bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Tibial and Median Nerves in Patients with Diabetic Peripheral Neuropathy Using Shear Wave Elastography
Authors: Singh Amandeep , Arora Manik , Awal Guneet , Sood Mehar Kaur
Published: January 2025

Background Diabetes mellitus (DM) leads to diabetic peripheral neuropathy (DPN), a significant complication affecting a large percentage of diabetic patients. Traditional methods like nerve conduction studies have limitations in diagnosing DPN, especially in advanced cases. High-resolution ultrasound has emerged as a valuable tool in enhancing diagnostic accuracy.

Objective The aim of the study is to evaluate the efficacy of shear wave elastography (SWE) in assessing DPN, focusing on the tibial and median nerves.

Materials and Methods The study involved 100 participants categorized into groups with DPN, DM without DPN, and healthy controls. SWE was performed on the tibial and median nerves, and statistical analysis was conducted to compare the findings among the groups.

Results The study found significant increases in SWE values from the normal group to the DM group, and further increases in the DPN group for both tibial and median nerves. Receiver operating characteristic analysis indicated high diagnostic accuracy of SWE in distinguishing DPN from non-DPN cases. Overall, the study suggests that SWE could be a valuable adjunctive imaging tool in diagnosing DPN, offering advantages in terms of sensitivity, specificity, and noninvasiveness.

Conclusion The study concludes that SWE of the tibial and median nerves is a noninvasive, sensitive, and specific method for detecting DPN. Combining high-resolution ultrasound with SWE enhances the diagnostic accuracy of DPN.
Coxoplastia médio-posterior em S: uma nova técnica com melhor ocultação da cicatriz
Authors: Santos Alexandre Melo dos , Souza Gustavo Moreira
Published: January 2025

O objetivo dos autores é apresentar uma nova técnica de coxoplastia que resolva o desconforto e estigma associados a cicatrizes na virilha ou outras regiões anteriores do corpo após coxoplastias convencionais.

O estudo apresenta um relato de caso de uma técnica de coxoplastia realizada em pacientes pós-bariátricas submetidas a intenso emagrecimento, por meio de ressecção de pele em S realizada na região póstero-medial da coxa, sem cicatriz na parte anterior do corpo. As pacientes não apresentaram complicações pós-operatórias e apresentaram cicatrizes discretas. Além disso, a técnica consegue uma grande redução do excesso de pele, em múltiplos vetores, melhorando o contorno corporal.

A técnica envolve o posicionamento inédito da cicatriz em forma de S nos sulcos sub-glúteos e posteromediais das coxas, sem cicatriz anterior na virilha, melhorando significativamente o ocultamento da cicatriz. Permite também não ter angulações na linha de sutura, melhor distribuição das trações cutâneas, menor chance de deiscência da ferida, ao mesmo tempo em que permite a ressecção de grandes quantidades de excesso de pele nas direções longitudinal e transversal, com tração em múltiplos vetores.

A técnica de coxoplastia apresentada é um procedimento inovador, inédito, que permite um melhor ocultamento da cicatriz e provável menor incidência de complicações devido à melhor distribuição da tensão cicatricial.
Há espaço para o uso de terapia por pressão negativa no tratamento de feridas complexas de pacientes do SUS?
Authors: Lopes Felipe Andrade , Inácio Mariana Fernandes , Banov Giovanna Cavalcanti , Salum Julia Innocenti Dinhane , Sousa Alexandre Venâncio , Ramos Luis Felipe Maatz
Published: January 2025

Objetivo Feridas complexas são lesões que geram uma alta morbimortalidade ao paciente e têm apresentado um aumento significativo de prevalência. Devido ao seu alto custo de tratamento, há busca por tecnologias que acelerem seu processo de cura, destacando-se a terapia por pressão negativa (TPN). O presente estudo objetiva revisar a literatura sobre o uso da TPN no tratamento de feridas complexas, para avaliar sua adoção e criar uma proposta de orientação de como essa técnica pode ser aplicada no tratamento de pacientes hospitalizados no Sistema Único de Saúde (SUS).

Materiais e Métodos Esta revisão integrativa da literatura, de enfoque qualitativo, foi pesquisada nas bases de dados PubMed, Scientiﬁc Electronic Library Online (SciELO) e Google Acadêmico. Foram utilizadas as palavras-chave: feridas e lesões, técnicas de fechamento de feridas, terapia por pressão negativa em feridas e cicatrização de feridas. Foram incluídos artigos originais e revisões sistemáticas publicados entre 2002 e 2022 em português, inglês ou espanhol, com foco na terapia de fechamento de feridas por pressão negativa. Foram excluídos tópicos não relacionados, textos incompletos, formas básicas de TPN (sem patente), estudos de indústrias de fabricação do dispositivo e artigos em que a TPN não foi utilizada para o fechamento de feridas complexas.

Conclusão Apesar dos custos significativos, a TPN demonstrou uma eficácia na redução do tempo de cicatrização e de internação, consequentemente, no alívio da carga financeira global do tratamento de feridas complexas. Ao mesmo tempo, ela tem o potencial de melhorar significativamente a qualidade de vida dos pacientes afetados.
Synchronization in spiking neural networks with short and long connections and time delays
Authors: Kusch Lionel , Breyton Martin , Depannemaecker Damien , Petkoski Spase , Jirsa Viktor K.
Published: January 2025

Synchronization is fundamental for information processing in oscillatory brain networks and is strongly affected by time delays via signal propagation along long fibers. Their effect, however, is less evident in spiking neural networks given the discrete nature of spikes. To bridge the gap between these different modeling approaches, we study the synchronization conditions, dynamics underlying synchronization, and the role of the delay of a two-dimensional network model composed of adaptive exponential integrate-and-fire neurons. Through parameter exploration of neuronal and network properties, we map the synchronization behavior as a function of unidirectional long-range connection and the microscopic network properties and demonstrate that the principal network behaviors comprise standing or traveling waves of activity and depend on noise strength, E/I balance, and voltage adaptation, which are modulated by the delay of the long-range connection. Our results show the interplay of micro- (single neuron properties), meso- (connectivity and composition of the neuronal network), and macroscopic (long-range connectivity) parameters for the emergent spatiotemporal activity of the brain.
Plastic responses to past environments shape adaptation to novel selection pressures
Authors: Coates Sarah E. R. , Comeault Aaron A. , Wood Daniel P. , Fay Michael F. , Creer Simon , Osborne Owen G. , Dunning Luke T. , Papadopulos Alexander S. T.
Published: January 2025

Phenotypic plasticity may pave the way for rapid adaptation to newly encountered environments. Although it is often contested, there is growing evidence that initial plastic responses of ancestral populations to new environmental cues may promote subsequent adaptation. However, we do not know whether plasticity to cues present in the ancestral habitat (past-cue plasticity) can facilitate adaptation to novel cues. Conceivably, this could occur if plastic responses are coincidentally optimal to both past and novel cues (i.e., are preadaptive) or if they are transferred to novel cues during adaptation. Past plastic phenotype values could also become fixed during adaptation to the new environment. To uncover the role of past-cue plasticity in adaptation, we tested gene expression plasticity responses of two parallel mine-waste-adapted
Silene uniflora
populations and their closest coastal relatives. Plants were exposed to the past and novel cues of salt and zinc, which revealed that during adaptation to mine waste, plasticity to salt diminishes. Despite this, our results show that ancestral plasticity to salt has a substantial impact on subsequent adaptation to zinc. For a third of genes that have evolved zinc plasticity in mine populations, salt plasticity has been transferred to the zinc response. Furthermore, a quarter of fixed expression differences between mine and coastal populations were similar to ancestral salt responses. Alongside evidence that ancestral plasticity to novel cues can facilitate adaptation, our results provide a clear indication that ancestral past-cue plasticity can also play a key role in rapid, parallel adaptation to novel habitats.
Global natural history infrastructure requires international solidarity, support, and investment in local capacity
Authors: Boldgiv Bazartseren , Lkhagva Ariuntsetseg , Edwards Scott , Stenseth Nils C. , Bayarsaikhan Jamsranjav , Altangerel Dondog , Usukhjargal Dorj , Dovchin Badamgarav , Gombobaatar Sundev , Batsaikhan Nyamsuren , Warinner Christina , Hart Isaac , Galbreath Kurt , Greiman Stephen E. , Malaney Jason , Murdoch James D. , McLean Bryan , DeWitte Sharon N. , Manzitto-Tripp Erin , Chin Karen , Karim Talia S. , Simpson Carl , Stevens Nancy J. , Dunnum Jonathan L. , Cook Joseph A. , Taylor William Timothy Treal
Published: January 2025

Amid global challenges like climate change, extinctions, and disease epidemics, science and society require nuanced, international solutions that are grounded in robust, interdisciplinary perspectives and datasets that span deep time. Natural history collections, from modern biological specimens to the archaeological and fossil records, are crucial tools for understanding cultural and biological processes that shape our modern world. At the same time, natural history collections in low and middle-income countries are at-risk and underresourced, imperiling efforts to build the infrastructure and scientific capacity necessary to tackle critical challenges. The case of Mongolia exemplifies the unique challenges of preserving natural history collections in a country with limited financial resources under the thumb of scientific colonialism. Specifically, the lack of biorepository infrastructure throughout Mongolia stymies efforts to study or respond to large-scale environmental changes of the modern era. Investment in museum capacity and training to develop locally-accessible collections that characterize natural communities over time and space must be a key priority for a future where understanding climate scenarios, predicting, and responding to zoonotic disease, making informed conservation choices, or adapting to agricultural challenges, will be all but impossible without relevant and accessible collections.
Optimal strategies for correcting merotelic chromosome attachments in anaphase
Authors: Kliuchnikov Evgenii , Marx Kenneth A. , Barsegov Valeri , Mogilner Alex
Published: January 2025

Accurate chromosome segregation in mitosis depends on proper connections of sister chromatids, through microtubules, to the opposite poles of the early mitotic spindle. Transiently, many inaccurate connections are formed and rapidly corrected throughout the mitotic stages, but a small number of merotelic connections, in which a chromatid is connected to both spindle poles, remain lagging at the spindle’s equator in anaphase. Most of the lagging chromatids are eventually moved to one or the other pole, likely by a combination of microtubules’ turnover and the brute force of pulling by the microtubules’ majority from the one pole against the microtubules’ minority from the other pole. We use computer simulations from two stochastic models (1D and full 3D CellDynaMo model) combining force balances and microtubules’ dynamics for the lagging chromatids to investigate what maximizes the percentage of segregated laggards. We find that a) brute force tug-of-war with slow (< 0.0001 s
−1
) microtubules’ detachment rate can move asymmetric laggards to the poles in limited time, b) rapid (> 0.01 s
−1
) microtubules’ detachment rate leads to a significant loss of the laggards, and c) intermediate (~ 0.001 s
−1
) microtubules’ detachment rate ensures higher than 90% accuracy of segregation. The simulations also shed light on the waiting time required to correct the merotelic errors in anaphase and on the roles of chromatid-attached microtubule number and Aurora B–mediated, spatially graded regulation of microtubule kinetics in anaphase.
Natural variations in
TT8
and its neighboring
STK
confer yellow seed with elevated oil content in
Brassica juncea
Authors: Qian Lunwen , Yang Liu , Liu Xianjun , Wang Tianyi , Kang Lei , Chen Hao , Lu Yin , Zhang Yukun , Yang Shujie , You Liang , Yao Min , Xiang Xingru , Cui Kan , Guo Ying , Yang Bin , Yan Mingli , Xia Shitou , Meng Jinling , Lin Tao , Mason Annaliese S. , Snowdon Rod J. , Liu Zhongsong
Published: January 2025

Seed color is a critical quality trait in numerous plant species. In oilseed
Brassica
crops, including rapeseed and mustard, yellow seeds are distinguished by their significantly higher oil content and faster germination rates compared to black or brown counterparts. Despite the agronomic significance of the yellow seeds being a prime breeding target, the mechanisms underlying elevated oil content remain obscure. In this study, we assembled the first telomere-to-telomere (T2T) genome of
B. juncea
and further investigated the genetic regulation, molecular mechanism, and the evolutionary history of yellow seeds in
B. juncea.
Through an analysis of allelic variation in the
TRANSPARENT TESTA 8
(
TT8
) genes across 1,002 worldwide
B
.
juncea
accessions, we traced the single origin of yellow seeds to approximately 2,300 y ago in Southwestern China. Furthermore, we discovered the MADS-box gene
SEEDSTICK
(
STK
) coevolved with
TT8
, and they coordinately regulated seed size, oil accumulation, and seed coat proportion in
B. juncea
. These findings open broad avenues for targeted breeding of yellow-seeded
Brassica
crops with elevated oil content.
Consonant stability in Portuguese-based creoles
Authors: Silva Carlos , Moran Steven
Published: January 2025

Research on language stability typically departs from a sample
of mother-daughter languages (e.g., Greenhill et al. 2017, Honeybone
2019, Moran et al. 2021).
Instead, this study aims at measuring consonant stability (presence or absence
of change) in Portuguese-based creoles. Our approach enables us to: (i) build a
stability scale of the adaptation of shifted phonological systems, and (ii)
measure distances between creoles with regard to their lexifier. Our hypothesis
is that less stable segments are typologically rare and that they were unstable
in Portuguese from the 16th century until today. Our main findings are: (i)
consonant stability is strongly correlated to typological frequency, (ii) the
similarity between the consonant systems of the substrates and the lexifier does
not affect the stability scores, and (iii) the sociohistorical characteristics
of each settlement, namely the duration and the conditions of contact, play a
role on phonological stability in the creoles under observation.
CCQM-K159 free amino acids in plasma
Authors: Whyte Emily , Hambidge Tabatha , Ellison Steve , Cowen Simon , Hopley Christopher , Lewin Mark , Kinumi Tomoya , Liu Quinde , Liu Hong , Ng Cheng Yang , Teo Tang Lin , Rego Eliane , Violante Fernando , Garrido Bruno , Wollinger Wagner , Fernandes Jane , Souza Waldemar , Gündüz Simay , Yılmaz Hasibe , Ün İlker , Bilsel Gökhan , Bilsel000-0002-8204-4976 Mine , Krylov Anatoliy , Mikheeva Alena , Lopushanskaya Elena , Nammoonnoy Jintana , Kwon Ha-Jeong , Jeong Ji-Seon , Renger Mareike , Henrion Andre , O'Connor Gavin , Alexopoulos Charalampos , Giannikopoulou Panagiota , Kakoulides Elias
Published: January 2025

Main text

Inherited metabolic disorders affect approximately 1 in 1000 babies; amino acid disorders are less frequent, at approximately 1 in 6000. Babies diagnosed with amino acid disorders require constant monitoring of amino acid blood concentration, especially for disease states such as phenylketonuria. In addition, amino acid measurement may aid in the evaluation of several other disorders such as neurological and nutritional disorders. Free amino acids in healthy patients are typically in the low mg/kg range but, for example, elevated phenylalanine indicates phenylketonuria disease state. Evidence of successful participation in formal, relevant international comparisons is needed to document calibration and measurement capability claims (CMCs) made by national metrology institutes (NMIs) and designated institutes (DIs).

This Track A study is being used to assess the core competencies of the National Metrology Institutes/Designated Institutes (NMIs/DIs) for provision of measurement services. The aim of this study is to assess the performance of the NMIs/DIs for a matrix material for clinical analytes. This follows and builds on the successful CCQM-K109 study on urea and uric acid in human serum.

Eleven NMIs participated in the Track A Key Comparison CCQM-K159 Free amino acids in plasma. NMIs/DIs were given the option of taking part in a parallel pilot study CCQM-P202, however all participants opted for the Track A key comparison and there were no participants for CCQM-P202. Participants were requested to evaluate the mass fractions, expressed in mg/kg, of DL-phenylalanine and DL-leucine in pooled frozen human plasma with lithium heparin added as an anticoagulant.

Successful participation in CCQM-K159 demonstrates the following measurement capabilities in determining mass fraction of organic compounds, with molecular mass of 50 g/mol to 500 g/mol, having high to mid polarity pKow > -4, in mass fraction range from 1 mg/kg to 1000 mg/kg in a biological matrix such as human plasma, serum and urine.

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database https://www.bipm.org/kcdb/.

The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Condition recognition based on multi-source heterogeneous data and residual temporal network in coal flotation process
Authors: Fan Yuhan , Lv Ziqi , Chen Sai , Cui Yao , Wu Yuxin , Zhao Xuan , Xu Zhiqiang , Wang Weidong
Published: January 2025

Condition recognition in coal flotation is a critical component in achieving flotation process control and optimization. To develop reliable models for condition recognition, two key challenges must be addressed: first, the effective extraction and integration of froth visual feature information from multiple flotation cells; and second, the fusion of froth visual features with process parameters to create a comprehensive representation of flotation conditions. To tackle these challenges, a time series classification model based on multi-source heterogeneous data was proposed for coal flotation condition recognition. First, a bubble size feature representation method combining the tsfresh and maximum relevance minimum redundancy algorithms was proposed. This method accurately describes bubble size distribution features through multi-scale feature extraction and mutual information-based feature selection. Next, a neural network feature evaluation model based on L1 regularization was presented, which quantifies the importance of visual features through the sparse expression of network weights, facilitates feature selection, and applies the resulting feature weights to the subsequent weighting process in classification models. Finally, a residual temporal network that integrates residual feature extraction and temporal modeling was proposed. This model employs one-dimensional convolution and cascaded residual structures for deep feature extraction, while temporal dependencies of condition changes are captured by combining long short-term memory and attention mechanisms. Validation on a flotation froth dataset collected from field sites in Anhui demonstrates that the proposed model achieves a condition classification accuracy of 85.08%, significantly improving the performance of flotation condition recognition compared to existing models.
Fourier transform digital moiré interferometry
Authors: Villa Jesús , Luis Flores Jorge , Garcia-Torales Guillermo , Montes-Flores Manuel
Published: January 2025

Processing interferometric images is a key task in optical interferometry for measurement purposes. It is well known that there are two main kinds of interferograms: those with open fringes and those with closed fringes. Often, processing a single interferogram with closed fringes can be challenging; therefore, applying phase-shifting is almost obligatory. However, it requires several images and a high precision mechanical device to achieve accurate results. On the other hand, interferograms with open fringes are more straightforward to process. However, precise knowledge of the carrier frequency of the fringes is essential for accurate processing. An alternative solution to the challenges posed above is the use of digital moiré interferometry, which consists of superimposing a reference interferogram and another obtained with the object to be measured. In this work we propose a digital moiré interferometry method that uses the Fourier transform and Butterworth-type filters. The feasibility and versatility of the proposed method is experimentally demonstrated using a Mach–Zehnder-type interferometer to analyze gas flow in a flame.
Algebraic identifiability of partial differential equation models
Authors: Byrne Helen M , Harrington Heather A , Ovchinnikov Alexey , Pogudin Gleb , Rahkooy Hamid , Soto Pedro
Published: January 2025

Differential equation models are crucial to scientific processes across many disciplines, and the values of model parameters are important for analyzing the behaviour of solutions. Identifying these values is known as a parameter estimation, a type of inverse problem, which has applications in areas that include industry, finance and biomedicine. A parameter is called globally identifiable if its value can be uniquely determined from the input and output functions. Checking the global identifiability of model parameters is a useful tool when exploring the well-posedness of a given model. This problem has been intensively studied for ordinary differential equation models, where theory, several efficient algorithms and software packages have been developed. A comprehensive theory for PDEs has hitherto not been developed due to the complexity of initial and boundary conditions. Here, we provide theory and algorithms, based on differential algebra, for testing identifiability of polynomial PDE models. We showcase this approach on PDE models arising in the sciences.
Comparing Compressed and Full-Modeling analyses with FOLPS: implications for DESI 2024 and beyond
Authors: Noriega H.E. , Aviles A. , Gil-Marín H. , Ramirez-Solano S. , Fromenteau S. , Vargas-Magaña M. , Aguilar J. , Ahlen S. , Alves O. , Brieden S. , Brooks D. , Cervantes-Cota J.L. , Chen S. , Claybaugh T. , Cole S. , Dawson K. , de la Macorra A. , de Mattia A. , Doel P. , Findlay N. , Forero-Romero J.E. , Gaztañaga E. , Gontcho S.Gontcho A. , Honscheid K. , Hou J. , Howlett C. , Ishak M. , Juneau S. , Lai Y. , Landriau M. , Manera M. , Maus M. , Miquel R. , Morales-Navarrete G. , Mueller E. , Muñoz-Gutiérrez A. , Myers A.D. , Nadathur S. , Niz G. , Palanque-Delabrouille N. , Percival W.J. , Poppett C. , Rezaie M. , Rocher A. , Rossi G. , Sanchez E. , Schlegel D. , Schubnell M. , Sprayberry D. , Tarlé G. , Verde L. , Yuan S. , Zarrouk P. , Zou H.
Published: January 2025

The Dark Energy Spectroscopic Instrument (DESI) will provide unprecedented information
about the large-scale structure of our Universe. In this work, we study the robustness of the
theoretical modelling of the power spectrum of Folps, a novel effective field theory-based
package for evaluating the redshift space power spectrum in the presence of massive neutrinos. We
perform this validation by fitting the AbacusSummit high-accuracy N-body simulations
for Luminous Red Galaxies, Emission Line Galaxies and Quasar tracers, calibrated to describe DESI
observations. We quantify the potential systematic error budget of Folps finding that the
modelling errors are fully sub-dominant for the DESI statistical precision within the studied
range of scales. Additionally, we study two complementary approaches to fit and analyse the power
spectrum data, one based on direct Full-Modelling fits and the other on the ShapeFit compression
variables, both resulting in very good agreement in precision and accuracy. In each of these
approaches, we study a set of potential systematic errors induced by several assumptions, such as
the choice of template cosmology, the effect of prior choice in the nuisance parameters of the
model, or the range of scales used in the analysis. Furthermore, we show how opening up the
parameter space beyond the vanilla ΛCDM model affects the DESI observables. These studies
include the addition of massive neutrinos, spatial curvature, and dark energy equation of
state. We also examine how relaxing the usual Cosmic Microwave Background and Big Bang
Nucleosynthesis priors on the primordial spectral index and the baryonic matter abundance,
respectively, impacts the inference on the rest of the parameters of interest. This paper
pathways towards performing a robust and reliable analysis of the shape of the power spectrum of
DESI galaxy and quasar clustering using Folps.
Performance tests and hardware qualification of the FEBs for the Super-FGD of T2K Phase II
Authors: Giannessi L. , Cadoux F. , Cap S. , Chakrani J. , Drapier O. , Favre Y. , Gastaldi F. , Jakkapu M. , Nanni J. , Sakashita K. , Sánchez F.
Published: January 2025

T2K is a long baseline neutrino experiment, entering Phase II with a Near Detector upgrade. The T2K near detector (ND280) upgrade consists of the installation of three new detector systems: a plastic scintillator neutrino active target (Super-FGD), two time projection chambers (HA-TPC) and a time of flight detector (TOF). The Super-FGD is composed of 2-million 1 cm3 scintillating cubes read by almost 60 thousand wavelength-shifting (WLS) fibers coupled to an MPPC on one end. Given the large number of channels, the limited space inside magnetic environment, and the limited time from production to installation, the development and testing of the Front-end electronics boards (FEB) for the read-out of the Super-FGD channels represented a challenging task for the success of the upgrade.

This work presents the performance tests confirming that the FEB aligns with detector requirements, and the hardware qualification of 240 FEBs through a custom QC test bench designed to detect and locate hardware failures to speed up the repairing process. Installation of the electronics in the detector took place in March 2024, one year after the beginning of the FEB mass production, and the first successful neutrino beam run took place in June of the same year.
Study on joint de-noising method of ECG signals with improved CEEMDAN-wavelet thresholding and singular spectrum analysis
Authors: Ge Liang , Ma Yuhong , Xiao Xiaoting , Cheng Jixiang , Li Zhidan , Qin Wang
Published: January 2025

The electrocardiogram (ECG) signal is often contaminated by various noises during acquisition and transmission, and the denoising effect directly affects the diagnosis of heart diseases. To improve the denoising effect, this paper proposes an improved Complete Ensemble Empirical Mode Decomposition (CEEMDAN)-wavelet thresholding and singular spectrum analysis (SSA) joint denoising method. First, the noise-dominated high-frequency intrinsic mode function (IMF) is identified using CEEMDAN; second, it is denoised to reduce high-frequency noise by the improved wavelet thresholding technique; and then, SSA is used to remove baseline wander (BW); finally, to verify the effectiveness of this denoising method, the root mean square error (RMSE) and signal-to-noise ratio (SNR) are used as the evaluation criteria for the denoising effect and the standard MIT-BIH ECG noise database signals are used for verification. The validation results show that compared with the existing ECG denoising methods, the denoising method improves the SNR by 39%∼ 55% and reduces the RMSE by 18%∼ 42%. The method can be used as an effective tool for ECG signal denoising and provide a better basis for diagnosis in computerized automated medical systems.
System design for improving the detection effect of wafer surface particles
Authors: Chen Gengyang , He Pan
Published: January 2025

Wafer is an important basic material in semiconductor manufacturing, mainly used for the production of integrated circuits and microelectronic devices. Surface defects on wafers can affect lithography and subsequent processes, leading to circuit failure, with particle defects accounting for the largest proportion. This article focuses on the particle defects on the wafer surface and analyzes the optical scattering field distribution of particles using the Mie scattering theory. The relationship between the system collection angle and the scattered light intensity is also studied. It is found that when the tilt angle is 75°, using a larger collection angle is more conducive to the detection of surface particle defects. The experimental system has two channels that can receive scattered light signals, the narrow channel uses a lens to collect scattered light at 3°–15°, while the wide channel uses an ellipsoidal mirror to collect scattered light at 25°–70°. The experimental object is silicon dioxide particles with a radius of 500 nm on the wafer surface. After comparing the vertical incidence and oblique incidence (incidence angle of 75°) experiments, it was found that the wide channel detection effect was the best under oblique incidence, which verified the simulation results and research conclusions.
2724 The impact of preoperative comprehensive geriatric assessment on anticholinergic burden in older surgical patients
Authors: Bown L , Chandler A , Male R , Humphry N
Published: January 2025

This service evaluation reviewed the impact of the Perioperative Care of Older People Clinic (POPS) on Anticholinergic Burden (ACB) in older surgical patients and identified areas for improvement. The study assessed 75 patients aged ≥65 years, revealing widespread anticholinergic use. Among patients on anticholinergics, 34% experienced a reduction in ACB post-POPS review. However, maintaining these changes at ≥6 months was challenging, with 50% of patients experiencing a change in their ACB score due to new prescriptions or the re-initiation of old medications. The study identified communication gaps at the POPS-primary care interface affecting de-prescribing efforts, underscoring the need for improved discharge letters, systems to flag high ACB patients, and a universal ACB tool.

Introduction

The UK’s ageing population is increasingly undergoing surgery, and older adults are at higher surgical risk partly due to anticholinergic use. POPS is a relatively new initiative aimed at reducing ACB in this demographic, but the sustainability of these reductions is not well understood. This service evaluation aims to fill this gap and suggest solutions for maintaining reduced ACB levels.

Methods

Retrospective data from 75 patients from 2022–2023 who met the criteria for ACB evaluation pre- and post-POPS review, with follow-up at ≥6 months, were included.

Results

Post-POPS, ACB was reduced in 34% of patients, with a median decrease of −2. However, ACB increased again in 50% of patients at ≥6 months, with re-initiation of amitriptyline and furosemide contributing to the rise in 67% of these cases.

Conclusions

CGA effectively reduces ACB in older surgical patients, but sustaining these reductions poses significant challenges. Communication difficulties at the POPS-primary care interface likely contribute to the re-initiation of medications, indicating a need for standardised discharge summaries and a universal system for evaluating and flagging high ACB patients to maintain improvements.
2874 An assessment of analgesia and laxative prescriptions for patients admitted with neck of femur fractures
Authors: Ferry J , Macrae A
Published: January 2025

Introduction

Neck of femur (NOF) fractures can cause significant morbidity in elderly patients. Adequate pain control is essential for early mobilisation and improved outcomes. Health board prescription protocols exist offering a multi-modal analgesia approach as well as laxatives on the electronic platform (HEPMA). The aim of this quality improvement (QI) project was to assess adherence to these protocols.

Methods

Patients over 65 with isolated NOF fractures admitted to trauma wards from ED at a single district general hospital were included. Baseline data was collected from patients admitted between October to December 2023. Post-intervention data collected from April to June 2024. Prescriptions for regular and breakthrough opioids, regular paracetamol and laxatives on admission to the trauma wards were audited. Day 3 and day 5 review of pain and bowel status were also audited.

Intervention

An information session was delivered at the time of staff change over to senior house officers and junior clinical fellows to ensure they were aware of the NOF fracture analgesia and bowel protocol and available electronic prescribing bundles.

Results

A total of 169 patients were included. 84 prior to the intervention and 85 post intervention. Prior to the intervention accuracy for regular opioid prescription was 72.6%, PRN 83.3%, laxatives 81.8%, Paracetamol 88.1%. Post intervention respectively 87.1%, 94.1%, 92.9% and 91.9%. We demonstrated statistically significant change (p < 0.05) in regular, PRN opioid and laxative prescribing. No change in paracetamol, Day 3 and 5 pain and bowel reviews was found.

Conclusion

A positive change in prescribing accuracy was demonstrated. Potential barriers to appropriate analgesia prescribing may be lack of awareness of protocols and hesitancy in prescribing opioids in elderly frail patients. Information sessions will continue to run to ensure appropriate prescribing for NOF patients on admission. Further data will be available following further educational and poster interventions.
2880 Reducing emergency Re-attendance in frailty SDEC patients
Authors: Twigg M , Martire J , Woolridge J , Gilpin R
Published: January 2025

Background

Frailty Same Day Emergency Care (FSDEC) is a service designed to identify and manage frail older people at the hospital front door with a view to provide early Comprehensive Geriatric Assessment, implement management and where appropriate support a same day discharge home.

Introduction

In September 2023 the FSDEC service opened with 6 assessment spaces adjacent to A&E. This project aimed to quantify the rate of re-admission for patients seen in FSDEC and explore approaches to improve performance.

Methods

This QIP utilised a PDSA approach. Baseline re-admission data was collected from a 2- week period in October 2023. Notes were reviewed for all patients seen in FSDEC during this timeframe and reviewed for evidence of any 30-day emergency re-attendances. Cases were then reviewed to identify any links between the 2 attendances and any preventative measures that could have been taken. Following PDSA cycle 1 frailty nurse telephone follow up was implemented. PDSA cycle 2 was a stress test of this (limited) service during winter pressures. PDSA cycle 3 followed expansion of Community Integrated Response Hub (CIRH) and discharged patients being able to self-refer for support once discharged.

Results

FSDEC 7-day re-attendance reduced from 10% to 5% after introduction of frailty nurse follow up. This was not sustained over challenging winter months with variable staff availability but did recover in Summer 24. There has also been a gradual improvement in 30-day re-admission by PDSA cycle 3 following roll-out of self-referral to CIRH.

Conclusion

Emergency re-admissions have reduced following implementation of frailty nurse telephone follow up and expansion of community services including patient access to CIRH for help following discharge from FSDEC. Addressing staffing model could allow for a more consistent follow up service. There is scope to trial this approach on geriatric ward discharges.
2545 The burden of frailty in a West London hospital: a case for an acute ‘front door’ team with robust links with community services
Authors: Brook S , Barnard R , Al-Haddawi Y , Wiggam A , Chaudhuri S , Murden M , Todorov G
Published: January 2025

Introduction

Global estimates indicate over half of individuals aged 85 and older are frail (1), costing the UK healthcare system approximately £5.8 billion annually (2). Locally, over 6500 patients aged 65+ are admitted to West Middlesex University Hospital (WMUH) every six months. The proposed frailty team aims to implement early comprehensive geriatric assessments (CGAs) through a multidisciplinary approach. Timely CGAs can increase the likelihood of patients remaining in their own homes at 6 and 12 months (3), reduce length of stay (LoS), and lower healthcare costs, contingent upon available community infrastructure. WMUH serves multiple boroughs, necessitating coordination with various community services to support discharges. These services include Hospital at Home and Integrated Community Response Services.

Objective

To gather baseline data on frail patients admitted before the introduction of a ‘Front Door Frailty’ team.

Methods

Data were collected for all medical admissions to WMUH from 1st to 14th July 2022, including:

Results

From 459 admissions over 2 weeks, 278 patients (61%) were ≥ 65 years old. Among these patients:

Conclusions

A high percentage of acute admissions at our hospital are characterised by frailty. Through early identification, multidisciplinary management, and improved links with local community services, the new acute frailty team aims to decrease length of stay and improve patient experience.
2797 Continuing therapy from intermediate care units to home: why wait?
Authors: Kinch-Mayhew C , Clift E
Published: January 2025

Background

Patients triaged as routine, discharged home from Intermediate Care Units (ICUs) in East Sussex wait 4 weeks until rehabilitation continues by the Community Therapy Team (CTT).

Introduction

NHS England (2023a) and NHS England (2023b) call for minimal delays, effective coordination processes and sharing of information for timely rehabilitation in intermediate care settings. Local patient feedback indicated poor patient satisfaction and increased clinicians’ anxiety regarding risk of deterioration due to long waits (Lewis A., Harding k., Snowdon D., BMC Health Service Research, 2018 18(1) 869).

Aim

To improve average wait times for routine ICU patients’ discharge, for ongoing community therapy input, to within 1 week by July 2024, while maintaining patient safety and improving patient satisfaction.

Method

Quality improvement methodology, using stakeholder engagement was used to determine the cause for long wait times for home therapy. PDSA cycles were engaged to determine if improvements could be made without a loss of quality of care, or impacting patient safety, while improving patient experience. These involved formal communication channels between teams and using a therapy assistant for an initial home assessment where full assessment had already been undertaken by registered therapists. Patient satisfaction surveys were undertaken to understand the experience of transition home.

Results

Baseline data indicated that waiting time for home therapy varied between 18–59 days, from discharge. After the initial PDSA cycle, waiting time reduced to between 4–10 days, and after the second cycle waits reduced further to between 3–7 days. Patients’ satisfaction improved significantly with shorter waiting times for therapy once home.

Conclusion

Therapy assistant initial visits at home reduced waiting times to within a week, and patients’ satisfaction improved with shorter waiting times. Patient safety was not compromised as there were clear protocols for appropriate escalations for unregistered staff.
2790 Changing the culture of personalised care plans in care homes: the Bromley experiment
Authors: Quirke S , Rees A , Adkin J , Garbharran U
Published: January 2025

Introduction

Care home residents have a greater incidence of frailty and co-morbidities. Polypharmacy and inequitable access to integrated healthcare are confounders to positive outcomes in this cohort. Providing proactive care through the Enhanced Health in Care Homes (EHCH) Framework seeks to address these inequalities using multidisciplinary team (MDT) working.

Method

A pilot MDT intervention was delivered across eleven older peoples care settings with the most ambulance conveyances in a London borough known for its ageing population. MDT members were from general practice (including pharmacist), geriatrics, ambulance service, district nursing, palliative care, psychiatry, social care, integrated care board and senior care home staff. The intervention was refined iteratively over five months via a Plan-Do-Study-Act cycle. The MDT undertook comprehensive geriatric assessments, advance care planning and structured medication reviews. Outcomes were documented in personalised care and support plans (PCSP).

Results

Sixty-nine of the most complex patients were selected to receive the intervention. 100% of these patients had a PCSP created post-intervention. A resultant system culture change led to a three-fold increase in the number PCSPs across all care settings. There was a reduction in 999 calls for 57% of MDT patients (across 8 settings) and there was 24% fewer 999 calls and hospital conveyances across the wider patient group in all MDT care settings. MDT professionals and care home staff reported high satisfaction and valued shared learning and clinical decision-making.

Conclusion(s)

This intervention addressed health inequalities of care home residents with a clear thread of advocacy for patients. Proactive personalised care planning offered opportunities for earlier diagnoses, treatment, and swifter recognition of the dying phase of life. Primary care interventions within EHCH framework could be augmented by this MDT approach for a more complex cohort of care home residents with severe frailty and greater co-morbidity profile including dementia.
2668 Polypharmacy in the elderly: are addressing the medication burden?
Authors: Olding L , Raza H , Hussain Y , Ganesaraja P , Kiczynska P , Eid S
Published: January 2025

Introduction

Polypharmacy represents a significant challenge in the vulnerable elderly population, where concurrent use of multiple medications increases the risk of interactions and adverse reactions, often precipitating acute events and complicated hospital stays. This necessitates thorough medication reviews to mitigate these risks; a hospital admission allows for such opportunities.

Methods

This project aimed to evaluate and address the medication burden among elderly patients, following WHO’s Global Patient Safety Challenge: Medication Without Harm. 50 patient’s medications were reviewed on a elderly care ward over the space of 3 months. A ward pharmacist and a senior member of the medical team critically evaluated inpatient charts on a twice weekly basis. Any changes made to the medication regimens were documented; additionally, the general practitioner was informed of any changes.

Results

Initial data indicated that 66% of patients were on five or more medications, with a high incidence of falls and a notable anticholinergic burden. On review of the 50 patients a total number of 36 drugs were de-prescribed, 38.9% were inappropriate anti-hypertensives, 13.8% vitamins among others.

Conclusions

This project has been an enlightening endeavour, teaching us the critical nature of addressing polypharmacy. We have learned that interdisciplinary collaboration, regular medication reviews, and patient education are key to managing this complexity. To ensure long-term sustainability, we plan to institutionalise pharmacy board rounds and implement mandatory medication reviews. We aim to work closely with primary care to maintain continuity post-discharge. These efforts are expected to foster a culture of mindful prescribing and medication safety.
2884 Protein for breakfast: a simple dietary change can bring glucose stabilisation benefits in care home residents
Authors: Bhambra P , Smith A , Paris H
Published: January 2025

Introduction

One in four Care Home (CH) residents have diabetes, making diet crucial for controlling glucose levels (GLs). Continuous blood glucose monitoring (CGM) now offers deeper insights into GL fluctuations. Diabetes in severe frailty is often overtreated, particularly with insulin, posing risks such as hypoglycemia, avoidable hospital admissions, and labour-intensive clinical supervision. While protein and vegetables can slow glucose absorption, dietary advice for CH residents typically emphasises carbohydrates and may not be tailored to their frailty. This study investigates the impact of modifying protein intake in insulin-using diabetics to improve glycaemic control.

Method

A small pilot study assessed if protein-rich foods (e.g. eggs, peanut butter) given for breakfast stabilise GLs throughout the day. Eight diabetic CH residents using insulin were randomly selected over four months. A diabetic frailty pharmacist monitored GLs with the CGM device (Freestyle Libre) and analysed GLs after a protein-rich breakfast. Descriptive analysis and t-tests were conducted using R before and after the food intervention, and ANOVA was used to analyse significant differences in GLs.

Results

Six out of eight patients showed statistically significant reductions in GL spikes, sustained throughout the day. For the remaining two patients, the food intervention helped maintain target GLs. This led to the discontinuation of insulin in one patient, and in the second, problematic frequent hypoglycemia was mitigated by the food intervention. Clinical decisions on patient safety influenced outcomes for these two patients but were not excluded from analysis.

Conclusion

Six of the eight residents given additional protein at breakfast showed significant GL reductions, leading to decreased insulin dosing and simpler regimes. Carers reported improvements in mood, sleep, and energy levels anecdotally. A holistic dietary approach in managing diabetes in CH residents, emphasising increased morning protein intake, should be considered to enhance GL control and allow deprescribing. A larger study is planned.