bluuebunny/crossref_metadata_2025 huggingface dataset:
An Investigation of the Factors affecting Flexible Manufacturing Competence of Organizations
Authors: Karadbhajane Asmit , Gaidhane Jeevan , Ullah Inayat , Shukla Sourabh , Kotta Anand Babu
Published: November 2022

Owing to the fluctuating demands of customers and intensified competition, organizations are searching ways to enhance their flexible manufacturing competence (FMC) as it has been recognized as one of the most important approaches to handle the aforementioned situations. The existing literature provides several factors that significantly affect FMC, however, the interrelationships among these factors are somewhat unexplored. The insights to the interactions among these factors could provide crucial managerial implications that could pave ways for success of organizations in today’s uncertain business environment. To this end, the present work makes an effort and highlights the important factors and investigates their interactions with each other for the enhancement of FMC of organizations. In this paper, the interpretive structural modelling (ISM) methodology has been implemented to explore the interactions and develop a structural model depicting the hierarchy of the factors. Further, MICMAC analysis has been used to categorize the factors into different groups based on their driving and dependence powers.
Bearing fault diagnosis using signal processing and machine learning techniques: A review
Authors: Barai Viplav , Ramteke Sangharatna M. , Dhanalkotwar Vismay , Nagmote Yatharth , Shende Suyash , Deshmukh Dheeraj
Published: November 2022

In the majority of machines, bearings are among the most crucial components. Bearings are so important that they have been the subject of intensive research and ongoing development throughout the years. Often, bearing fails to reach its expected service life, resulting in failures that cause economic losses. Therefore, there has been a growing interest in research on bearing failure diagnosis systems due to the availability of condition monitoring techniques. Fault feature extraction techniques with the application of signal processing methods and machine learning techniques introduce an Intelligent Fault Diagnosis system that can identify and diagnose the bearing faults. Many researchers have been interested in such techniques in recent decades, which use artificial intelligence to diagnose machine health conditions. In this article, the authors have explored certain fault diagnosis methodologies based on signal processing and machine learning. From the discussed literature review, a research gap for future work has been defined.
Maintenance scheduling under multiple resource constraints using a project scheduling technique
Authors: Chaudhary Amol , Meshram Sachin
Published: November 2022

The work presented in this paper deals with the scheduling problem under multiple resource constraints. A heuristic method called the current float technique of resources scheduling under multiple resource constraints is applied to solve this problem. The maintainance activities of some machines of coal handling plant of a thermal power station is considered. The activities are arranged in network diagram and a schedule is developed which will give the information of current status of activities, utilization of resources and idle resources.
Implementation of AHP to evaluate variables of prognosis agent technology managing manufacturing organizations
Authors: Singh Vikram , Sharma Somesh
Published: November 2022

This research aims to use AHP model to evaluate variables of PAT managing manufacturing organizations. Using AHP approach, an evaluation model can be constructed, capable to measure the weight and ranking of variables. Literature helps to identify twenty six variables of PAT. These variables are arranged on the basis of expert’s opinion and construct a conceptual domain in which variable are divided as five major and twenty one sub variables. This domain is used to draw hierarchy framework of AHP model. Thereafter, pair wise comparison is performed on the expert’s responses to measure weight of PAT variables, the responses and matrices, validated by computing consistency ratio. Finally, weight and ranking of entire variables are evaluated in AHP methodology section and concluded in last section which gives interesting suggestions to the manufacturing organizations so as to manage their manufacturing system.
Application of Design for Manufacturing Technique to Lubricating Oil Pump Body for Reduction of Its Machining Time
Authors: Kulkarni P R , Pathak T S , Tuljapure S B
Published: November 2022

Design, manufacturing (production) & quality are linked to each other. Design has large impact on manufacturing ease & time along with the quality of product. Hence design need to be modified taking into consideration the manufacturing aspect. In this work, a lubricating oil pump body is studied from manufacturing point of view. The operations requiring more processing time were identified. An effort is made to change the design of the lubricating oil pump body to reduce the manufacturing time & efforts. Use of finite element method-based software ANSYS is done to determine the stresses during the machining with reference to the present design. The lubricating oil pump body is redesigned from manufacturing point of view keeping the end product as it is, to avoid the modifications of the other components in assembly. The machining parameters are predicted for this new design. At last, comparison of the machining parameters for existing & proposed design is done. There seems to be overall improvement in processing time.
An overview of recent advancement in grade cladded surface using overlay techniques and various materials
Authors: Butaley Sudarshan , Dhole Lalit P. , Khond Vivek W.
Published: November 2022

In this review paper, previous studies on effect of cladding on surface of welding using overlay was discussed. The Research papers up to 2021 related with various cladding methods, effect on mechanical properties and overlay methods were discussed. Also, paper discussed the effect on tribological behavior. This paper reported the various metal and its alloy, recent development in advanced materials for cladding in various high temperature applications. The merits, demerits, limitations and future development and possible area of research in welding cladding methods were discussed.
Study on Polyether-ether-ketone (PEEK) dental implant, future alternatives to Titanium
Authors: Parekh Archi , Doifode Hitakshi , Patil Prasad , Katole Ritik , Pitale Amol , Awate Nilesh , Priya Praneeta
Published: November 2022

Dental implant can be defined as the process of inserting an artificial tooth in the place of the natural tooth. This artificial tooth consists of a) an abutment b) Custom made crown and (c) Implant. Dental implants are of two major types Endosteal and Subperiosteal Implant, endosteal is more widely used and nowadays Subperiosteal is very rare. Apart from types, it also has variety of materials usage. The widely used materials are titanium and zirconia. Both titanium and zirconium have lots of disadvantages, to overcome those we can use PEEK that is polyether-ether-ketone. PEEK has many advantages like Flexibility, Radiolucency, Aesthetic features, Thermal resistance, Cost-Efficient and its Biocompatibility. One of main factor responsible for selection of dental implant material is Osseointegration. This all advantages make us see PEEK as a reliable alternative to the present materials that is titanium and zirconia. PEEK also has long life and it is insoluble having low moisture absorption, low density (1.32 g/cm3), and low elastic modulus. This study shows mechanical analysis of PEEK abutments.
Utilization of Nanomaterials in Bioimaging and Cancer Theranostics
Authors: Dabhade Prachi , Bagde Ashutosh , Syed Zahiruddin Quazi , Fulzele Punit
Published: November 2022

Cancer therapy has evolved in recent times on diagnostic and therapeutic grounds. Nanotechnology is the latest technique used to design nanoparticles having therapeutic applications in diseases like cancer. There are various such nanoparticles types made up of gold, silver, iron, and other compounds. Much recent are the bioinspired and theragnostic nanoparticles which exhibit good biocompatibility and much more effective drug delivery compared to the traditional drug delivery mechanisms. Bioimaging is a visualization process that aids to locate the target cancer cell or tumor-targeted delivered nanoparticles to understand and study the actual status of the disease conditions. In this review, we have discussed these various nanomaterials and its counterparts having applications in cancer.
Experimental Studies on TIG Welding of Advanced Material under various parameters
Authors: Ansari Safraj , Dosar Amrit Anand , Kumar Sunil
Published: November 2022

The material stainless steel (AISI 309) is extensively used in almost all types of thermal power plant, petroleum industries, waste treatment industries etc. The material AISI 309 stainless steel is used as sample which is prepared by wire cut EDM process. The sample dimension is tested according to the ASTM standard. Tungsten inert gas (TIG) welding is used to improve mechanical properties and to reduce the manufacturing costs, by the taguchi`s experimental design method which is used for optimization. The three different welding process parameters such as GFR, WS and WC have opted to perform the tests using L9 orthogonal array. The tensile strength and bending strength test are conducted to check the final weld quality. The maximization of ultimate tensile strength, impact strength and bending strength of weld joints results has obtained by input parameters such as welding current 170amp, welding speed 2 mm/sec and gas flow rate 15 lit/min. It is observed that current and welding speed influence to maximize mechanical properties of weld joints.
Surface Functionalization of Jute Fibers In The Presence Of Sodium Hydroxide and Graphene Oxide in the Preparation of Bio Composite
Authors: Verma Yogendra Kumar , Singh Amit Kumar , Paswan M. K. , Sonker Puneet Kumar
Published: November 2022

The natural fibers (jute, bamboo, banana etc.) has high strength to weight ratios, inexpensiveness, low densities, good mechanical properties, environment friendly, ease of manufacturing and availability due to this properties natural fibers are now days vitally popular. Jute fibers have good mechanical properties. The interfacial strength (23.6%) and tensile strength (96%) of the coated jute fibers increases more than untreated jute fibers. The morphologies of treated and untreated jute fibers surface are display very different in the analysis of SEM. Which jute fibers are untreated that smooth and it contains hemicellulose, lignin and pectin and they are covered with lots of lump materials. Which are removed after functionalization of the jute fibers in the presence of NaOH. This work presented the improvement of the epoxy based composite with the functionalized jute fibers as filler used for increased the mechanical (tensile, flexural strength) properties of the composites. The flexural strength of the prepared composites increases from 259.9MPa to 325.5MPa and the flexural modulus increases from 16.7GPa to 21.5GPa in the prepared composites by using functionalized jute fibers in the comparison of untreated jute fibers composites. These jute fibers based composites very useful for the environment so it can reduce the synthetic fibers based composites.
In-situ EBSD study of 409 L ferritic stainless steel during tensile testing
Authors: Chen Jichang , Wang Junan
Published: November 2022

Two ferritic stainless steel (FSS) specimens, denoted as loading axis along the rolling direction(LR) and the transverse direction(LT) respectively, were produced to elucidate the mechanical anisotropyof409L FSS at grain scale. This approach was realized by the combination of in situ tensile test and field emission scanning electron microscopy (SEM) with electron backscattering diffraction (EBSD) at room temperature. Microstructure evolution, grain orientation rotation, and crystallographic slip were investigated in the tensile test. During tensile deformation, the tensile axis of LR specimens rotated towards the 〈101〉 direction, which is the stable end orientation of body-centered cubic (BCC) metals. However, the rotation of tensile axis towards 〈101〉 was restrained in LT specimens due to the operation of less favorable slip systems. {110}〈111〉 was the most favorable slip system in both specimens. The mechanical anisotropy in grain scale is due to different slip behaviors of LR and LT specimens.
Investigation of the corrosion resistance of graphene-nickel composite micro-parts
Authors: Suo Wenhua , Wang Yi , Ji Yaotang , Liu Zhuangzhuang , Liu Jing , Wang Shanfei , Suo Hongli , Liu Min
Published: November 2022

Nickel-based microparts possess a short lifetime owing to their rapid dissolution in corrosive environments. To mitigate this phenomenon, composite microparts of graphene/Ni were prepared using UV-LIGA technology; their corrosion behavior was examined in acid, alkali, and salt solutions as well as after subjecting them to heat-treatment processes. The microstructures were investigated with scanning electron microscopy (SEM), x-ray diffraction (XRD), electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM). Corrosion resistances were characterized through various electrochemical tests and compared with those of pure Ni microparts. The results demonstrate that the surface oxidation layer (i.e.,the protective layer) of the microparts was readily destroyed in NaCl and H2SO4 solutions without the formation of a passivation film; however, a passivation film was formed in the NaOH solution. The corrosion rates of graphene/Ni in NaCl, NaOH, and H2SO4 corrosion solutions were reduced by 73%, 22%, and 84%, respectively, relative to those of pure Ni microparts. This can be primarily attributed to the homogeneous dispersion of graphene in the Ni matrix, which refined the grain size, and the impermeability and chemical stability of graphene, which lengthened the diffusion path of the corrosive medium. In addition, heat treatment of the graphene/Ni microparts at 200 °C increased the corrosion resistance by a factor of nearly one with little change in microhardness, which can be attributed to the removal of internal stress and the increased proportion of CSL grain boundares. Corrosion occurred at the interface between nickel and graphene, lengthening the corrosion path.
Printed temperature sensor based on self-doped conducting polymers
Authors: Beaumont Catherine , Lapointe Rosalie , Beaupré Patrick , Trudeau Charles , Le Bouch Nolwenn , Leclerc Mario
Published: November 2022

The printing of an efficient thermistor temperature sensor by using self-doped conducting polymers has been achieved. The use of a water-soluble polymer as the active material allows printing and processing in green solvents. The sensor showed a good sensitivity to temperature variations, with a temperature coefficient of resistance of −1.3%. The sensor also exhibited a better stability and reversibility towards humidity compared to the state-of-the-art poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS).
Understand anisotropy dependence of damage evolution and material removal during nanoscratch of MgF2 single crystals
Authors: Li Chen , Piao Yinchuan , Zhang Feihu , Zhang Yong , Hu Yuxiu , Wang Yongfei
Published: November 2022

To understand the anisotropy dependence of the damage evolution and material removal during the machining process of MgF2 single crystals, nanoscratch tests of MgF2 single crystals with different crystal planes and directions were systematically performed, and surface morphologies of the scratched grooves under different conditions were analyzed. The experimental results indicated that anisotropy considerably affected the damage evolution in the machining process of MgF2 single crystals. A stress field model induced by the scratch was developed by considering the anisotropy, which indicated that during the loading process, median cracks induced by the tensile stress initiated and propagated at the front of the indenter. Lateral cracks induced by tensile stress initiated and propagated on the subsurface during the unloading process. In addition, surface radial cracks induced by the tensile stress were easily generated during the unloading process. The stress change led to the deflection of the propagation direction of lateral cracks. Therefore, the lateral cracks propagated to the workpiece surface, resulting in brittle removal in the form of chunk chips. The plastic deformation parameter indicated that the more the slip systems were activated, the more easily the plastic deformation occurred. The cleavage fracture parameter indicated that the cracks propagated along the activated cleavage planes, and the brittle chunk removal was owing to the subsurface cleavage cracks propagating to the crystal surface. Under the same processing parameters, the scratch of the (001) crystal plane along the [100] crystal-orientation was found to be the most conducive to achieving plastic machining of MgF2 single crystals. The theoretical results agreed well with the experimental results, which will not only enhance the understanding of the anisotropy dependence of the damage evolution and removal process during the machining of MgF2 crystals, but also provide a theoretical foundation for achieving the high-efficiency and low-damage processing of anisotropic single crystals.
Hyperfine interactions and coherent spin dynamics of isotopically purified 167Er3+ in polycrystalline Y2O3
Authors: Rajh Tijana , Sun Lei , Gupta Shobhit , Yang Jun , Zhang Haitao , Zhong Tian
Published: November 2022

167Er3+ doped solids are a promising platform for quantum technology due to erbium’s telecom C-band optical transition and its long hyperfine coherence times. We experimentally study the spin Hamiltonian and dynamics of 167Er3+ spins in Y2O3 using electron paramagnetic resonance (EPR) spectroscopy. The anisotropic electron Zeeman, hyperfine and nuclear quadrupole matrices are fitted using data obtained by X-band (9.5 GHz) EPR spectroscopy. We perform pulsed EPR spectroscopy to measure spin relaxation time T
1 and coherence time T
2 for the 3 principal axes of an anisotropic g tensor. Long electronic spin coherence time up to 24.4 μs is measured for lowest g transition at 4 K, exceeding previously reported values at much lower temperatures. Measurements of decoherence mechanism indicates T
2 limited by spectral diffusion and instantaneous diffusion. Long spin coherence times, along with a strong anisotropic hyperfine interaction makes 167Er3+:Y2O3 a rich system and an excellent candidate for spin-based quantum technologies.
Introducing Environmental Research: Health—a new journal devoted to addressing important global challenges at the interface of the environment and public health
Authors: Bell Michelle L
Published: November 2022

Environmental Research: Health is a new open access, interdisciplinary journal devoted to addressing important global challenges at the interface of the environment and health in ways that bridge scientific progress and assessment with efforts relating to impact and future risks, resilience, mitigation, adaptation, security and solutions in the broadest sense. While progress has been made in many areas of environmental health, many problems remain and are in fact rising, with increasing threats from climate change and growing disparities in the health burdens of environmental conditions. Although many disciplinary and some broader journals exist, Environmental Research: Health functions at the intersection of science and solutions, which necessitates contributions from multiple disciplines, often working collaboratively, to provide science to better inform decisions from the local to global levels. The journal welcomes contributions from all research methodologies, including qualitative, quantitative, experimental, theoretical and applied approaches, including work on exposure assessment, implementation studies, policy analysis, and health assessment. Through open access, all science published in the journal will be made available free of charge to everyone. The inaugural Editorial Board spans experts from many fields including medicine, epidemiology, architecture, environmental engineering, statistics, and more. Environmental Research: Health aims to facilitate high caliber scientific evidence on how environmental conditions can harm or improve health to allow decision-makers from community groups to national and international leaders to make the best choices to improve health and the environment.
ACC for local volumes and boundedness of singularities
Authors: Han Jingjun , Liu Yuchen , Qi Lu
Published: November 2022

The ascending chain condition (ACC) conjecture for local volumes predicts that the set of local volumes of Kawamata log terminal (klt) singularities

x
∈
(
X
,
Δ
)

x\in (X,\Delta )

satisfies the ACC if the coefficients of

Δ
\Delta

belong to a descending chain condition (DCC) set. In this paper, we prove the ACC conjecture for local volumes under the assumption that the ambient germ is analytically bounded. We introduce another related conjecture, which predicts the existence of

δ
\delta

-plt blow-ups of a klt singularity whose local volume has a positive lower bound. We show that the latter conjecture also holds when the ambient germ is analytically bounded. Moreover, we prove that both conjectures hold in dimension 2 as well as for 3-dimensional terminal singularities.
BraneMF: integration of biological networks for functional analysis of proteins
Authors: Jagtap Surabhi , Çelikkanat Abdulkadir , Pirayre Aurélie , Bidard Frédérique , Duval Laurent , Malliaros Fragkiskos D
Published: November 2022

Motivation

The cellular system of a living organism is composed of interacting bio-molecules that control cellular processes at multiple levels. Their correspondences are represented by tightly regulated molecular networks. The increase of omics technologies has favored the generation of large-scale disparate data and the consequent demand for simultaneously using molecular and functional interaction networks: gene co-expression, protein–protein interaction (PPI), genetic interaction and metabolic networks. They are rich sources of information at different molecular levels, and their effective integration is essential to understand cell functioning and their building blocks (proteins). Therefore, it is necessary to obtain informative representations of proteins and their proximity, that are not fully captured by features extracted directly from a single informational level. We propose BraneMF, a novel random walk-based matrix factorization method for learning node representation in a multilayer network, with application to omics data integration.

Results

We test BraneMF with PPI networks of Saccharomyces cerevisiae, a well-studied yeast model organism. We demonstrate the applicability of the learned features for essential multi-omics inference tasks: clustering, function and PPI prediction. We compare it to the state-of-the-art integration methods for multilayer networks. BraneMF outperforms baseline methods by achieving high prediction scores for a variety of downstream tasks. The robustness of results is assessed by an extensive parameter sensitivity analysis.

Availability and implementation

BraneMF’s code is freely available at: https://github.com/Surabhivj/BraneMF, along with datasets, embeddings and result files.

Supplementary information

Supplementary data are available at Bioinformatics online.
O070 Can the compass trial recommendations be implemented following symptomatic carotid endarterectomy (CEA)?
Authors: Marzouqa N. , Weerakkody RA , Kythreotou A. , Baker DM
Published: November 2022

Introduction

The paradigm changing COMPASS trial (1) demonstrated that in stable atherosclerotic disease, low-dose Rivaroxaban and Aspirin has a significantly greater protective effect on subsequent cardiovascular events (death, stroke or myocardial infarct) than antiplatelet medication alone. This included carotid endarterectomy patients. We assessed our success at implementing COMPASS in our symptomatic CEA patients

Methods

At the four-week virtual post-CEA review, in suitable patients the general practitioner was advised to change from single antiplatelet to COMPASS regimen. At 6-month follow-up the success and safety of the conversion was assessed.

Results

For 18 months up to February 2021, 47 patients underwent successful CEA. 29 were recommended for COMPASS, 3 were lost to follow up and 15 were not suitable (6 on DOAC for AF/VTE, 9 complex drug regimen). At 6 months 18 of 29 patients were on the COMPASS regimen (9 not started; 2 withdrawn due to bruising). All patients reported compliance to the regimen. There were no reported haemorrhagic events. 1 patient (not in the COMPASS group) had further multi-territory cerebrovascular events.

Conclusion

COMPASS is well tolerated in this cohort. Conversion from established drug regimens has yet to gain traction. The benefits on future cardiovascular events post-CEA is yet to be determined.

Take-home message

Changing post-op medications after a carotid endarterectomy can reduce the later risk of Cardiovascular events. We demonstrate it is possible to successfully do this, but should aim for a higher rate of uptake.

(1): N Engl J Med 2017; 377:1319–1330 DOI: 10.1056/NEJMoa1709118
EP-68 A Case of Spontaneous Pneumomediastinum due to Marijuana usage- A rare cause
Authors: Loganathan Santhosh , Gungadin Pallavi , Ichim Petre
Published: November 2022

Pneumomediastinum without trauma or clear secondary cause is called Spontaneous pneumomediastinum with an incidence between 0.001%-0.014% and most commonly seen in young males. Marijuana smoking has rarely been identified as a possible cause of spontaneous pneumomediastinum, which is likely caused by barotrauma during breathing manoeuvres. Fewer than 10 case reports have been reported in the literature on Marijuana causing Spontaneous pneumomediastinum.

We present a 24year male who presented with dysphagia, swelling and crackling under the skin of his neck for the past 12hours, half an hour after blowing his nose. There was no chest pain or dyspnoea, and he was hemodynamically stable with normal blood investigations. He smokes cannabis regularly and occasionally does cocaine. On examination, surgical emphysema was felt on both sides of the neck; the systemic examination was unremarkable. CT thorax demonstrated extensive pneumomediastinum and surgical emphysema from the angle of the jaw throughout the neck and down to the right subcapsular region. No pneumothorax was seen, and lung parenchyma was unremarkable. However, to rule out the clinical suspicion of oesophageal rupture, he had a CT oesophagus with oral contrast, which showed no extravasation of contrast from the oesophagus. The patient was admitted for observation, and the Chest X-ray after 12hours dint show pneumothorax. He was clinically well, tolerating oral feeds, so he was discharged with oral antibiotics as a prophylactic cover as per UGI surgeons.

The knowledge about this rare cause would help the physicians diagnose and educate the patients on the risk involved in using Marijuana.
EP-142 Assessing the Diagnostic Sensitivity of CT and Ultrasound in Suspected Appendicitis
Authors: Ahmed Salma , Hassan Karim , Abubaker Malaz , Wilson Jeremy , Magee Conor
Published: November 2022

Introduction

Acute appendicitis is the most common surgical emergency and accounts for one-third of adult patients presenting to A&E. CT imaging has high positive predictive value for acute appendicitis. Ultrasound, on the other hand, is preferred as a first-line imaging in children and women of child-bearing age. However, it is dependent on operator experience, variation in appendiceal anatomy and patient body habitus.

The RCR standards for the CT sensitivity should be >90% and for US it should be >70%. We conducted this study to investigate whether the diagnostic yield of CT and Ultrasound imaging in suspected appendicitis meet that of published research studies.

Method

All patients who underwent CT or US for suspected appendicitis followed by confirmed diagnosis where included. RCR AuditLive template was used to assess the performance in our local hospital.

Results

Sixty patients included. Of which eighteen had Ultrasound Abdomen and pelvis, forty-six had contrast CT scan and four patients had US followed by CT. Sensitivity for CT and US was 93% and 40% respectively with negative appendectomy rate of nearly 2%.

Conclusion

The standards for CT have been met in our hospital, however this is not the case for the US. This could be related to the performing operator, group of patients referred for US or the request itself, weather we request it to confirm the presence of appendicitis or rather excluding other pathologies. In all cases we recommend that we discuss these results in our next joined meeting with the radiologists.
SP7.2 Student reported outcomes of a novel virtual medical work experience: results from an international cohort
Authors: Shakir Taner , Matwala Kabir , Lovett Bryony
Published: November 2022

Introduction

The COVID-19 pandemic had a deleterious effect not only upon medical and surgical training, but also upon inspiring the medics and surgeons of the future. Prior to applying for a career in medicine, students often take part in work experience. This observership provides in insight into what a medical career entails. Nationwide lockdowns and hospital visiting restrictions rendered it impossible to gain this understanding. We designed a novel virtual work experience (VWE) aimed at mitigating this loss.

Methods

A timetable was created to simulate a chronological progression throughout a medical career. A range of speciality talks were given by junior and senior doctors. Students were invited to sign up after contacting local schools, dissemination on social media and word of mouth. The one day event was free and hosted using online video conferencing software. Pre and post course questionnaires assessed confidence with regards to a career in medicine.

Results

There were 434 student registrations which spanned internationally to 9 countries. 140 post course responses were obtained. 131 students (94%) responded that the event was a good alternative to face to face (F2F) experience. Confidence levels of above 3 (on a 5 point Likert scale) improved from 54% to 99% regarding medical school applications and the interview process. 96% of students were interested in pursuing a career in medicine after the event.

Conclusions

This VWE event aimed to combat the loss of F2F experience. Student reported outcomes were extremely favourable. This may form the foundation of a hybrid work experience in the future.
SP11.2 Tackling the post pandemic NHS waiting lists- Mission impossible?
Authors: Bodapati Shruti , Singh Gambhir Raghvinder Pal , Kimura Shiori
Published: November 2022

Aim

The office of national statistics (ONS) has estimated that around 5.8 million people are currently, waiting for treatment and the government has allocated £ 1.5 billion to tackle the backlog. The study aimed to analyze the likely effectiveness of these measures.

Methods

We looked at various government and NHS resources pertaining to the recovery plan.

Results

The actual numbers currently waiting to be treated is predicted to be closer to 13 million. Working within the current timeframes it will take up to 12 years to clear this backlog. Among the surgical specialities the numbers waiting are Orthopaedics- 700,547, Ophthalmology - 595,824, ENT - 459,087, Gynaecology - 438,703, General Surgery - 409,823. The £1.5 billion for elective recovery, includes £500 million capital funding (£250 million for increasing operating theatre capacity and hospital productivity and £250 million for an elective recovery technology fund).

The private setup has been utilized in fits and starts to ensure there is no undue delay for cancer surgeries. Pop up centers and surgical hubs are to speed up the diagnosis and treatments for things like day case cataract surgeries.

Conclusion

Without disruptive thinking, clearing the backlog is mission impossible. The existing capacity has to be utilized beyond the conventional working hours and Hospital at weekend has to designated for pandemic backlog. This will give 104 additional full time days in each of the NHS Hospitals and paying the staff a “new pandemic bank rate” may help get the job done in 4–5 years.

References

1. https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2021-22/; 2. https://www.ons.gov.uk/search?q=nhs+waiting+lists; 3. https://committees.parliament.uk/publications/8352/documents/85020/default/; 4. https://nhswaitlist.lcp.uk.com/; 5. https://ifs.org.uk/publications/15557
WE6.1 A Sustainable Appendicectomy
Authors: Boag Katie , Ho Timothy , Quyn Aaron , Peckham-Cooper Adam
Published: November 2022

Background and Aim

Equipment consumption is the third largest contributor to the carbon footprint of surgery. Laparoscopic surgery is particularly resource intensive. The aim of this quality improvement project is to reduce the carbon footprint of laparoscopic appendicectomies performed at this high volume trust.

Methods

The laparoscopic appendicectomy was process-mapped and carbon footprint calculations performed. Three areas of change were identified: elimination of single use gowns and drapes, elimination of peri-operative catheterisation, and rationalisation of the equipment tray from 119 to 49 items. A staff survey was used to identify practices and gain feedback on the proposed changes. Changes were implemented from January 2022. Surgeons are able to ask for a ‘sustainable appendicectomy pathway’ at team brief. Procedures were monitored for one week.

Results

Survey feedback indicated 100% (n=19) supported the proposed changes. The interventions save an estimated 7.48kgCO2e and £25.1 per procedure. No extra equipment was required during the procedures monitored.

Conclusions

The interventions are predicted to save annually 3.9TCO2e and £13,081 in the approximately 500 appendicectomies performed in this trust, and can be extrapolated to many types of procedures. Support from all members of the operating department is vital to sustaining the momentum of interventions. Following initial positive results, changes were extended to only use reusable gowns in one of the CEPOD theatres which perform around 2400 procedures/year. This will lead to a saving of at least 6386 disposable gowns/year (1.43T of waste). Further plans within this trust are to make the ‘sustainable appendicectomy pathway’ an opt-out decision.
WE6.5 Back to the future: Does increasing the proportion of local anaesthetic inguinal hernia repairs help achieve a #NetZeroNHS?
Authors: Robb Henry , Gan Jonathan , Winter-Beatty Jasmine , Dryden Simon , Ortega Patricia , Purkayastha Sanjay
Published: November 2022

Aim

To investigate whether increasing the proportion of local anaesthetic (LA) inguinal hernia repairs (IHR) provides benefit across the sustainability ‘triple bottom line’ of environmental, financial, and social improvement.

Methods

After establishing suitability criteria for LA IHR, the IHR waiting list was screened and 20 patients were deemed suitable for LA repair. Data was collated on clinical outcomes, surgical timings, medical equipment usage and patient satisfaction. Trust data on our pre-pandemic (2019) practises was analysed to provide environmental and financial estimates.

Extensive carbon footprinting was performed of the resources used in LA and general anaesthetic (GA) cases.

Results

Of the 20 cases identified, 10 IHRs were performed under LA and 10 under GA. LA IHR had a 53.2% shorter length of stay (LOS) and a 40% reduced complication rate. Analysis of our 2019 data mirrored this with the LA IHR patients having a 4.75-hour shorter LOS. In 2019, only 27.7% of cases were performed under LA, far below that in published literature (Sanjay 2007) of 64%.

LA IHR saved 10.2kgCO2e/case. If we increased our annual LA rate to 64%, we would save 2005.12kg/CO2e/year. Financially, our trust would save £15, 984.54/year. Our patient surveys did not identify a difference in quality-of-life outcomes, however our improved clinical outcomes support the superiority of LA IHR for patients.

Conclusion

Increasing the number of LA IHRs would provide significant benefits across the triple bottom line. Our carbon emission savings alone is equivalent to driving from London to Edinburgh 12.5 times.
TH4.1 Systematic review of preoperative magnetic resonance angiography, computed tomography angiography and duplex ultrasonography for diagnosis and planning of surgical, endovascular or hybrid procedures for lower limb revascularisation
Authors: Edgerley Daisy , Rahi Asad
Published: November 2022

Aims

This systematic review assessed literature concerning preoperative magnetic resonance angiography (MRA), computed tomography angiography (CTA), and duplex ultrasonography to determine the sensitivity and specificity at detecting lower limb arterial stenosis and/or occlusion, with digital subtraction angiography (DSA) as the reference standard. The aim was to see if any, or a combination of, methods could replace DSA in peripheral arterial disease diagnosis and treatment planning.

Methods

10 databases were searched on Ovid for studies involving MRA, CTA and/or duplex ultrasonography of the lower limb arteries. The period of interest was 1995-April 2021. The papers were assessed for their relevance to the review against the exclusion criteria.

Results

41 studies were included. For detecting ≥50% stenosis or occlusion, multi-detector CTA had the highest median sensitivity of 93.9% and specificity of 93.4%. Contrast-enhanced MRA and duplex ultrasonography reported median sensitivities and specificities of 91.1% and 91.9%, and 82.7% and 90.6%, respectively. For detecting occlusions, duplex ultrasonography had the best median sensitivity of 92.3% and specificity of 99.5%. Contrast-enhanced MRA and multi-detector CTA had median sensitivities and specificities 92.0% and 96.5%, and 88.6% and 98.3%, respectively.

Conclusion

Contrast-enhanced MRA had the best overall diagnostic accuracy. Multi-detector CTA detected ≥50% stenosis or occlusion well, but the sensitivity for occlusions was lower than MRA and duplex ultrasonography. Though duplex ultrasonography detected occlusions better than MRA and CTA, it was less sensitive and specific at detecting ≥50% stenosis or occlusion. Consequently, contrast-enhanced MRA could be used as an alternative to DSA.
698 Frequency of Short vs Long-Term Reporting of Bariatric Surgery Outcomes
Authors: Oochit K , Shahwan S , Kourounis G
Published: November 2022

Bariatric surgery is an effective treatment for obesity. Though both short- and long-term outcomes have been reported, most of the published literature to date has focused on short-term outcomes. Identification of post-operative weight regain, and re-emergence of comorbidities require long-term follow-up. We aimed to identify the distribution and changes in follow-up times within the bariatric surgery literature.

We screened through 1807 articles from 9 bariatric surgery journals from January to June of 2015 and 2021 via PubMed and identified articles reporting weight loss as a main outcome. Follow-up intervals were divided into short- (<3 years), medium- (3–5 years), and long-term (≥5 years) as per the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines.

53 and 63 articles were identified in 2015 and 2021 respectively. Reported follow-up lengths in 2015 were 32 (60%) short-term, 14 (26%) medium-term, and 7 (14%) long-term; while in 2021 there were 41 (65%) short-term, 6 (10%) medium-term and 16 (25%) long-term articles in 2021. Of the articles reporting long-term outcomes in 2015 and 2021, only 48% and 70% of the included patients respectively had >5 years follow up data available.

Though reporting of long-term outcomes increased (14% to 25%), the majority of published outcomes remains short-term. Bariatric surgery registries such as the United Kingdom National Bariatric Surgery Registry (NBSR) are helping to mitigate this, but an increased focus on investigating and reporting long-term outcomes would be beneficial to clinicians and patients making decisions regarding surgery.
663 Potential for Prophylactic Antibiotics in Renal Transplantation: A Retrospective Study of Kidney Perfusion Fluid Cultures and Kidney Cold Ischaemic Time
Authors: Haq I , Berjaoui N , Hunter J , Roy D , Imray C , O'Callaghan J
Published: November 2022

Aim

Infection is a significant cause of morbidity in kidney transplantation, and it is believed that an increased cold ischemic time is an independent risk factor. Identification of common pathogens in perfusion fluids, as well as the safe limit of cold ischaemic time can be used to reduce the risk of postoperative complications. There are currently no guidelines for prophylactic antibiotics.

Method

This is a retrospective review of the microbiological analysis of kidney perfusion fluids samples for a recipient transplant between 2017–2020. 100 patients were identified in this time period and this data was compared against the cold ischaemic time of the donor kidney.

Results

23% (22/96) samples were positive for bacteria with the majority being gram positive cocci. The most common bacteria grown was Coagulase Negative Staphylococcus (44% - 11/25). However, a broad spectrum of bacteria was grown including Hafnia, Pseudomonas, Klebsiella, Kocuria and E-coli. 3% (3/96) of samples grew two different species of bacteria.

The mean cold ischemic time for all transplants was 799 minutes with a range of 281–1618 minutes. The mean for infected samples was 935 mins with a range of 645–1410. Samples that grew 2 bacteria had a range of 913–941 mins.

Conclusions

There is potential to reduce the risk of infection with the use of broad-spectrum induction antibiotics and it is important that potential bacterial species and common resistance profiles are covered. There is a possible correlation between increased cold ischaemic time and bacterial growth in perfusion fluid however further research is warranted.
Canyons Community Schools: Universities and Colleges as Key Partners
Authors: Anderson-Butcher Dawn , Bates Samantha , Sterling Karen , Voegler Michelle , Dau Wendy , Amorose Anthony
Published: November 2022

Community schools respond to a variety of risk factors that impede student learning and development. School and community leaders in Canyons School District (CSD) have created community schools across one highly impacted feeder pattern to strengthen academic learning efforts, school climate and youth development opportunities, parent and family engagement efforts, health and social services, and community partnerships. Over the past decade, school improvement processes and practices have been supported through key partnerships with colleges and universities. This article describes how universities and colleges assisted five community schools in CSD and illustrates outcomes associated with ongoing evaluation and continuous improvement efforts. The myriad of ways higher education institutions can assist community schools in highly impacted school communities are described, highlighting the various ways schools can leverage university expertise, time, personnel, and capital to help implement expanded models of schooling.
Acute effects of electronic cigarettes on vascular endothelial function: a systematic review and meta-analysis of randomized controlled trials
Authors: Meng Xing-chen , Guo Xin-xin , Peng Zhen-yan , Wang Chun , Liu Ran
Published: November 2022

Aim

The effects of e-cigarettes on endothelial function remained controversial. The study aimed to investigate the effects of e-cigarettes on vascular endothelial function.

Methods and results

PubMed, Web of Science, Embase, and Cochrane Library were searched up to December 2021. We only included the studies in which the control group included vaping without nicotine and tobacco. Pairwise and network meta-analyses were conducted for flow-mediated dilation (FMD), pulse wave velocity (PWV), and heart rate corrected augmentation index (AIx75). Eight studies involving 372 participants were eligible for this review. Compared with vaping without nicotine, e-cigarettes significantly increase in PWV (mean difference = 3.09; 95% confidential interval: 1.51–4.68, P < 0.001) and AIx75 (mean difference = 2.11; 95% confidential interval: 1.02–3.21, P < 0.001) indicators, but not affect FMD (mean difference = 0.78; 95% confidential interval: −0.08 to 1.64, P = 0.075). But compared with traditional tobacco, e-cigarettes did not affect FMD (mean difference = 0.28, 95% confidential interval: −0.45 to 0.59, P = 0.084). According to surface under the cumulative ranking curve (SUCRA), the e-cigarette ranked first for FMD (SUCRA = 97%), tobacco ranked first for PWV (SUCRA = 75%), and AIx75 (SUCRA = 99%).

Conclusion

In summary, evidence from our pooled analyses indicated that acute inhalation of e-cigarettes leads to negative changes in vascular endothelial function. E-cigarettes cannot be used as an alternative to public health strategies for tobacco control and should not be considered cardiovascular safety products. More future research should be conducted to verify our findings.
Diagnostic group differences in return to work and subsequent detachment from employment following cardiovascular disease: a nationwide cohort study
Authors: Bernt Jørgensen Sidsel Marie , Gerds Thomas Alexander , Johnsen Nina Føns , Gislason Gunnar , El-Chouli Mohamad , Brøndum Stig , Maribo Thomas , Kristiansen Maria
Published: November 2022

Aims

Return to work and employment maintenance following cardiovascular disease (CVD) are important rehabilitation goals for people of working age. To identify people in particular need of vocational rehabilitation, we examined differences in return to work and subsequent detachment from employment among people with atrial fibrillation (AF), heart failure (HF), heart valve disease, and ischaemic heart disease.

Methods and results

We conducted a nationwide cohort study and included all individuals of working age (35–65 years) who were employed when diagnosed with incident CVD in 2018. We estimated sex- and age-standardized probabilities of remaining employed at 3, 6, and 12 months after diagnosis, and of detachment from employment within 6 months after having returned to work. Of 46 912 individuals diagnosed in 2018, 8187 were of working age and employed at diagnosis. The mean age was 54.7 years (SD = 6.7), and 74.0% were men. Within 1 year, 89.8% had returned to work, but within the subsequent 6 months, 23.5% of these experienced detachment from employment. At 3, 6, and 12 months after diagnosis the highest standardized probability of being employed was found among people with AF, whereas the lowest probability was found among people with HF {78.9% [95% confidence interval (CI): 77.3–80.4] vs. 62.2% [95% CI: 59.0–65.4] at 12 months}. Similarly, the highest probability of detachment was found for people with HF [30.3% (95% CI: 26.9–33.7)].

Conclusion

People with HF present the highest probability of not returning to work. There is a need for developing and documenting effects of vocational rehabilitation strategies within comprehensive cardiac rehabilitation programmes.