bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning to Search for Accreting Neutron Star Binary Candidates Using Chinese Space Station Telescope Photometric System
Authors: Lan Shun-Yi , Ji Kai-Fan , Meng Xiang-Cun
Published: November 2022

Accreting neutron star binary (ANSB) systems can provide some important information about neutron stars (NSs), especially on the structure and the equation of state of NSs. However, only a few ANSBs are known so far. The upcoming Chinese Space Station Telescope (CSST) provides an opportunity to search for a large number of ANSB candidates. We aim to investigate whether or not a machine learning method may efficiently search for ANSBs based on CSST photometric system. In this paper, we generate some ANSBs and normal binaries under CSST photometric system by binary evolution and binary population synthesis method and use a machine learning method to train a classification model. We consider the classical multi-color disk and the irradiated accretion disk, then compare their effects on the classification results. We find that no matter whether the X-ray reprocessing effect is included or not, the machine learning classification accuracy is always very high, i.e., higher than 96%. If a significant magnitude difference exists between the accretion disk and the companion of an ANSB, machine learning may not distinguish it from some normal stars such as massive main sequence stars, white dwarf binaries, etc. False classifications of the ANSBs and the normal stars highly overlap in a color–color diagram. Our results indicate that machine learning would be a powerful way to search for potential ANSB candidates from the CSST survey.
Transgenic Schwann cells overexpressing POU6F1 promote sciatic nerve regeneration within acellular nerve allografts
Authors: Li Wen-Yuan , Li Zhi-Gang , Fu Xiu-Mei , Wang Xiao-yu , Lv Zhong-xiao , Sun Ping , Zhu Xiao-Feng , Wang Ying
Published: November 2022

Objective. Acellular nerve allograft (ANA) is an effective surgical approach used to bridge the sciatic nerve gap. The molecular regulators of post-surgical recovery are not well-known. Here, we explored the effect of transgenic Schwann cells (SCs) overexpressing POU domain class 6, transcription factor 1 (POU6F1) on sciatic nerve regeneration within ANAs. We explored the functions of POU6F1 in nerve regeneration by using a cell model of H2O2-induced SCs injury and transplanting SCs overexpressing POU6F1 into ANA to repair sciatic nerve gaps. Approach. Using RNA-seq, Protein–Protein Interaction network analysis, gene ontology enrichment, and Kyoto Encyclopedia of Genes and Genomes pathway analysis, we identified a highly and differentially expressed transcription factor, POU6F1, following ANA treatment of sciatic nerve gap. Expressing a high degree of connectivity, POU6F1 was predicted to play a role in peripheral nervous system myelination. Main results. To test the role of POU6F1 in nerve regeneration after ANA, we infected SCs with adeno-associated virus—POU6F1, demonstrating that POU6F1 overexpression promotes proliferation, anti-apoptosis, and migration of SCs in vitro. We also found that POU6F1 significantly upregulated JNK1/2 and c-Jun phosphorylation and that selective JNK1/2 inhibition attenuated the effects of POU6F1 on proliferation, survival, migration, and JNK1/2 and c-Jun phosphorylation. The direct interaction of POU6F1 and activated JNK1/2 was subsequently confirmed by co-immunoprecipitation. In rat sciatic nerve injury model with a 10 mm gap, we confirmed the pattern of POU6F1 upregulation and co-localization with transplanted SCs. ANAs loaded with POU6F1-overexpressing SCs demonstrated the enhanced survival of transplanted SCs, axonal regeneration, myelination, and functional motor recovery compared to the ANA group loaded by SCs-only in line with in vitro findings. Significance. This study identifies POU6F1 as a novel regulator of post-injury sciatic nerve repair, acting through JNK/c-Jun signaling in SCs to optimize therapeutic outcomes in the ANA surgical approach.
Neuromodulation of brain power topography and network topology by prefrontal transcranial photobiomodulation
Authors: Shahdadian Sadra , Wang Xinlong , Wanniarachchi Hashini , Chaudhari Akhil , Truong Nghi Cong Dung , Liu Hanli
Published: November 2022

Objective. Transcranial photobiomodulation (tPBM) has shown promising benefits, including cognitive improvement, in healthy humans and in patients with Alzheimer’s disease. In this study, we aimed to identify key cortical regions that present significant changes caused by tPBM in the electroencephalogram (EEG) oscillation powers and functional connectivity in the healthy human brain. Approach. A 64-channel EEG was recorded from 45 healthy participants during a 13 min period consisting of a 2 min baseline, 8 min tPBM/sham intervention, and 3 min recovery. After pre-processing and normalizing the EEG data at the five EEG rhythms, cluster-based permutation tests were performed for multiple comparisons of spectral power topographies, followed by graph-theory analysis as a topological approach for quantification of brain connectivity metrics at global and nodal/cluster levels. Main results. EEG power enhancement was observed in clusters of channels over the frontoparietal regions in the alpha band and the centroparietal regions in the beta band. The global measures of the network revealed a reduction in synchronization, global efficiency, and small-worldness of beta band connectivity, implying an enhancement of brain network complexity. In addition, in the beta band, nodal graphical analysis demonstrated significant increases in local information integration and centrality over the frontal clusters, accompanied by a decrease in segregation over the bilateral frontal, left parietal, and left occipital regions. Significance. Frontal tPBM increased EEG alpha and beta powers in the frontal-central-parietal regions, enhanced the complexity of the global beta-wave brain network, and augmented local information flow and integration of beta oscillations across prefrontal cortical regions. This study sheds light on the potential link between electrophysiological effects and human cognitive improvement induced by tPBM.
A steady state vs pulsed fusion neutron science facility
Authors: Guazzotto L. , Freidberg J.P.
Published: November 2022

Two major modifications to the existing steady state fusion neutron science facility (FNSF) concept (Kessel et al 2018 Fusion Eng. Des. 135 236–70) are investigated with the aim of determining whether or not its predicted performance can be improved. The modifications are high magnetic field and pulsed operation. We find that high field leads to major economic improvements in a steady state FNSF, although at the expense of lowering the engineering gain. Pulsed operation replaces the problems associated with low current drive efficiency, with hopefully more manageable engineering problems. Here, however, high toroidal field (TF) is not helpful, and a lower TF field is more desirable economically. Pulsed FNSFs also have a reduced engineering gain. Further modifications lead to FNSF designs satisfying the additional constraint of engineering gain equal to unity. For these designs there is a large cost penalty for the steady state FNSF but only a modest penalty for the pulsed FNSF. All of our modified designs show modest to large potential economic improvements over the existing design. Overall, our conclusion is that it may be desirable to carry out a more detailed analysis of one of our improved designs, the choice depending upon which issue in the existing design is most important.
Observational Analysis of Stationary C.I. Engine Output and Emission Evaluation for Variance of Induction Pressure Aspects
Authors: Talele Dipak C , Deshmukh Dheeraj S , Deshmukh Manish S , Deshmukh Sheetal D , Patil Vilas S
Published: November 2022

In the current environment, improved engine performance, reduced fuel consumption and reduced emissions are important goals for automotive manufacturers. To understand the factors involved in the compartment assemblies in Compression Ignition (C I) engines it is crucial to concentrate on such goals. Pressure rating, fuel atomization, fuel pressure, fuel quality, air pressure rating, air temperature, pressure and other design components such as piston, Air induction system, and assembly chamber and more to work. It is evident from the literature review and research work carried out to date that the airing system is best method of promoting C I operation of the engine. The design of the Air suction system could be achieved in this way that it takes into account the objectives of entire system. Effective air suction system improvement needs least energy utilization and most extreme use of air intake pressure for decrease in poisonous productions at outlet of C I engines. Furthermore, powerful use of fuel vitality. In present work, air suction arrangement, exclusively less air inlet pressure during suction stroke of four stroke cycle engine concern is topic of explicit enthusiasm for plan. Advancement of air induction system with air induction pressure regulator, flow distribution, action is studied and useful information is developed through proper intake manifold arrangement for better fuel efficiency.
Variation in the enhancement of heat transfer with different fluids using twisted tape inserts
Authors: Thote Shrikant Arunrao , Singh Netra Pal
Published: November 2022

This research intends to look into the transformation of heat, factors affecting the friction, and characteristics of the efficacy ratio for the ratio of twist as 3.0, 4.4, and 6.0, independently of a concentric pipe heat exchanger with and without trapezoidal section twisted tape insert. For different Reynold’s Number (Re) ranges of 200-2000, 800-2000, and 2000-12000, experimentation was accomplished to find the transformation of heat energy and aspect of factors of the friction of coaxial tubes. The investigated data from the tube without an insert were compared to the conventional correspondence to assure that the investigation output was valid. The findings of the trapezoidal section twisted tape tube has been in contrast to the simple tube’s results. The consequences reveal that the trapezoidal section twisted tape appreciably improves heat transmission along with friction coefficient. The Trapezoidal section twisted tape enhancement transmission of heat was once additionally judged to be practical because the realized output ratio is maximum than unity. The twisted tape has a greater Nusselt Number (Nu), frictional influence, and overall efficacy attainment than a plain tube, by the research. According to the tapes that have been tested, the tapes with the lowest twist ratio 3.0 are greater fine than the tapes with the other ratio of twist, as a consequence of the fact that the tape with the lowest ratio of twist is the most environmentally friendly at supplying heat augmentation.
Analysis of CNC Turning Process of AA6082-T6 using Ansys Software
Authors: Aseerullah Mohd , Bhushan C. , Vishwakarma R.
Published: November 2022

In this new technological world, CNC and manual turning operations engage in a significant role in different types of designing and manufacturing industries. Before initiating the manufacturing processes, analysis is a crucial part of the manufacturing process. This study involves modelling and analysis of the CNC machining process of a cylindrical AA6082-T6 workpiece with a Tungsten Carbide tip tool. A 3D model is first modelled on CATIA V5 and the analysis is then carried on in Ansys R19.2’s explicit module. The experimental and analytical results are carried out to justify the work. The cutting parameters used in CNC machining are Spindle rotational speed, feed rate, and depth of cut. The Normal Stress’s percentage error value varied too much compared to Shear stress and Shear Strain. This shows that the aluminium is suitable for the machining processes and can also be used more efficiently.
Design and Development of Pneumatic Sheet Metal Cutting Machine
Authors: Om Prasaad J. , Krishnan A.B. , Lokhande Parth , Mustaffa Biradar
Published: November 2022

A Pneumatic sheet metal cutting machine, is a mechanism designed to cut metal sheets at a quick pace, based on the inputs given by the operator, using a switch. The machine consists of a cutter blade system, a double acting pneumatic cylinder held over the cutter blade system, an air compressor, a pneumatic valve to regulate the air flow to the pneumatic cylinder from the compressor, and a frame to hold the machine in position. Cutting and shearing technology used nowadays, includes laser cutting, hydraulic cutters, among others. These machines are costly, with expensive maintenance. Small and medium scale industries cannot tend to afford this technology. Currently basic sheet metal cutting operations are incorporated in such industries including basic handheld sheet cutters. This is not accurate in terms of the dimensions of the final output and poses safety hazards to the operator too. Thus, the novelty of this machine is that it provides an automated system to cut aluminium sheet metal, while making sure that the system is compact and portable, which has otherwise not been implemented in industries. Pneumatic sheet metal cutters find a tremendous scope in such industries owing to their simple and easy working, low cost and ensured safety with a good degree of dimensional accuracy. The main aim of this study is to research and innovate a safe and efficient way to cut aluminium sheets at a fast and regular pace, as compared to manual cutting, using a pneumatic system.
Design Analysis and Weight Optimization of Top Beam Up-packing 15 BPH Bale Press Machine
Authors: Kandalkar Bhagyashri , Bhaiswar Vinod , Khond Vivek W.
Published: November 2022

In the Ginning industry, the process of removing seeds from the cotton fibres and after that seedless cotton is compress to make a lint bale is carried out. The pressing of seedless cotton is compress to make a lint bale. The pressing of seedless cotton is the last process at the ginnery. The cotton bailing press is taken under consideration, a product of Bajaj Steel Industry. It is important to modify the structure and check for suitability to improve the efficiency. Top beam modeling is done in solid edge. The static structural analysis is performed of top beam of bailing press in order to check the sustainability. ANSYS software was used to carried out the static structural analysis. The results obtained like maximum Von- mises stress and maximum deformation are used for improving design modification. Also adopting a technique of optimization it helps in provide a better outcome.
Performance Investigation of Cylindrical Cavity Receiver Using Roughened Surfaces
Authors: Kumar Kamuju Naveen , Maurya Akanksha , Sharma Deepak
Published: November 2022

Solar cavity receiver is an integral part of the solar parabolic dish collectors used for absorbing concentrated solar irradiation. The performance of the receivers can be enhanced utilizing different types of heat transfer fluids (HTF) and modified geometries. The thermal performance of a redesigned cavity receiver with solid semi-circular tube attached to its surface was investigated using CFD three-dimensional simulation. The influence of operating and geometric parameters (i.e., inlet mass flow rate and inlet temperature) were investigated. The results obtained shows that, redesigned solar cavity receiver has thermal efficiency of 8.49-10.27% higher than a normal cavity receiver with an inlet flow rate of 0.01-0.04 kg/s under the same environmental and operating conditions. The temperature of outlet of HTF increases with increases in inlet temperature for Therminol66 oil. The comparison of thermal performance using different HTF (i.e., Therminol66, Ethylene Glycol, Water) is also conducted and it is found that Therminol66 oil gives 9% and 17% higher outlet temperature than ethylene glycol and water respectively at intake flow rate of 0.02 kg/s.
Experimentation and Optimization of Milling Machine Parameters Using Taguchi Method
Authors: Joshi Amol Vikas , Charkha Pranav , Panchal Avinash , Tayade Devanand R.
Published: November 2022

In this research work, the problem is to reduce the surface roughness of the Jacquard body which is a casting part to optimize the effects of different process parameters of surface roughness & to reduce surface roughness for milling operation by using the Taguchi method. Milling is better than other machines in the surface finish and accuracy. Greater quality product and higher productivity is the main vision of every entrepreneur. To achieve this, the process parameters of each process need to be optimized. In a milling machine, some of the important parameters like feed rate, depth of cut, speed, etc, play an important role in achieving the required quality product. To optimize these parameters, the most suitable and widely used method is the Taguchi method. The most significant objective of this research is to obtain effective quality parameters. Experimentation is done on the Jacquard body by varying the milling machine parameters. The experimental results indicate that the minimum surface roughness is obtained for the process parameters feed 0.7 mm per revolution, speed 225 rpm and 1.5 mm depth of cut. This study recommended that more surface finish be obtained by increasing speed, low feed rate, and depth of cut.
Detailed study on basic methodology of dental implant and surface modification techniques
Authors: Alagatu Aditya , Dhapade Darshan , Gajbhiye Mayuresh , Panjrekar Ritik , Raut Ashish , Awate Nilesh , Priya Praneeta
Published: November 2022

Dental implant can be defined as the process of inserting an artificial tooth in the place of natural tooth. This artificial tooth consists of: a) abutment b) Custom made crown and c) an implant. Since it is replacing the natural tooth, it should resemble and work in the same manner. It should not break under the chewing load. Dental implant shows great success rate but over the years. They are regarded as a significant contribution to dentistry since they have changed the process of replacing lost teeth. The capacity of the implant material to integrate with the surrounding tissue is critical to its success. Dental implants are artificial dental roots that are used to replace missing teeth. Dental implant is slightly expensive and patient has to go through plenty of processes like surgery. Moreover, even after taking all the preventive measures there are still chances of failing the implant and hence material selection and surface modification techniques used in Dental implant plays a crucial role. In this review paper we will see the different material used in dental implant and different surface modification techniques.
A review on wear characterization of electrodeposited nickel matrix composites
Authors: Dhakne Atul , Jaju Santosh , Shukla Sourabh
Published: November 2022

Corrosion resistance across a wide temperature range, increased physical, mechanical, and tribological capabilities, variable surface hydrophobicity, and an attractive appearance are all advantages of electrodeposited metal matrix composite coatings (MMCs). As a result, several studies have been conducted to evaluate the various physical, mechanical, biochemical, electrochemistry, and thermodynamics characteristics of nanocrystalline composite material, generated on a variety of substrates with numerous electrodeposition settings. In this review paper, the current literatures on wear rate of electrode-posited Ni-based coatings made of composite materials are being reviewed. More specifically, the research papers on weight management, wear resistance, coefficient of friction, surface roughness, hardness and associated deterioration methods has been identified and reviewed. The observations showed that nano-composite films offer substantially superior wear resistance than magnesium alloys and pure nickel coatings due to the diffraction stiffening and grain refining effects. Also, abrasion is the main wear process for nano-composite coatings, whereas adhesion wear is the primary wear arrangement for magnesium alloys and major wear mechanism for pure nickel coatings is exfoliation wear.
Flexural strength of Epoxy resin and Bagasse fiber reinforced composite materials
Authors: Saroj Anurag , Vishwakarma Ravi , Bhushan Chandra
Published: November 2022

In this research, we are going to take out to investigate flexural strength and tensile strength properties of composite material with the using of epoxy resin and bagasse fibre in the powder form. These composites are bonded using epoxy resin and hardener mixed in appropriate volume. This composite was prepared with using bagasse fibre in powder form and the bagasse fibre powder used with different ratio in each material which are prepared and we found the high strength at the using 5gm bagasse fibre powder in both of Tensile and Flexural strength. Here for preparing specimen using Hand layup method. It can be use in more way because rare future of the environmentally friendly, waste utilization, good strength, bio-degradability and alternative for plastic.
EP-25 Double Gastric Outlet Obstruction Caused by an Incarcerated Right Inguinal Hernia, a Rare Presentation
Authors: Abbakar Malaz , Ahmed Salma , Lim Michael
Published: November 2022

We report a case of an 84-year old man who presented with double gastric outlet obstruction from an incarcerated right inguinal hernia that contained part of the stomach, most of the small bowel, omentum, appendix, caecum, ascending and transverse colon, causing a double gastric outlet obstruction.

Several intra-abdominal organs have been reported in groin hernias including the appendix, bladder, small and large bowel and ovaries. There are approximately 60 cases of inguinal hernias containing the stomach, the majority were before 1980. It's believed that the emphasis of early repair minimized the occurrence of complications and decreased presentations of these cases. Two cases were published in the UK with a similar condition in 2014 of which one was treated conservatively and the other had an open inguinal hernia repair with mesh.

He presented to the emergency department with a 1 day history of severe abdominal pain and dark brown vomiting due to incarceration of inguino-scrotal hernia which he had for the last 24 years with no symptoms. His abdomen was soft and non-tender with large right inguino-scrotal hernia which was tender on palpation and irreducible.

The diagnosis was confirmed with a CT scan. The P-Possum score was calculated, 2.56% mortality and 49.5% morbidity. He was taken to the theatre, after resuscitation for exploratory laparotomy, omentectomy and inguinal hernia Lichtenstein repair with Vicryl® mesh.

At the end, it is thought that long-standing traction on the greater omentum and its attachments may be responsible for the descent of the stomach into the hernia sac.
BJS Prize 2 Exploring variation in surgical practice: the colorectal surgeon's personality influences anastomotic decision-making in rectal cancer
Authors: Bisset Carly , Ferguson Eamonn , Oliphant Raymond , Macdermid Ewan , Moug Susan ,   Plato Project Steering Group
Published: November 2022

Background

The influence of internal surgeon-specific factors, such as personality, on cognitive bias and decision-making in surgery is not well understood. These factors may be particularly influential in clinical cases where there is a high degree of equipoise. This study aimed to explore personality traits that may influence anastomotic decision-making in rectal cancer.

Methods

Colorectal surgeons were invited via social media to participate in a 2-part online survey (Snap11). The survey included: 1) 44-item Big Five Inventory (personality), 2) 30-item DOSPERT (risk-taking), 3) 3-item Cognitive Reflection Test (thinking style), and twenty hypothetical patient scenarios involving rectal anastomotic decisions.

Results

186 certified colorectal surgeons participated with 127 completing both parts (68.3%). 143 participants in this cohort were aged 30–49 years (79.6%) and 131 participants were male (70.4%).

Surgeons scored higher than average population levels for emotional stability (degree of even-temperedness; 3.25 vs 2.97), with lower levels of agreeableness (ability to cooperate with others; 3.03 vs 3.74) and openness (creativity; 3.19 vs 3.67). Personality influenced anastomotic decision-making in specific circumstances e.g., high levels of openness predicted stoma formation when providing a second opinion, whereas high levels of extraversion predicted stoma formation when the patient was a staff member. Early career surgeons were highly influenced by colleague criticism following recent anastomotic leakage.

Conclusions

Surgeon personality influences anastomotic decision-making in difficult circumstances. Colleague support is vital following anastomotic leakage and is influential upon early career surgeons’ subsequent decision-making. Personality is modifiable through experiences, therefore targeted educational interventions (e.g. reflexivity) may enable surgeons to recognize their own cognitive biases.
SP4.1.3 Validation of the Emergency Surgery Score (ESS) in the UK patient population and comparison with NELA scoring: a retrospective multi-centre cohort study
Authors: Clinch Darja , Wong Michael , Imbert Emma , Haddow Laura , Simpson Keith , Damaskos Dimitrios
Published: November 2022

Aims

Accurate risk scoring in emergency general surgery (EGS) is vital for consent, resource allocation and benchmarking quality of care. The emergency surgery score (ESS) is a reliable predictor of post-operative outcomes in EGS, but has only been studied in the US population. Our primary aim was to perform an external validation study of the ESS in a UK population. Our secondary aim was to compare the accuracy of ESS and NELA scores.

Methods

We conducted an observational cohort study of adult patients undergoing emergency laparotomy over three years in two UK centres. ESS was calculated retrospectively. NELA score and all other variables were obtained from the prospectively held Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA) database. Primary outcome was 30-day mortality. Secondary outcome was need for post-operative ICU admission.

Results

609 patients were included. Both ESS and NELA were good predictors of 30-day mortality (c-statistic=0.78 [95% CI: 0.71–0.85] for ESS and c-statistic=0.83 [95% CI: 0.77–0.88] for NELA). Similarly, both scores were good predictors of need for post-operative ICU admission (c-statistic=0.76 [95% CI: 0.71–0.81] for ESS and 0.80 [95% CI: 0.76–0.85] for NELA). There was no significant difference in performance between the two scores for predicting 30-day mortality (p=0.20) or need for ICU admission (p=0.09).

Conclusion

We recommend that ESS can be used in the UK population. It is non-inferior to NELA in predicting 30-day mortality and need for ICU admission, but has been validated for a wider range of outcomes and does not require scoring of intra-operative variables.
SP7.4 Near-peer surgical simulation & teaching day for newly qualified FY1 doctors
Authors: Thompson Joe , Dodd Eleanor , Morris Rebecca , Wragg Ashley , Gleeson Joe
Published: November 2022

Aims

The aims of this study were to ascertain how prepared newly qualified Foundation Year 1 (FY1) doctors felt for their surgical rotation and to evaluate the effectiveness of a surgical-themed teaching day for new FY1 doctors.

Methods

A near-peer surgery-themed teaching day was delivered to 44 newly qualified FY1 doctors and delivered by clinical teaching fellows (FY3 doctors). The day involved four surgical-themed simulation scenarios: (i) haemodynamically unstable pancreatitis, (ii) anastomotic leak following ileocaecal resection, (iii) septic shower post ureteric stent and (iv) post-operative pulmonary embolism. Classroom-based teaching included: (i) microbiology and antibiotic prescribing (ii) interpreting abdominal films and (iii) insulin prescribing (including for nil by mouth patients). FY1s were randomly allocated a participant number and completed pre- and post-session anonymised questionnaires.

Results

Only 31.7% (13/41) agreed that Medical School had adequately prepared them for their surgical foundation job and 46.3% (19/41) felt less prepared for surgical rotations compared with medical rotations. When compared with the pre-session scores: 93% (58% pre-session) felt prepared to manage acutely unwell surgical patients and 84% (43.9% pre-session) were confident with escalating patients to level 2/3 care. Confidence improved across the board for classroom-based sessions.

Conclusion

This study has highlighted a need to ensure newly qualified FY1 doctors feel better prepared for their surgical rotations. The introduction of a mixed simulation and classroom teaching day has, in this instance, improved confidence across a number of important domains. Teaching delivered in the near-peer style may be the key to imparting relevant knowledge to new FY1s.
WE7.3 Splenic abscess formation following selective splenic embolisation for a traumatic splenic injury and its subsequent conservative management
Authors: Collis Justin , Farquharson Barnaby , Bajomo Oreolow , Lascelles Simon
Published: November 2022

Splenic injuries are the most commonly injured organ following blunt abdominal trauma1. Current standard of care for a haemodynamically stable patient is non operative management (NOM). Although selective arterial embolization (SAE) is a useful adjunct in NOM, the complications from this intervention and subsequent management are poorly detailed in the literature4. This report describes the development of a splenic abscess post SAE for a traumatic splenic injury. A 50-year-old haemodynamically stable blunt trauma patient with a grade IV splenic laceration and concomitant rib fractures was treated conservatively with SAE. Post embolization the patient's haemoglobin and inflammatory markers remained stable and he self-discharged on day 5. He returned 3 days later with abdominal pain, a repeat CT demonstrated a left sided pleural effusion and his subcapsular haematoma had increased in size, but inflammatory markers and haemoglobin remained stable. He was admitted for monitoring. During admission he reported increasing abdominal pain and his inflammatory markers had drastically worsened, CRP 340 (60) and WBC 14 (7). A repeat CT demonstrated a splenic abscess and worsening of his pleural effusion. He was taken for IR drainage, which led to an immediate improvement of his pain and resolution of his pleural effusion after 2-weeks. This case report of a post SAE abscess following a splenic injury is unique because the patient did not demonstrate typical signs of infection. It was serial monitoring of bloods and early repeat cross sectional imaging that facilitated a timely diagnosis, allowing us to avoid a splenectomy, thus preserving splenic function.
458 Urological Cancers During COVID-19: Analyses of Short-Term Outcomes from the COVIDSurg-Cancer Study
Authors: Chan Vinson Wai-Shun ,   COVIDSurg Collaborative,   British Urology Researchers in Surgical Training (BURST) Collaborative
Published: November 2022

Aim

To assess 30-day postoperative outcomes for patients undergoing urological cancer surgery during the COVID-19 pandemic.

Method

All bladder, kidney, UTUC and prostate cancer patients from the COVIDSurg-Cancer Study who underwent elective potentially curative cancer surgery during the COVID-19 pandemic until July 2020 were included. Univariable and multivariable regression was performed to assess the association of patient factors with mortality, respiratory complications, and operative complications.

Results

A total of 1,902 patients from 36 countries were included. A total of 42/1902 (0.2%) patients were diagnosed with COVID-19 during their inpatient stay.

21 (0.1%) mortalities were observed; of those, 8 (38.1%) were diagnosed with COVID-19. Mortalities were found to be more likely in patients with concurrent COVID-19 infection (OR 31.7, 95% CI 12.4–81.42, p<0.001), aged over 80, ASA grade 3+ and ECOG grade 1+.

40 (0.2%) respiratory complications (acute respiratory distress syndrome or pneumonia) were observed within 30 days of surgery. Respiratory complications were more likely in patients aged with concurrent COVID-19 infection (OR 40.6, 95%CI 11.41–144.45, p<0.001), over 70, from an area with high community risk or with a revised cardiac risk index of 1+.

There were 84 (4.4%) major complications (Clavien-Dindo score ≥3). Patients with a concurrent COVID-19 infection (OR 7.45, 95% CI 2.73–20.3, p<0.001) or aged 80 or above were more likely to experience major complications.

Conclusions

Our data can inform health services to safely select patients for surgery during the pandemic. Patients with concurrent COVID-19 infection have a higher risk of mortality and respiratory complications and should not undergo surgery if possible.
607 A Career in Neurosurgery: Perceptions and the Impact of a National SBNS/NANSIG Neurosurgery Careers Day
Authors: Solomou G , Venkantesh A , Patel W , Chari A , Mohan M , Bandyopadhyay S , Gillespie C , Mendoza N , Watts C , Jenkins A
Published: November 2022

Entrance to neurosurgical training is highly competitive. Without advice and opportunities, talented individuals may be dissuaded from applying. The Neurology and Neurosurgery Interest Group organised the 9th Annual Careers Day in Neurosurgery every year. Our objective was to assess the overall utility of a neurosurgery careers day and the perceived factors that attract and detract from the speciality.

18-item pre-conference post-conference questionnaires were disseminated electronically to conference attendees. Questions aimed to capture: i) baseline demographics; ii) previous experience and exposure in neurosurgery; iii) interest in neurosurgery; iv) understanding training and a career in neurosurgery; v) perceived factors of attraction and dissuasion of neurosurgery; and vi) perceived value, quality and educational purpose of the conference.

In total, 77 delegates attended. 19/77 did not have a formal neurosurgical rotation during medical school, but almost half had gained neurosurgical experience. The careers day increased knowledge of the neurosurgical application process (median Likert score 3/5 to 4/5), duration of training (72.7% to 88.3%), and desire to pursue a career in neurosurgery (75.3% to 81.8%). The most common factors attracting delegates to neurosurgery were interest in neuroanatomy (80.5%, n=62) and practical skills (64.9%, n=50). Dissuasive factors were competition to entry (64.9%, n=50) and long working hours (40.3%, n=31). Almost all would recommend the event to a colleague (94.9%, n=73).

Undergraduate exposure to neurosurgery is limited. Neurosurgery careers days increase awareness and understanding of the application process and improve interest in a selected cohort. The factors attracting applicants to neurosurgery remain practical links to anatomy and direct impact on patients.
873 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty
Authors: McCulloch R , Adlan A , Evans S , Parry M , Stevenson J , Jeys L
Published: November 2022

Aim

The primary aim of this study was to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons for soft-tissue coverage in the context of periprosthetic joint infection (PJI) and, secondly, to evaluate the infection-free survival of this patient group.

Method

We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97%) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52% of PJIs were polymicrobial.

Results

Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65).

Conclusions

The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.
Smartphone and wearable detected atrial arrhythmias in Older Adults: Results of a fully digital European Case finding study
Authors: Fabritz L , Connolly D L , Czarnecki E , Dudek D , Guasch E , Haase D , Huebner T , Zlahoda-Huzior A , Jolly K , Kirchhof P , Obergassel J , Schotten U , Vettorazzi E , Winkelmann S J , Zapf A , Schnabel R B ,   Smart in OAC—AFNET 9 investigators
Published: November 2022

Aims

Simplified detection of atrial arrhythmias via consumer-electronics would enable earlier therapy in at-risk populations. Whether this is feasible and effective in older populations is not known.

Methods and results

The fully remote, investigator-initiated Smartphone and wearable detected atrial arrhythmia in Older Adults Case finding study (Smart in OAC—AFNET 9) digitally enrolled participants ≥65 years without known atrial fibrillation, not receiving oral anticoagulation in Germany, Poland, and Spain for 8 weeks. Participants were invited by media communications and direct contacts. Study procedures adhered to European data protection. Consenting participants received a wristband with a photoplethysmography sensor to be coupled to their smartphone. The primary outcome was the detection of atrial arrhythmias lasting 6 min or longer in the first 4 weeks of monitoring. Eight hundred and eighty-two older persons (age 71 ± 5 years, range 65–90, 500 (57%) women, 414 (47%) hypertension, and 97 (11%) diabetes) recorded signals. Most participants (72%) responded to adverts or word of mouth, leaflets (11%) or general practitioners (9%). Participation was completely remote in 469/882 persons (53%). During the first 4 weeks, participants transmitted PPG signals for 533/696 h (77% of the maximum possible time). Atrial arrhythmias were detected in 44 participants (5%) within 28 days, and in 53 (6%) within 8 weeks. Detection was highest in the first monitoring week [incidence rates: 1st week: 3.4% (95% confidence interval 2.4–4.9); 2nd–4th week: 0.55% (0.33–0.93)].

Conclusion

Remote, digitally supported consumer-electronics-based screening is feasible in older European adults and identifies atrial arrhythmias in 5% of participants within 4 weeks of monitoring (NCT04579159).
A calibrated choice experiment method
Authors: Chenarides Lauren , Grebitus Carola , Lusk Jayson L , Printezis Iryna
Published: November 2022

Although choice experiments (CEs) have emerged as the most popular stated preference method in applied economics, the method is not free from biases related to order and presentation effects. This paper introduces a new preference elicitation method referred to as a calibrated CE (CCE), and we explore the ability of the new method to alleviate starting-point bias. The new approach utilises the distribution of preferences from a prior CE to provide real-time feedback to respondents about our best guess of their willingness-to-pay (WTP) for food attributes and allows respondents to adjust and calibrate their values. The analysis utilises data collected in 2017 in two US cities, Phoenix and Detroit, on consumer preferences for local and organic tomatoes sold through supermarkets, urban farms and farmers’ markets to establish a prior preference distribution. We re-conducted the survey in May 2020 and implemented the CCE. Conventional analysis of the 2020 CE data shows that WTP is strongly influenced by a starting point: the higher the initial price respondents encountered, the higher the absolute value of their WTP. Despite this bias, we show that when respondents have the opportunity to update their WTP when presented with the best guess, the resulting calibrated WTP is much less influenced by the random starting point.
How socioeconomic status affects weight status through health-related lifestyles: a latent class analysis
Authors: García-Mayor Jesús , Moreno-Llamas Antonio , De la Cruz-Sánchez Ernesto
Published: November 2022

Aims

Obesity levels have increased worldwide with serious public health concerns. However, weight status is related to socioeconomic status (SES), which may also influence health-related lifestyles. Here, we study the association between SES and obesity mediated by diet and physical activity.

Methods and results

Using cross-sectional data from 2006, 2011, 2014, and 2017 Spanish health surveys (the final sample consisted of 61 768 adults aged between 18 and 64 years), we conducted a latent class analysis to estimate health-related lifestyle clusters (based on dietary patterns and physical activity) and mediation analyses to evaluate the association of SES and obesity through the clustering of health-related lifestyles. In both men and women, SES was inversely related to obesity (P < 0.001) and positively related to healthier lifestyle classes (P < 0.001). Obesity was inversely related to healthier lifestyle classes (P < 0.001). A small—although significant—proportion mediated by the clustering of lifestyles was found as follows: 4.9%, 95% CI (6.6%, 3.2%) in men and 2.3%, 95% CI (3.4%, 1.3%) in women for educational attainment, 5.3%, 95% CI (7.2%, 3.6%) in men and 2.0%, 95% CI (2.9%, 1.1%) in women for occupational social class, and 4.9%, 95% CI (6.5%, 3.1%) and 1.9%, 95% CI (2.9%, 1.1%) combining the above two SES indicators.

Conclusions

SES is related to obesity through clustering health-related lifestyles, with greater emphasis on men. However, the complex relationship between SES and weight status also suggests other indicators that contribute to the social gradient of obesity.
Perspective of smokers and healthcare professionals toward real-time video counseling smoking cessation program in general out-patient clinics in Hong Kong: a qualitative study
Authors: Yung Hiu Ting , Wong Man Kin , Lai Shiu Kee , Liang Jun
Published: November 2022

Objective

This study aimed to explore the perceptions and experiences of individuals that currently smoke and healthcare professionals on using real-time video counseling in the Smoking Cessation and Counselling Program in General Out-patient Clinics in Hong Kong.

Design

This was a qualitative study using face-to-face semi-structured interviews based on the extended technology acceptance model. All interviews were audiotaped and transcribed verbatim. Two investigators coded the transcripts independently. Thematic analysis was adopted.

Participants

Individuals that currently smoke and healthcare professionals who had experience using real-time video counseling in the Smoking Cessation and Counselling Program in General Out-patient Clinics in Hong Kong were recruited. Purposive sampling was adopted. 18 participants were interviewed to reach data saturation.

Main Outcome Measures

Themes that emerged from thematic analysis of data were the main outcome measures. The emerged themes were refined and verified via inductive and then deductive processes until data saturation was reached.

Results

Two core themes, which were in coherence with the extended technology acceptance model, namely (i) perceived ease of use and (ii) perceived usefulness, were identified. Under perceived ease of use, we identified 2 subthemes: (i) convenience and (ii) measures to facilitate the use of real-time video counseling. Three subthemes were identified under perceived usefulness: (i) empathy and rapport, (ii) measures for pandemics, and (iii) service outcome.

Conclusion

Our study provided a culture-specific perspective of users towards real-time video counseling. It identified users’ opinions on the easiness and usefulness of the service. Those could provide clues for future improvement and development of using real-time video counseling in healthcare services.
Integrated seismic source model of the 2021M7.1 Fukushima earthquake
Authors: Zhang Yijun , Bao Han , Aoki Yosuke , Hashima Akinori
Published: November 2022

We constructed an integrated rupture model of the 2021 Mw 7.1 Fukushima earthquake, an intraplate earthquake, by resolving both its spatiotemporal distribution of slip-rate and high-frequency (∼1 Hz) radiations. We analysed near-field seismic observations using a novel finite-fault inversion method that allows automatic parametrization and teleseismic data from multiple arrays using the MUSIC backprojection (BP) method that enhances imaging resolution. The inverted slip distribution obtained from waveforms filtered in the frequency band of 0.02–0.2 Hz showed that the kinematic rupture propagated along both the strike (∼35 km) and dip directions (∼85 km), and that the large-slip area was located southwest to the hypocentre with a maximum slip of ∼1.03 m. Overall, no obvious frequency-dependent rupture behaviours occurred during the rupture process due to the deep nucleation of the Fukushima earthquake on a heterogeneous fault where sizes of asperities do not monotonically increase with depth, which sheds light on understanding the rupture dynamics of intraplate earthquakes in subduction zones. Both the slip inversion and BP revealed the general rupture feature of this earthquake with southwestward and updip directivity. A comparison of BPs between multiple arrays indicates that the source–receiver geometry and the directivity effect of an earthquake may cause critical discrepancies in BPs of different arrays. From the temporal change of stress around the hypocentre of the 2021 Fukushima earthquake due to the 2011 Tohoku-Oki Mw 9.1 earthquake, the long-term dominance of viscoelastic relaxation increased the Coulomb failure function (CFF) by 0.3–0.7 MPa, indicating that the occurrence of the Fukushima earthquake has been likely promoted by the post-seismic deformation due to the Tohoku-Oki earthquake.
Exploring the roles of players in strategic purchasing for healthcare in Africa—a scoping review
Authors: Kachapila Mwayi , Kigozi Jesse , Oppong Raymond
Published: November 2022

Following the World Health Organization (WHO) guidance on strategic purchasing in 2000, low- and middle-income countries (LMICs) are trying to shift from passive purchasing (using fixed budgets) to strategic purchasing of healthcare which ties reimbursement to outcomes. However, there is limited evidence on strategic purchasing in Africa. We conducted a scoping literature review aimed at summarizing the roles played by governments, purchasers and providers in relation to citizens/population in strategic purchasing in Africa. The review searched for scientific journal articles that contained data on strategic purchasing collected from Africa. The literature search identified 957 articles of which 80 matched the inclusion criteria and were included in the review. The study revealed that in some countries strategic purchasing has been used as a tool for healthcare reforms or for strengthening systems that were not functional under fixed budgets. However, there was some evidence of a lack of government commitment in taking leading roles and funding strategic purchasing. Further, in some countries the laws need to be revised to accommodate new arrangements that were not part of fixed budgets. The review also established that there were some obstacles within the public health systems that deterred purchasers from promoting efficiency among providers and that prevented providers from having full autonomy in decision making. As African countries strive to shift from passive to strategic purchasing of healthcare, there is need for full government commitment on strategic purchasing. There is need to further revise appropriate legal frameworks to support strategic purchasing, conduct assessments of the healthcare systems before designing strategic purchasing schemes and to sensitize the providers and citizens on their roles and entitlements respectively.