bluuebunny/crossref_metadata_2025 huggingface dataset:
Full Modeling and parameter compression methods in configuration space for DESI 2024 and beyond
Authors: Ramirez-Solano S. , Icaza-Lizaola M. , Noriega H.E. , Vargas-Magaña M. , Fromenteau S. , Aviles A. , Rodríguez-Martínez F. , Aguilar J. , Ahlen S. , Alves O. , Brieden S. , Brooks D. , Claybaugh T. , Cole S. , de la Macorra A. , Dey Arjun , Dey B. , Doel P. , Fanning K. , Forero-Romero J.E. , Gaztañaga E. , Gil-Marín H. , Gontcho S.Gontcho A. , Honscheid K. , Howlett C. , Juneau S. , Lai Y. , Landriau M. , Manera M. , Maus M. , Miquel R. , Mueller E. , Muñoz-Gutiérrez A. , Myers A.D. , Nadathur S. , Nie J. , Percival W.J. , Poppett C. , Rezaie M. , Rossi G. , Sanchez E. , Schlegel D. , Schubnell M. , Seo H. , Sprayberry D. , Tarlé G. , Verde L. , Weaver B.A. , Wechsler R.H. , Yuan S. , Zarrouk P. , Zou H.
Published: January 2025

In the contemporary era of high-precision spectroscopic surveys, led by projects like DESI, there is an increasing demand for optimizing the extraction of cosmological information from clustering data. This work conducts a thorough comparison of various methodologies for modeling the full shape of the two-point statistics in configuration space. We investigate the performance of both direct fits (Full Modeling) and the parameter compression approaches (ShapeFit and Standard). We utilize the ABACUS-SUMMIT simulations, tailored to exceed DESI's precision requirements. Particularly, we fit the two-point statistics of three distinct tracers (LRG, ELG, and QSO), by employing a Gaussian Streaming Model in tandem with Convolution Lagrangian Perturbation Theory and Effective Field Theory. We explore methodological setup variations, including the range of scales, the set of galaxy bias parameters, the inclusion of the hexadecapole, as well as model extensions encompassing varying ns
and allowing for w
0
w

a
CDM dark energy model. Throughout these varied explorations, while precision levels fluctuate and certain configurations exhibit tighter parameter constraints, our pipeline consistently recovers the parameter values of the mocks within 1σ in all cases for a 1-year DESI volume. Additionally, we compare the performance of configuration space analysis with its Fourier space counterpart using three models: PyBird, FOLPS and velocileptors, presented in companion papers. We find good agreement with the results from all these models.
Synthetic spectra for Lyman-α forest analysis in the Dark Energy Spectroscopic Instrument
Authors: Herrera-Alcantar Hiram K. , Muñoz-Gutiérrez Andrea , Tan Ting , González-Morales Alma X. , Font-Ribera Andreu , Guy Julien , Moustakas John , Kirkby David , Armengaud E. , Bault A. , Cabayol-Garcia L. , Chaves-Montero J. , Cuceu A. , de la Cruz R. , García L.Á. , Gordon C. , Iršič V. , Karaçaylı N.G. , Le Goff J.M. , Montero-Camacho P. , Niz G. , Pérez-Ràfols I. , Ramírez-Pérez C. , Ravoux C. , Walther M. , Aguilar J. , Ahlen S. , Brooks D. , Claybaugh T. , Dawson K. , de la Macorra A. , Doel P. , Forero-Romero J.E. , Gaztañaga E. , Gontcho S.Gontcho A. , Honscheid K. , Kehoe R. , Kisner T. , Landriau M. , Levi Michael E. , Manera M. , Martini P. , Meisner A. , Miquel R. , Nie J. , Palanque-Delabrouille N. , Poppett C. , Rezaie M. , Rossi G. , Sanchez E. , Seo H. , Tarlé G. , Weaver B.A. , Zhou Z.
Published: January 2025

Synthetic data sets are used in cosmology to test analysis procedures, to verify that systematic errors are well understood and to demonstrate that measurements are unbiased. In this work we describe the methods used to generate synthetic datasets of Lyman-α quasar spectra aimed for studies with the Dark Energy Spectroscopic Instrument (DESI). In particular, we focus on demonstrating that our simulations reproduces important features of real samples, making them suitable to test the analysis methods to be used in DESI and to place limits on systematic effects on measurements of Baryon Acoustic Oscillations (BAO).
We present a set of mocks that reproduce the statistical properties of the DESI early data set with good agreement. Additionally, we use a synthetic dataset to forecast the BAO scale constraining power of the completed DESI survey through the Lyman-α forest.
Forward modeling fluctuations in the DESI LRGs target sample using image simulations
Authors: Kong H. , Ross A.J. , Honscheid K. , Lang D. , Porredon A. , de Mattia A. , Rezaie M. , Zhou R. , Schlafly E.F. , Moustakas J. , Rosado-Marin A. , Aguilar J. , Ahlen S. , Brooks D. , Chaussidon E. , Claybaugh T. , Cole S. , de la Macorra A. , Dey Arjun , Dey Biprateep , Doel P. , Fanning K. , Forero-Romero J.E. , Gaztañaga E. , Gontcho S.Gontcho A. , Gutierrez G. , Howlett C. , Juneau S. , Kremin A. , Landriau M. , Levi M.E. , Manera M. , Martini P. , Meisner A. , Miquel R. , Mueller E. , Myers A.D. , Newman J.A. , Nie J. , Niz G. , Percival W.J. , Poppett C. , Prada F. , Rossi G. , Sanchez E. , Schlegel D. , Schubnell M. , Seo H. , Sprayberry D. , Tarlé G. , Vargas-Magaña M. , Weaver B.A. , Zou H.
Published: January 2025

We use
the forward modeling pipeline, Obiwan, to study the imaging systematics of
the Luminous Red Galaxies (LRGs) targeted by the Dark Energy Spectroscopic Instrument
(DESI). Imaging systematics refers to the false fluctuation of galaxy densities due to varying
observing conditions and astrophysical foregrounds corresponding to the imaging surveys from which
DESI LRG target galaxies are selected. We update the Obiwan pipeline, which we
previously developed to simulate the optical images used to target DESI data, to further simulate
WISE images in the infrared. This addition allows simulating the DESI LRGs sample, which
utilizes WISE data in the target selection. Deep DESI imaging data combined with a method to
account for biases in their shapes is used to define a truth sample of potential LRG targets. We
inject these data evenly throughout the DESI Legacy Imaging Survey footprint at declinations
between -30 and 32.375 degrees. We simulate a total of 15 million galaxies to obtain a simulated
LRG sample (Obiwan LRGs) that predicts the variations in target density due to imaging
properties. We find that the simulations predict the trends with depth observed in the data,
including how they depend on the intrinsic brightness of the galaxies. We observe that faint LRGs
are the main contributing source of the imaging systematics trend induced by depth. We also find
significant trends in the data against Galactic extinction that are not predicted by
Obiwan. These trends depend strongly on the particular map of Galactic extinction chosen
to test against, implying systematic contamination in the Galactic extinction maps is a likely
root cause (e.g., Cosmic-Infrared Background, dust temperature correction). We additionally
observe a morphological change of the DESI LRGs population evidenced by a correlation
between OII emission line average intensity and the size of the z-band PSF. This effect most
likely results from uncertainties in background subtraction. The detailed findings we present
should be used to guide any observational systematics mitigation treatment for the clustering of
the DESI LRGs sample.
How different immersive environments affect intracortical brain computer interfaces
Authors: Tortolani Ariana F , Kunigk Nicolas G , Sobinov Anton R , Boninger Michael L , Bensmaia Sliman J , Collinger Jennifer L , Hatsopoulos Nicholas G , Downey John E
Published: January 2025

Objective. As brain–computer interface (BCI) research advances, many new applications are being developed. Tasks can be performed in different virtual environments, and whether a BCI user can switch environments seamlessly will influence the ultimate utility of a clinical device. Approach. Here we investigate the importance of the immersiveness of the virtual environment used to train BCI decoders on the resulting decoder and its generalizability between environments. Two participants who had intracortical electrodes implanted in their precentral gyrus used a BCI to control a virtual arm, both viewed immersively through virtual reality goggles and at a distance on a flat television monitor. Main results. Each participant performed better with a decoder trained and tested in the environment they had used the most prior to the study, one for each environment type. The neural tuning to the desired movement was minimally influenced by the immersiveness of the environment. Finally, in further testing with one of the participants, we found that decoders trained in one environment generalized well to the other environment, but the order in which the environments were experienced within a session mattered. Significance. Overall, experience with an environment was more influential on performance than the immersiveness of the environment, but BCI performance generalized well after accounting for experience.

Clinical Trial: NCT01894802
Bayes-optimal learning of deep random networks of extensive-width*
Authors: Cui Hugo , Krzakala Florent , Zdeborová Lenka
Published: January 2025

We consider the problem of learning a target function corresponding to a deep, extensive-width, non-linear neural network with random Gaussian weights. We consider the asymptotic limit where the number of samples, the input dimension and the network width are proportionally large. We propose a closed-form expression for the Bayes-optimal test error, for regression and classification tasks. We further compute closed-form expressions for the test errors of ridge regression, kernel and random features regression. We find, in particular, that optimally regularized ridge regression, as well as kernel regression, achieve Bayes-optimal performances, while the logistic loss yields a near-optimal test error for classification. We further show numerically that when the number of samples grows faster than the dimension, ridge and kernel methods become suboptimal, while neural networks achieve test error close to zero from quadratically many samples.
Breaking the wire: the impact of critical length on melting pathways in silver nanowires
Authors: Ridings K M , Vaka’uta E E L , Croot S M
Published: January 2025

We explore the melting mechanisms of silver nanowires through molecular dynamics simulations and theoretical modelling, where we observe that two distinct mechanisms or pathways emerge that dictate how the solid-liquid interface melts during the phase transition. For wires longer than a critical length (L > L
crit), an Arrhenius-type diffusion model successfully predicts the solid-liquid interface velocity, highlighting diffusion-driven melting pathways. In contrast, wires shorter than the critical length (L ≤ L
crit) exhibit unique behaviours driven by non-equilibrium effects, including rapid overheating of the solid core, stabilization of the solid-liquid interface, and the pronounced impact of higher energy densities. These mechanisms lead to accelerated melting and distinct phase transition dynamics. Our findings reveal how geometry and nanoscale effects critically shape melting behaviour, offering insights for the design and stability of nanostructures in advanced applications.
Niobium-buffered tantalum for a superconducting fluxonium qubit
Authors: Li Zi shuo , Guo Ting ting , Xu Wen qu , Shi Li li , Zhang Kai xuan , Zuo Quan , Zhou Tian shi , Sun Guo zhu , Wu Pei heng
Published: January 2025

We use a magnetron sputtering system to grow a tantalum film on a sapphire substrate with a niobium buffer layer at room temperature. The tantalum film is in α-phase, which is preferred for superconducting quantum devices. We fabricate a superconducting heavy fluxonium qubit with this niobium-buffered tantalum film, which demonstrates good performance. Forbidden transitions and sideband transition phenomena between specific energy levels are observed. Due to the specific design parameters, the fluxonium described herein exhibits high anharmonicity while maintaining a long decoherence time in the higher energy states, making it well-suited for use as a qudit and enabling high-dimensional quantum computation. With further optimization of the film deposition process, superconducting qubits other than fluxoniums with higher performance are expected to be obtained using these multilayer films grown at room temperature.
Combined influence of eggshell powder and nylon fiber on self-compacting concrete production: experimental assessment and machine learning quantifications
Authors: Safayet Md Abu , Abdullah Abu Abrar , Islam Md Faseehul , Alahmari Turki S , Sobuz Md Habibur Rahman , Khan Md Munir Hayet
Published: January 2025

The focus of this paper is on the study of the impact of nylon fibers (NF) as a reinforcing agent and eggshell powder (ESP) as an SCM in the production of self-compacting concrete (SCC) for sustainable buildings design. For this reason, the experiment involves finding the optimum amounts of ESP replacement for cement, which ranges between 5% to 15%, and the quantity of nylon fibers added in percent, which is between 0.05% and 0.10%. This study dealt with using ESP and nylon fibers for fresh, mechanical, durability, and microstructure of concrete. Additionally, random forest (RF) and artificial neural network (ANN) based machine learning methods were planned in order to examine the fresh and mechanical response of concrete. The study discovered that concrete containing 0.1 percent nylon fibers and 5 percent ESP performed relatively better compared to the control sample, especially in hardened characteristics. After 28 days, the compressive and splitting tensile strengths increased by 6% and 4%, respectively, compared to the control mixture. Although the UPV test revealed excellent quality in all mixtures, increased ESP levels decreased concrete strength. The maximum R2 value (0.989) and the minimum RMSE value (1.393) for the RF model indicate a strong overall estimation. The study emphasizes the potential of enhancing the overall performance of SCC by utilizing eggshell powder and nylon fibers. These results present a more sustainable approach to concrete production and contribute to a reduced environmental footprint.
Universal behavior of tunneling time and barrier time-delay decoupling in attoclock measurements
Authors: Kullie Ossama
Published: January 2025

The measurement of the tunneling time-delay is hotly debated and remains controversial. In previous works, we showed that a model that accurately describes the time-delay measured by the attoclock experiment in adiabatic and nonadiabatic field calibrations. In the present work, we show that the tunneling time reveals a universal behavior with disentangled contributions. Even more remarkable is that the barrier tunneling time-delay can be convincingly defined and determined from the difference between the time-delay of adiabatic and nonadiabatic tunnel-ionization, which also show good agreement with experimental results. Furthermore, we illustrate that in the weak measurement limit, the barrier time-delay corresponds to the Larmor-clock time and the interaction time within the barrier.
A bidirectional prediction framework for melt pool size and process parameters in LPBF
Authors: Yang Ao , Zhao Zhibin , Zhang Xingwu
Published: January 2025

In laser powder bed fusion (LPBF), the melt pool geometry is closely related to the final quality of the formed part. Establishing the relationship between the molten pool morphology and process parameters is of great significance for monitoring and controlling the LPBF process. However, the use of Artificial Intelligence (AI) methods, such as Machine Learning (ML), to establish the correlation between the process parameters and melt pool size remains challenging due to issues such as data acquisition, algorithm suitability and feature correlation analysis. Therefore, a framework for bidirectional prediction of process parameters and melt pool size is proposed in this study. Firstly, for LPBF experimental data with complex data components, low feature dimensions and a large number of features, ten ML regression algorithms suitable for bidirectional fitting of such data are selected and integrated into the framework. Secondly, a comprehensive feature analysis was conducted around the baseline features that are closely related to the melt pool size was performed, focusing on how various combinations of baseline features with other weakly correlated features affect the model performance. Finally, the dataset used was extensively collected from published works. The dataset, after integration and supplementation, is more than five times the size of a typical LPBF single-track experiment. The final results demonstrate that the prediction accuracy of this framework on this dataset exceeds 96%.
Efficient fabric defect detection based on lightweight model
Authors: Zou Juncheng , Yang Fuli
Published: January 2025

In the field of textile inspection, the detection of small-sized targets poses a challenge due to its high sensitivity to size variations. Currently, the commonly used methods in this field often rely on a large number of parameters and computing resources. Based on YOLOv8m, this study integrates the Coordinated Attention (CA) mechanism and the Mixed Local Channel Attention (MLCA) strategy and proposes a lightweight textile defect detection model - YOLOv8-mini. The CA mechanism enhances the discriminative ability of features by explicitly modeling the interdependencies between spatial and channel coordinates, enabling more effective feature representation for varying defect sizes. The MLCA strategy captures both global contextual information and local detailed features through a multi-scale approach, which is crucial for accurate defect localization and classification. On the dataset of the Xuelang Manufacturing AI Challenge, compared with the current state-of-the-art methods, the model proposed in this study has achieved a significant reduction in the number of parameters, decreasing to 18.8M (a reduction of 27.4%), while the mean Average Precision at 50% recall (mAP50) has reached 93.3% (an increase of 4%). The improvement in the efficiency of this model is expected to boost productivity and reduce production costs in the textile manufacturing process.
ReSpike: residual frames-based hybrid spiking neural networks for efficient action recognition
Authors: Xiao Shiting , Li Yuhang , Kim Youngeun , Lee Donghyun , Panda Priyadarshini
Published: January 2025

Spiking Neural Networks (SNNs) have emerged as a compelling, energy-efficient alternative to traditional Artificial Neural Networks (ANNs) for static image tasks such as image classification and segmentation. However, in the more complex video classification domain, SNN-based methods fall considerably short of ANN-based benchmarks due to the challenges in processing dense frame sequences. To bridge this gap, we propose ReSpike, a hybrid framework that synergizes the strengths of ANNs and SNNs to tackle action recognition tasks with high accuracy and low energy cost. By partitioning film clips into RGB image Key Frames, which primarily capture spatial information, and event-like Residual Frames, which emphasize temporal dynamics cues, ReSpike leverages ANN for processing spatial features and SNN for modeling temporal features. In addition, we propose a multi-scale cross-attention mechanism for effective feature fusion. Compared to state-of-the-art SNN baselines, our ReSpike hybrid architecture demonstrates significant performance improvements (e.g.

>

30% absolute accuracy improvement on HMDB-51, UCF-101, and Kinetics-400). Furthermore, ReSpike achieves comparable performance with prior ANN approaches while bringing better accuracy-energy tradeoff. Code is shared at https://github.com/Intelligent-Computing-Lab-Yale/ReSpike.
Historical and future trends
Authors: Leachman Jacob W , Wilhelmsen Øivind , Matveev Konstantin I
Published: January 2025

Hydrogen was the first element created after the Big Bang and remains the most abundant element in the universe. This chapter reviews many important developments in the history of humanity enabled by hydrogen. The question of why liquid hydrogen at cryogenic (or extremely cold) temperatures is used relative to other hydrogen forms is presented and answered. This leads to modern technology developments in liquid hydrogen to form a context for the current status of the field. The potential for catastrophic climate change is driving a global push toward clean hydrogen fuel and energy systems. Current technology trends and future needs for widespread adoption of cryogenic hydrogen are reviewed.
Safety
Authors: Leachman Jacob W , Wilhelmsen Øivind , Matveev Konstantin I
Published: January 2025

This chapter is focused on the development of safety plans for early-stage cryogenic hydrogen research and development. The safety planning process is essentially linked with the design process for testing a new concept. This chapter describes the “Cool Fuel School,” a series of 10 hands-on liquid hydrogen training workshops created by the authors to provide the essential experiences for developing cryogenic hydrogen systems. A five-phase process is followed that begins with design specifications and associated safety planning. Processes for conceptual design reviews and the associated conceptual design hazard and operability studies (HAZOPs) are presented next. The preliminary design review phase follows with failure modes and effects analysis (FMEA). Practical aspects of cryogenic hydrogen system manufacture and testing are presented concurrently with operational HAZOP analysis. Best practices for training and maintenance are reviewed. The book concludes with a retrospective of the Cool Fuel School and opportunities for future adaptation.
2837 Learning from deaths; embedding education in the process of certification of death during rollout of the medical examiner service
Authors: Nelmes A , Goodison S , Monteith R , Morse R
Published: January 2025

Introduction

The recent introduction of the Medical Examiner (ME) service changed the process for Medical Certificate of Cause of Death (MCCD) completion across Wales. This offered opportunity for local process redesign and embedding of team-based education and reflective practice, whilst reducing delays in MCCD completion for bereaved families.

Methods

We produced a process map and discussed with key stakeholders—ward teams, bereavement staff and the ME Office. We developed a team–based Proposed Cause of Death form (several PDSA Cycles) to prompt and stimulate early medical team discussion/reflection and to aid a clear formation of a proposed cause of death, in advance of ME review. This was piloted (paper form) on 2 wards (A&B) in 2022, followed by a further 3 wards (C,D&E) in electronic form in 2023. We collected data on numbers of deaths, forms completed and time between death and MCCD completion. Feedback sought from teams, bereavement, and the ME service re usefulness of the intervention.

Results

The process was successfully adopted on 2 of the 5 pilot wards. For the 2 wards adopting the process, the educational discussion and form were completed in 71% (27/38) of deaths on ward B, and 60.9% (14/23) on ward C. Time from death to MCCD completion was not significantly increased by this additional step. Feedback from adopting teams was positive, commenting on educational opportunities and improved communication between the ward and bereavement teams.

Conclusions

Facilitators of adoption were ward level consultant engagement, availability of notes and prompting of the medical team by the bereavement team. Barriers to adoption were a perception of extra work and being unable to perceive usefulness of the process. Adoption of the process led to improved team ownership of cause of death decisions, educational opportunities and better communication with the ME and bereavement teams.
2878 The adoption of a frailty early discharge scheme is beneficial in reducing length of stay
Authors: Nahhas A , Andrews S , Alexander H , Settle S , Bilal A , Ransom L , Peasgood H
Published: January 2025

Introduction

Hospital-Associated Deconditioning Syndrome (HADS) can lead to prolonged length of stay (LOS). Evidence indicates that early intervention may reduce HADS and LOS. (British Geriatrics Society, Deconditioning, Healthy Ageing, 11 May 2017, DrAmit Arora, NHS England, 24 January 2017, Time to Move). The Acute Frailty Team (AFT) at Eastbourne District General Hospital piloted a Frailty Early Discharge Scheme (FEDS) in the Frailty Unit for 8 weeks between May–June 2023 with the aim of providing early mobilisation and discharge planning to reduce LOS.

Methods

Patients were admitted to either FEDS or Non-FEDS (NFEDS) beds depending on the bed availability. FEDS patients were provided with additional early assessments and interventions including discharge plans from day 1 after admission, offering early, continuous and active mobilisation by a trained FEDS team of a registered Nurse and Health Care Assistant. The FEDS team worked in conjunction with the medical team to actively promote discharge planning while patients were still receiving acute medical treatment, before patients becoming medically fit for discharge (MFFD). NFEDS followed the standard care plan, usually initiated after patients were declared MFFD. Data was collected for all patients, comparing FEDS 12 beds with NFEDS 12 beds.

Results

83 patients were enrolled 45 FEDS, 38 NFEDS. Discharged within 48 hrs FEDS 11.11%, NFEDS 2.63%. Discharged within 7 days FEDS 44.44%, NFEDS 28.94%. LOS 8.07 days FEDS, 11.36 days NFEDS (30 day trim point).

Conclusions
2847 Frailty Hospital at Home (H@H): numbers needed to treat to avoid an unplanned admission to an acute hospital
Authors: Sage S , O'Riordan S , Baxter A , Seeley J
Published: January 2025

Introduction

East Kent Frailty H@H provides an alternative to admission to an acute hospital for frail people who are acutely unwell. Treatment at home is often the preferred option for People living with frailty and prevents some of the complications associated with hospitalisation such as environmental delirium, loss of function, isolation from usual contacts and infection. However, it was not known whether H@H also reduced the workload of the acute hospital.

Method

Frail people who are acutely unwell are offered treatment in H@H instead of admission to an acute hospital. Referrals were made by community clinician e.g. Primary care, community nurse, Single point of access, paramedics etc. Interventions include CGA based assessment, point-of-care blood tests, ultrasound, urgent outpatient x-ray, CT and MRI scans, Intravenous therapies etc. Data were collected using electronic patient records for the community and hospital services. The data collection period was April 22-Dec 23 Patients of 69 and over were included. SPA charts were generated for results.

Results

Before the introduction of H@H the number of non-elective admissions plus the corridor activity closely matched the predicted number of admissions. Since the introduction of the H@H there is a significant drop in the number of non-elective admissions plus the corridor activity compared to predicted admissions. This number (~400 per month) is similar to the number admitted to H@H.

Conclusion(s)

H@H Data validated by NHS England has demonstrated that for every 1.03 patients treated 1 non-elective admission to the acute hospital was avoided.
2752 Reducing the wait for dementia diagnosis: another use for day hospitals
Authors: Keir S , McClung I , Smith L , Cowell J
Published: January 2025

Introduction

The Assessment and Rehabilitation Centre (ARC) in Edinburgh sees around 600 new patients a year who are beginning to demonstrate signs of frailty, principally around mobility and balance. When taking a comprehensive geriatric assessment, we commonly identify concerns around cognition. We noted in some cases people were already waiting to be seen by the Memory Clinic Services, the current wait for which is approximately 10 months. We decided to see what ARC could do to help.

Method

From within existing resources, alongside the Psychiatry of Older Age (POA) Team, the ARC multi-disciplinary team coproduced a pathway that involved an initial assessment comprising identification of potentially cognitively frail patients, taking a corroborative history, performing cognitive and imaging investigations. Each step was added to a shared spreadsheet enabling us to chart progress of diagnostic information steps.

Then once assessment complete, a POA colleague reviewed the evidence and made a diagnosis with treatment recommendations. The ARC team then discusses the outcome with the patient and their family, arranges a medication tolerance follow-up in ARC, then refers onward for ongoing community support.

Results

Between March 2023 and 2024, 52 patients completed the Memory MDT process, 34 (65%) of which were diagnosed with a dementia, 20 (33%) of which were started on dementia medication. 16 were removed from the Memory service waiting list (2.5%) and a further 18 avoided the need to be referred.

Conclusion

We identified a group of patients with a common underlying pathology that had resulted in them being referred to multiple specialities. By arranging our services around this vulnerable patient group rather than the other way around, we reduced their need for multiple hospital attendances and freed up resource in the memory service. Work is underway to spread and scale up.
2753 Prioritising patient experience: a multidisciplinary, quality improvement project using patient feedback and Co-design
Authors: Capek E , Mason Z , Latif A , Minematsu A , Rough C , Francis S , Burns E , Cameron L , Trafford H , Donnelly T , Hettle R , Wright E , Oommen E , Weir G
Published: January 2025

Introduction

There are multiple national drivers promoting person-centred healthcare. In the face of competing pressures, patient experience is often compromised.

Aim

To increase the percentage of service users in our orthogeriatric rehabilitation ward rating experience as more than 6/10 to 90% by June 2024.

Methods

A multidisciplinary project using quality improvement methodology. Patients and carers were involved throughout. Patient, staff and carer interviews shaped improvement themes and change ideas. Broad themes identified:

Several, cost neutral, tests of change were studied: weekly exercise class, mobile library, ‘activities trolley’, music concerts, volunteer recruitment, improved signposting and coordinating weekly relative update.

Run and SPC charts were used to study impact. Measures used:

Results

The % of patients scoring experience >6/10 increased over the project but did not meet ‘special cause’ criteria. Feedback themes shifted positively.

Conclusions
2877 Can we make comprehensive geriatric assessment (CGA) person-centred? A quality improvement project using the CGA-questionnaire
Authors: Chin K , Watson G , Paveley A , Dulson H , Thompson L , Schiff R
Published: January 2025

Introduction

CGA is the gold-standard intervention for older adults living with frailty. A challenge is providing person-centred, time-efficient CGA. The CGA-questionnaire (CGA-Q) aims to facilitate person-centred CGA, allowing patients/carers to highlight concerns. We describe a two-site multi-cycle QIP implementing the CGA-Q.

Methods

CGA-Q is a 19-item questionnaire covering seven CGA domains. It was adapted from the validated CGA-GOLD questionnaire. Between March 2023–June 2024, CGA-Q was established in a London and Scottish NHS Trust using ‘Plan-Do-Study-Act’ methodology. Cycle 1–3 involved designing and establishing CGA-Q at one London geriatric clinic. Cycle 4 assessed feasibility in multiple London geriatric clinics. Cycle 5 examined implementation of CGA-Q in a Scottish day-hospital. Person-centredness refers to inclusion of person-selected concerns in clinic letters, and not including person-excluded concerns.

Results

Across cycles, cohorts were comparable in age, sex, frailty and cognitive status. In cycles 1–3 (n = 174), CGA-Q completion rates improved from 39% to 83%. More CGA-Q questions were addressed especially cognition, mood, continence and falls. Inclusion of person-selected concerns increased from 60% to 70%; exclusion of person-excluded concerns remained ~70%. In cycle 4, completion rates varied by clinic: renal-CGA 100% (12/12); CGA 42% (13/31); bone-health 14% (10/60). >50% of questionnaires were completed by patients, except in bone-health where two-thirds were completed by staff. Staff feedback highlights CGA-Q is a useful discussion prompt. In cycle 5 (n = 41), a similar breadth of CGA-Q questions was addressed among respondents compared to baseline. With CGA-Q, continence and pain were addressed more frequently. Inclusion of person-selected concerns was 62%; exclusion of person-excluded concerns was 71%.

Conclusion

CGA-Q has been successfully implemented across multiple sites and clinics. It can improve person-centeredness and breadth of CGA, but early results vary across subspecialty geriatric medicine clinics with their unique processes. Ongoing work will determine the experience of patients and carers of this approach.
2791 Sharing learning from incidents and complaints through whole team In-situ simulation training in older person medicine
Authors: Murdoch R , Russell K
Published: January 2025

Introduction

Incidents and complains are an important form of learning for healthcare institutions. The learning is often shared via huddles, handovers, emails and learning alert bulletins. In the older persons medicine (OPM) department at James Cook University Hospital, we identified that there may be a role for whole team in-situ sim to not only facilitate learning around important and highly relevant topics but also improve the education provision for nurses and healthcare assistants who have less access to education compared to their doctor colleagues and improve whole team communication.

Methods

Initially a working group including a consultant, advanced clinical practitioner, SIM training facilitator, liaison psychiatry nurse, teaching fellow and ward manager was set up to organise a pilot session. Following the success of this session the training was initially organised to be monthly, arranged by the advanced clinical practitioners, facilitated by the sim technicians. The ward managers fully supported the training and facilitated the attendance of the ward staff. The clinical director identified topics for learning from incidents and complaints and there was support from the OPM registrars and teaching fellow. It quickly became so popular among staff that the session frequency was increased first to fortnightly and is now run weekly.

Results

The feedback was excellent. From the attendees to the sim trainers, it was said that the OPM department had been the most enthusiastic about ward-based training. The anonymised and entirely positive feedback from the sessions was that they were interesting, informative, and relevant to clinical practice.

Conclusion

Using in-situ simulation training on the older persons medicine wards to share learning from incidents and complaints is not only practical, but incredibly well received by staff of all disciplines.
2535 Anticoagulation in atrial fibrillation
Authors: Saeed M
Published: January 2025

Introduction

A Clinical Audit was recommended by the ME following identification of potential safety signal because of possible non-compliance with guidelines on Anticoagulation in AF. The audit data collection tool was developed in discussion with the Chief Pharmacist and took account of up-to-date prescribing guidance from the Integrated Commissioning Board (ICB).

Aim

of the audit was to identify if, as per NICE guidelines patients had:

Objectives

To ensure that patients with new diagnosis of atrial fibrillation are assessed for stroke and bleeding and involved in discussion regarding anticoagulation which is prescribed as per national recommendations.

Method

This local audit was carried out by analysis of both electronic and paper-based patient records using an Excel spreadsheet for analysis. Data was then analysed with the help of the Senior Clinical Effectiveness Advisor.

Results and highlighted risks

It was observed that in most cases (82%), patients were not made aware about the condition and associated risk of stroke due to underlying AF. They were also not involved in discussion regarding commencing lifelong anticoagulation, and not explained the benefits and risks of anticoagulation. Omittance/Ignorance of anticoagulation upon new diagnosis of AF hence increasing the risk of stroke with lethal consequences of preventable death in 21% of patients.

Recommendations and Conclusion

Formulation of ‘AF Anticoagulation Checklist’ (based on NICE guidelines) ensuring every patient with a new diagnosis of AF has a repeat ECG for confirmation of diagnosis, CHA2DS2-VASc and ORBIT scores for risk assessment, their renal functions and coagulation profile checked, followed by discussion with patient regarding results of risk assessment and risk vs benefit of anticoagulation.
2795 Using the dynamics of the frailty index to assess population health across different countries
Authors: Drijver-Headley S , Godin J , Rockwood K , Hanlon P
Published: January 2025

Background

Worldwide population ageing is motivating how to measure the health of ageing populations. One approach is to compare dynamics of frailty, assessed by the cumulative-deficit frailty index, across different populations. We aim to compare the frailty distribution, mortality risk, and change in frailty over time between 18 countries.

Methods

Using data from five harmonised international surveys (HRS, SHARE, ELSA, CHARLS and MHAS) we assessed frailty with a 40-item frailty index (baseline, 2-, 4- and 6-year follow-up), along with mortality status. We constructed separate regression models for participants with the fewest baseline health deficits (‘zero-state’—assessing ambient health of the population) and the rest of the population (‘non-zero-state’). Using logistic and negative binomial, respectively, we assessed the odds of mortality and the rate of deficit accumulation (i.e. change in frailty index) between countries, adjusted for baseline frailty, age, and sex.

Results

Highest baseline frailty, mortality risk, and the most rapid increases in frailty were observed in Mexico, followed by China. Differences in mortality risk and deficit accumulation were similar regardless of baseline frailty. Lowest mortality risk and the slowest rates of deficit accumulation were observed in Scandinavian countries and in Switzerland. Differences between Central/Southern European countries, USA and UK varied when comparing zero-state with non- zero-state models. For example, mortality rates and deficit accumulation were relatively lower among the healthiest subset of the USA (and to a lesser extent UK) population. However, when modelling those with some degree of baseline frailty, mortality and deficit accumulation in the USA were relatively higher compared to European countries.

Conclusion

Dynamics of the frailty index can provide insights into population-level differences in health across different settings. For some, but not all, countries, findings are sensitive to the degree of frailty present at baseline, which may reflect inequalities in healthcare provision or access.
2821 The feasibility of delivering evidence-based fall prevention exercise in the voluntary sector—a mixed methods study
Authors: Whitney J , Belderbos K , Boyd T
Published: January 2025

Introduction

Highly challenging, regular strength and balance exercise classes (SBE) reduces fall risk but there are few options for long-term continuation. SBE could be delivered by the voluntary sector, but care is needed to ensure good fidelity. The feasibility of delivering evidence-based SBE outside the governance of health services is unclear. A voluntary sector-led weekly SBE class ‘Strong and Steady (S&S)’, led by a level 4 qualified postural stability and funded via grants and fees, was set up in December 2022 alongside an existing community coffee morning.

Methods

Baseline measures and adherence were collected for all who commenced S&S. Two classes were observed using a standardised fidelity checklist. Interviews and focus groups were undertaken with class participants, a previous participant, the exercise instructor and lead volunteer.

Results

Since December 2022, 24 participants aged 59–95 (63% female) self-referred to S&S. Baseline measures, collected in 100% of assessments, (timed up and go, four-step balance scale and 60-second sit-to-stand) indicated performance slightly below age-matched norms with the exception of falls efficacy (FES-I). Three participants dropped out (1 died) and adherence was 67%. Fidelity in both observed classes was good (mean score 21/24). Four themes emerged from thematic analysis of all the interviews and focus groups:

Conclusion

Delivering SBE via the voluntary sector is feasible and can be delivered with good fidelity. The provision tends to attract people who have high levels of self-efficacy and motivation to exercise.
2671 A description of a patient navigator program for persons living with dementia in Canada
Authors: Jarrett P , MacNeil L , Luke A , Faig K , Gionet S , Doucet S
Published: January 2025

Introduction

Receiving a dementia diagnosis can be overwhelming for persons living with dementia (PLWD) and their carers. Accessing information and home supports can be challenging. Having access to a Patient Navigation (PN) program is one way that may assist PLWD and their carers.

Methods

This study used a mixed methods design and involved the implementation of a Patient Navigation (PN) program in 6 primary care settings in New Brunswick, Canada, between July 2022–July 2023. PLWD/carers living in their own homes were eligible to enrol.

Results

There were 150 PLWD with a mean age of 76.4 (SD = 9.4) years and 51.4% were male. The majority (60.7%) were living in rural communities. Most (50.7%) had been diagnosed within the past 2 years with 50.7% having seen a specialist, most commonly a geriatrician. Almost all (88.7%) had a primary care provider; however, only 25.2% were connected to the social care system, and 19.8% were connected to the home care system. The most common reasons for enrolling were gaining access to social programs and home supports and seeking dementia specific information. The average number of goals per PLWD/carer was 3.79 (SD = 1.7). The average time in the program was 121.7 days (SD = 100.0) and 76.6% achieved their goals. The majority (84.0%) were somewhat to very satisfied with the PN program. Carers stated that with increased knowledge, access, and support there was a decrease in social isolation as well as improved confidence, which allowed PLWD to remain in the community longer.

Conclusions

Most PLWD/carers were connected to the health system, but the minority were connected to social and home care programs. Through connection to the PN program, carers increased their confidence; improved their knowledge; and increased their access to home supports and other care programs, allowing PLWD to remain in the community longer.
2866 Clusters of multimorbidity and subjective cognitive decline (the ELSI-Brazil study)
Authors: Batista SRR , Leão NLG , Nogueira SCM , Melo SY , Silveira EA , Rodrigues RRD , Silva RR
Published: January 2025

Introduction

Subjective cognitive decline (SCD) is defined by cognitive complaints expressed by the individual, without evidence of cognitive impairment on objective neuropsychological tests. Studies have analysed SCD among patients with specific groups of diseases. An increased understanding of the association between disease patterns and subjective cognitive decline is essential to develop targeted interventions for these groups.

Method

Using data from the baseline of the Brazilian Longitudinal Study of Ageing (ELSI-Brazil), this cross-sectional study included 2508 participants. Subjective Cognitive Decline (SCD) was assessed using the Subjective Cognitive Decline Initiative Working Group’s criteria. Multimorbidity (MM) was defined as the presence of two or more of 14 self-reported health conditions. Clusters of MM were identified based on the most prevalent dyads and triads of diseases within the sample. Robust Poisson regression models were used to estimate adjusted prevalence ratios (PR) for the association between MM clusters and SCD, accounting for potential confounders.

Results

The following dyads of chronic conditions were associated with higher prevalence of SCD: ophthalmological problems/osteoporosis (RR: 1.497 p = 0.042), heart problems/stroke (RR: 2.33, p < 0.001), and hypertension/asthma (RR: 3.309, p = 0.013). No triads had positive association with SCD, although the triads of ophthalmological problem/hypertension/osteoporosis (RR: 0.367, p < 0.001) and hypertension/cardiac problems/dyslipidemia (RR: 0.545, p = 0.012) were negatively associated with the prevalence of SCD.

Conclusion

Our study demonstrated an association between SCD and MM clusters, which is important for developing and managing care for individuals with cognitive decline and/or those multimorbidity patterns. The results could also provide a foundation for future research exploring the causality between these variables.
2816 Decision-making experiences with older adults following a cancer diagnosis: a systematic review
Authors: Lewis L , Wagland R , Patel HP , Bridges J , Farrington N , Hunt K
Published: January 2025

Introduction

Little evidence exists about decision-making with older adults diagnosed with cancer (Bridges et al 2015). However, older age is associated with changes in physical, social, and psychological health domains in ways that influence treatment decisions potentially impacting on quality and quantity of life. We sought to explore the experiences of older adults, their significant others and healthcare professionals when decisions regarding cancer treatment and support are made.

Methods

Synonyms relating to search terms Cancer, Older People, Complexity and Qualitative research were used to search the databases CINAHL, Medline, Embase and PsychINFO. The Mixed Methods Appraisal Tool (MMAT) identified strengths and limitations of the evidence allowing concurrent appraisal of qualitative, quantitative, and mixed methods studies.

Results

Searches identified 534 articles: 37 studies underwent full text screening, and 15 of these were included. The synthesis identified six themes: Preconditions in decision-making; Identifying frailty and setting goals; Maintaining independence; Information provision; Support during the decision-making process/role distribution; Trust in physicians; Preferences and choice. Most included studies reported the views of the older person, or health care professionals (predominantly physicians/oncologists/surgeons). However, there is a paucity of evidence representing the views of the older adult’s significant other and a dearth of evidence exploring the efforts and contributions of all people involved in the process of decision-making.

Conclusions

Research is needed urgently to understand how and why decisions are made regarding cancer treatment and support, as well as how older adults are involved in these decisions throughout their cancer trajectory. Understanding this would assist healthcare professionals to prioritise individual’s healthcare preferences with the potential to positively influence service delivery and workforce development. This review has informed the research design for The CHOICES study which aims to understand how clinicians, older individuals and their significant others make decisions following a new diagnosis of cancer.