bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi Jet Fusion printed lattice materials: characterization and prediction of mechanical performance
Authors: Chen Andrew Yen-Jong , Chen Ailin , Fitzhugh Andrew , Hartman Aja , Kaiser Pierre , Nwaogwugwu Ihuoma , Zeng Jun , Gu Grace X.
Published: January 2023

Multi Jet Fusion (MJF) is a 3D-printing process capable of fabricating large-scale polymer structures. Herein, we present a framework for MJF-printed lattices with tunable stiffness and strength based on an empirical analysis of structural behavior.
Enhanced detoxification of Cr6+ by Shewanella oneidensis via adsorption on spherical and flower-like manganese ferrite nanostructures
Authors: Raie Diana S. , Tsonas Ioannis , Canales Melisa , Mourdikoudis Stefanos , Simeonidis Konstantinos , Makridis Antonis , Karfaridis Dimitrios , Ali Shanom , Vourlias Georgios , Wilson Peter , Bozec Laurent , Ciric Lena , Kim Thanh Nguyen Thi
Published: January 2023

An enhancement strategy for the bio-reduction of Cr6+ in the presence of manganese ferrite nanostructures using Shewanella oneidensis.
Indirect bandgap MoSe2 resonators for light-emitting nanophotonics
Authors: Borodin Bogdan R. , Benimetskiy Fedor A. , Davydov Valery Yu. , Eliseyev Ilya A. , Smirnov Alexander N. , Pidgayko Dmitry A. , Lepeshov Sergey I. , Bogdanov Andrey A. , Alekseev Prokhor A.
Published: January 2023

Whispering-gallery-mode disk optical nanocavities with an enhancement factor up to 100 can be fabricated from bulk transition metal dichalcogenides having an indirect bandgap using scanning probe lithography.
Interplay of the mechanical and structural properties of DNA nanostructures determines their electrostatic interactions with lipid membranes
Authors: Morzy Diana , Tekin Cem , Caroprese Vincenzo , Rubio-Sánchez Roger , Di Michele Lorenzo , Bastings Maartje M. C.
Published: January 2023

Nucleic acids and lipids function in close proximity in biological processes, as well as in nanoengineered constructs for therapeutic applications.
A label-free electrochemical immunosensor based on Au-BSN-rGO for highly-sensitive detection of β-amyloid 1–42
Authors: Li Mengjiao , Yu Qingjie , Zheng Meie , Jiang Rongrong , Zhu Hongda , Guo Huiling , Sun Hongmei , Liu Mingxing
Published: January 2023

In this study, a label-free electrochemical immunosensor with high sensitivity for the detection of Aβ 1–42 was constructed based on Au-BSN-rGO. It has the advantages of low detection limits, high sensitivity and a wide linear range.
Visible and infrared photodiode based on γ-InSe/Ge van der Waals heterojunction for polarized detection and imaging
Authors: Yang Baoxiang , Gao Wei , Li Hengyi , Gao Peng , Yang Mengmeng , Pan Yuan , Wang Chuanglei , Yang Yani , Huo Nengjie , Zheng Zhaoqiang , Li Jingbo
Published: January 2023

High-performance visible and near-infrared photodetection and single-pixel imaging can be achieved by our γ-InSe/Ge photodiode at zero bias. Meanwhile, a maximum polarization sensitivity of 3.01 is obtained under 635 nm among the broadband spectrum.
The first observation of 3,1-benzoxazine polymerization for developing high performance thermosets
Authors: Zhang Lei , Liang Yujie , Xu Jiazhu , Zheng Hong , Sun Wenjie , Cheng Yonghong
Published: January 2023

This is the first report on polymerizable 3,1-benzoxazine, providing a new type of resin for preparing high performance thermosets.
A facile method based on a superabsorbent polymer composite for concentration and separation of exosomes from cell culture media
Authors: Li Wei , Li Jianna , Xie Yuanting , Tan Yan , Wang Huili , Su Lei , Zhang Xueji
Published: January 2023

A method using superabsorbent polymers of alginate and poly(acrylamide-co-acrylic acid) composites for concentration and purification of exosomes from cell culture media is reported, and it is efficient, facile and equipment-free.
An organelle-specific photoactivation and dual-isotope labeling strategy reveals phosphatidylethanolamine metabolic flux
Authors: Simon Clémence , Asaro Antonino , Feng Suihan , Riezman Howard
Published: January 2023

Organelle-targeting, photocaged, isotopically labeled analogs of phosphatidylethanolamine are developed to track how cells metabolize PE lipids that originate from the ERversusthe mitochondria.
Enabling a rapid SnO2 chemical bath deposition process for perovskite solar cells
Authors: Tay Darrell Jun Jie , Febriansyah Benny , Salim Teddy , Wong Zi Sheng , Dewi Herlina Arianita , Koh Teck Ming , Mathews Nripan
Published: January 2023

Ultrasonication during the chemical bath deposition of SnO2 produces films with better homogeneity for electron-transport layers in perovskite solar cells.
Effects of the diphenyl ether additive in halogen-free processed non-fullerene acceptor organic solar cells
Authors: Di Mario Lorenzo , Garcia Romero David , Pieters Meike J. , Eller Fabian , Zhu Chenhui , Bongiovanni Giovanni , Herzig Eva M. , Mura Andrea , Loi Maria A.
Published: January 2023

Using diphenyl ether as additive in an environmentally friendly fabrication process for non-fullerene acceptor organic solar cells, the nanostructure of the active layer can be fine-tuned to improve efficiency and stability of the devices.
HDAC6, une désacétylase très spécifique porteuse d’espoir thérapeutique
Authors: Osseni Alexis , Schaeffer Laurent
Published: January 2023

L’histone désacétylase 6 (HDAC6) est envisagée aujourd’hui comme une cible thérapeutique de choix dans le traitement de nombreuses maladies. L’expression de HDAC6 est fortement augmentée dans un ensemble varié de maladies. Depuis une dizaine d’années, une pléiade de nouveaux inhibiteurs sélectifs de l’activité de HDAC6 ont été synthétisés et caractérisés. De nombreuses études ont démontré l’efficacité et les effets bénéfiques des inhibiteurs de HDAC6 dans différents cancers, maladies neurodégénératives ou inflammatoires, ainsi que dans diverses maladies neuromusculaires. Tous les mécanismes d’actions de HDAC6 expliquant l’effet de son inhibition dans les pathologies ne sont pas encore connus. Nous avons récemment montré que HDAC6, via la régulation du réseau de microtubules, joue un rôle au niveau des jonctions neuromusculaires en contrôlant l’acheminement des récepteurs de l’acétylcholine.
Les agrégats nucléaires dans la dystrophie musculaire oculopharyngée
Authors: Boulinguiez Alexis , Roth Fany , Mouigni Hadidja Rose , Butler-Browne Gillian , Mouly Vincent , Trollet Capucine
Published: January 2023

La dystrophie musculaire oculopharyngée est une des maladies en rapport avec des expansions pathologiques de triplets nucléotidiques. Sa physiopathologie est encore imparfaitement connue même si la présence d’agrégats au niveau des noyaux de la fibre musculaire semble jouer un rôle déterminant. Les travaux fondamentaux présentés ici permettent de mieux comprendre leur composition et leur rôle délétère. Autant d’éléments qui pourraient déboucher sur des voies thérapeutiques nouvelles.
La deuxième École Balte de Neuromyologie
Authors: Andoni Urtizberea J. , Malfatti Edoardo , Carlier Pierre G.
Published: January 2023

La deuxième édition de l’École Balte de Neuromyologie s’est tenue du 26 au 27 août 2022 à Riga (Lettonie) dans une ambiance un peu particulière étant donné la situation internationale. Ce fut l’occasion pour les auteurs de mesurer le chemin parcouru par leurs homologues baltes tant dans le domaine du diagnostic que celui de la prise en charge des maladies neuromusculaires. Cette entreprise difficile mais couronnée de succès a conduit à l’intégration de trois centres de référence neuromusculaire baltes au sein de l’ERN (réseau européen des maladies rares) Euro-NMD. Au-delà de cette forme de consécration, et même si beaucoup reste à faire, au niveau de l’histopathologie musculaire notamment, les différentes équipes baltes ont présenté des travaux de recherche clinique tout à fait remarquables et utiles à l’ensemble de la communauté myologique.
A Review of Coronavirus Disease 2019 in Pregnancy
Authors: Zamparini Jarrod , Saggers Robin , Buga Chandia Edward
Published: January 2023

Pregnancy is an independent risk factor for morbidity and mortality in coronavirus disease 2019 (COVID-19) with increased rates of operative delivery, intensive care unit admission, and mechanical ventilation as well as a possible increased risk of death, independent of other risk factors, compared with nonpregnant women with COVID-19. Furthermore, pregnancy outcomes are worse in those with COVID-19 with increased risk for preeclampsia, venous thromboembolism, preterm birth, miscarriage, and stillbirth compared with pregnant women without COVID-19. Importantly, pregnant women of nonwhite ethnicity appear to be at greater risk of severe COVID-19, necessitating improved access to care and closer monitoring in these women. The management of COVID-19 in pregnancy is largely similar to that in nonpregnant people; however, there is an important emphasis on multidisciplinary team involvement to ensure favorable outcomes in both mother and baby. Similarly, vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is safe in pregnancy and improves maternal and neonatal outcomes.
Characterization of Polyvinyl Alcohol–Collagen–Hydroxyapatite Composite Membrane from
Lates calcarifer
Scales for Guided Tissue and Bone Regeneration
Authors: Ariesanti Yessy , Octavianus Putri Graesya Melani , Handayani Annisa Tri , Abbas Basril
Published: January 2023

Objective To determine the chemical structure, tensile strength, porosity, and degradability of polyvinyl alcohol (PVA)–collagen–hydroxyapatite (HA) composite membranes for guided tissue and bone regeneration.

Materials and Methods The PVA–collagen–HA composite membrane was divided into three groups: the group without irradiation, the group with 15 kGy irradiation, and 25 kGy irradiation. Each group was tested for chemical structure with Fourier-transform infrared (FT-IR) at a wavelength of 400 to 4,000 cm−1. Tensile strength test was tested in dry and wet conditions with the standard method of American Standard Testing Mechanical (ASTM) D638, and porosity using scanning electron microscope and analyzed using ImageJ software. Degradability test immersed in a solution of phosphate-buffered saline. Data were analyzed using analysis of variance (ANOVA) and Tukey's test.

Results FT-IR test before and after storage for 30 days on three media showed a stable chemical structure with the same functional groups. ANOVA analysis showed a significant difference (p < 0.05) in the dry condition (p = 0.006), Tukey's test showed a significant difference in the 15 kGy and 25 kGy irradiated groups (p = 0.005), but the groups without irradiation had no significant difference with the 15 kGy (p = 0.285) and 25 kGy (p = 0.079) irradiation groups. In wet conditions, there was no significant difference (p > 0.05) in each group (p = 373). The size of the porosity in the group without irradiation, 15 kGy irradiation, and 25 kGy irradiation showed a size of 4.65, 6.51, and 8.08 m, respectively. The degradability test showed a decrease in weight in each group, with the total weight of the membrane being completely degraded from the most degraded to the least: the groups without irradiation, 15 kGy irradiation, and 25 kGy irradiation. The ANOVA test on the degradability test shows significant (p < 0.05) in the PVA–collagen–HA composite membrane group over time intervals (p = 0.000). Tukey's post hoc test showed a significant difference (p < 0.05) after 1 week between the groups without irradiation with 15 kGy (p = 0.023).

Conclusion PVA–collagen–HA composite membrane has a stable chemical structure, optimal tensile strength, porosity, and ideal degradability as guided bone regeneration and guided tissue regeneration.
Informal work, informal mobilisation? The lateral paths of health volunteers in Senegal
Authors: Diallo Abdoulaye Moussa
Published: January 2023

Community health workers (CHWs) are neither a profession nor a volunteer group, but a hybrid professional group, receiving modest allowances that vary according to the reference authority (states or non-governmental organisations). Their identities are manifold, depending on whether their work brings them closer to the hospital, the population, or the municipality. Sometimes loyalist, sometimes rebel, CHWs oscillate between municipal clientelism (to gain access to employment) and illegal practices (surreptitiously selling medicines or even conducting clandestine abortions). It is such empowerment and professional frustration that justifies their organisation to preserve their activity. It goes from the creation of associations to negotiate with public authorities, via more radical mobilisations in parallel, up to protest, boycotts of health campaigns, or sit-ins for improved status.
Validation of gas flow experiments for porous media by means of computer simulations
Authors: Laddha Sunny , Macher Wolfgang , Kargl Günter , Zivithal Stephan , Blum Jürgen , Gundlach Bastian , Güttler Carsten , Sierks Holger , Rose Martin
Published: January 2023

A profound understanding of gas flow in porous media is of great interest for various technological and scientific fields. Its investigation by laboratory measurements, however, poses several challenges. In particular, the determination of macroscopic flow parameters from pressure and gas flow measurements is prone to various error influences, some of which are very difficult to analyze experimentally. Computer simulations are a solution in this context as they facilitate modifications of the underlying geometry and boundary conditions in a flexible way. Here we present a simulation framework for the analysis of a recent experiment for determining the Knudsen diffusion coefficient and viscous permeability of various porous granular materials. By combining the finite element method with analytical models and other numerical methods, we were able to identify previously neglected physical effects that increase the uncertainty of the measurements. In particular, the porosity increase due to finite sample dimensions, in a layer of about a grain diameter thickness near the container wall, creates a deviation of the measured pressure gradient. This deviation amounts to ca. 5% for a sample width of about 100 grains and a porosity of 0.5, and is indirectly proportional to the porosity. The second most prominent error source, the sample support sieve, causes a slight constriction of the flow volume. Simulations of this effect show an error around 4%–7%, dependent on the grain size. Based on these findings we recommend an overall sample dimension of 100 grains or larger. As an example of failures of the sample homogeneity, we elaborate how channels through the sample influence the flow properties. Respective suggestions for keeping all discussed effects negligible are discussed in detail. Our methodology demonstrates how the combination of finite element computations with analytical representations of the involved macroscopic parameters can assess the validity and accuracy of laboratory experiments.
Three-dimensional force detection using PVDF and room temperature-vulcanized silicone rubber layers
Authors: Wang Zhihua , Zhang Duanshuai , Yang Li , An Jinlong
Published: January 2023

Three-dimensional force perception plays an extremely important role in human-computer interaction. The main objective of the present study is to propose a three-dimensional force detection sensor using room temperature-vulcanized silicone rubber, polyvinylidene fluoride (PVDF), and a silver coating layer. The sensor was designed in a cylindrical structure to detect the tangential force. The performed analyses reveal that the silver coating layer improves the surface charge output of the PVDF film. The output peak voltage of the sensing unit is 271.7% higher than that of the single PVDF film. The sensor has a response time of 40 ms. It is found that the angle detection error of the sensor along horizontal and vertical directions is less than 2.79° and 0.88°, respectively. In order to evaluate the performance of the proposed sensor, it is fixed on the mechanical hand to perform grasping and sliding tests. The tested results show that the proposed sensor can effectively identify the weight and slip of the object, and can be used in the field of manipulator clamping control.
Structure of pressure-gradient-driven current singularity in ideal magnetohydrodynamic equilibrium
Authors: Huang Yi-Min , Zhou Yao , Loizu Joaquim , Hudson Stuart , Bhattacharjee Amitava
Published: January 2023

Singular currents typically appear on rational surfaces in non-axisymmetric ideal magnetohydrodynamic (MHD) equilibria with a continuum of nested flux surfaces and a continuous rotational transition. These currents have two components: a surface current (Dirac δ-function in flux surface labeling) that prevents the formation of magnetic islands, and an algebraically divergent Pfirsch–Schlüter current density when a pressure gradient is present across the rational surface. On flux surfaces adjacent to the rational surface, the traditional treatment gives the Pfirsch–Schlüter current density scaling as

J
∼
1

/

Δ
ι

, where

Δ
ι

is the difference of the rotational transform relative to the rational surface. If the distance s between flux surfaces is proportional to

Δ
ι

, the scaling relation

J
∼
1

/

Δ
ι
∼
1

/

s

will lead to a paradox that the Pfirsch–Schlüter current is not integrable. In this work, we investigate this issue by considering the pressure-gradient-driven singular current in the Hahm–Kulsrud–Taylor problem, which is a prototype for singular currents arising from resonant magnetic perturbations. We show that not only the Pfirsch–Schlüter current density but also the diamagnetic current density are divergent as

∼

1

/

Δ
ι

. However, due to the formation of a Dirac δ-function current sheet at the rational surface, the neighboring flux surfaces are strongly packed with

s
∼
(
Δ
ι

)

2

. Consequently, the singular current density

J
∼
1

/

s

, making the total current finite, thus resolving the paradox. Furthermore, the strong packing of flux surfaces causes a steepening of the pressure gradient near the rational surface, with

∇
p
∼

d

p

/

d

s
∼
1

/

s

. In general non-axisymmetric MHD equilibrium, contrary to Grad’s conjecture that the pressure profile is flat around densely distributed rational surfaces, our result suggests a pressure profile that densely steepens around them.
Binding energy produced within the framework of the accretion of millisecond pulsars
Authors: Taani Ali
Published: January 2023

The role and implication of binding energy through the accretion-induced collapse (AIC) of accreting white dwarfs (WDs) for the production of millisecond pulsars (MSPs) are investigated. The binding energy model is examined due to the dynamic process in closed binary systems, and the possible mass of the companion sufficient to induce their orbital parameters is investigated. The deterministic nature of this interaction has a strong sensitivity to the equation of state of the binary systems (where the compactness of a neutron star is proportional to the amount of binding energy) associated with their initial conditions. This behavior mimics the commonly assumed mass and amount of accreted matter under the instantaneous mass loss (

). As a result, this indicates an increase in the MSP's gravitational mass due to angular momentum losses. The outcome of such a system is then a circular binary MSP in which the companion is a low-mass WD, thus distinguishing the binary formation scenarios. In addition, the results of this work could provide constraints on the expected mass and binding energy of a neutron star based on the accretion rate.
Additive manufacturing and performance of bioceramic scaffolds with different hollow strut geometries
Authors: Pang Shumin , Wu Dongwei , Gurlo Aleksander , Kurreck Jens , Hanaor Dorian A H
Published: January 2023

Additively manufactured hollow-strut bioceramic scaffolds present a promising strategy towards enhanced performance in patient-tailored bone tissue engineering. The channels in such scaffolds offer pathways for nutrient and cell transport and facilitate effective osseointegration and vascularization. In this study, we report an approach for the slurry based additive manufacturing of modified diopside bioceramics that enables the production of hollow-strut scaffolds with diverse cross-sectional forms, distinguished by different configurations of channel and strut geometries. The prepared scaffolds exhibit levels of porosity and mechanical strength that are well suited for osteoporotic bone repair. Mechanical characterization in orthogonal orientations revealed that a square outer cross-section for hollow struts in woodpile scaffolds gives rise to levels of compressive strength that are higher than those of conventional solid cylindrical strut scaffolds despite a significantly lower density. Finite element analysis confirms that this improved strength arises from lower stress concentration in such geometries. It was shown that hollow struts in bioceramic scaffolds dramatically increase cell attachment and proliferation, potentially promoting new bone tissue formation within the scaffold channel. This work provides an easily controlled method for the extrusion-based 3D printing of hollow strut scaffolds. We show here how the production of hollow struts with controllable geometry can serve to enhance both the functional and mechanical performance of porous structures, with particular relevance for bone tissue engineering scaffolds.
Effect of laser texturing bulges on tribological properties of 316L stainless steel
Authors: Li Wen-Xuan , Liu Yan , Duan Hai-Tao , Wang Yi-Han , Zhan Sheng-Peng , Zhang Wu-Lin , Yang Tian , Li Guo-Zheng , Dan Jia
Published: January 2023

The laser surface texture process will inevitably produce the edge of material surface texture bulges. Currently, laser processing bulges are generally polished directly, but this method ignores its impact on the friction pairs. In this paper, the tribological properties of polished and unpolished textured surfaces were investigated under dry friction, oil lubrication, and seawater lubrication conditions using three shapes of texture (grooves, square pits, and round pits) prepared on the surface of 316L stainless steel. The results show that the polished surface of 316L stainless steel texture increases wears, and the friction mechanism is mainly adhesive wear, while the unpolished surface of the texture has less wear, and the friction mechanism is mainly abrasive wear. The method and principle of using machining bulges to improve the wear resistance of friction pairs are discussed to address the differences in the tribological performance of entire friction pairs due to the influence of machining bulges of different shapes of texture.
An overview on plasma-assisted thermochemical treatments of martensitic stainless steels
*
Authors: Scheuer Cristiano José , Cardoso Rodrigo Perito , Brunatto Silvio Francisco
Published: January 2023

Demand for higher wear and corrosion resistance components has attracted increasing interest in surface engineering. This line of research develops alternative processes for improving the surface properties of engineering materials. The traditional route seeks the development of new alloys. However, the cost and time associated with these developments become prohibitive in many cases. Currently, the application of plasma-assisted thermochemical treatments has been a technically and economically viable alternative to extend the lifespan of components exposed to severe environments. In this sense, the tooling industry is one of the oldest and most traditional users of plasma-assisted processes, since forming, injection and/or cutting tools are usually subjected to wear and corrosion degradation. Among the various materials used to make tools, we highlight the martensitic stainless steels, which are used in the manufacture of molds and inserts for injection of chlorinated and fluorinated thermoplastic and thermoset polymers. In these applications, martensitic stainless steels are exposed to severe deterioration conditions due to abrasive wear and corrosion by chloride and fluoride ions. Considering the variety of available plasma-assisted thermochemical treatments whose application allows improving metallic materials corrosion and wear resistance, it is a complex task to select the better process and its execution parameters to ensure the maximum performance in operation. In this work, it is proposed a systematic method to aid the process selection task, focused on thermochemical treatments of martensitic stainless steels, which integrates the processing conditions and the resulting microstructure, properties and performance. For this purpose, working envelop for selecting processes and processing parameters were elaborated, that allow qualify and quantify the correlations among each specific plasma-assisted thermochemical treatment (like nitriding, carburizing, nitrocarburizing, etc.) execution conditions, with the resulting properties and performance for treated martensitic stainless steels. In parallel, the genesis of plasma-assisted thermochemical treatments is also described, a bibliometric analysis is carried out on the publications on the subject, and also, a summary description of the surface characteristics of the treated materials is realized.
A combination of experimental and numerical method for optimizing the sensitivity of ultra-thin piezoelectric sensor with interdigitated electrodes
Authors: Laurila Mika-Matti , Montero Karem Lozano , Mäntysalo Matti
Published: January 2023

We report the development of a finite element model (FE-model) for ultra-thin piezoelectric poly(vinylidene-trifluoroethylene) sensor with interdigitated electrodes (IDE) which includes the effect of a non-homogenous poling field determined via the combination of experimental and numerical methods. The non-homogenous poling magnitude is estimated by comparing the remanent polarization (P
r) of IDE based device to the P
r of the same material in metal–insulator–metal electrode configuration. The non-homogenous poling orientation is estimated by comparing the experimentally determined normal mode sensitivity (S
n) values to FE-modelled sensitivity values with different poling orientation distributions. The poling orientation distribution is modelled using two approaches: (a) 33-direction parallel and perpendicular to the electrode plane and (b) 33-direction defined by an average angle. The first approach yields the best correspondence with the experimental results (R
2 = 94.70% and σ = 0.10 pC N−1) and it is used to optimize the device geometry and poling condition for maximum S
n.
1242 CO-MORBIDITY, FRAILTY AND EJECTION FRACTION IN OLDER HEART FAILURE INPATIENTS
Authors: Shah G , Nehikhare I , Obiechina N , Michael A , Gill A , Carey P , Khan R , Slavica M , Khan T , Rahman S , Mushtaq W , Brar H , Senthilselvan S , Mukherjee M , Nandi A
Published: January 2023

Introduction

Co-morbidities and frailty are common in older heart failure patients. The aim of this study is to explore the relationship between co-morbidity, frailty and ejection fraction (EF) in older heart failure inpatients

Methods

A cross-sectional, observational, retrospective analysis of consecutive patients aged 60 years and over who were admitted with heart failure in a UK hospital. Patients with incomplete data were excluded. The Carlson’s comorbidity index (CCI) was used to compute comorbidity and the Rockwood Clinical Frailty Scale (CFS) was used to measure frailty. The EF was calculated as the midpoint of the ranges measured by echocardiography. IBM SPSS 28 software was used for statistical analysis. Descriptive statistics were used to measure baseline characteristics and Pearson’s correlation coefficient and linear regression were used to calculate correlation.

Results and discussion

101 patients were analysed; 48 males and 53 females. Mean age was 81.2 years(SD 9.98). Mean CCI was 6.97(SD 1.63) and mean CFS was 5.09(SD 1.14). There was statistically significant positive correlation between CCI and CFS (r= 0.232; p= .01). There was statistically significant inverse correlation between CCI and EF (r= -.277; p=. 005). When taking into account the level of frailty the correlation between CCI and EF was much stronger in non-frail than in frail patients (r= -.612; p=. 035 and r= -.216; p= .047 respectively). There was no correlation between CFS and EF (r= .095; p=.26). This was not surprising as HFpEF is the most common type of HF in the elderly. HFpEF patients are more likely to have more comorbidities and to be more frail compared to HFrEF patients.

Conclusion

There was a positive correlation between multi-morbidity and frailty in older inpatients admitted with heart failure. There was statistically significant inverse correlation between CCI and ejection fraction but there was no correlation between frailty and ejection.
1299 CO-CREATING A VIDEO FOR TRAINING HEALTHCARE PROFESSIONALS IN DEMENTIA
Authors: Madkor O , Gamal A , Gamal M , Refaat A , ElSayed R , Ali K
Published: January 2023

Introduction

There are 400 thousand people living with dementia (PLWD) in Egypt. Most of the care for PLWD is delivered by family members. Healthcare Professionals (HCP) supporting these families need adequate training. Involving HCP in designing and producing training material ensures sustainability of these educational resources as their content will be socially and culturally relevant.

Methods

The first part of the project involved the lead author (OM) meeting with two geriatricians to identify common challenging situations in dementia. A short video for training HCP in dementia using these situations was produced, based on OM lived experience, and then shared with two old-age psychiatrists for comments. Feedback on the video was subsequently obtained via semi-structured interviews with 16 HCP (2 doctors, 1 nurse, 1 dietitian, 1 communication therapist, 2 social workers, and 9 clinical psychologists) either in person (3), over the phone (1), or virtually (12) approached in two institutions for ageing in Cairo and Alexandria in 2021. The video was finally checked by an adult psychiatrist for consistency with non-violent communication approaches. All interviews were analysed using a thematic framework. Comments and feedback were used to co-produce a final version of the video.

Results

From the initial co-design phase, six frequently-encountered situations were identified: anger, low mood, wandering, repetitive behaviour, refusing support with activities of daily living, and sleep disturbance. Five key qualities for appropriate response in these situations were agreed on: kindness, sensitivity, compassion, avoiding confrontation, and shared-decision making in activities of daily living. The subsequent co-production phase with 19 HCP resulted in an 18-minute: 43-seconds simulation video of six challenging interactions between PLWD and their carers. The video is now freely available on YouTube, https://m.youtube.com/watch?v=ylINBXZwH8M&feature=youtu.be

Conclusions

Involving healthcare professionals in dementia in co-creating a video for training their peers led to a freely available online educational resource.
1311 FRAILTY IN RANDOMISED CONTROLLED TRIALS FOR DEMENTIA OR MILD COGNITIVE IMPAIRMENT
Authors: Wightman H , Quinn T , Mair F S , Lewsey J , McAllister D A , Hanlon P
Published: January 2023

Background

Frailty and dementia have a bidirectional relationship. However, frailty is rarely reported in clinical trials for dementia and mild cognitive impairment (MCI) which limits assessment of trial applicability. This study aims to use a frailty index (FI) to measure frailty using individual participant data (IPD) from clinical trials for MCI and dementia and to quality the prevalence of frailty and its association with serious adverse events (SAEs) and trial attrition.

Methods

We analysed IPD from three dementia (n=1) and MCI (n=2) trials. An FI comprising physical deficits was created for each trial using baseline IPD. Poisson and logistic regression were used to examine associations with SAEs and attrition, respectively. Estimates were pooled in random effects meta-analysis. Analyses were repeated using an FI incorporating cognitive as well as physical deficits, and results compared.

Results

The mean physical FI was 0.13 and 0.14 in the MCI trials and 0.25 in the dementia trial. Frailty prevalence (FI>0.24) was 5.1%, 5.4% in MCI trials and 55.6% in dementia. After including cognitive deficits, prevalence was similar in MCI (4.6% and 4.9%) but higher in dementia (80.7%). 99th percentile of FI (0.29 in MCI, 0.44 in dementia) was lower than in most general population studies. Frailty was associated with SAEs (physical FI IRR = 1.63 [1.43, 1.87]; physical/cognitive FI IRR = 1.67 [1.45, 1.93]). Frailty was not associated with trial attrition (physical FI OR = 1.18 [0.92, 1.53]; physical/cognitive FI OR = 1.17 [0.92, 1.49]).

Conclusion

Measuring frailty from IPD in dementia and MCI trials is feasible. Severe frailty may be under-represented. Frailty is associated with clinically significant outcomes. Including only physical deficits may underestimate frailty in dementia. Frailty can and should be measured in trials for dementia and MCI, and efforts should be made to facilitate inclusion of people living with frailty.
1310 FRAILTY, LONELINESS AND SOCIAL ISOLATION IN THE UK BIOBANK COHORT
Authors: Politis M , Crawford L , Jani B , Nicholl B , Lewsey J , McAllister D A , Mair F S , Hanlon P
Published: January 2023

Background

Three challenges for ageing populations are frailty (a state of reduced physiological reserve), social isolation (objective lack of social connections), and loneliness (subjective experience of feeling alone). These are associated with adverse outcomes. This study aims to examine how frailty in combination with loneliness or social isolation is associated with all-cause mortality and hospitalisation rate using data from UK Biobank, a large population-based research cohort.

Methods

502,456 UK Biobank participants were recruited 2006-2010. Baseline data assessed frailty (via two measures: Fried frailty phenotype, Rockwood frailty index), social isolation, and loneliness. Adjusted cox-proportional hazards models assessed association between frailty in combination with loneliness or social isolation and all-cause mortality. Negative binomial regression models assessed hospitalisation rate.

Findings

Frailty, social isolation, and loneliness are common in UK Biobank (frail as per frailty phenotype 3.38%, frail as per frailty index 4.68%, social isolation 9.04%, loneliness 4.75%). Social isolation/loneliness were more common in frailty/pre-frailty. Frailty is associated with increased mortality regardless of social isolation/loneliness. Hazard ratios for frailty (frailty phenotype) were 3.38 (3.11-3.67) with social isolation and 2.89 (2.75-3.05) without social isolation, 2.94 (2.64-3.27) with loneliness and 2.9 (2.76-3.04) without loneliness. Social isolation was associated with increased mortality at all levels of frailty; loneliness only in robust/pre-frail. Frailty was also associated with hospitalisation regardless of social isolation/loneliness. Incidence rate ratios for frailty (frailty phenotype) were 3.93 (3.66-4.23) with social isolation and 3.75 (3.6-3.9) without social isolation, 4.42 (4.04-4.83) with loneliness and 3.69 (3.55-3.83) without loneliness. At all levels frailty, social isolation/loneliness are associated with increased hospitalisation Results were similar using the frailty index definition.

Conclusion

Social isolation is relevant at all levels frailty. Risk of loneliness is more pronounced in those who are robust or pre-frail. Proactive identification of loneliness, regardless of physical health status may provide opportunities for intervention.
1174 THE ROLE OF HIP FRACTURE IN TRAJECTORIES OF DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS: ANALYSIS FROM THE ENGLISH LONGITUDINAL STUDY
Authors: Milton-Cole R , Ayis S , O'Connell M D L , Smith T , Sheehan K
Published: January 2023

Introduction

Older adults experience ‘Late life depression’. Hip fractures may negatively influence trajectories of depressive symptoms in older adults. This study aimed to determine trajectories of depressive symptoms among older adults in England, overall and for those after hip fracture, and identify characteristics defining trajectory membership.

Methods

Analysis of adults aged 60 years or more (n=7,050), including a hip fracture subgroup (n = 384), from the English Longitudinal Study of Ageing. Latent class growth mixture modelling was completed. Depressive symptom prevalence was estimated at baseline. Chi-squared tests were completed to compare baseline characteristics across trajectories.

Results

Three trajectory groups were identified overall and for those with hip fracture: no-, mild-, and moderate-severe- symptoms. The moderate-severe group comprised 13.7% and 7% of participants for overall and hip fracture populations respectively. Overall, the proportion of participants with depressive symptoms were 0.4%, 12.4% and 65.4% for no-, mild-, and moderate-severe- symptom groups, respectively. For the hip fracture subgroup, these proportions were 0.7%, 28.8%, and 85.2%. Depressive symptoms were stable over time, with a weak trend towards increasing severity for the moderate-severe group. Individuals with moderate-severe trajectories were older, more likely to be female, live alone and had worse health outcomes (p < 0.001).

Conclusions

Older adults, and those after hip fracture, follow one of three trajectories of depressive symptoms which are broadly stable over time. The prevalence of depressive symptoms was lower for those with hip fracture however, when present, the symptoms were more severe than the overall population. Results suggest a role of factors including age, gender, and marital status in depressive symptoms trajectories.
1272 A PILOT ROUTINE ELECTRONIC HEALTH RECORD FUNCTIONAL TRACKING SCORE FOR OLDER PATIENTS IN HOSPITAL
Authors: Zioupos L , Kirkpatrick J , Anand A
Published: January 2023

Introduction

Approximately one-third of older patients leave hospital with a new functional impairment. Tracking rehabilitation progress following acute illness could improve recognition and understanding of hospital-acquired disability. However, traditional mobility and functional scores include measures that are not part of routine rehabilitation therapy, adding a time burden for staff to report. Capturing data already recorded in routine electronic records could provide an efficient patient tracking measure of rehabilitation success.

Methods

A scoping literature review appraised existing scores of mobility and functional status. Analysis of 15 admissions through the Royal Infirmary of Edinburgh identified mobility and functional domains which were reliably recorded in free text electronic health records. A pilot score was drafted, comprising admission and discharge scores (0-30 points), medical progress (0-10), physiotherapy and occupational therapy tracking (0-30). Higher scores indicate greater functional independence. Expert feedback was obtained through focus group discussion with physiotherapists and occupational therapists. The approach was tested in a fresh set of six case studies. Two independent scorers applied the scoring schema and agreement was assessed using Cohen’s weighted-kappa coefficient.

Results

The selected electronic health records contained 438 medical, 352 nursing and 183 therapist entries. Existing measures such as the Barthel Index were not recorded for any patient. Focus group discussion identified value in the overall approach and informed item-weighting. The pilot functional score allowed visualisation of rehabilitation trajectories over the course of each admission. Excellent inter-rater reliability was demonstrated for the medical (Cohen’s Kappa 0.99, 95% confidence interval [CI] 0.96–1.00) and physiotherapy (Kappa 0.96, 95% CI 0.93–0.99) components.

Conclusions

A functional tracking score generated from routine health records proved feasible and reproducible in this pilot. Future development should assess validity, reliability and prognostic power in larger populations, exploring automation using natural language processing. Development of graphic visualisations may aid communication within multidisciplinary teams.
1296 DEMOGRAPHIC AND MORTALITY EVALUATION OF URGENT COMMUNITY RESPONSE REFERRALS THAT ARE MANAGED IN COMMUNITY VS THOSE HOSPITALISED
Authors: Tayler-Gray J , Patel M , Wigley A , McCall B , Gossage J
Published: January 2023

Introduction

Demographic evaluation of urgent community response teams [UCR] is important to ensure equity of access and clinical outcomes for patients from all socio-demographic groups using such services. This retrospective descriptive study aimed to evaluate demographic and mortality differences between patients referred to UCR in terms of those managed in the community [Group1] versus those subsequently hospitalised [Group2].

Methods

Data was obtained over a 12-month period [2021-2022] for all new patients referred to a 7-day consultant-led UCR that serves a multi-ethnic, inner-city population. Data included demographic details, source of referral, urgency of referral and mortality within 60 days.

Results

Of 995 patients, 75.6%[n=752] were in Group 1; 24.4%[243] were in Group 2. The two groups were comparable in terms of age [mean(SD): 80.1(12.6) vs 80.0(11.4), p=ns] and gender [males:39.4% vs 42.4%,p=ns]. There were similar proportion of Black and minority ethnic patients within the two groups [21.0% (158) vs 24.7% (60), p=ns]. Source of referral were comparable between the two groups[p=ns]; overall, 67.7%[674] were from GP practices, 5.6%[56] Community Practitioners, 4.7%[47] NHS111, 2.7%[27] Ambulance, 32%[32] Palliative care, 5.9%[59] Emergency department, 10.1%[100] post-hospitalisation. Compared to Group 1 [46.9% (353)], significantly more patients in Group 2 were referred for urgent assessment within 2 hours [65.4% (159), p<0.001]. More patients died in Group2 within 60 days [22.2% (54) vs 11.3% (85), p<0.001].

Discussion

This large survey has described age, gender and ethnic similarities between the two groups, demonstrating equity of provision irrespective of protected characteristics. As might be clinically expected, patients referred for hospitalisation were assessed more urgently and had higher mortality rates compared to those managed in the community. This study provides valuable information for clinicians and researchers of similar UCR services in future.
1302 THE VIEWS AND THE USE OF INFORMATION COMMUNICATION TECHNOLOGIES TO ACCESS DEMENTIA POST-DIAGNOSTIC SUPPORT: A SYSTEMATIC REVIEW
Authors: Caprioli T , Maceo S , Tetlow H , Reilly S , Giebel C
Published: January 2023

Introduction

Post-diagnostic support is key to ensuring the well-being of people with dementia and unpaid carers. The COVID-19 pandemic has caused a shift from in-person to remote service delivery, often with the use of information communication technologies (ICT) formats. This systematic review examined how ICT has been used to access remote post-diagnostic support services that address the needs people with dementia, or those of dyad, and explored care recipients’ views on accessing dementia-related support remotely.

Method

Concepts relating to dementia and ICT were searched across six databases (PsychInfo, PubMed, Cochrane Library, CINAHL, Social Care Online, and Web of Science) in March 2021 and updated in March 2022. Studies published from 1990 and written in English, German or French were considered for inclusion. Methodological quality was appraised using the Hawker quality assessment tool and reporting structured according to PRISMA guidelines.

Results

The search yielded 8,485 citations. Following the removal of duplicates and two screening processes, 18 papers were included. Papers described a range of post-diagnostic support, including exercise classes and therapeutic sessions, which were largely delivered remotely on a one-to-one basis. Videoconferencing software was the most employed ICT format, and people with dementia were directly engaging with ICT to access post-diagnostic support in 13 studies. Whilst studies demonstrated the feasibility of accessing post-diagnostic service remotely, overall, care recipients’ views were mixed.

Conclusions

Following the increased reliance on ICT during the pandemic, it is likely that service delivery will continue with a hybrid approach. Accessing post-diagnostic support remotely is likely to benefit some care recipients. However, to prevent widening inequalities in access, service provision is required to accommodate to people with dementia and unpaid carers who are digitally excluded. Future research should capture the support provided by unpaid carers facilitating the engagement of the person with dementia when accessing remote post-diagnostic support.
1350 “TO BE A DEMENTIA-FRIENDLY HOSPITAL, I THINK YOU NEED TO HAVE…” - THE PERSPECTIVES OF PROFESSIONAL DEMENTIA EXPERTS
Authors: Manietta C , Purwins D , Reinhard A , Pinkert C , Fink L , Feige M , Knecht C , Roes M
Published: January 2023

Introduction

Dementia-friendly hospitals (DFH) are mentioned as one of several key initiatives in national dementia strategies. In our previous integrative review, we identified 17 descriptions of DFHs and analysed six characteristics of DFH: continuity, person-centredness, consideration of phenomena within dementia, environment, valuing relatives and knowledge and expertise within the hospital (Manietta, Purwins, Reinhard et al., BMC Geriatrics, 2022, 22, 468, 1-16). We also learned that the term DFH is based more on healthcare practice than research. To address this research gap, one step of our DEMfriendlyHospital study is to examine the perspectives of professional dementia experts working in hospitals in Germany.

Method

We used a qualitative design and conducted 14 semi-structured interviews with professional dementia experts from various healthcare professions (12 nurses, two physicians, and one physiotherapist). Data were collected between November 2021 and March 2022. Using an inductive content analysis, we furthermore analysed the interviews in a participatory way involving a group of research associates and professional dementia experts.

Results

From the professional dementia experts’ perspectives, a DFH is characterised by specific hospital processes, structures and environment which consider the needs of people with dementia, dementia-specific knowledge and the skills of hospital staff, their awareness and attitude towards people with dementia. A DFH needs the social inclusion of patients with dementia and their perception as a person as well as the involvement of relatives, who are an important support for the patients and their care.

Conclusion

There are links between our results from interviews with professional dementia experts and our integrative review. At the same time, the perspectives of patients with dementia and their relatives are underrepresented. To fill this gap, our next step is to interview people with dementia who are hospitalised and their relatives, aiming to enhance the description of a DFH and its characteristics.