bluuebunny/crossref_metadata_2025 huggingface dataset:
Parallel electrophysiological abnormalities due to COVID‐19 infection and to Alzheimer's disease and related dementia
Authors: Jiang Yang , Neal Jennifer , Sompol Pradoldej , Yener Görsev , Arakaki Xianghong , Norris Christopher M. , Farina Francesca R. , Ibanez Agustin , Lopez Susanna , Al‐Ezzi Abdulhakim , Kavcic Voyko , Güntekin Bahar , Babiloni Claudio , Hajós Mihály
Published: August 2024

Many coronavirus disease 2019 (COVID‐19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting‐state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID‐19 and to Alzheimer's disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID‐19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in Long COVID and ADRD are due to parallel neuroinflammation, astrocyte reactivity, hypoxia, and neurovascular injury. These neurophysiological abnormalities underpinning cognitive decline in COVID‐19 can be detected by routine EEG exams. Future research will explore the value of EEG monitoring of COVID‐19 patients for predicting long‐term outcomes and monitoring efficacy of therapeutic interventions.

Highlights

Abnormal intrinsic electrophysiological brain activity, such as slowing of EEG, reduced alpha wave, and epileptiform are characteristic findings in COVID‐19 patients. EEG abnormalities have the potential as neural biomarkers to identify neurological complications at the early stage of the disease, to assist clinical assessment, and to assess cognitive decline risk in Long COVID patients.

Similar slowing of intrinsic brain activity to that of COVID‐19 patients is typically seen in patients with mild cognitive impairments, ADRD. Evidence presented supports the idea that cognitive deficits in Long COVID and ADRD are driven by overlapping neurophysiological abnormalities resulting, at least in part, from neuroinflammatory mechanisms and astrocyte reactivity.

Identifying common biological mechanisms in Long COVID‐19 and ADRD can highlight critical pathologies underlying brain disorders and cognitive decline. It elucidates research questions regarding cognitive EEG and mild cognitive impairment in Long COVID that have not yet been adequately investigated.
Exploring the concept of a responsive curriculum in teacher education from the perspective of students and teacher educators
Authors: van Bemmel Rieke , Zitter Ilya , de Bruijn Elly
Published: August 2024

Economic, social and environmental changes place high demands on teachers and teacher education. Consequently, teacher education is challenged to design curricula that respond to and anticipate changes. Curricula are value‐driven and even though part of these values might be constant, the relative importance of values and the values themselves may also be subject to change since society is changing rapidly. In vocational education, responsive curriculum development refers to balancing the needs of students, workplaces and society. Vocational education qualifies students for coping with unpredictable situations and complex problems in occupational practice. As in vocational education, teacher education also prepares students for unpredictability and complexity and thus, we adopt the concept of responsiveness from vocational education to explore teacher education. This study explores the concept of a responsive curriculum for teacher education using a qualitative approach. Interviews were conducted with the key actors, namely students and teacher educators, in the context of Dutch teacher education. An initial framework, consisting of three responsive dimensions and five designable elements, was used to guide the interviews and analyse the data. The data revealed 14 relevant themes to identify how a teacher education curriculum can be responsive to changes in society, to a variety of schools and to student diversity. The developed framework can serve as a conceptual frame to study the enactment of responsive curriculum designs. Also, it can support practitioners when designing responsive curricula.
“Some college, no credential” population rises
Authors: May Rachel
Published: August 2024

In June, the National Student Clearinghouse Research Center released a report that reveals that, as of July 2022, the population of people under age 65 who started college and “stopped out” has risen to “36.8 million, up 2.9 percent from 2021.”
Antiviral Effects of Silver, Copper Oxide, Cerium Oxide, and Cobalt Oxide Nanoparticles and Silver and Copper Sheets Against COVID‐19
Authors: Norouzi Aida , Mansouri Sobhan , Mardani Rozita , Nematollahi Mohammad Hadi , Abolhassani Moslem , Norouzmahani Mohammad Erfan , Najmadini Atefeh , Sardari Ali Abbasi , Asadikaram Gholamreza
Published: August 2024

COVID‐19 the most devastating pandemic of the current millennium, can survive from hours to months in environment, devices, and surface. Its transmission by asymptomatic carriers has significantly strained the existing testing resources. At present, there are no clinically proven therapeutic methods that effectively inhibit the effects of this virus. Nanoparticles (NPs) have been extensively utilized in various medical applications, including biosensing, drug delivery, imaging, and antimicrobial/antiviral treatment. Synthetic NPs can closely resemble the virus and strongly interact with its proteins due to their similar morphology. Therefore, NP‐based strategies for combating this virus hold immense potential and may reduce the survivability of the virus in the environment due to unique physicochemical features and surface modification properties. In this study, antiviral properties of silver (Ag), copper oxide (CuO), cobalt oxide (Co3O4), and cerium oxide (CeO2) NPs besides Ag and Cu sheets against COVID‐19 in nasopharyngeal samples were investigated. All NPs suspensions were prepared in Virus Transporter Media (VTM) in 25, 50, and 100 mg/mL concentrations, additionally, Cu and Ag sheets were added to SARS‐CoV‐2 virus pooled and then incubated at room temperature. Viral RNA was extracted from those suspensions after different incubation times and concentrations and quantitative polymerase chain reaction (qPCR) analysis was performed. For virucidal activity evaluation, the estimated lysed virus copy number was assessed according to the pooled virus sample serial dilution and eventually based on changes in the cycle threshold (CT) of qPCR. According to CT number changing after incubation of NPs with pooled virus sample, CuO NPs had the greatest virus inactivation on virus lysis at all concentrations and times while Co3O4 NPs showed moderate antiviral activity (P<0.05). The antiviral activity of other NPs was less than CuO and Co3O4 and were almost identical at similar concentrations and times. Cu and Ag sheets have shown a direct linear relationship between incubation time and antiviral activity. Cu nanoparticles had significant destructive effects on the SARS‐CoV‐2 virus among all nanoparticles, and the Cu sheet had considerably less antiviral activity than its own Cu NPs. These findings might make it helpful to use CuO NPs in masks, and air/water filters, make coated surfaces with effective NPs, and manufacture disinfectant solutions to combat coronaviruses and other viruses that can cause respiratory infections.
An observational study on the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma
Authors: Tsuda Takeshi , Ichikawa Tomomi , Matsumoto Masahiro , Mizusihima Isami , Azechi Kenji , Takata Naoki , Murayama Nozomu , Hayashi Kana , Hirai Takahiro , Seto Zenta , Tokui Kotaro , Masaki Yasuaki , Taka Chihiro , Okazawa Seisuke , Kambara Kenta , Imanishi Shingo , Taniguchi Hirokazu , Miwa Toshiro , Hayashi Ryuji , Matsui Shoko , Inomata Minehiko
Published: August 2024

Background

Pulmonary sarcomatoid carcinoma is a rare tumor that is resistant to cytotoxic agents. This observational study aimed to evaluate the detection rate of driver gene alteration and the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma.

Methods

We established a database of patients with pulmonary sarcomatoid carcinoma and their clinical information, including EGFR mutation, ALK fusion gene, ROS1 fusion gene, BRAF mutation, and MET exon 14 skipping mutation. The present study retrieved and analyzed the data of patients with pulmonary sarcomatoid carcinoma in whom driver gene alterations were evaluated, and the survival duration after the initiation of treatment with targeted therapy was examined.

Results

A total of 44 patients were included in the present study. The EGFR mutation, ALK fusion gene, and MET exon 14 skipping mutation were detected in 2/43 patients (4.7%), 2/34 patients (5.9%), and 2/16 patients (12.5%), respectively. The ROS1 fusion gene (0/18 patients) and BRAF mutation (0/15 patients) were not detected. Female patients (P = 0.063, Fisher’s exact test) and patients without smoking history (P = 0.025, Fisher’s exact test) were the dominant groups in which any driver mutation was detected. Five patients with driver gene alterations were treated with targeted therapy. Progression-free survival (PFS) was 1.3 months and 1.6 months in 2 of the patients treated with gefitinib. Two patients with the ALK fusion gene showed 2.1 and 14.0 months of PFS from the initiation of treatment with crizotinib, and a patient with the MET exon 14 skipping mutation showed 9.7 months of PFS from the initiation of treatment with tepotinib.

Conclusion

The EGFR mutation, ALK fusion gene, and MET exon 14 skipping mutation were detected in patients with pulmonary sarcomatoid carcinoma in clinical practice, and some patients achieved long survival times after receiving targeted therapy. Further investigation is necessary to evaluate the efficacy of targeted therapy for pulmonary sarcomatoid carcinoma.
A comparative assessment of Lead (Pb) concentration and physicochemical parameters in groundwater from the Kabwe mine and Lusaka non-mine sites, Zambia
Authors: Siame Tasha , Muzandu Kaampwe , Kataba Andrew , Weisiyu Qin , M’kandawire Ethel
Published: August 2024

This study addresses the comparative influence of physicochemical parameters on the dissolution of Pb and its levels in the groundwater of former Pb mining areas in Kabwe and non-mining areas in Lusaka, Zambia. This cross-sectional study analyzed 61 groundwater samples from hand pump boreholes using atomic absorption spectrometry. Physicochemical parameters were measured, including electrical conductivity (EC), temperature, total dissolved solids (TDS), and pH. Statistical analysis involved the Wilcoxon test, Spearman’s correlation, robust linear regression, Principal component analysis (PCA), and generalized additive models. Pb concentrations were particularly higher (p = 0.029; median = 0.131 mg/L) in mining areas compared to non-mining areas (median = 0.071 mg/L). The EC in the mining areas (median = 585 µS/cm) was significantly (p = 0.001) lower than those in the non-mining area (median = 1100 µS/cm). Likewise, TDS levels revealed a significant (p = 0.001) difference between the mining area (median = 303 ppm) and the non-mining area (median = 601 ppm). The median pH values for groundwater samples in the mining and non-mining areas were 6.96 and 7.27, respectively. Spearman’s rank correlation revealed a significant (rho = − 0.405; p = 0.036) inverse relationship between Pb concentrations and pH in non-mining areas. Robust linear regression and generalized additive models underscored a significant (p = 0.016) non-linear relationship between temperature and Pb across all areas, with the non-mining area demonstrating a significant (p = 0.003) non-linear relationship between temperature and pH concerning Pb. The study associates mining activities with increased Pb concentrations, underscoring it as a principal contamination source. In contrast, elemental dissolutions from the basement limestone with dolomite might increase Pb concentration in the non-mining areas. The observed positive relationship between temperature and pH in non-mining areas highlights its positive interactions with Pb mobility while temperature greatly influences Pb dissolutions in mining areas.
WEITER.BILDUNG
Authors: Gentner Thomas
Published: August 2024

Zusammenfassung: Weiterbildung in der Pflege ist aktuell unübersichtlich und wenig einheitlich geregelt. Pflegeberufliche Weiterbildung bewegt sich im Spannungsfeld zwischen Verwertbarkeit/Nachfrageorientierung und Bildungsauftrag. Neben den Praxisbedarfen dürfen die Lernenden aber auch die Professionalisierung der Pflege nicht außer Acht gelassen werden.
Urban Lights Make Tree Leaves a Tougher Meal for Insects
Authors: Mayer Amy
Published: August 2024

Two common street trees in Beijing show different responses to artificial light at night, but both grow leaves that are tougher and less toothsome to insects.
Autumn Warming of the Cold Intermediate Layer in the Labrador Shelf
Authors: Hu Rou , Zhao Jian
Published: August 2024

The Labrador Shelf is integral to the North Atlantic Ocean's climate system, exerting a significant influence on both regional and global scales. This study examines continuous, high‐temporal resolution hydrographic profiles collected by two Argo floats located on the Labrador Shelf. Our focus centers on the subsurface changes. Among observed seasonal variations, the most pronounced and consistent change is a marked temperature increase during autumn in the Cold Intermediate Layer, which is also confirmed in an eddy resolving global reanalysis data set. Contrary to previous studies that attributed this warming to the autumnal deepening of the mixed layer, our analysis indicates that the warming extends to underneath the deepest mixed layer. Thus, mixed layer development cannot account for the observed warming in the deeper layer. On the other hand, analysis of velocity fields from reanalysis data set reveals active onshore intrusions at several locations, with a section at 58°N emerging as the northernmost hotspot. Budget analysis further indicates that the dominant factor driving autumn warming at Section 58°N is cross‐isobath advection that is associated with the intrusion of slope waters onto the shelf. Subsequently, the positive temperature anomaly at Section 58°N and other enhanced intrusion locations are transported downstream through along‐isobath currents, resulting in lagged yet intensified warming at lower latitudes. Our findings underscore the essential role of cross‐isobath intrusion, in combination with along‐isobath movements in governing seasonal temperature variability in the deep layer of the Labrador Shelf. Incorporating this mechanism is crucial for accurately hindcasting and forecasting bottom environmental conditions in the region.
Assessing the Potential for Medium‐Range Ice Forecasts in the Laurentian Great Lakes
Authors: Yeo A. J. , Anderson E. J. , Jablonowski C. , Wright D. M. , Mann G. E. , Fujisaki‐Manome A. , Mroczka B. , Titze D.
Published: August 2024

Real‐time forecasted ice information for large lakes, such as the Great Lakes, is critical for essential operations, such as ice breaking, commercial navigation, search and rescue, and oil spill response. Existing forecast products for large lake ice conditions are not available for medium‐range time horizons (5–16 days out), yet they could provide important information for decision making, particularly for ice breaking and spill responses. In addition, ice forecasts for Earth's largest lakes at these timescales could be important for Medium‐Range Weather (MRW) forecasting. However, the skill of existing operational products in predicting ice conditions at MRW timescales has not been studied. This work aims to determine how well ice forecasts from a coupled large lake hydrodynamic‐ice model perform for MRW forecast horizons. Simulations were carried out for the 2022 Great Lakes ice season, using 8 different 16‐day forecast periods. Forecast results were compared to observations of meteorology and ice conditions from the U.S. National Ice Center. Results show the MRW ice forecasts in the Great Lakes outperform persistence‐based forecasts. These findings could inform the development or extension of lake operational ice forecasting and the potential of coupling between atmospheric and large lake models at medium‐range forecast time scales.
Dispensed prescription medications and short-term risk of pulmonary embolism in Norway and Sweden
Authors: Aune Dagfinn , Vardaxis Ioannis , Lindqvist Bo Henry , Brumpton Ben Michael , Strand Linn Beate , Horn Jens Wilhelm , Bakken Inger Johanne , Romundstad Pål Richard , Mukamal Kenneth J. , Ljung Rickard , Janszky Imre , Sen Abhijit
Published: August 2024

Scandinavian electronic health-care registers provide a unique setting to investigate potential unidentified side effects of drugs. We analysed the association between prescription drugs dispensed in Norway and Sweden and the short-term risk of developing pulmonary embolism. A total of 12,104 pulmonary embolism cases were identified from patient- and cause-of-death registries in Norway (2004–2014) and 36,088 in Sweden (2005–2014). A case-crossover design was used to compare individual drugs dispensed 1–30 days before the date of pulmonary embolism diagnosis with dispensation in a 61–90 day time-window, while controlling for the receipt of other drugs. A BOLASSO approach was used to select drugs that were associated with short-term risk of pulmonary embolism. Thirty-eight drugs were associated with pulmonary embolism in the combined analysis of the Norwegian and Swedish data. Drugs associated with increased risk of pulmonary embolism included certain proton-pump inhibitors, antibiotics, antithrombotics, vasodilators, furosemide, anti-varicose medications, corticosteroids, immunostimulants (pegfilgrastim), opioids, analgesics, anxiolytics, antidepressants, antiprotozoals, and drugs for cough and colds. Mineral supplements, hydrochlorothiazide and potassium-sparing agents, beta-blockers, angiotensin 2 receptor blockers, statins, and methotrexate were associated with lower risk. Most associations persisted, and several additional drugs were associated, with pulmonary embolism when using a longer time window of 90 days instead of 30 days. These results provide exploratory, pharmacopeia-wide evidence of medications that may increase or decrease the risk of pulmonary embolism. Some of these findings were expected based on the drugs' indications, while others are novel and require further study as potentially modifiable precipitants of pulmonary embolism.
Identification of factors affecting fattening efficiency of commercial pig herds and analysis of their impact at different performance levels
Authors: Guan Ran , Zheng Zhiwei , Yu Hai , Wu Lili , Huang He , Jiang Ping , Li Xiaowen
Published: August 2024

Improving fattening efficiency is an important goal of breeding commercial pigs, especially for the large-scale pig farms. Fattening efficiency index (FEI) can be used to evaluate the fattening efficiency. The aim of this study was to identify the factors affecting the fattening efficiency of commercial pigs in large-scale pig farms and further study the impact of these factors on the production performance of commercial pig batches at different production levels. The data of 9,570 batches was mainly consisted of four parts (farm facilities, general information of piglets, production performance of nursery pigs and finishing pigs). A total of 28 variables were evaluated by the multi-variable linear regression models. The differences in production factors significantly correlated with FEI at piglets-finishing stage were compared among high-performing (HP), moderate-performing (MP), and low-performing (LP) batches of commercial pigs during the nursery and finishing stage. Among the 28 variables, 18 were significantly correlated with fattening efficiency (P < 0.05), including 11 continuous variables and seven discrete variables. The significant differences among the 11 consecutive variables in the HP, MP, and LP batches of commercial pigs mostly persisted from the piglets-nursery stage to the growing-finishing stage, ultimately affecting the FEI at piglets-finishing stage. For the seven significant discrete variables, the HP batches had a lower proportions in owned source of piglets, number of the purchasing piglets in spring and winter, number of batches in the East and North regions and five-way crossbred pigs, while a higher proportions in the use of closed circuit television video (CCTV) and wastes treatment system. The fattening efficiency of commercial pigs in large-scale pig farms was comprehensively affected by farm facilities, piglets, and production performance at nursery and finishing stage. The low fattening efficiency may have started at the end of nursery stage.
Use of Mangrove Rhizophora Mucronata as a Natural Dye in Exploration of Natural Dye Shibori
Authors: Sholikhah Roudlotus , Widowati  , Nurmasitah Sita , Sudiyono
Published: August 2024

This research aimed to determine the results of the motif clarity test, color sharpness test, color evenness test, and color absorption test of the natural dye mangrove Rhizophora mucronata on shibori. The method used in this research is experimental. There are 3 types of samples used, namely sample A (the Kumo shibori technique with a natural dye composition of 1 kg of mangrove mixed with 10 liters of water), sample B (the Kanoko shibori technique with a natural dye composition of 1 kg of mangrove mixed with 8 liters of water), and sample C (the Itajime shibori technique with a natural dye composition of 1 kg of mangrove mixed with 5 liters of water). The data analysis used is descriptive. The research results show that: 1). The results of the motif clarity test in sample A have the clearest motif clarity, namely 4.7; 2). The color sharpness test results for sample C have the sharpest motif sharpness, namely 4.7; 3). The color evenness test results for sample A have the most even color evenness, namely 4.55.; and 4). The color absorption test results for sample C had the best color absorption, namely 4.55.
Planning and Design of the Safe Route to School (SR2S) on the Taman Siswa Road Section, Semarang City
Authors: Sholahudin Farhan , Ayu Hapsari Rahma Nindya , Baharuddin Alfan , Hendardi Agi Rivi , Nurmayadi Dicky
Published: August 2024

The Taman Siswa Road section is an educational area where many students carry out activities both crossing and walking along the road. The high volume of traffic and speed on these roads also has the potential for traffic accidents to occur. The purpose of this study was to analyze the planning and design of the Safe Route to School (SR2S), in the educational area on Taman Siswa Road section, Semarang City. The research method used to planning and design the Safe Route to School (SR2S), is by carrying out traffic surveys including traffic volume surveys, road inventory, vehicle speed, pedestrian volume and movement, pedestrian behavior characteristics and delivery behavior characteristics which are analyzed based on MKJI 1997 and PV2. From the results of the analysis, it was found that the traffic volume was 912 pcu/hour during peak hours and the road capacity was 1,304.331 pcu. So that the road service level is 0.699 with an average speed on Taman Siswa Road Section of 37.65 km/hour. For the analysis of the need for pedestrian crossing facilities at MI Al-Iman Banaran, SD N Sekaran 1, SD N Sekaran 2, and MI Roudlotul Huda, it is recommended to provide pedestrian crossing facilities in the form of zebra cross. For the facilities needed by pedestrians, it is recommended to provide sidewalks with a width of 3 meters. At all school locations that have carried out an analysis of the needs of the Safe School Zone facilities, it was concluded that the road is not safe. For this reason, it is necessary to planning and design the Safe Route to School (SR2S), on the Taman Siswa Road Section which is expected to be of benefit to road users, especially pedestrians in the school area, so that when walking along and crossing the road it provides security and safety for pedestrians.
Analysis of Traffic Accidents on Brigjen Sudiarto Road, Pedurungan District, Semarang City
Authors: Nugroho Untoro , Kusumawardani Rini , Kusbiantoro Arief , Pratama Muhammad Jordan
Published: August 2024

Brigjen Sudiarto roads is a provincial road located in the Pedurungan sub-district, Semarang City, Central Java Province. This research uses this road because in the last 5 years from 2018 to 2022, there have been 230 accidents on this road with a total of 271 accident victims based on accident data from the West Semarang Police. The purpose of this study is to determine the characteristics of traffic accidents on Brigjen Sudiarto road during the 2018 – 2022 period, find out the locations of accident-prone points on Brigjen Sudiarto road, and provide advice as a prevention of traffic accidents in the future. This study describes the current conditions. This study uses the Accident Equivalence Rate (AEK) method and the Upper Control Limit (UCL) method. If the AEK value is greater than the UCL value, it means that the location is an area prone to traffic accidents.

The results of the research are the characteristics of traffic accident data from 2018 – 2022 based on the highest per segment the highest is in segment 3 with a total of 105 incidents, and for all characteristics segment 3 is also the highest recorded. The highest accidents based on time (hour) occurred at 06.01-12.00 WIB with a total of 86 incidents, the highest accidents based on day occurred on Wednesday with a total number of 38 incidents, the highest accident based on victim class was minor injured victims (LR) with a total number of 200 incidents, the highest accidents based on gender were male victims with a total of 175 incidents, the highest accidents based on age occurred in victims aged (> 48 years) with a total of 71 incidents, and the highest accidents based on the type of vehicle were motorcycles with a total a total of 155 incidents. The results of the analysis of accidents on the Brigjen Sudiarto road which were carried out for five years (2018-2022) based on the Accident Equivalent Number (AEK) method and the Upper Control Limit (UCL) method occurred in segment 3 in 2018 with AEK = 114 and UCL = 82 Segment 1 in 2019 with AEK = 111 and UCL = 97. Segment 3 in 2021 with AEK = 117 and UCL = 93. Segment 3 in 2022 with AEK = 105 and UCL = 102. Meanwhile in 2020 the AEK value does not exceed the UCL value limit. This means 4 years of blackspot and 1 year of no blackspot during the last 5 years. The solution as a step to minimize accidents in segments 3 and 1 is to remake road markings, install traffic warning signs in accident-prone locations and repair damaged roads in accident-prone locations. This solution is expected to be implemented to reduce the occurrence of traffic accidents and casualties.
Optimization urban transportation system based on trends using suitable algorithm
Authors: Salim N A , Subiyanto  , Rachmat S K , Anantyo A
Published: August 2024

The operation of public transportation, especially within the scope of urban transportation, has become a highly significant issue in maintaining the smoothness of urban mobility. Nevertheless, situations during peak hours and the occurrence of special events tend to lead to an increase in the number of passengers utilizing urban transportation services, thereby inducing varying demand. The primary focus of this paper is to present a more adaptive approach by developing updates to conditions at each stop, which can provide flexibility and periodic implementation of optimization. To achieve this goal, we propose the application of the Holt-Winters Exponential Smoothing method, considering aspects of level, trend, and seasonal components when conducting forecasts. This method evaluates actual data, previous component values, and predetermined parameters, aiming to generate more accurate forecasts and adeptly address the existing seasonal patterns and trends within the time series data. The findings of this research will offer practical guidance to decision-makers in optimizing the operational schedule of urban transportation, while taking dynamic factors into account. Overall, this paper holds the potential for a positive impact on service enhancement by adjusting the timing of urban transportation deliveries according to prevailing conditions.
Forecasting Agricultural Waste Composting Maturity Through Machine Learning: A Mini Review
Authors: Pradnya Irene Nindita , Hasanah Uswatun , Asri Sarwi , Imani Nadya Alfa Cahaya , Auralita Kakalia Putri , Enjelita Anggun
Published: August 2024

The effective management of agricultural waste through composting is essential for promoting sustainable waste practices and enhancing soil quality. Forecasting the maturity of compost is of utmost importance to assess its suitability and efficacy in enhancing soil as an amendment. Recently, the application of machine learning methods has risen as a robust solution for projecting compost maturity, showcasing enhanced precision and efficiency in contrast to conventional techniques. This article seeks to offer a comprehensive summary of the present research landscape concerning the utilization of machine learning in foreseeing the maturity of compost derived from agricultural waste. It provides insight into the methods used, challenges faced, and prospective paths for future investigation.
Combination of adsorption using activated carbon and advanced oxidation processes (AOPs) using O3/H2O2 in decreasing BOD of tofu liquid waste
Authors: Wulansarie R , Fardhyanti D S , Ardhiansyah H , Nuroddin H , Salsabila C A , Alifiananda T
Published: August 2024

The tofu industry is one of the industries that is growing rapidly in Indonesia, which has an impact on the abundance of liquid waste it produces. In general, liquid waste from the tofu industry has a Biological Oxygen Demand (BOD) of 5,000–10,000 mg/L, Chemical Oxygen Demand (COD) of 7,000–12,000 mg/L, Total Suspended Solid (TSS) of 6,000–8,000 mg/L, and a pH of around 4-5. Based on the Regulation of the Minister of Environment and Forestry of the Republic of Indonesia No. 5 of 2014, states that the maximum level of COD is 300 mg/L, BOD level is 150 mg/L, TSS level is 200 mg/L, and pH is 6-9. Several methods that have been carried out in previous research for tofu liquid waste treatment are ozonation, Advanced Oxidation Processes (AOPs) based on O3/H2O2, adsorption with activated carbon. In this study, a combination of adsorption using activated carbon and the O3/H2O2-based AOPs method was carried out for tofu wastewater treatment by reducing BOD levels. The best result is the combination of AOPs and adsorption which is able to degrade BOD levels to 64%.
54 Improving Responsible Opioid Prescribing on Patient Discharge
Authors: Wombwell A , Bowyer D
Published: August 2024

Aim

There has been a 15-fold increase in opioid prescribing between 1992-2012. Interestingly, the duration of the first opioid prescription, rather than the strength, is more likely to be associated with misuse in post-operative patients. GPs are unaware on discharge, of the quantity of opioids dispensed (in Australia). We undertook an audit of current opioid prescribing habits on patient discharge (in a regional Australian hospital), with the aim to increase the number of GPs that receive details of the quantity of opioids prescribed, by including this in the discharge letter.

Method

We completed a closed-loop 3-cycle audit. The first cycle involved auditing the discharge letters from the ward for 3 consecutive weeks, in order to determine how many of these included the opioid quantity prescribed on discharge. Following this, we instigated change, by publishing a weekly reminder to the team. We then re-audited the discharge letters for another three consecutive weeks. The third cycle of the audit, included putting a poster in the doctor’s office, followed by re-auditing another three consecutive weeks.

Results

Initially, 3% of discharge letters included the opioid quantity that the patient was discharged with. In the second cycle, this increased to 27%, and in the third cycle this improved again to 53%.

Conclusions

This audit has shown an improvement with each audit cycle, resulting in more responsible opioid prescribing. This will contribute to reducing opioid-related harm in the community, whilst providing community doctors with information that they can use to continue responsible opioid prescribing.
283 Blood Transfusion Documentation in Surgical Patients - Are We Doing It Correctly? an Audit on the Blood Transfusion Documentation in Surgical Patients at a District General Hospital in the United Kingdom
Authors: Pal S , Feyang Limbu D , Pangeni A , Shrestha A
Published: August 2024

Aim

Transfusion of blood products is commonly indicated in surgical patients, especially in patients with gastro-intestinal bleeding, gastro-intestinal cancers, and trauma patients. However, the documentation regarding blood transfusion in these patients often does not meet the guidelines. The aim of this clinical audit was to improve the blood transfusion (BT) related documentation in patients of general surgery (GS) at a district general hospital (DGH) in the United Kingdom, in accordance with the national guidelines (Administration of blood components: a British Society for Haematology Guideline) and the local trust guidelines.

Method

For the 1st-cycle of the audit, we did retrospective study of all adult patients admitted under GS in our DGH from 01.07.2023 to 15.08.2023 who received BT, and their electronic records were assessed with regards to documentation regarding the following criteria: decision to transfuse, patient's consent and understanding, post-transfusion effect and discharge notes. Following this, we had a discussion with the junior doctors in the department, who do this documentation, to make them aware of the BT guidelines, and to improve adherence. The 2nd-cycle included retrospective data collection from 01.09.2023 to 15.102023.

Results

BT-documentation during the 2nd-cycle showed significant improvement to adherence above 80% in most of the criteria where it needed improvement in the 1st-cycle.

Conclusions

This clinical audit successfully improved the BT-documentation adherence to the guidelines, showing that through simple educational methods, the documentation practices could be improved significantly. Our plan for subsequent improvement includes posters in the departmental resource room to increase the awareness, and to re-audit in December 2023.
317 A Trust-Wide Assessment of Follow-Up Care & Success Rates for the Conservative Management of Urinary Stones
Authors: Ullah H K , Olaniyi O , Muoka O
Published: August 2024

Aim

A re-audit to determine the effectiveness and quality of follow-up care in conservatively managed ureteric/renal colic patients. This is by assessing the proportion of cases that had timely follow-up appointments with imaging studies in accordance with the BAUS (British Association of Urological Surgeons) recommendations.

Method

Retrospective study with data collection over 12 months(1st January 2021 – 31st December 2021) from anonymised patient data, PACS, discharge documents and patient portal.

Results

A total of 116 (68 males/48 females) urinary colic patients were admitted during this period and 46% were treated nonoperatively. The mean age of patients was 48 years with a higher incidence in males. Specifically, while 60% of patients had successful conservative management, 31% were unsuccessful and 9% were lost to follow-up. Furthermore, just 7% had a follow-up appointment within 28 days while 45% were followed up in three months & 20% beyond this. Finally, 88% of these patients had follow-up imaging done but only 51% had it within 28 days as per BAUS recommendations. CT-Renal was the imaging modality in 81% while ultrasonography was used in the remainder.

Conclusions

This re-audit showed that conservative management continues to remain a viable option for stones <5mmwith more distal stones also having better success rates locally. We did not meet the 95% national objective for follow-up imaging & appointments within four weeks however, we did make some progress from the prior cycle. Our recommendations include setting up virtual stone clinics & streamlining local follow-up procedures.
343 Distal Radius Fracture Emergency Analgaesia and Management Audit
Authors: Winder J , Mamoowala N , O’Malley O , Jayatilika L , Sreenivasan S , Abdelmegid O , Mason L , Graham S
Published: August 2024

Aim

To audit analgesia used in the initial management of patients with Distal Radius Fractures (DRFs) that require manipulation against the current standards.

Method

Standards used were 2018 British Society for Surgery to the Hand (BSSH) guidelines, which recommend intravenous regional anaesthesia and haematoma blocks when manipulating DRFs. Data collection using survey dissemination at 2 tertiary centres included adult patients presenting between 13/08/2022 and 26/11/2022 with DRFs. Exclusion criteria were open fractures, multiple fractures and major trauma. Patient factors and management, with corresponding pain Visual Analogue Scale (VAS) before, during and post manipulation were recorded. Imaging was reviewed to determine radiographic measurements on presentation and in clinic. Data was recorded using REDCap database.

Results

There were 33 mostly female (F:M 29:4) patients included. Only 24.24% had no co-morbidities. Comorbidities included Hypertension (42.42%), Ischaemic Heart Disease (24.24%) and Asthma (21.21%). Most patients (87.88%) received Methoxyflurane (Penthrox), the remainder had Lidocaine haematoma block. Manipulations were mostly performed by staff from A+E (63.64%). Increased pain scores during manipulation were reported in 64.29% of patients, with a median increase of 7 points. Decreased post manipulation scores were reported in 87.10% with a median decrease of 16 points. Further manipulation was required in 27.27%. Operative fixation was required in 21.21%.

Conclusions

In conclusion the current guidelines are not being followed in the centres we audited. Methoxyflurane was used for the majority of patients, with good outcomes. Further data is required from multiple centres across the UK to assess whether guidelines need to be updated.
364 Single Centre Evaluation of Enhanced Recovery After Surgery (ERAS) Protocol for Elective Colorectal Surgical Procedures
Authors: Gujjuri R , Welch J , Farrugia A , Sarma D
Published: August 2024

Aim

Enhanced Recovery After Surgery (ERAS) have proven to be the safest and most effective standards in managing elective colorectal cancer patients pre-, peri- and post-operatively. This audit assesses the compliance to ERAS protocol in a single centre.

Method

Retrospective data were collected on 87 patients undergoing elective colorectal surgery in a single centre between January to October 2023. Rate of compliance to selected pre-, peri- and post-operative audit standards as defined in the ERAS protocol was assessed. Outcomes of ERAS discharge success (% discharged before day 6 post-op) and length of stay were also collected.

Results

Eighty-seven patients were found to have undergone elective colorectal surgery between January and October 2023. Laparoscopic (64.4%) and robotic (21.8%) surgery were the most common operative methods with right hemicolectomy (33.3%) and high anterior resection (26.4%) comprising the most common operations. The compliance to pre-operative criteria was 63.2%, intra-operative criteria was 78.5%, and post-operative criteria was 59.8%. The overall compliance to ERAS protocol was 65.4%. Mean length of stay was 6.2 days and 60.9% of patients were deemed to have a successful ERAS discharge.

Conclusions

This audit illustrates that improvements are required to ensure better compliance with the ERAS protocol in our department. Pre-operatively, this can be facilitated by providing patients with carbohydrate drinks. Post-operatively, this can be achieved through prompt discussions regarding analgesia, opioid prescribing and by ensuring appropriate prescribing of nutritional support. A second cycle post-intervention will allow a review of our chosen outcomes to ensure we are optimising post-operative outcomes for elective colorectal patients.
371 Anticoagulation Management in Urological Surgical Patients
Authors: Mancuso R , Haider M U , Abbasi M , Sami M
Published: August 2024

Aim

Anticoagulation management in urology surgery involves a trade-off between decreased risk of venous thromboembolism and increase of risk of bleeding which ultimately affects patient’s quality of care and complication rate. This audit is intended to review the current anticoagulation management of the uro-surgical patients, audited against local policies at Kingston Hospital NHS Foundation trust:” VTE assessment in adults “and “guideline for the interruption of anticoagulant and antiplatelet drugs before surgery and invasive procedures”.

Method

Data have been collected retrospectively via computer archives. The sample encompasses elective adults patients undergoing urological surgical procedures. The sample consisted in 167 adult patients, operated between January 2022 and July 2023.

Results

97% (162/167) were appropriately assessed for the risk of VTE.2.9% (5/167) were not assessed. 0% (0/40) uro-surgical patients on chronic anticoagulation were stratified for the risk of bleeding and thrombosis before the surgery.

127/167 analysed patients were not included as were not on anticoagulation medication at the time of surgery.62.5% (25/40) received a proper anticoagulation bridging plan.

37.5% (15/40) patients were discharged without bridging plan. 5% (2/40) patients were check-listed for Anticoagulation bridging.

0% (0/167) were assessed for the VTE risk at 24h as per protocol.

Conclusions

Overall, the audit showed substandard management of anticoagulation bridging in uro-surgical patients. Patients were not appropriately stratified for their individual and procedure-based bleeding risks. The anticoagulation bridging was not appropriately completed for all the patients. The post operative management including the checklist at 24 hours VTE re-assessment was not done for any of the admitted patients. Improvements are urgently needed.
372 Imaging in Gynaecomastia: Audit of Imaging Practice at BHRUT to Establish Guidelines
Authors: Pestrin O , Agilinko J , Basharat S , Ali T , Wahab T
Published: August 2024

Aim

Our study aim was to audit our imaging practice against national standards to formulate guidelines and standardise practice.

Method

The authors performed a retrospective data collection of imaging and pathology for clinically suspected gynaecomastia in our breast unit between January and December 2023, using hospital radiology and pathology computer information systems. Data included clinical history, clinical, ultrasound and mammographic scores. Patients with clinical suspicion of malignancy (written on imaging request or P4/P5) were excluded. Descriptive statistics were performed.

Results

A total of 148 male patients had been referred for imaging with P1 (19), P2 (113), P3 (11) or no P value (34), clinical history stating or querying gynaecomastia. Ultrasound was performed in all patients. All P1 and P2 patients were U1 or U2, and M1 or M2 if mammogram was performed (0/19 P1 patients, 20/113 P2 patients, 4/11 P3 patients). In P1, P2 and no P value patients, 6/166 patients underwent ultrasound-guided biopsy (5/6 B2 gynaecomastia, 1/6 B1 benign angiolipoma). In P3 patients, two biopsies were performed: B2 gynaecomastia in one patient, but one biopsy (M4U4) revealed B5b invasive carcinoma.

Conclusions

The findings support guideline formulation where imaging is not indicated for typical (P1, P2) gynaecomastia. Imaging should, however, be performed where there is any doubt at all about the clinical diagnosis. The probability of finding cancer when performing imaging of clinically benign findings in the male breast is negligible. Routine imaging of gynecomastia should be discouraged.
432 Perioperative Antithrombotic Agent Use in Cutaneous Surgery: A Complete Audit Cycle
Authors: Nagra R S , Gujjuri R , Salibi A
Published: August 2024

Aim

Management of antithrombotic therapy prior to cutaneous surgery is a contentious topic with mixed opinions. The primary of this audit was to analyse the incidence of post-operative bleeding following cutaneous surgery in our minor operations theatre over two audit cycles. Secondary aims included measuring the standards outlined by BSDS and BSH peri-operative antithrombotic guidelines and assessing bleeding by risk.

Method

A single centre retrospective review of all patients undergoing cutaneous surgery on established antithrombotic therapy between 8/9/22 - 31/10/22 (cycle 1) and 10/7/2023 to 15/09/2023 (cycle 2) was conducted. A poster 'cheat sheet' containing antithrombotic agent advice was displayed in the department, forming the intervention.

Results

A total of 165 patients underwent cutaneous surgery with continuation of their antithrombotic agent. A reduction in post-operative bleeding from 8.6% to 7.4% in the second cycle was observed. The most common agent associated with bleeding in both cohorts was a DOAC, 33.3% and 42.9%, respectively. Overall, high risk operations had a proportionally higher incidence of post-op bleed compared with lower risk; 26.7% versus 4.6%, respectively. We recommended aspirin monthotherapy was not ceased before surgery, this improved from 80% to 71.4%. Equally we saw an increase in pre-op INR from 75% to 100% for warfarin users.

Conclusions

Patient factors, indication for antithrombotic agent and risk of the procedure should be all considered when listing for surgery, to help determine how the antithrombotic agent should be managed. Postoperative bleeding increases the risk of delayed wound healing, graft/flap failure and wound infection, and therefore should be considered.
686 National Audit Assessing the Imaging of Acute Pancreatitis at Mater Dei Hospital, Malta
Authors: Formosa D , Catania S , Caruana C
Published: August 2024

Aim

The aim of this audit is to assess the imaging of acute pancreatitis (AP) in patients admitted to Mater Dei Hospital, Malta using the Royal College of Radiologists (RCR) recommendations as standard.

Method

Retrospective data of patients admitted with AP between 1/1/22 and 31/12/22 was collected. Timing of initial CT (at least 72 hours after symptom onset), CT report inclusion of prognostic factors, and timing of ultrasonography (US) of the gallbladder (within 24 hours of diagnosis) were analysed.

Results

187 patients were included in this study. 99 patients were investigated with a CT scan during their admission, with only 25.3% of these patients being scanned at least 72 hours after developing symptoms. 74.7% of CTs were done within 72 hours of symptom onset. 47.3% of patients who had an early CT received a further CT or MRCP scan in the same admission. 24.2% of CTs mentioned all 3 key prognostic factors outlined in the RCR recommendations: pancreatic necrosis, free intraperitoneal fluid, and peripancreatic fat stranding. Only 20.2% of patients had an US examining the gallbladder within 24 hours of diagnosis.

Conclusions

Results show that CT scans are being performed too early in the clinical course of AP, with little reliance on US as a quick, non-invasive, and inexpensive first-line scan. Early CTs in AP generally do not alter management and risk missing complications. Our aim is to improve local practices through multiple educational sessions addressed towards emergency doctors, general surgeons, and radiologists.