bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensitive temperature-dependent phase resolution of polyethylene-clay nanocomposites
Authors: Sagitova E A , Donfack P , Prokhorov K A , Kuznetsov S M , Guseva M A , Gerasin V A , Nikolaeva G Yu , Materny A
Published: June 2022

With the help of spectroscopic and differential scanning calorimetry (DSC) techniques, we have studied conformational and phase reorganizations as function of temperature in intercalated polymer-clay nanocomposites based on low-, middle-, and high-density polyethylene (PE) matrices. We show that Raman spectroscopy is sensitive to structural changes appearing during heating at much lower temperatures (about 47 °C) in comparison to DSC measurements. In fact, in the melting region where DSC traces show endotherms, Raman spectra reveal dramatic changes in the phase and conformational compositions of PE and PE-matrices within PE-clay nanocomposites. Noteworthy, the structural reorganization pathway, through which the semicrystalline nanocomposites transform into a melt state, depends primarily on the PE density and weakly on the filler (nanoclay). Moreover, the temperature-dependent crystallinity degree and the total amount of trans-conformers of the PE system are determined, and the evidence for the formation of intermediate crystal-like phase during heating is shown.
Data parallel processing in block streams for analysis of long-term series of ozone content in ground atmosphere
Authors: Stepanov Eugene V
Published: June 2022

The article describes a new approach to the processing of long series of ozone monitoring data in the surface atmosphere called the Data Parallel Processing in Block Streams. The proposed method is based on splitting of a sequential series of initial data into blocks filled with surface ozone monitoring data for one day. Further, a chain is formed from such blocks, the length of which is determined by the total length of the monitoring process. Along this chain of blocks, parallel processing of the initial data is carried out, aimed at smoothing out fast fluctuations. The smoothed data is then used to determine the daily production of ozone due to photochemical reactions, its minimum nighttime levels, as well as the magnitude of nighttime maxima. The possibilities of the proposed approach are demonstrated using the analysis of surface ozone monitoring data in Moscow, Russia, in 2020. The prospects for further application of the developed method are discussed.
Driving potential and fission-fragment charge distributions
Authors: Su Yuan , Liu Min , Wang Ning
Published: June 2022

We propose an efficient approach to describe the fission-fragment charge yields for actinides based on the driving potential of the fissioning system. Considering the properties of primary fission fragments at their ground states, the driving potential, which represents the potential energies of the system around scission configuration and closely relates to the yields of fragments, can be unambiguously and quickly obtained from the Skyrme energy-density functional together with the Weizsäcker–Skyrme mass model. The fission-fragment charge distributions for thermal-neutron-induced fission and spontaneous fission of a series of actinides, especially the odd–even staggering in the charge distributions, can be well reproduced. Nuclear dynamical deformations and pairing corrections of fragments play an important role in the charge distributions.
Enhanced magnetic transduction of neuronal activity by nanofabricated inductors quantified via finite element analysis
Authors: Phillips Jack , Glodowski Mitchell , Gokhale Yash , Dwyer Matthew , Ashtiani Alireza , Hai Aviad
Published: June 2022

Objective. Methods for the detection of neural signals involve a compromise between invasiveness, spatiotemporal resolution, and the number of neurons or brain regions recorded. Electrode-based probes provide excellent response but usually require transcranial wiring and capture activity from limited neuronal populations. Noninvasive methods such as electroencephalography and magnetoencephalography offer fast readouts of field potentials or biomagnetic signals, respectively, but have spatial constraints that prohibit recording from single neurons. A cell-sized device that enhances neurogenic magnetic fields can be used as an in situ sensor for magnetic-based modalities and increase the ability to detect diverse signals across multiple brain regions. Approach. We designed and modeled a device capable of forming a tight electromagnetic junction with single neurons, thereby transducing changes in cellular potential to magnetic field perturbations by driving current through a nanofabricated inductor element. Main results. We present detailed quantification of the device performance using realistic finite element simulations with signals and geometries acquired from patch-clamped neurons in vitro and demonstrate the capability of the device to produce magnetic signals readable via existing modalities. We compare the magnetic output of the device to intrinsic neuronal magnetic fields (NMFs) and show that the transduced magnetic field intensity from a single neuron is more than three-fold higher at its peak (1.62 nT vs 0.51 nT). Importantly, we report on a large spatial enhancement of the transduced magnetic field output within a typical voxel (40 × 40 × 10 µm) over 250 times higher than the intrinsic NMF strength (0.64 nT vs 2.5 pT). We use this framework to perform optimizations of device performance based on nanofabrication constraints and material choices. Significance. Our quantifications institute a foundation for synthesizing and applying electromagnetic sensors for detecting brain activity and can serve as a general method for quantifying recording devices at the single cell level.
A Bayesian-optimized design for an interpretable convolutional neural network to decode and analyze the P300 response in autism
Authors: Borra Davide , Magosso Elisa , Castelo-Branco Miguel , Simões Marco
Published: June 2022

Objective. P300 can be analyzed in autism spectrum disorder (ASD) to derive biomarkers and can be decoded in brain–computer interfaces to reinforce ASD impaired skills. Convolutional neural networks (CNNs) have been proposed for P300 decoding, outperforming traditional algorithms but they (a) do not investigate optimal designs in different training conditions; (b) lack in interpretability. To overcome these limitations, an interpretable CNN (ICNN), that we recently proposed for motor decoding, has been modified and adopted here, with its optimal design searched via Bayesian optimization. Approach. The ICNN provides a straightforward interpretation of spectral and spatial features learned to decode P300. The Bayesian-optimized (BO) ICNN design was investigated separately for different training strategies (within-subject, within-session, and cross-subject) and BO models were used for the subsequent analyses. Specifically, transfer learning (TL) potentialities were investigated by assessing how pretrained cross-subject BO models performed on a new subject vs. random-initialized models. Furthermore, within-subject BO-derived models were combined with an explanation technique (ICNN + ET) to analyze P300 spectral and spatial features. Main results. The ICNN resulted comparable or even outperformed existing CNNs, at the same time being lighter. BO ICNN designs differed depending on the training strategy, needing more capacity as the training set variability increased. Furthermore, TL provided higher performance than networks trained from scratch. The ICNN + ET analysis suggested the frequency range [2, 5.8] Hz as the most relevant, and spatial features showed a right-hemispheric parietal asymmetry. The ICNN + ET-derived features, but not ERP-derived features, resulted significantly and highly correlated to autism diagnostic observation schedule clinical scores. Significance. This study substantiates the idea that a CNN can be designed both accurate and interpretable for P300 decoding, with an optimized design depending on the training condition. The novel ICNN-based analysis tool was able to better capture ASD neural signatures than traditional event-related potential analysis, possibly paving the way for identifying novel biomarkers.
Regularization and uniqueness of solutions of Volterra linear integral equations of the third kind
Authors: Toigonbaeva Aizat , Obodoeva Gumushai , Kambarova Aisalkyn
Published: June 2022

Annotation

Integral equations, as well as their solutions, play an important role in the study of various problems of science and technology. Of particular interest are the Volterra integral equations. In this paper, a regularizing operator is constructed using the method of M. M. Lavrentiev for solving a class of Volterra linear integral equations of the third kind.
Deformation analysis of CoCrMo-on-CoCrMo hip implant based on body mass index using 2D finite element procedure
Authors: Ammarullah Muhammad Imam , Afif Ilham Yustar , Maula Mohamad Izzur , Winarni Tri Indah , Tauviqirrahman Mohammad , Bayuseno Athanasius Priharyoto , Basri Hasan , Syahrom Ardiyansyah , Md Saad Amir Putra , Jamari
Published: June 2022

The paper available of total hip arthroplasty is still concerned with the external factors of implant user, but the internal factor that is the user’s body weight has not deeply understood. Our research presents deformation analysis of total hip arthroplasty with different loading conditions based on the patient’s body mass index category. 2D model is selected to conducting numerical analysis of CoCrMo-on-CoCrMo that giving vertical load from different category of body mass index, namely underweight, normal, overweight, and obese class I, obese class II, and obese class III using finite element procedures. Peak loading under normal walking conditions from actual condition of human hip joint is adopted. Our result explains that displacement in direction - y is larger in line with greater user’s body mass index.
Graph coloring program for variation of exam scheduling modeling at Binus University based on Welsh and Powell algorithm
Authors: Arifin Samsul , Muktyas Indra Bayu , Mandei Jeremy Matthew
Published: June 2022

In this article, we will design a computer program to solve graph colouring and to visualize the variation of exam scheduling modelling at Binus University in graphs based on the Welch and Powell Algorithm. A vertex colouring of graph G = (V, E) is an F: V → N mapping where the adjacent vertex are different colours in N, i.e. if the edge (u, v) are in E, then F (u) is not equal to F (v). The formulation of problems regarding computer programs based on a small experiment and variations in modelling exams is carried out in graph form using the Visual Basic Application.
Prospective elementary teachers’ attitude toward technology-based mathematics assessment
Authors: Putra Zetra Hainul , Rahmadhani Desri , Noviana Eddy , Hermita Neni
Published: June 2022

This research is motivated by the rapid development of information communication and technology (ICT) in the era of the industrial revolution 4.0. Most teachers seem to be unfamiliar with the use of technology in teaching and learning mathematics. In the present study, we are interested in investigating prospective elementary teachers’ attitudes towards technology-based mathematics assessment. We surveyed 70 prospective elementary teachers from a teacher education study program in Riau province, Indonesia. The study results show that prospective elementary teachers have positive attitudes towards the technology-based mathematics assessment. More than 75% and 55% of third and first-year students agreed with technology usage in mathematics assessment. They provided several reasons underlying the agreeableness of technology-based mathematics assessment, such as innovation, practices, and need to be used in line with the current situation.
The relationship between confidence and mathematics learning achievement of junior high school students
Authors: Febrianto  , Sulistiawati  , Rahman Bobbi , Arifin Samsul
Published: June 2022

Self-confidence is very important for students to actualize their potential and information on the level of student confidence is very helpful for teachers as a basis for decision making, as well as providing feedback to improve the learning process. This study aims to investigate whether there is a positive and significant relationship between self-confidence and student mathematics achievement. This research uses quantitative research methods, namely ex post facto type with a population of VII grade students of SMP Puspita Tangerang which consists of 5 classes total 188 students. Determination of the number of samples looked at the table of Issac and Michael with α = 0.05 and obtained a sample of 123 students. The data analysis of this study used a high confidence level of 95%. Based on the results of the simple linear regression test, it is found that the equation Ŷ = 21,714 + 0,374x means that there is a positive and significant relationship between self-confidence and student mathematics achievement. Then, the simple correlation coefficient test result count.
Mathematical thinking process based on student IQ test results and talented mathematical
Authors: Patmawati Hetty , Turmudi  , Prabawanto Sufyani
Published: June 2022

This study aims to determine how the students’ mathematical thinking processes are evaluated from the IQ test results and mathematical giftedness. Each student has his level of intelligence and talent in learning science, including mathematics. Until now, mathematics is considered a difficult subject to learn, including at the Elementary School level. However, there are elementary school students who have more advantages and have the talent to study and solve mathematical problems. The purpose of this research is to find out how the mathematical thinking ability of gifted elementary school students and how the type or model of the thinking process of gifted students in terms of the results of the IQ test, the Mathematical Gifted test. This research was conducted on elementary school students in the city of Tasikmalaya, who had been taken by purposive sampling to obtain 15 students who were used as research samples. IQ test results were obtained by 2 people belonging to the gifted category, and 13 people belonging to the superior category. The mathematical thinking process of two people who are classified as gifted fulfilled the indicators of representation, generalization, abstraction, and mathematical creativity.
A human exposure-based traffic assignment model for minimizing fine particulate matter (PM2.5) intake from on-road vehicle emissions
Authors: Bin Thaneya Ahmad , S Apte Joshua , Horvath Arpad
Published: June 2022

An exposure-based traffic assignment (TA) model and accompanying analysis framework have been developed to quantify primary and secondary fine particulate matter (PM2.5) exposure due to modeled on-road vehicle flow on a regional network at a high spatial resolution. The Chicago Metropolitan Area transportation network is used to demonstrate the model’s decision-informing power. The study compares the spatially distributed exposure impacts due to traffic emissions of two TA optimization scenarios: a baseline user equilibrium with respect to travel time (UET) and a novel system optimal with respect to pollutant intake (SOI). The UET and SOI scenarios are developed through the use of (a) the TA model used for obtaining vehicle flow patterns and characteristics including emissions, (b) a source-receptor matrix for PM2.5 developed through a reduced-complexity air quality model to quantify primary and secondary PM2.5 concentrations across the exposure domain, (c) spatial analysis for assessing exposure profiles at the census tract level, and (d) a health impact model to quantify exposure damages. The SOI scenario yields a 9% – 10% total reduction in exposure damages, with the most impacted census tracts benefiting from up to 20% – 30% of reductions, but leads to a 16% increase in travel time costs. Further reduction to PM2.5 exposure by the SOI is hindered by network constraints, where travel demand in populous areas around the network must still be satisfied. The model can be used to systematically quantify the mitigation potential of different transportation exposure reduction strategies, to assess the exposure impacts of newly developed transportation infrastructure, and to address the equity implications of PM2.5 exposure from traffic, all under realistic system behavior and bounded by actual system constraints.
Future flooding increases unequal exposure risks to relic industrial pollution
Authors: Marlow Thomas , Elliott James R , Frickel Scott
Published: June 2022

Climate change is increasing the probability that urban communities with lengthy histories of land-based industrial pollution and ongoing residential segregation will experience more frequent and destructive flooding in the years ahead. This paper investigates where these past, present, and future forces will converge to potentially produce a new type of climate injustice, as the flooding of former, or ‘relic,’ industrial sites threatens to transport sequestered industrial contaminants off site. Merging property-level flood-risk projections from the First Street Foundation with historical data on former hazardous manufacturing facilities in 6 U.S. cities, we identify more than 6000 relic industrial sites with elevated flood risk over the next 30 years. Exploratory spatial analysis reveals that these sites cluster spatially to create identifiable zones of cumulative impact, within which as many as 560 thousand residents and 229 thousand housing units are currently located. Spatial multilevel modeling further indicates that socially vulnerable groups (i.e. racial minorities, those with lower incomes, and those residing in less autonomous housing) are consistently and disproportionately likely to live in these areas. These findings highlight the need to develop new strategic plans to rethink site-based strategies of remediation and to engage residents of historically marginalized communities in planning efforts as government agencies at all levels work to make their cities more resilient and environmentally just in the age of climate change.
Satellite observed recent rising water levels of global lakes and reservoirs
Authors: Xu Nan , Ma Yue , Wei Zhongwang , Huang Conghong , Li Guoyuan , Zheng Huiying , Wang Xiao Hua
Published: June 2022

Monitoring global lake/reservoir water level changes is needed to understand the global water cycle and investigate its potential drivers. The existing global water level products only cover lakes/reservoirs with large sizes (>100 km2). Here, Ice, Cloud, and land Elevation Satellite (ICESat) and ICESat-2 altimetry data with small footprints are employed to examine global water level changes for 22 008 lakes/reservoirs greater than 1 km2. We report that 77.56% of them exhibited rising water levels over 2003–2021. Across the globe, 78.84% of lakes exhibit a rising water level, while the proportion for reservoirs is only 56.01%. Global lake/reservoir is estimated to experience a median water level change rate of +0.02 ± 0.02 m yr−1 over 2003–2021, and lakes have a larger water level rise (+0.02 ± 0.02 m yr−1) than reservoirs (+0.008 ± 0.14 m yr−1). We detect large-scale rising water levels in the Tibetan Plateau, the Mississippi River basin, and high-latitude regions of the Northern Hemisphere. Our calculation also suggests a negative relationship between the percentage of water level rise in lakes/reservoirs and population density for global river basins (r = −0.41, p-value < 0.05) and 11 hotspots (r = −0.48, p-value < 0.05). Our result suggests that inland water level has tended to rise in recent years under natural processes while human activities (i.e. with higher population density) can balance the water level rise via reservoir regulation. We find the existing datasets underestimated global water level rise, which may be caused by the exclusion of numerous small lakes/reservoirs. Our estimated global water level change rates (that include numerous small lakes with areas of 1–10 km2) can improve the understanding of global hydrological cycle and water resource management under the double pressure of climate warming and human activities.
Index of the transversally elliptic complex in Pestunization
Authors: Mauch Roman , Ruggeri Lorenzo
Published: June 2022

In this note we present a formula for the equivariant index of the cohomological complex obtained from localization of

N
=
2

SYM on simply-connected compact four-manifolds with a T 
2-action. Knowledge of said index is essential to compute the perturbative part of the partition function for the theory. In the topologically twisted case, the complex is elliptic and its index can be computed in a standard way using the Atiyah–Bott localization formula. Recently, a framework for more general types of twisting, so-called cohomological twisting, was introduced for which the complex turns out to be only transversally elliptic. While the index of such a complex has been computed for some cases where the manifold can be lifted to a Sasakian S
1-fibration in five dimensions, a general four-dimensional treatment was still lacking. We provide a formal, purely four-dimensional treatment of the cohomological complex, showing that the Laplacian part can be globally split off while the remaining part can be trivialized uniquely in the group-direction. This ultimately produces a simple formula for the index applicable for any compact simply-connected four-manifold. Finally, the index formula is applied to examples on S
4,

C

P

2

and

F

1

. For the latter, we use the result to compute the perturbative partition function.
Photoluminescence behavior of Eu3+ doped XAl2O4 (X = Mg, Ca, Sr and Ba) phosphors: a comparative study
Authors: Choudhary A K , Dwivedi A , Rai S B
Published: June 2022

In this work, the Eu3+ doped stuffed tridymite type structure of alkaline earths aluminate i.e. XAl2O4 (X = Mg, Ca, Sr and Ba) phosphor materials have been synthesized by conventional high temperature solid state reaction method at 1623 K. The Samples were structurally and morphologically characterized by x-ray diffraction (XRD) and Scanning electron microscope (SEM) measurements. The vibrational behavior of the phosphor samples were investigated by Fourier transform infrared (FTIR) measurements. The phosphor samples emit intense red emission in 610–615 nm range due to 5D0 → 7F2 transition of Eu3+ ion on excitation with charge transfer band (CTB) wavelength arising due to Eu3+-O2- and also by the discrete bands of Eu3+ ions .The decay time of 5D0 level of Eu3+ ion were recorded on excitation with 393 nm and by the CTB wavelength for all the four samples. The optimized 1 mol% Eu3+ doped CaAl2O4 phosphor exhibits optimum emission intensity and color purity under the excitation with 393 nm than others. The decay time is also found to be larger in the case of Eu3+ doped CaAl2O4 phosphor sample. Therefore, Eu3+ doped CaAl2O4 phosphor may be promising material for red color light emitting applications and white light generation.
Surface potential based modeling of zinc oxynitride thin film transistors
Authors: J G Anjana , Anand Venu , Nair Aswathi R
Published: June 2022

In this work we present analytical models for the drain current and threshold voltage of zinc oxynitride thin film transistors. A surface potential based modeling approach has been adopted and the exact closed form solutions for the potential profile, drain current and threshold voltage have been obtained. In order to account for the effects of both free and localized charges in the semiconductor, an effective charge density method has been used. The models were validated against experimental data from literature. The models show good agreement with the data.
A rigidity theorem for parabolic 2-Hessian equations
Authors: He Yan , Pan Cen , Xiang Ni
Published: June 2022

In this paper, we consider the entire solution to the parabolic

2
2

-Hessian equation

−

u
t

σ
2

(

D
2

u
)
=
1

-u_t\sigma _2(D^2 u)=1

in

R

n

×
(
−
∞
,
0
]

\mathbb {R}^n\times (-\infty ,0]

. We prove a rigidity theorem for the parabolic

2
2

-Hessian equation in

R

n

×
(
−
∞
,
0
]

\mathbb {R}^n\times (-\infty ,0]

by establishing Pogorelov type estimates for

2
2

-convex-monotone solutions.
Scalar curvature deformation and mass rigidity for ALH manifolds with boundary
Authors: Huang Lan-Hsuan , Jang Hyun Chul
Published: June 2022

We study scalar curvature deformation for asymptotically locally hyperbolic (ALH) manifolds with nonempty compact boundary. We show that the scalar curvature map is locally surjective among either (1) the space of metrics that coincide exponentially toward the boundary, or (2) the space of metrics with arbitrarily prescribed nearby Bartnik boundary data. Using those results, we characterize the ALH manifolds that minimize the Wang-Chruściel-Herzlich mass integrals in great generality and establish the rigidity of the positive mass theorems.
Alexandrov-Fenchel inequality for convex hypersurfaces with capillary boundary in a ball
Authors: Weng Liangjun , Xia Chao
Published: June 2022

In this paper, we first introduce the quermassintegrals for convex hypersurfaces with capillary boundary in the unit Euclidean ball

B

n
+
1

{\mathbb {B}}^{n+1}

and derive its first variational formula. Then by using a locally constrained nonlinear curvature flow, which preserves the

n
n

-th quermassintegral and non-decreases the

k
k

-th quermassintegral, we obtain the Alexandrov-Fenchel inequality for convex hypersurfaces with capillary boundary in

B

n
+
1

{\mathbb {B}}^{n+1}

. This generalizes the result of Scheuer [J. Differential Geom. 120 (2022), pp. 345–373] for convex hypersurfaces with free boundary in

B

n
+
1

{\mathbb {B}}^{n+1}

.
Cones of special cycles of codimension 2 on orthogonal Shimura varieties
Authors: Zuffetti Riccardo
Published: June 2022

Let

X
X

be an orthogonal Shimura variety associated to a unimodular lattice. We investigate the polyhedrality of the cone

C

X

\mathcal {C}_X

of special cycles of codimension 2 on 

X
X

. We show that the rays generated by such cycles accumulate towards infinitely many rays, the latter generating a non-trivial cone. We also prove that such an accumulation cone is polyhedral. The proof relies on analogous properties satisfied by the cones of Fourier coefficients of Siegel modular forms. We show that the accumulation rays of 

C

X

\mathcal {C}_X

are generated by combinations of Heegner divisors intersected with the Hodge class of 

X
X

. As a result of the classification of the accumulation rays, we implement an algorithm in SageMath to certify the polyhedrality of 

C

X

\mathcal {C}_X

in some cases.
Higher stabilization and higher Freudenthal suspension
Authors: Blomquist Jacobson , Harper John
Published: June 2022

We prove that the stabilization (resp. iterated suspension) functor participates in a derived adjunction comparing pointed spaces with certain (highly homotopy coherent) homotopy coalgebras, in the sense of Blumberg-Riehl, that is a Dwyer-Kan equivalence after restriction to 1-connected spaces, with respect to the associated enrichments. A key ingredient of our proof, of independent interest, is a higher stabilization theorem (resp. higher Freudenthal suspension theorem) for pointed spaces that provides strong estimates for the uniform cartesian-ness of certain cubical diagrams associated to iterating the space level stabilization map (resp. Freudenthal suspension map)—these technical results provide, in particular, new proofs (with strong estimates) of the stabilization and iterated loop-suspension completion results of Carlsson and the subsequent work of Arone-Kankaanrinta, and Bousfield and Hopkins, respectively, for 1-connected spaces; this is the stabilization (resp. Freudenthal suspension) analog of Dundas’ higher Hurewicz theorem.
927 MENDELIAN RANDOMIZATION ANALYSIS SHOWS A CAUSAL EFFECT OF NOISE EXPOSURE ON ALZHEIMER’S DISEASE RISK
Authors: Guo X , Li R
Published: June 2022

Introduction

Epidemiological studies suggested that exposure to transportation noise and long-term community noise was associated with a higher incidence of dementia, especially Alzheimer’s disease (ad). However, since subjects with low education and low income were also more likely to live or work in noisy environments, the association observed between noise exposure and ad may be distorted by education level, income level, and hearing impairment. Thus, whether noise exposure was causally associated with ad risk remained to be further clarified.

Method

A bidirectional Mendelian randomization (BMR) analysis was performed leveraging genome-wide association studies (GWAS) summary statistics of noise exposure (N = 456,380, UK Biobank) and ad (N = 54,162, IGAP) from the OpenGWAS database. Those single nucleotide polymorphisms (SNPs) with a P value less than 1E-05 were selected as instrumental variables (IVs). The TwoSampleMR package (version 0.5.6) was used to do BMR analysis using the inverse variance weighted (IVW) method with default parameters.

Results

The IVW results howed that exposure to noise at different times of day was causally associated with increased risk of ad (daytime: odds ratio [OR] = 2.2113, P = 0.0326; evening: OR = 2.2127, P = 0.0324; nighttime: OR = 2.2110, P = 0.0326; 16-hour: OR = 2.2114, P = 0.0325; 24-hour: OR = 2.2128, P = 0.0324). No obvious pleiotropic effects and heterogeneity were found in the BMR analysis, suggesting good reliability of the causal effect of noise exposure on ad. Moreover, the BMR results remained significant despite removing IVs associated with an education degree, average income, and hearing impairment. There was no reverse causal effect of ad on noise exposure in BMR analysis, which has been deposited in FigShare (https://figshare.com/s/09e30a1a0ccff450246b).

Conclusion

The results BMR analysis demonstrate that noise exposure is causally associated with an elevated risk of ad, independently of education degree, average income, and hearing impairment. Further studies are needed to confirm the underlying mechanism of this effect.
1050 DELIRIUM RECOGNITION AND MANAGEMENT IN AN INPATIENT REHABILITATION UNIT
Authors: Stoodley I , Kyzy R , Conroy  , McKenzie J , Geen S , Asino J , Cruz E , Hazan J
Published: June 2022

Introduction

Delirium is associated with poor outcomes, but is under-diagnosed and under-treated. This project aimed to improve delirium recognition and multidisciplinary team (MDT) management on an inpatient rehabilitation ward. (NICE delirium: prevention, diagnosis and management, 2010).

Methodology

Using the Model for Improvement, the MDT identified four areas of delirium care; prevention, recognition, causes and management. Aspects of each were mapped in a driver diagram. The MDT voted on areas to target. Results and interventions were reviewed at weekly meetings. PDSA cycles 1.A delirium marker was introduced to the nursing handover and patients’ rooms. Data was collected on its use and weekly MDT meetings were used to check the accuracy of delirium identification. 2.An audit was completed of the 'patient profile’ information held in patients' bedside files. A person-centred ‘about me’ board was introduced instead and positioned visibly in patients’ rooms. 3.Healthcare assistants completed daily bowel charts. 4.Doctors completed anticholinergic medication reviews. Data was analysed using SPC charts.

Results

Before the delirium flag 0% of patients with delirium were identified on nursing handover. This improved to 58% on average, although some patients were incorrectly identified as delirious. Baseline personal profile completion rate was 61% on average, but the information quality collected was poor. The new ‘about me’ profile completion rate improved over time, varying between 16% and 86%. 100% of patients had medication reviews. Bowel chart completion improved from 89% to 100%.

Conclusion

Recognition of delirium improved. Stool charts and medication reviews were successfully implemented. The ‘about me’ board completion rate fluctuated but the information is now more visible. Our long-term goal is to improve patient-related outcomes such as engagement in therapy quality of life, and length of stay. Teaching sessions on delirium will be delivered by MDT members. Successful interventions will be expanded to other wards and PDSA cycles will continue.
994 CURRENT SECONDARY PREVENTION AFTER HIP FRACTURE IN ENGLAND AND WALES—RESULTS FROM THE NATIONAL HIP FRACTURE DATABASE (NHFD)
Authors: Mohsin Z , Javaid K , Johansen A
Published: June 2022

Introduction

National clinical audit seeks to enhance the quality of care of the 75,000 people who break their hip in the UK each year. A key aim for the National Hip Fracture Database (NHFD) is to encourage secondary fracture prevention through bone health assessment and the appropriate provision of anti-osteoporosis medication (AOM). We set out to describe trends in anti-osteoporosis medication prescription, and to examine the types of oral and injectable AOM being prescribed both before and after a hip fracture.

Method

We used data freely available from the NHFD www.nhfd.co.uk to analyse trends in oral and injectable AOM prescription across a quarter of a million patients presenting between 2016 and 2020, and more detailed information on the individual type of AOM prescribed for 63,284 patients from 171 hospitals in England and Wales who presented in 2020.

Results

Most patients (88.2%) were not taking any AOM when they presented with hip fracture. Half of all patients (49.9%) were prescribed AOM treatment by the time of discharge, but the proportion deemed ‘inappropriate for AOM’ varied hugely (0.2–83.6%) in different hospitals. Nearly two thirds (64%) of those who were previously taking an oral bisphosphonate were simply discharged on the same type of medication. The total number of patients started on oral medication fell by 11.4% over 5 years. The number started on injectable AOM almost doubled to 14.4% over the same period, but remains hugely variable across the country, with rates ranging 0–67% across different units.

Conclusion

A recent hip fracture is a strong risk factor for future fractures. If teams are to learn from each other’s experience and patients are to be protected against further fragility fractures the huge variability in approaches, and in particular to the use of injectables, in different trauma units across England and Wales requires further investigation.
1013 DIAGNOSTIC TEST ACCURACY OF FRAILTY SCREENING TOOLS USING DATA IN ELECTRONIC PRIMARY CARE RECORDS
Authors: Makin S , Brack C , Kynn M , Murchie P
Published: June 2022

Introduction

Targeted interventions aimed at people living with frailty key to NHS Strategy and is incentivised in the NHS England GP contract. eFrailty, and similar risk prediction tools aim to detect frail people automatically from their electronic primary care health-records and can predict mortality and hospital admission. We carried out a systematic review of currently available risk prediction tools to assess frailty using primary care data.

Method

We searched Medline, Pubmed, CENTRAL, CINHAL and Embase to identify studies comparing a frailty assessment utilising primary care records with face-to-face assessment with a healthcare professional. Studies were quality assessed using QUADAS-2. Sensitivity and specificity values were extracted directly or calculated and pooled using StatsDirect.

Results

The initial search generated 2,245 titles with 10 studies remaining for review after screening. This described 3 different index tests (electronic frailty index (eFI), claims-based frailty index (cFI), and polypharmacy. Frailty Phenotype was the reference standard in each study. 1 study of 60 patients, average age 80.2 examined eFI, with a pooled sensitivity of 0.84 (95% CI 0.55,0.98), and specificity of 0.78 (0.64,0.89). 2 studies of 7,679 patients, average age 75.5, examined cFI, with a pooled sensitivity of 0.84 (95% CI 0.55,0.98), and specificity of 0.78 (0.64,0.89). 7 studies of 34,328 patients, average age 77.4, examined a polypharmacy as a screening tool (defined as ≥5 medications) with a pooled sensitivity of 0.84 (95% CI 0.55,0.98), and specificity of 0.78 (0.64,0.89).

Conclusion

eFI performed best however, for an average UK GP practice with a list size of 10,000, 18% of patients aged over 65, of which 20% were frail, eFI would flag 597 as frail, of which 272 would be actually frail, and an additional 51 frail patients would be missed. In conclusion, existing frailty risk prediction tools would have strictly limited value in UK primary care currently.
1059 PHYSICAL ACTIVITY AMONG OLDER PEOPLE ADMITTED TO A UNIVERSITY HOSPITAL IN MALAYSIA
Authors: Leong W H , Chew M Y , Lee Z Y , Lim C X , Norizam N A I B , Ong R Y , Khor H M , Ong T
Published: June 2022

Introduction

Physical inactivity is prevalent among hospitalised older people and is associated with poor outcomes. This study aims to determine activity levels in a Malaysian university hospital.

Method

Direct observation of patients admitted to the geriatric medicine ward over 2 weeks between the hours of 8 am-8 pm was performed. Data was collated onto an observation diary which was piloted, and changes made iteratively. A taxonomy of inpatient activity and healthcare staff interaction was created. Observer training was done to ensure familiarity and consistency in the recording. Data was presented descriptively and comparison made between weekday/weekend. Minutes of activity time per-hour (mins/hr) was use to report findings.

Results

Ninety-one patients were observed over 1918.8 hours (weekday, 1579.67 hours; weekends, 363.87 hours). The observed median (Q1,Q3) was 15.1 (9.4, 30.1) hours per-patient. 32.6 minutes per day on average was spent upright, with the rest spent either sitting or lying down. 78.9% of patients’ time was spent doing nothing. Patients’ position was different between weekdays vs weekends, lying, 35.7 vs 40.8 mins/hr; sitting, 23.3 vs 18.2 mins/hr; and standing, 1.1 vs 1.0 mins/hr. Patients spent significantly less proportion of time active at the weekends (weekdays, 28.3% vs weekends, 19.9%). When individual activities were analysed, patients were doing less walking (weekend, 0.4 vs weekday, 0.01 mins/hr, p = 0.01) therapy-supervised exercise (1.1 vs 0.02 mins/hr, p < 0.01), and nursing care (0.6 vs 0.1 mins/hr, p < 0.01) over the weekend. There was also less doctor interaction (weekday, 1.1 vs 0.5 mins/hr, p = 0.04) and no therapist interaction at the weekend. Nursing input was unchanged.

Conclusion

Older people admitted to a university hospital in Malaysia were very inactive. There was further reduction in activity levels and healthcare interaction at the weekend. Maintaining physical activity during hospitalisation is required to ensure best possible recovery from their acute illness.
937 COMMUNITY ORIENTATION AND HYBRID PHYSICIANS IN AMBULATORY EMERGENCY CARE FOR OLDER PEOPLE
Authors: Glogowska M , Lasserson D , Reeve J
Published: June 2022

Introduction

AEC (Ambulatory Emergency Care) provides acute assessment and treatment in the community for acutely unwell complex older patients, with patients staying in their own homes overnight. This investigation aimed to understand the impact of the AEC Setting on Clinical Decision-Making.

Method

Three AEC sites were purposively sampled to recruit twelve clinicians with backgrounds in Geriatrics, General Practice, Emergency and Acute Medicine. This qualitative investigation used focused ethnography within a case study approach to understand the decision-making processes in the context of the AEC environment. Observation during an AEC shift was complemented by informant interviews. A framework approach to thematic analysis used ‘a priori’ and data derived codes to develop explanatory themes. Constant comparison and cognitive task analysis were used to evaluate the clinicians’ decision-making processes for index patient cases.

Results

Across-case analysis of the experience and training of the AEC clinicians identified that the main similarity in training was having a varied background experience. These ‘hybrid physicians’ were able to work across professional boundaries and considered their diversity of training a strength. The AEC clinicians had considerable contextual awareness of their environment and how this differed from their routine clinical practice. The participants felt that AEC working altered their thresholds for concern and increased their community orientation.

Conclusion

This critical example demonstrates the importance of diversity of background training and community orientation when considering alternatives to acute hospitalisation for unwell older adults. As more interventions such as the Urgent Community Response are implemented across the UK, further training is needed to ensure that AEC clinicians obtain a broad spectrum of practice. Future research is needed to investigate optimal team and skill mix in AEC.
941 EFFECTIVENESS OF ACUTE GERIATRIC UNIT CARE AMONG HOSPITALISED OLDER ADULTS WITH ACUTE MEDICAL COMPLAINTS: A META-ANALYSIS
Authors: O'Shaughnessy Í , Robinson K , O'Connor M , Conneely M , Ryan D , Steed F , Carey L , Leahy A , Shanahan E , Quinn C , Galvin R
Published: June 2022

Introduction

Older adults are clinically heterogeneous and are at increased risk of adverse outcomes during hospitalisation due to the presence of multiple comorbid and complex conditions. This systematic review and meta-analysis aims to update and synthesise the totality of research evidence on the effectiveness of acute geriatric unit (AGU) care for older adults admitted to hospital with acute medical complaints.

Method

MEDLINE, CINAHL, CENTRAL, and Embase databases were systematically searched from 2008 to February 2021. Screening, data extraction, and quality grading were undertaken by two reviewers. Only trials with a randomised design comparing AGU care and conventional care units were included. Meta-analyses were performed in Review Manager 5.4 and the Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence for outcomes reported. The primary outcome measure was incidence of functional decline between baseline two-week prehospital admission status and discharge and at follow-up.

Results

11 trials recruiting 7,496 participants across three countries were included. AGU care was associated with a 23% reduction in functional decline at six-month follow-up (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.64–0.92; moderate certainty evidence), and significant cost savings (mean difference (MD) -538.01USD, 95% CI -571.05USD—-504.96USD; low certainty evidence). No differences were found in functional decline at hospital discharge or at three-month follow-up, length of hospital stay, the likelihood of living at home, mortality, hospital readmission, cognitive function, or patient satisfaction with the index admission.

Conclusion

AGU care improves clinical and process outcomes for older adults admitted to hospital with acute medical complaints. Future research should focus on greater inclusion of clinical and patient reported outcome measures including quality of life. Use of such measures may lead to a greater focus on patient-centered care and service provision priorities.
974 ASSOCIATION BETWEEN NOTTINGHAM HIP FRACTURE SCORE AND FRAILTY IN ELDERLY ACUTE HIP FRACTURE PATIENTS
Authors: Nandi A , Obiechina N , Mubin M , Khan R , Mukherjee B
Published: June 2022

Introduction

Nottingham Hip Fracture Score (NHFS) is a well validated risk stratification tool that has been shown to predict 30 day mortality in elderly patients with acute hip fractures. A lot of older patients that sustain hip fractures are frail. The Rockwood Clinical Frailty Scale (CFS) has been validated as a tool to screen for frailty in acutely ill patients and has been shown to predict outcomes in acutely ill elderly patients. The aim of this study was to determine if there is any correlation between the NHFS and CFS in elderly patients with acute hip fractures and to evaluate the effect of gender on this correlation.

Method

A retrospective, cross-sectional analysis was carried out on patients admitted with acute hip fractures between January and December 2019 in a single centre trauma and orthopaedic unit. Data was extracted from anonymized electronic patient records. Patients were included if they were 60 years and above; those less than 60 were excluded. Patients with missing data were excluded from analysis. NHFS and CFS were calculated in these patients. SPSS 27 IBM software was used for statistical analysis. Baseline characteristics were calculated using descriptive statistics and spearman’s correlation co-efficient and linear regression were used to determine correlation.

Results

A total of 268 patients were analysed—65 males and 202 females. Mean age was 83 years (SD 8.5). There was statistically significant positive correlation between NHFS and CFS in all patients, male patients and female patients (r = 0.589; p < 0.001, r = 0.603; p < 0.001, and r = 0.599; p < 0.001 respectively).

Conclusion

NHFS is positively correlated with CFS in elderly acute hip fracture patients. Reference(s) Doherty W.J, Stubbs T.A et al. Prediction of Postoperative Outcomes Following Hip Fracture Surgery: Independent Validation and Recalibration of the Nottingham Hip Fracture Score. Journal of the American Medical Directors Association;22(3):663–669.e2.
975 RELATIONSHIP BETWEEN HAND GRIP STRENGTH (HGS) AND 10 YEAR PROBABILITY OF MAJOR OSTEOPOROTIC FRACTURES IN OLDER
Authors: Obiechina N , Nandi A , Mubin M , Khan R , Chan R , Pathmanathan K , Titheridge L , Tse N , Kachala P , Rahman S , Mukherjee B
Published: June 2022

Introduction

HGS has been shown to be associated with adverse outcomes in a wide range of conditions. It has also been found to be associated with bone mineral density and is inversely associated with risk of osteoporotic fractures. The aim of this study was to determine the association between HGS and 10 year probability of sustaining a major osteoporotic fractures in older inpatient and to evaluate the effect of gender on this association.

Method

This was a cross-sectional, observational analysis of older patients admitted into hospital between September and November 2021. HGS was measured in these patients using the JAMAR hydraulic hand held dynamometer. The Southampton protocol was used. The FRAX UK tool (without BMD) was used to calculate 10 year probability of major osteoporotic fractures. Patients were included if they were 60 years and above. Younger patients were excluded as were stroke patients. Patients with incomplete data were excluded from analysis. The SPSS 27 package was used for statistical analysis. Baseline characteristics were calculated using descriptive statistics. Pearson’s correlation coefficient and linear regression were used to calculate correlation.

Results

104 patients were analysed—41 males and 63 females. Mean age was 83 years (SD 8.2). Grip strength was inversely correlated with FRAX UK in predicting 10 year probability of major osteoporotic fractures in all patients, male patients and female patients (r = −0.452; p < 0.001, r = −0.351; p = 0.02 and r = −0.271; p = 0.03 respectively).

Conclusion

Grip strength is negatively associated with increased probability of major osteoporotic fractures in older inpatients. Reference(s) Ma Y, Fu L, Jia L, et al. Muscle strength rather than muscle mass is associated with osteoporosis in older Chinese adults. J Formos Med Assoc. 2018;117(2):101–108. doi:10.1016/j.jfma.2017.03.004