold for a good therapeutic response to lamotrigine augmentation therapy in Japanese patients with treatment-resistant depression. The optimal dose of lamotrigine can be predicted using a previously established nomogram based on the plasma lamotrigine concentration at week 2. The aim of the present study was to prospectively evaluate the validity of this nomogram.

Methods:

Participants included 59 patients with depression who showed insufficient therapeutic responses to psychotropics, including antidepressants, antipsychotics, and mood stabilizers. The patients were diagnosed with major depressive disorder (n = 26), bipolar II disorder (n = 25), or bipolar I disorder (n = 8). Lamotrigine was administered to all the patients. The initial dose of lamotrigine was 25 mg/d for 32 patients not taking valproate and 25 mg/d every other day for 27 patients taking valproate. Blood samples were collected at week 2 and at least 2 weeks after the final daily dose, which was estimated by a nomogram based on the plasma lamotrigine concentration at week 2. The plasma concentrations of lamotrigine were measured by liquid chromatography–mass spectrometry.

Results:

In 30 of the 32 patients (93.8%) who were not taking valproate and 23 of the 27 patients (85.2%) who were taking valproate, a plasma lamotrigine concentration of 12.7 mcg/mL or higher was achieved at the final daily administration of lamotrigine.

Conclusions:

The results of the present study suggest that the previously established nomogram is valid for determining the optimal dose of lamotrigine for Japanese patients with treatment-resistant depression in clinical settings.
Development of the Observer Scales of the Patient and Observer Scar Assessment Scale: An International Delphi Study
Authors: Carrière Michelle E. , Mokkink Lidwine B. , Pleat Jonathon , Tyack Zephanie , Pijpe Anouk , de Vet Henrica C.W. , van Zuijlen Paul P.M. ,   The POSAS Group
Published: February 2025

Background:

This Delphi study aimed to develop the Observer Scale of the Patient and Observer Scar Assessment Scale (POSAS) 3.0 for measurements of scar quality in patients with all types of scars. The POSAS 3.0 Patient Scale has been developed using an extensive qualitative study, which has been published separately.

Methods:

An online, 3-round Delphi study was performed with 124 international scar experts from 23 countries spanning 7 continents. Panelists rated their (dis)agreement with proposals regarding the wording and relevance of scar characteristics on a 5-point scale (“strongly disagree” to “strongly agree”), and provided arguments for their decisions. Consensus was reached if ≥67% of the panelists agreed or strongly agreed to a proposal.

Results:

Consensus was reached on the inclusion of 9 items. Two versions of the Observer Scale of the POSAS 3.0 have been developed, 1 generic version including 7 items, and 1 linear scar version, containing the same 7 items and 2 additional scar-specific items.

Conclusions:

This is the first study using the Delphi process to develop an instrument for the assessment of scars. Panelists from all over the world reached a consensus on the content of 2 versions of the Observer Scale, the generic version and the linear scar version. By involving the potential end-user community of the new POSAS version in its development, we expect the developed instrument to have high content validity. For a comprehensive scar assessment, the Observer Scale should be used in combination with the Patient Scales of the POSAS 3.0.
Bilateral giant retinal tear detachments in an infant with Donnai-Barrow syndrome: A case report and review of literature
Authors: Huang Alan Y. , Caplash Sonny , Scoles Drew
Published: February 2025

Purpose:

To report a rare case of bilateral giant retinal tear (GRT)-related retinal detachments in a 24-month-old male with Donnai-Barrow syndrome (DBS) and to review the current literature on this disorder.

Methods:

Clinical information was obtained from the medical records of a patient with Donnai-Barrow syndrome seen at the Children’s Hospital of Philadelphia. A literature review was conducted to identify all published cases of genetically or clinically diagnosed Donnai-Barrow syndrome.

Results:

We report a case of a 24-month-old male with a history of DBS presenting with sudden loss of vision in both eyes. Ophthalmic examination revealed bilateral retinal detachments with GRT, complicated by grade C proliferative vitreoretinopathy (PVR) in the right eye. The patient underwent sequential scleral buckling, pars plana vitrectomy, membrane peeling, perfluoron, endolaser, fluid air exchange, and silicone oil placement in both eyes. Both eyes developed re-detachment, requiring repeat pars plana vitrectomy. Literature review revealed 10 reported cases of retinal detachments out of 38 DBS patients who survived past 1 year (26.3%).

Conclusion:

This case highlights the early presentation and complexity of GRT-related retinal detachment in DBS patients. Early, aggressive management using prophylactic laser retinopexy or scleral buckling may be essential in improving visual outcomes in DBS patients.
Accuracy of Predicted Refraction Using Two Swept-Source Optical Coherence Biometers and an Intraoperative Aberrometer
Authors: Watanabe Keizo
Published: February 2025

Purpose:

To compare the refractive accuracy of Optiwave Refractive Analysis (ORA) using biometric measurements of ARGOS and OA-2000 in the same patient planned for a monofocal intraocular lens (IOL) insertion.

Setting:

Single center

Design:

Prospective, observational study

Methods:

Patients scheduled for cataract surgery between January 2021 and March 2022 (expected corrected distance visual acuity of ≥0.8 postoperatively at 1-3 months) underwent preoperative ocular measurements using ARGOS and OA-2000 biometers on the same day, which were entered into the intraoperative aberrometer ORA system to assess the refractive accuracy of the IOL implant and postoperative spherical equivalent at 1–3 months. The refractive accuracy was compared between ORA using ARGOS (ORA-AR) and ORA using OA-2000 (ORA-OA). The primary endpoint was the comparison of the mean absolute refractive prediction error (MAE) between the ORA-AR and ORA-OA methods.

Results:

A total of 117 eyes of 81 patients were evaluated (mean ± standard deviation [SD] age, 72.8 ± 7.4 years; male, 65.4%). The criteria for noninferiority were met between the ORA-AR and ORA-OA methods, as the upper boundary of the confidence interval (CI) was lower than the noninferiority margin of 0.10 D for the difference in MAE (−0.03 D; 95% CI: −0.061 to 0.001). MAE was numerically smaller with ORA-AR (0.243 ± 0.215 D) but not significantly different from that with ORA-OA (0.269 ± 0.246 D).

Conclusions:

Postoperative MAE obtained using ORA-AR was noninferior to that of ORA-OA. However, the MAE and SD of refractive prediction errors with ORA-AR were numerically lower compared with ORA-OA.
The Arabic Version of the Prosthesis Embodiment Scale (AR-PEmbs): Translation, Cross-Cultural Adaptation, Reliability, and Validity in Lebanese Individuals with Lower-Limb Amputation
Authors: Saleh Nour El Hoda , Yassine Zainab , Saleh Fatima , Summaka Marwa , Hamieh Fatima , Naim Ibrahim
Published: February 2025

Introduction

This study aimed to translate and cross-culturally adapt the Arabic version of the Prosthesis Embodiment Scale for Individuals with lower-limb amputation (AR-PEmbS-LLA) and evaluate its validity and reliability.

Methods

The AR-PEmbS-LLA was developed using a forward-backward translation process, expert reviews, and pilot testing with 10 individuals with lower-limb amputation (LLA). A cross-sectional, correlational study was conducted with 60 Lebanese adults with major LLAs who used prosthetic devices. Participants completed the AR-PEmbSLLA and the Houghton scale for prosthetic use, the revised Trinity Amputation and Prosthesis Experience Scale (TAPES-R) for adjustment and satisfaction, and the Locomotor Capabilities Index (LCI) for locomotor abilities. Internal consistency, test-retest reliability, and exploratory factor analysis were performed to assess the psychometric properties of the AR-PEmbS-LLA. Convergent validity was evaluated using Spearman correlations with the other scales.

Results

The AR-PEmbS-LLA demonstrated high internal consistency (Cronbach α = 0.97) and test-retest reliability (intraclass correlation coefficient = 0.95, P < 0.01). Exploratory factor analysis confirmed a single-factor structure explaining 78.23% of the variance. Significant correlations were found with TAPES-R general adjustment (r = 0.37, P < 0.001), social adjustment subscales (r = 0.33, P = 0.001), and the LCI basic activities score (r = 0.39, P < 0.001), and the LCI advanced activities score (r = 0.35, P < 0.01).

Conclusions

The AR-PEmbS-LLA is a reliable and valid instrument for assessing prosthesis embodiment in Arabic-speaking individuals with LLA. It can be effectively used in clinical and research settings to understand and enhance the prosthesis integration experience.

Clinical Relevance

The AR-PEmbS-LLA represents a valuable addition to the limited toolkit for evaluating and optimizing prosthetic outcomes in Arabic-speaking individuals with LLA, enhancing clinical practice and research endeavors in this field.
Orthotics and Prosthesis Management in Nicolaides-Baraitser Syndrome
Authors: Alsancak Serap , Güven Enver , Güner Senem , Özgün Ali Koray , Vasefnia Alireza
Published: February 2025

Introduction

The research aimed to increase the quality of life in this rare disease by including orthotic and prosthetic treatment approaches, which are not found in the literature, in the treatment protocol of a child with Nicolaides-Baraitser syndrome (NCBRS) diagnosis who has multiple congenital anomalies. In addition to the anomalies seen in different parts of the body of the patient with NCBR, there are deformities and anomalies in the limbs. It was planned to design and produce the most suitable prosthesis and orthosis for the child by making clinical prosthetic and orthotic evaluations.

Method

Orthoses were produced using two different methods: traditional fabrication and 3D printing. Functional and satisfaction outcomes were measured.

Results

The Pediatric Balance Scale scores were 36 with the polypropylene knee-ankle-foot orthosis (PP-KAFO) and 30 with the 3D-printed knee-ankle-foot orthosis (3D-KAFO). The timed up and go (TUG) scores were 24.7 seconds with the PP-KAFO and 23.5 seconds with the 3D-KAFO. Pediatric Reach Test results showed similar forward reach for both devices, with slight differences in lateral reach directions. Stride length and stride time increased, while cadence and walking speed decreased with the PP-KAFO compared with the 3D-KAFO. According to the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) survey, satisfaction levels ranged from “more or less satisfied” to “very satisfied,” with total satisfaction being equal for both KAFO conditions.

Conclusions

There is no difference between the 3D-printed orthosis and PP-KAFO in patient satisfaction with NCBRS in the functional tests.

Clinical Relevance

Orthoses produced with 3D printers can be used instead of orthoses produced using traditional methods. However, larger sample groups are needed.