bluuebunny/crossref_metadata_2025 huggingface dataset:
EMG Dataset for Gesture Recognition with Arm Translation
Authors: Kyranou Iris , Szymaniak Katarzyna , Nazarpour Kianoush
Published: January 2025

Myoelectric control has emerged as a promising approach for a wide range of applications, including controlling limb prosthetics, teleoperating robots and enabling immersive interactions in the Metaverse. However, the accuracy and robustness of myoelectric control systems are often affected by various factors, including muscle fatigue, perspiration, drifts in electrode positions and changes in arm position. The latter has received less attention despite its significant impact on signal quality and decoding accuracy. To address this gap, we present a novel dataset of surface electromyographic (EMG) signals captured from multiple arm positions. This dataset, comprising EMG and hand kinematics data from 8 participants performing 6 different hand gestures, provides a comprehensive resource for investigating position-invariant myoelectric control decoding algorithms. We envision this dataset to serve as a valuable resource for both training and benchmark arm position-invariant myoelectric control algorithms. Additionally, to expand the publicly available data capturing the variability of EMG signals across diverse arm positions, we propose a novel data acquisition protocol that can be utilized for future data collection.
Remote sensing-derived time series of transient glacier snowline altitudes for High Mountain Asia, 1985–2021
Authors: Loibl David , Richter Niklas , Grünberg Inge
Published: January 2025

This study presents a new dataset of remote sensing-derived Transient Snowline Altitude (TSLA) measurements for glaciers in High Mountain Asia. We use the Google Earth Engine to obtain TSLA data for approx. 2.8 · 104 glaciers larger than 0.5 km2. After filtering and postprocessing, the dataset comprises ca. 9.66 million TSLA measurements with an average of 341 ± 160 measurements per glacier, covering the time span 1985 to 2021.
Evaluation of ozonated and ultrasonically treated corn starch as an adsorbent for patulin in buffer solutions
Authors: El-desouky Tarek A.
Published: January 2025

This study evaluates the potential of ozonated corn starch (OCS) and ultrasonicated ozonated corn starch (USOCS) as adsorbents for patulin removal in buffer solutions. The results indicated that dual modification significantly altered the starch’s structure, introducing functional groups such as carbonyl and carboxyl groups, and increasing its surface area. These modifications led to enhanced patulin adsorption capacity. Adsorption efficiency was tested across different adsorbent doses (150 mg, 200 mg, 250 mg) and contact times (15, 30, 45, and 60 min). The highest removal efficiency of 92.5% was recorded for the 250 mg dose at 60 min, with USOCS showing superior performance compared to native corn starch and OCS. Kinetic studies revealed that the pseudo-second-order model provided the best fit for the adsorption process, indicating chemisorption as the dominant mechanism. The Langmuir and Freundlich isotherms were used to describe the adsorption behavior, with a maximum adsorption capacity (q

max
) of 15.19 µg/mg and a Langmuir constant (K

L
) of 54.00 L/µg for the 250 mg dose. Additionally, the modified starch demonstrated consistent adsorption performance at varying concentrations, with a favorable adsorption intensity (n > 1), supporting its potential for practical applications. These findings highlight the modified corn starch as an efficient, biodegradable, and low-cost adsorbent suitable for mitigating patulin contamination in food products, offering a sustainable alternative for improving food safety.
Divergent application of 5-amino-isoxazoles for the construction of nitrogen heterocycles via the hydride transfer strategy
Authors: Pan Mengzhe , Guo Feng-Wei , Sun Xinjie , Zhang Jie , Lu Wei , Xu Lubin , Hu Fangzhi , Li Shuai-Shuai
Published: January 2025

The hydride transfer-enabled divergent application of 5-amino-isoxazoles for the controllable construction of diverse tetrahydroquinolines and tetrahydroquinazolines was disclosed with the employment of different Lewis acids.
Expression of concern: Heterostructured nanocomposite tin phthalocyanine@mesoporous ceria (SnPc@CeO2) for photoreduction of CO2 in visible light
Authors: Kumar Pawan , Kumar Arvind , Joshi Chetan , Singh Raghuvir , Saran Sandeep , Jain Suman L.
Published: January 2025

Expression of concern for ‘Heterostructured nanocomposite tin phthalocyanine@mesoporous ceria (SnPc@CeO2) for photoreduction of CO2 in visible light’ by Pawan Kumar et al., RSC Adv., 2015, 5, 42414–42421, https://doi.org/10.1039/C5RA06449J.
Correction: Genetically engineered gas vesicle proteins with proliferative potential for synergistic targeted tumor therapy
Authors: Lin Li , Du Yan , Wang Yaotai , Luo Yong , Jiang Fujie , Yang Haiyan , Ren Li , Zou Jianzhong
Published: January 2025

Correction for ‘Genetically engineered gas vesicle proteins with proliferative potential for synergistic targeted tumor therapy’ by Li Lin et al., RSC Adv., 2025, 15, 157–166, https://doi.org/10.1039/D4RA07532C.
The Evaluation of Thermodynamics and Environmental Impact of Waste Heat Recovery System Using Alternative Refrigerants
Authors: Aisyah Nyayu , Mukhtar Ariyadi Hifni , Ayu Putri Pratiwi Ilham , Sugiyanto  , Fuadi Robith
Published: January 2025

Diesel engines play a critical role in numerous sectors due to their robustness and efficiency but contribute significantly to environmental pollution through exhaust emissions. These emissions contain substantial thermal energy, which, if not harnessed, exacerbates air quality issues and global climate change. The Organic Rankine Cycle (ORC) offers a promising solution for recovering this waste heat and converting it into mechanical or electrical power. This study conducts thermodynamic simulations using MATLAB to analyze ORC systems for diesel engine exhaust heat recovery, focusing on thermal efficiency, power generation potential, and environmental impact of different refrigerants, specifically R-141b, R-245fa, and R-123. Results indicate that ORC performance is significantly influenced by the refrigerant’s critical temperature. R-141b demonstrates the highest thermal efficiency at 13.13% with a heat source temperature of 120°C but also has the highest environmental impact, contributing 3,090 kgCO2 eq/year. In contrast, R-123 shows the lowest environmental impact at 231 kgCO2 eq/year for direct TEWI and 7.73 kgCO2 eq/year for indirect TEWI, with a slightly lower thermal efficiency of 12.73%. R-245fa, with the lowest efficiency at 12.14%, also has a substantial environmental impact. This research provides insights into optimizing energy recovery from diesel engine waste heat and advancing sustainable energy solutions.
Trusts on nerd immunity and health-associated apparatus predict the level of obedience of indonesians toward health resilience threat-anticipation enforced by the government
Authors: Nurlaila Ika , Amalya Dewi Meta
Published: January 2025

The global concept of One Health has gained popularity, with countries like Indonesia implementing policies to combat the pandemic. Despite this, many Indonesians have been slow to follow pandemic-related measures, such as getting vaccinated and social distancing. This study aims to investigate the connection between people’s experiences, their understanding of One Health, and their willingness to follow government policies to prevent and control pandemics. Using numerically scaled surveys, we analyzed the relationships between these variables. We recruited 224 participants from 19 provinces in Indonesia. Our results show a strong link between trust built through experience and understanding of One Health, and people’s compliance with government policies. This study emphasizes the importance of educating the public about One Health and building trust to improve adherence to future pandemic prevention measures.
Determination of diagnostic reference level (DRL) on computed tomography (CT) non contrast examination
Authors: Mulyati Sri , Rasyid Rasyid , Daryati Siti , Latifah Leny
Published: January 2025

Monitoring patient doses on CT Scans in hospitals very important, it must be monitored periodically especially in DRL monitoring of CT Examination. There is still a need for socialization regarding the need for radiation monitoring of high dose radiation in CT Scan used. The DRL was related to efforts to optimize radiation protection must be monitored periodically on CTDI Vol and DLP for lowest possible dose and optimum image quality results. Determination of DRL values from 75% percentile from recording mean CTDI vol and total DLP MSCT examination of head and abdomen non-contrast. The overall results obtained from the Head MSCT examination DRL as follows: DRL on CTDI Vol from Quarters I-IV obtained 63.45 mGy, exceeding the standards IDRL requirement of 60 mGy. Meanwhile, DRL in DLP Total from Quarters I-IV was 1005.05-1096.45 mGy.cm which was lower than IDRL 1275 mGy.cm. Meanwhile, the results of the DRL on theAbdominal MSCT are as follows: Quarter I-IV is 9.35-10.31 mGy below the IDRL that was17 mGy. Meanwhile, local DRL from QuartersI-IV obtained: 401.34 - 428.73 mGy.cm below IDRL which was 885 mGy.cm, its suitable with Decree of the Head of Bapeten Number 1211/K/V/2021.
The bearing capacity based on standard penetration test
Authors: Widiarso Dian Agus , Qadaryati Nurakhmi , Winarno Tri
Published: January 2025

The stability of building construction or series is not only determined by the upper circuit but the stability of the lower series in this case the foundation plays an equally important role in maintaining the stability of the structure. In planning the foundation, the bearing capacity of the soil is an important issue. This research is focused on knowing the bearing capacity value of the allowable bearing capacity formula developed by Meyerhof. This research was conducted in the Tambakharjo area and its surroundings, Semarang City, Central Java. Field data collection includes the results of the standard penetration test (SPT) and undisturbed soil samples (UDS). The N-SPT data was later used to determine the bearing capacity of the soil. The results show a positive linear relationship between N-SPT and carrying capacity, which means the higher the N-SPT, the higher the carrying capacity value. The distribution of bearing capacity at several soil depths is indicated by a zoning map of the bearing capacity of the soil. N-SPT correlation with soil physical properties (clay fraction percentage, plasticity index percentage, and activity value) was also carried out, but most of the data stations were not in accordance with normal conditions.
“Wairon and Waimansusu”: War Boat and Trade Boat of The Biak People in Papua-Indonesia
Authors: Rumbekwan Albert , Sulistiyono Singgih Tri , Rochwulaningsih Yety , Susilowati Endang , Ali Ismail , Masruroh Noor Naelil
Published: January 2025

This article discusses the traditional boat technology of the Wairon and Waimansusu, which were the main means of transport for the Biak tribe in shipping and trade on the north coast of Papua during the 8th to 19th centuries. Although Papua has various types of traditional boats with their own uniqueness, only a few are able to sail as far as the Maluku Islands. For the Biak Tribe, the Wairon and Waimansusu boats are not only functional, but also have artistic and symbolic value in the maritime history of the eastern region of the archipelago. Using a historical and ethnographic approach, this article reconstructs the manufacturing technology, cruising ability and carrying capacity of both types of boats in the context of voyaging, trading and hunting. Today, the manufacture of Wairon and Waimansusu is increasingly rare, despite their high cultural value and great potential to support the development of marine tourism in Cenderawasih Bay, Papua-Indonesia.
Experimental validation of the analytical modelling of a digitally created duffing acoustic nonlinear oscillator at low amplitudes
Authors: Morell Maxime , Collet Manuel , Gourdon Emmanuel , Ture Savadkoohi Alireza , De Bono Emanuele
Published: January 2025

Nonlinear dynamics have long been exploited in order to damp vibrations in solid mechanics. The phenomenon of irreversible energy transfer from a linear primary system to a nonlinear absorber has driven great attention to the optimal design of vibration absorbers both for stationary and transient regimes. Recently, the same principle has also been targeted in acoustics for the absorption of sound waves at high excitation amplitudes. Meanwhile, acoustic absorption by electro-active means has found great success for noise reduction in the linear regime. This study uses a method allowing the design of nonlinear resonators at amplitudes that typically induce linear behaviors. This research proposes an analytical study of the implementation of the duffing equation as a nonlinear electroacoustic resonator coupled to an acoustic mode of a tube. Experiments are carried out and compared to the analytical results. The experimental implementation is done using a real-time-based algorithm retrieving the measured pressure from a microphone and giving the electrical current to send to a loudspeaker as an output thanks to a Runge-Kutta-like algorithm. Despite the several assumptions of the model, the analytical modelling is validated by the experiment, showing that the model is able to predict the two-degree-of-freedom system.
Video-based Informed Consent in Radiology – Acceptance, Satisfaction, and Effectiveness
Authors: Vogele Daniel , Nedelcu Andrea , Beer Meinrad , Kildal Daniela
Published: January 2025

Before any medical procedure, including computed tomography (CT), it is crucial to ensure patients are fully informed about the risks and alternative options. Video-based informed consent offers an increased transfer of information in less time.

In a monocentric, prospective, questionnaire-based study, video-based informed consent, which included a digital medical history form, was compared to the traditional paper-based consent form. Two groups (doctors and patients) were divided into a control group (traditional informed consent) and one study group (video-based informed consent). Participants rated their satisfaction and acceptance on a scale of 1 to 6 (1: very good). Additionally, patients’ understanding of the information provided was evaluated, and the duration of informed consents process was measured.

A total of 205 patients in the control group and 150 in the study group were surveyed. Satisfaction ratings of “very good” or “good” were similar for both methods (91% control group, 94% study group). The patients’ study group showed a higher recall of the information provided in all six areas, e.g. radiation exposure (73% control group; 86% study group).

Among the doctors, 20 from the control group and 11 from the study group were interviewed. Satisfaction was significantly higher in the study group (30% control group, 72% study group).

The duration of the traditional informed consent process averaged 270.2 seconds, compared to 228.7 seconds for the video-based informed consent.

Satisfaction with video-based information is high among both patients and doctors. Patients retain the content more effectively with video-based informed consent, which also saves time.
A biodegradable polymer plug for liver tract embolization after percutaneous or surgical placement of transhepatic biliary drainage tubes: a feasibility study
Authors: Thurner Annette , Dalla Torre Giulia , Hartung Viktor , Kickuth Ralph
Published: January 2025

To evaluate the feasibility of liver tract embolization after transhepatic biliary drainage using a biodegradable polymer plug (IMPEDE-FX, Shape Memorial Medical, Santa Clara, CA, USA).

In a retrospective observational study, 15 plug embolizations were performed in 13 patients at risk for tract-related adverse events (AEs). Risk factors included coagulopathy, cirrhosis, central bile duct puncture, previous drain-related bleeding, malignant obstruction, large tract diameter, or multilevel strictures. Clinical and imaging follow-up was performed at 24 hours, 3 months, and 6 months. Primary endpoints were technical and clinical success. Technical success was defined as plug deployment in the intended position. Clinical success was defined as the absence of biliary, infectious, or bleeding AEs. To assess clinically occult bleeding or biliary obstruction, periprocedural hemoglobin, hematocrit, and bilirubin levels were compared. Secondary endpoints were plug migration, plug oversizing, and plug visibility on imaging.

The technical success rate was 100%. The clinical success rate was 84.6%. There were no infectious or bleeding AEs. In 2 cases where the persistence of biliary congestion was clinically underestimated prior to drain removal, 2 biliary AEs occurred (2 biliocutaneous fistulas including 1 plug migration within 24 hours; 15.4% SIR grade 3 AEs). The median plug oversizing relative to the diameter of the hepatic tract was substantially lower in unsuccessful cases than in successful cases (27% vs. 86%). The plug was visible on ultrasound and CT. On MRI, no plug-related artifacts occurred.

The plug could be an option when a non-permanent, precisely deployable device is desired for tract embolization. Adequate plug-to-tract oversizing and biliary decongestion are essential to achieve durable tract closure. Therefore, the plug seems unsuitable for patients with multilevel strictures where complete drainage of the biliary system is not feasible.
Enhanced quantum synchronization of a driven qubit under structured reservoir
Authors: Chen Po-Wen , Radhakrishnan Chandrashekar , Ali Md Manirul
Published: January 2025

Synchronizing a few-level quantum system is of fundamental importance to the understanding of synchronization in the deep quantum regime. We investigate quantum phase synchronization of a two-level system (qubit) driven by a semiclassical laser field, in the presence of a dissipative environment having finite bath correlation. The phase preference of the qubit is demonstrated through the Husimi Q-function, and the existence of a limit cycle is also shown in our system. Synchronization of the qubit is quantified using the shifted phase distribution. The signature of quantum phase synchronization viz. the Arnold tongue is obtained from the maximal value of the shifted phase distribution. Two distinct types of qubit dynamics are considered depending on the reservoir correlation time being very short and a situation when bath correlation time is finite. When the reservoir’s frequency spectrum is broad and the bath correlation time is short, the qubit’s phase preference vanishes in the long-time limit. In contrast, a finite bath correlation time and narrow spectral density result in persistent long-time phase localization. The synchronization regions are governed by system–environment parameters, with qubit phase synchronization being enhanced when the reservoir exhibits a narrow frequency spectrum.
Temperature and field dependences of the converse piezoelectric strain coefficient d*33 in PbFe1/2Nb1/2O3, 0.91PbFe1/2Nb1/2O3–0.09PbTiO3, and PbSc1/2Nb1/2O3 ceramics
Authors: Titov V. V. , Shi Xue , Li G. , Raevskaya S. I. , Gusev A. A. , Malitskaya M. A. , Erofeeva E. A. , Kolosov S. I. , Topolov V. Y. , Raevski I. P.
Published: January 2025

Temperature and field dependences of the dielectric permittivity (ɛ) and unipolar electric field-induced strain (S) of PbFe1/2Nb1/2O3, PbSc1/2Nb1/2O3, and 0.91PbFe1/2Nb1/2O3–0.09PbTiO3 solid solution ceramics are studied in the temperature range from 25 to 160 °C. Using these experimental data, both the effective d*33eff = Smax/Emax and differential d*33dif = dS/dE converse piezoelectric moduli are calculated, and (E, T) diagrams were plotted. The possible critical behavior of the converse piezoelectric modulus d*33 and its correlation with the position of the known critical points in the (E, T) diagrams of studied ceramics are discussed.
Stimulating the regenerative capacity of the human retina with proneural transcription factors in 3D cultures
Authors: Wohlschlegel Juliette , Kierney Faith , Arakelian Kayla L. , Luxardi Guillaume , Suvarnpradip Naran , Hoffer Dawn , Rieke Fred , Moshiri Ala , Reh Thomas A.
Published: January 2025

Retinal diseases often lead to degeneration of specific retinal cell types with currently limited therapeutic options to replace the lost neurons. Previous studies have reported that overexpression of
ASCL1
or combinations of proneural factors in Müller glia (MG) induce regeneration of functional neurons in the adult mouse retina. Recently, we applied the same strategy in dissociated cultures of fetal human MG and although we stimulated neurogenesis from MG, our effect in 2D cultures was modest and our analysis of newborn neurons was limited. In this study, we aimed to improve our MG reprogramming strategy in a more intact retinal environment. For this purpose, we used an in vitro culture system of human fetal retinal tissue and adult human postmortem retina. To stimulate reprogramming, we used lentiviral vectors to deliver constructs with a glial-specific promoter (HES1) driving
ASCL1
alone or in combination with additional developmental transcription factors (TFs) such as
ATOH1
and
NEUROD1
. Combining IHC, scRNA-seq, and electrophysiology, we show that human MG can generate new neurons even in adults. This work constitutes a key step toward a future clinical application of this regenerative medicine approach for retinal degenerative disorders.
Semantic and pragmatic properties of post-truth discourse
Authors: Sang Zhonggang , Shi Tongtong
Published: January 2025

Social media discourse is characterized by the post-truth phenomenon, in which feelings and personal beliefs
appear to exert greater influence on shaping public opinions than truth. In such cases, the truth of news may be blurred and
reported events are often reversed along revelations of the facts. Reverse news on social media is, in a sense, a typical instance
of post-truth discourse. This study attempts to provide a corpus-based description of attitude appraisal and illocutionary acts in
reverse news on social media, with the aim of investigating semantic and pragmatic properties of post-truth discourse. The corpora
for this study consist of social media posts in Chinese and English about a defamation lawsuit, which were collected from Weibo
and Facebook.

The results indicate that the English corpus emphasizes the use of appreciations and judgments with more complex
co-occurring relations among three attitudinal domains while the Chinese corpus contains more judgments than appreciations and
affects. Meanwhile, both corpora exhibit higher frequencies of assertives and expressives than the other acts, yet the Chinese
corpus presents more complicated illocutionary act sequences than the English corpus. After the verdict, the frequencies of both
attitude appraisal and illocutionary acts decrease in the Chinese corpus but increase in the English corpus. Based on this, we
propose that the development of post-truth discourse may go through three functional stages: starting with expression, progressing
to appeal, and ending with representation. The sequence of these stages may vary depending on sociocultural contexts.
Determining state space anomalies in mean field games
Authors: Liu Hongyu , Lo Catharine W K
Published: January 2025

In this paper, we are concerned with the inverse problem of determining anomalies in the state space associated with the stationary mean field game (MFG) system. We establish novel unique identifiability results for the intrinsic structure of these anomalies in MFGs systems, including their topological structure and parameter configurations, in several general scenarios of practical interest, including traffic flow, market economics and epidemics. To the best of our knowledge, this is the first work that considers anomalies in the state space for the nonlinear coupled MFG system.
False Strange Attractors as Sources of Pseudo Randomness
Authors: Moysis Lazaros , Lawnik Marcin , Maraslidis George S. , Fragulis George F. , Volos Christos
Published: January 2025

In this work, the use of false chaotic attractors in enhancing the security of chaos-based encryption applications will be explored. False attractors result by rearranging the solution trajectories of a nonlinear dynamical system, leading to novel shapes in the 3D space. This way, a single solution trajectory of a chaotic system can be used to generate numerous new false trajectories. Examples of such attractors are provided for the Lorenz system, and a system with line equilibrium from Moysis et al. (2019). By formalizing the method of constructing false attractors, and generalizing it by adding a series of elementary operations, the key parameters of this procedure can be used as part of the secret key in symmetric encryption applications, effectively increasing the key space. Specifically, the key space increases significantly with respect to the simulation time, and the system’s dimension. Moreover, due to its fast implementation, this technique can be used as a less complex, but much lighter alternative to full scale permutation. The usability of the false attractors as sources of randomness is showcased through the design of a chaotic pseudo-random bit generator. The generator can output 64 bits per iteration, and is equally effective under any false attractor of the chaotic system.
Periodic modulation of adiabatic dynamics in non-reciprocal Landau-Zener systems
Authors: Chang Rong , Li Sheng-Chang
Published: January 2025

The control of adiabatic dynamics is essential for quantum manipulation. We investigate the effects of both periodic modulating field and linear sweeping field on adiabatic dynamics based on a non-reciprocal Landau-Zener model with periodic modulation. We obtain adiabatic phase diagrams in the (ω, δ) parameter space, where the adiabatic region is bounded by the modulating frequency ω greater than a critical value ω

c
and the non-reciprocal parameter δ less than one. The results show that the adiabaticity of the system is not sensitive to the modulating amplitude. We find that the critical modulating frequency can be expressed as a power function of the modulating period number or the sweeping rate. Our findings suggest that one can change the adiabatic region or improve the adiabaticity by adjusting the parameters of both the modulating and the sweeping fields, which provides an effective means to flexibly control the adiabatic dynamics of non-reciprocal systems.
Experimental Manipulation of Fine Structures on High Harmonic Spectrum of Aligned CO2 Molecules
Authors: Wang Ge-Wen , Zhao Yi-Wen , Wang Yi-Chen , Ma Jing , Liu Bo-Dun , Jiang Wei , Liang Hong-Jing , Ma Ri
Published: January 2025

Molecular high-order harmonic spectroscopy is a significant advancement in ultrafast science, enabling the measurement multielectron dynamics with attosecond temporal resolution. The fine structures observed in the molecular harmonic spectrum provide crucial insights into the structural or multielectron dynamical effects induced by intense laser fields. In this study, we measure the high-order harmonic spectrum of aligned CO2 molecules contributed from short trajectories. Two distinct groups of minima are identified in the plateau region. Our findings indicate that the participation of deeper-lying molecular orbitals and two-center interference play a significant role in molecular harmonic generation. The results pave the way for advancing the understanding of multielectron dynamics in polyatomic molecules under intense laser fields.
O4 Rapid Review: Management of Recurrent Sigmoid Volvulus
Authors: Shaikh Amarah Ghani
Published: January 2025

Aims

Sigmoid volvulus is a common emergency condition resulting from the twisting of the sigmoid colon, leading to bowel obstruction. This rapid review aims to synthesize evidence from recent studies on the management of recurrent sigmoid volvulus. Given the high rates of recurrence and associated complications, understanding effective treatment strategies is crucial for improving clinical outcomes.

Methods

A rapid review of the literature was conducted, incorporating 26 relevant articles published between 2014 and 2024. These studies included case reports, retrospective series, randomized controlled trials, and reviews that examined various treatment modalities for recurrent sigmoid volvulus.

Results

Findings indicated that endoscopic decompression, while effective for acute episodes, often led to recurrence without subsequent surgical intervention. Studies highlighted endoscopic sigmoidopexy as a viable option for inoperable patients, offering lower recurrence rates. Surgical resection, particularly laparoscopic approaches, was identified as the gold standard for preventing recurrence. Additionally, minimally invasive techniques, including percutaneous colostomy, provided options for high-risk patients.

Conclusions

Effective management of recurrent sigmoid volvulus necessitates a comprehensive, individualized approach. While endoscopic decompression serves as an initial treatment, definitive surgical resection offers the best long-term outcomes by significantly reducing recurrence rates. Minimally invasive alternatives should be considered for high-risk patients, with management strategies tailored to individual risk factors. Ultimately, prioritizing proactive surgical interventions is essential to prevent severe complications and enhance patient outcomes in cases of recurrent sigmoid volvulus.
eP10 Decision Making For and Against Emergency Laparotomy in High Risk Patients: A Prospective Trust-Wide Study
Authors: Bradley Rebecca , Krishna Amritha Priya , Blatchford Chloe , Mohamed Hamza , Nikolopoulos Ionnais
Published: January 2025

Intro

High Risk emergency laparotomy patients are characterised as having a NELA score >5%, but this often underestimates risk. Many factors influence the decision for laparotomy in these patients. Outcomes for patients who do not proceed to laparotomy are less reported in literature.

Aims

The primary aim was to compare outcomes in high risk patients (NELA >5%) who were managed with a laparotomy (Lap), vs those who were managed non-operatively (NoLap). Our secondary aim was to explore the decision making process to investigate which factors influenced the decision for a laparotomy vs non-operative management

Methods

A prospective study over 6 months was conducted across two hospitals. Patients with NELA >5% and aged 65 or over warranting laparotomy were included. Fisher's and Mann-Whitney U testing was used to compare Lap and NoLap outcomes. Multivariable regression analysis was used to determine which factors were most relied upon to make the decision for or against laparotomy.

Results

A total of 62 patients were included. NoLap patients had significantly higher NELA(p=<0.001), ASA (p=0.008), Clinical Frailty (p=<0.001) scores, but higher mortalities (<0.001). Only 32% of all cases had a full MDT involved in decision for/against laparotomy. Clinical Frailty Score was the most specific and sensitive factor influencing decision for a laparotomy (p=<0.001).

Conclusions

High risk NoLap patients have worse outcomes than their Lap counterparts. Although Clinical Frailty Score is not currently included in the NELA calculation, it is a crucial variable in influencing decision making for laparotomy in high risk patients.
eP12 Identifying and Managing Surgical Site Infections in Emergency and Elective General Surgery: A Quality Improvement Project
Authors: Mostafa Omar , Khan Amnah , Reay Michael , Kumar Prajeesh
Published: January 2025

Background

Surgical Site Infection (SSI) pose a significant health and economic burden to healthcare services within the United Kingdom. GIRFT and PHE have strongly recommended local auditing, protocols, and systems to identify, reduce and manage SSI across surgical specialities.

Method

A newly designed electronic SSI database was used to retrospectively screen and capture adult patients who underwent an emergency or elective general surgical procedure between January 2022 and March 2024. Records were automatically screened for biochemical changes suggestive of infection or keywords documented during ward round entries. Patients who met the criteria were highlighted as ‘probable infections’. Subsequently, a manual retrospective review of patient records was carried out to assess cases of actual infection. SSI was identified as described by the Centre for Disease Control (CDC).

Results

According to the database, 699 patients were identified, of which 21.8% were probable infections (153/699). Of those with a probable infection, 13% had a true infection documented (20/153). The median length of stay of those with a true infection was 15 days (6 – 170). 60% of infected cases were emergency surgeries (12/20) and 40% were open (8/20). 7.1% had documented cases of wound dehiscence (11/153), and 56% had clear documentation of a wound assessment post-operatively (86/153). Our intervention relied on creating an electronic SSI bundle to standardise documentation and capture true rate of infected cases in general surgical patients.

Conclusion

Heterogeneity and inaccuracy in wound assessment and documentation calls for robust, standardised methods to accurately capture SSI rates.
eP15 National survey on management practices for adhesional small bowel obstruction and nasogastric tube use among general surgeons in Australia
Authors: Al-Mashat Ali
Published: January 2025

Background

The nasogastric tube (NGT) is considered a necessary component in the management of adhesional small bowel obstruction (ASBO) and is recommended by current guidelines. Retrospective studies indicate that ASBOs may be managed without a NGT with non-inferior outcomes. We aimed to explore the current practice of Australian General Surgeons in ASBO management and NGT use, to determine if there is surgical equipoise for a randomised controlled trial (RCT).

Methods

We surveyed all active members of General Surgeons Australia in October 2021 using an online REDCap questionnaire. It consisted of clinical scenarios and questions surrounding demographics, management and reasoning. Descriptive statistics were reported for all relevant variables.

Results

Out of 893 emails sent, we received 181 (20%) responses. The respondents were predominantly from New South Wales (47%) and had subspecialty training (71%). Forty-two percent of respondents used an NGT in greater than 90% of ASBO cases. Sixty-four percent of surgeons believed that an NGT can save an ASBO patient from an operation and 93% believed it can have a therapeutic role. Vomiting was the most common reason for NGT insertion and 69% believed an NGT reduces the risk of aspiration. Gastrograffin® was used by 96% of surgeons. Forty-two percent of respondents were willing to participate in an RCT investigating NGT use.

Conclusions

In Australia, there is a trend towards selective NGT use in the management of ASBO, with variation existing in the beliefs surrounding its use. An RCT is required to determine best practice in the non-operative management of ASBO.
eP27 Treatment Escalation Plan (TEP) Completion Rates in Emergency Surgical Admissions: A Closed Loop Audit
Authors: Riad Aya , Atkinson Isobel , Nicolay Christopher
Published: January 2025

Aims

We aimed to audit treatment escalation plan (TEP) completion rates, including cardiopulmonary resuscitation (CPR) decisions, in patients admitted under emergency surgery.

Methods

Data was retrospectively collected on all emergency surgical admissions in a district general hospital in March 2024. Exclusion criteria included patients under the age of 16 and patients discharged on the same day without an operation. Results were presented in a departmental meeting and a target of TEP completion on the first consultant ward round was set. The second cycle was completed in July 2024.

Results

126 patients were admitted in March 2024 and 151 in July 2024. 19 patients (15%) admitted in March had TEP forms completed during their admission compared to 26 patients (17%) in July. In the first cycle 5 TEP discussions were completed by the parent surgical team (26%) compared to 11 in the second cycle (42%). The median time to TEP form completion from admission was 2 days in March and 1 day in July. 47 patients of the those admitted in March were operated on, of whom 39 did not have a TEP form (83%) compared to 69 patients operated on in July, 56 of whom had no TEP (81%).

Conclusion

TEP form completion rates remained low across both cycles, with an increase in the proportion of TEP discussions completed by the parent surgical team from 26% to 42%. Qualitative approaches may aid in understanding barriers to CPR discussions in emergency surgical patients and identifying strategies to improve TEP completion rates.
eP37 NO-LAP - A New Expansion within NELA
Authors: Barton George , Frith Dan , Koizia Louis , Hudson Murray
Published: January 2025

The National Emergency Laparotomy Audit (NELA), launched in 2013, has markedly improved outcomes for emergency abdominal surgeries in England and Wales by implementing systematic reviews, preoperative risk assessments, and geriatric evaluations. This approach has resulted in reduced 30-day mortality rates and shorter hospital stays for around 22,000 annual laparotomies.

In its latest expansion, NELA now includes the NO-LAP cohort—patients with acute abdominal conditions who do not undergo surgery. This group faces high mortality rates (63%-95%) due to advanced age, comorbidities, and frailty. The inclusion of NO-LAP aims to fill critical gaps in understanding and managing these high-risk patients.

The addition of the NO-LAP cohort will provide valuable insights into the factors influencing the decision not to operate and enhance understanding of non-surgical management strategies. This will inform new quality improvement initiatives and offer a clearer picture of patient outcomes in this vulnerable group.

This expansion is especially relevant given the ageing population and increasing prevalence of frailty. It also contributes to the education of junior surgeons, shaping future practices. NELA’s proactive approach underscores its commitment to adapting to evolving healthcare needs and improving patient outcomes.
eP40 Falciformopexy as an Alternative to Omentopexy in Perforated Peptic Ulcer Repair: A Systematic Review and Meta-analysis
Authors: Abosheisha Mohamed Dorgham , Shalaby Amr , Zarad Islam , Nasr Elmoatazbellah , Abdelsalam Mohamed
Published: January 2025

Aim

Peptic ulcer disease, characterised by defects in the gastric or duodenal mucosa, frequently leads to complications including perforation. The Graham repair using omental patch is the gold standard surgical intervention, but the falciform ligament patch repair serves as an alternative when the omentum is inadequate. This systematic review and meta-analysis aim to compare the efficacy and safety of omentopexy and falciformopexy in patients with perforated peptic ulcers.

Methods

Following PRISMA guidelines, a comprehensive search across four databases (Web of Science, PubMed, Scopus, and Cochrane Library) was conducted up to July 5th, 2024. Eligible studies included adult patients undergoing surgical repair for perforated peptic ulcer disease comparing omentopexy with falciformopexy. Data extraction and quality assessment were performed by two independent reviewers. Meta-analyses were conducted using Review Manager (RevMan) software.

Results

Out of 58 identified articles, three retrospective cohort studies comprising 1089 patients met the inclusion criteria. Omentopexy was performed in 960 patients and falciformopexy in 129 patients. Baseline characteristics were comparable. Falciformopexy showed a shorter duration of surgery and hospital stay but had a significantly higher risk of leakage and post-operative ileus. No significant difference in mortality and other complications was found. Heterogeneity was noted in some outcomes, necessitating further research.

Conclusion

Both omentopexy and falciformopexy are viable for managing perforated peptic ulcers with comparable safety and efficacy. Further high-quality, prospective studies are necessary to clarify the relative benefits of each method.
eP55 Nela Compliance in A District General Hospital: A Clinical Re-Audit
Authors: Unadike Chinedu , Itoko Tamaraebi , Aweke Gelila , Rutter Peter
Published: January 2025

Background and Aim

The National Emergency Laparotomy Audit (NELA) is a national clinical audit, commissioned by the Health Quality Improvement Partnership (HQIP), under the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NELA aims to enhance the quality of care for patients undergoing emergency laparotomies by providing high-quality comparative data from care providers.

The aim of this re-audit is to assess compliance with NELA data entry by the trust, compare the results with the first audit cycle post-intervention and to ensure continuous trust compliance.

Methods

A re-audit was conducted using electronic data from emergency laparotomies performed between June and September 2024. All emergency laparotomies performed within this period were included, while non-emergency laparotomies and those outside the timeframe were excluded. The re-audit compared data from an initial audit cycle (which assessed data collection over a year), identifying compliance rates for data entry into the NELA database.

Results

In the initial audit, 111 laparotomies were performed, with 66% (n = 73) entered into the NELA database, while 34% (n = 38) were not. This re-audit revealed an increase in compliance, with 71% (n = 10) of 14 laparotomies entered, and 28% (n = 4) not entered.

Conclusion

The re-audit showed an improvement in compliance. Key interventions such as incorporating surgical registrars into the NELA team, redesigning the theatre booking form, and ensuring continuity of team roles during doctors' inductions were effective in boosting data entry rates. Continuous audits and improvements will help ensure sustained compliance and improved patient outcomes.
eP77 What does it take to drain an abscess?: A quality improvement project to optimise the Incision and Drainage pathway for simple abscesses at Homerton Hospital
Authors: Denfhy Jonathan , Karimi Roham , Hari Tushar
Published: January 2025

Background

A quality improvement project (QIP) with the goal of enhancing the efficiency of the next-day SDEC incision and drainage (I&D) pathway by characterising and improving the surgical team’s effect on wait times, cancellations and related documentation.

Methods

Pre-intervention data was collected retrospectively using the hospital record system and then following intervention for a further two weeks.

The intervention consisted of sending a departmental email outlining the pre-intervention data as well as clarifying the I&D pathway. To accompany this a proforma was developed to aid documentation, pre-op planning and patient communication.

Results

Pre-intervention data showed that 29% of next-day I&Ds were cancelled, with an average wait time of 16 hours from admission to theatre, with one patient waiting 72 hours. Additionally, 33% of patients were not booked or consented the day before admission.

Post-intervention, 86.5% of patients were booked and consented the day before, cancellations dropped to 12.5%, and mean wait time decreased to 11.2 hours.

Conclusions

While there was a reduction in wait times and cancellations, the improvements did not clearly relate to proforma use and may have been attributable to the email and department-wide clarification of the existing I&D pathway. Going forward there is further scope to improve surgical team efficiency but a broader focus with the inclusion of the theatre team would be useful in building on these gains as it seems there is a limit to the influence that surgical team practice can have on reducing delays and cancellations in this context.
eP84 The good, the bad, and the ugly - use of a care bundle reduces surgical site infection after all grades of contaminated emergency laparotomy
Authors: Williams Ruby , Brewster Oliver , Swain Cara , Thornton James , Pullyblank Anne
Published: January 2025

Aim

The following care-bundle has halved surgical site infection (SSI) after elective colorectal surgery from 20% to 10%.2% chlorhexidine skin preparationSecond dose of antibiotics after 4 hoursDual-ring wound protectorAntibacterial sutures for deep closure and skin

The bundle was adapted for emergency laparotomy and two elements added:Glove changeBetadine wound wash

Overall, SSI rates were reduced. However, this analysis will assess whether the bundle is effective at all levels of intra-operative contamination.

Methods

30-day patient reported SSI was measured using the Health Security Agency questionnaire with a response rate of 71%. For 25% of patients with a length of stay >30 days, SSI was measured by in-hospital surveillance. Data was collected for 178consecutive patients before, and 604 patients after intervention. Patients who had trauma, enterocutaneous fistulae, death before 30 daysor who never had skin closure were excluded. Contamination code assigned using OPCS guidelines.Infection rates were compared pre and post intervention across clean, clean contaminated and dirty surgeries. Chi2 test was used to test significance at p<0.05.

Results

  Pre-intervention Post-intervention Classification SSI No SSI Infection % SSI No SSI Infection % p= Clean 3 10 23% 7 54 11.5% 0.266609 Clean-contaminated 17 47 26.5% 18 105 14.6% 0.047232 Dirty 17 14 55% 15 68 18% 0.000101 Overall 37 71 34% 40 227 15% 0.000029

Conclusion

This bundle is associated with a significant reduction in SSI across all degrees of contaminated emergency laparotomy. This was most effective in dirty cases.
eP112 "Beyond Age: Unveiling the Real Drivers of Complications in Emergency Laparotomy"
Authors: Shaikh Amarah Ghani , Sultan Tabinda , Khalifa Khali
Published: January 2025

Background

The aging population presents unique challenges in healthcare, particularly concerning surgical outcomes and associated risk factors. This retrospective study aims to compare outcomes after Emergency laparotomies in geriatric versus non-geriatric populations, highlighting the specific risk factors that influence these outcomes.

Methods

We analysed data from 40 patients who underwent Emergency Laparotomies between November 2023 to February 2024. Patients were categorized into geriatric (aged 65 and older) and non-geriatric groups. Key outcomes measured included complication rates, length of hospital stay, and mortality rates.

Results

Our findings indicate in general 30% of patients (12/40) were below 65 years of age, rest were above 65 years of age. Geriatric patients experienced significantly higher complication rates including wound infection, ileus, intra-abdominal collection, as well as medical complications like development of pneumonia and catheter associated infection and longer hospital stays compared to their non-geriatric counterparts which is obvious but that is because a greater population of patients undergoing emergency laparotomies are above 65 years of age. More-over it was noted that more than age, type of primary pathology like level of perforation/obstruction, severity of sepsis and type of surgery played more significant role in recovery and complication rates.

Conclusion

The study highlights differences in outcomes between geriatric and non-geriatric populations undergoing emergency laparotomy with primary pathology and type of surgery playing more important role in post-operative complications and delay recovery rather than age alone.