bluuebunny/crossref_metadata_2025 huggingface dataset:
Sun Safety: Knowledge and Behavior among Egyptian Farmers—a Multicomponent Intervention Study
Authors: El-Shafei Dalia A. , Said Randa M.
Published: October 2022

The purpose of study was to screen for health hazards related to sun exposure and to examine the effectiveness of a sun safety multicomponent intervention designed specifically for the Egyptian farmers. A multicomponent interventional study was conducted among 128 farmers from three villages in Zagazig district, Sharkia Governorate, Egypt, from January to July 2022. It passed through three phases: phase 1: assessment of participants’ risk of skin cancer and vision screening; phase 2: filling a semi-structured questionnaire assessing sun exposure hazards and sun safety knowledge, behavior, and barriers; and phase 3: conducting multicomponent intervention composed of education session, providing sun safety supplies and reminders then evaluate the effect of this intervention after one month. Most of participants had moderate risk for skin cancer (69.0%), history of photokeratitis (77.3%), cataract (15.6%), and bad/very bad self-reported overall eyesight (43.0%). After intervention, there was a statistically significant improvement in the participants’ awareness regarding sun exposure-related hazards, all knowledge items about sun safety measures (p < 0.01) and some sun safety behaviors (p < 0.05) including wearing protective clothing, minimization of direct sunlight exposure, taking breaks, plentiful water intake, regular self-checking of skin, wearing wide brimmed hats, and job rotation. Furthermore, there was a statistically significant improvement in all sun protection barriers (p < 0.01) except sunscreen and sunglasses related barriers (p ˃ 0.05). The multicomponent intervention composed of education session, providing sun safety supplies and reminders was effective in increasing awareness of farmers with sun exposure hazards and improving their knowledge and behavior towards sun safety measures.
Question routing via activity-weighted modularity-enhanced factorization
Authors: Krishna Vaibhav , Vasiliauskaite Vaiva , Antulov-Fantulin Nino
Published: October 2022

Question Routing (QR) in Community-based Question Answering (CQA) websites aims at recommending newly posted questions to potential users who are most likely to provide “accepted answers”. Most of the existing approaches predict users’ expertise based on their past question answering behavior and the content of new questions. However, these approaches suffer from challenges in three aspects: (1) sparsity of users’ past records results in lack of personalized recommendation that at times does not match users’ interest or domain expertise, (2) modeling based on all questions and answers content makes periodic updates computationally expensive, and (3) while CQA sites are highly dynamic, they are mostly considered as static. This paper proposes a novel approach to QR that addresses the above challenges. It is based on dynamic modeling of users’ activity on topic communities. Experimental results on three real-world datasets demonstrate that the proposed model significantly outperforms competitive baseline models.
Rational framing effects and morally valid reasons
Authors: Żuradzki Tomasz
Published: October 2022

I argue that the scope of rational framing effects may be broader than Bermúdez assumes. Even in many “canonical experiments,” the explanation of the judgment reversals or shifts may refer to reasons, including moral ones. Referring to the Asian disease paradigm (ADP), I describe how non-consequentialist reasons related to fairness and the distinction between doing and allowing may help explain and justify the typical pattern of choices in the cases like ADP.
Equation‐Free Surrogate Modeling of Geophysical Flows at the Intersection of Machine Learning and Data Assimilation
Authors: Pawar Suraj , San Omer
Published: October 2022

There is a growing interest in developing data‐driven reduced‐order models for atmospheric and oceanic flows that are trained on data obtained either from high‐resolution simulations or satellite observations. The data‐driven models are non‐intrusive in nature and offer significant computational savings compared to large‐scale numerical models. These low‐dimensional models can be utilized to reduce the computational burden of generating forecasts and estimating model uncertainty without losing the key information needed for data assimilation (DA) to produce accurate state estimates. This paper aims at exploring an equation‐free surrogate modeling approach at the intersection of machine learning and DA in Earth system modeling. With this objective, we introduce an end‐to‐end non‐intrusive reduced‐order modeling (NIROM) framework equipped with contributions in modal decomposition, time series prediction, optimal sensor placement, and sequential DA. Specifically, we use proper orthogonal decomposition (POD) to identify the dominant structures of the flow, and a long short‐term memory network to model the dynamics of the POD modes. The NIROM is integrated within the deterministic ensemble Kalman filter (DEnKF) to incorporate sparse and noisy observations at optimal sensor locations obtained through QR pivoting. The feasibility and the benefit of the proposed framework are demonstrated for the NOAA Optimum Interpolation Sea Surface Temperature (SST) V2 data set. Our results indicate that the NIROM is stable for long‐term forecasting and can model dynamics of SST with a reasonable level of accuracy. Furthermore, the prediction accuracy of the NIROM gets improved by almost one order of magnitude by the DEnKF algorithm.
MMP7 cleavage of amino-terminal CD95 death receptor switches signaling toward non-apoptotic pathways
Authors: Kenji Shoji F. , Kurma Keerthi , Collet Brigitte , Oblet Christelle , Debure Laure , Di Primo Carmelo , Minder Laëtitia , Vérité Franck , Danger Yannic , Jean Mickael , Penna Aubin , Levoin Nicolas , Legembre Patrick
Published: October 2022

CD95 is a death receptor that can promote oncogenesis through molecular mechanisms that are not fully elucidated. Although the mature CD95 membrane receptor is considered to start with the arginine at position 17 after elimination of the signal peptide, this receptor can also be cleaved by MMP7 upstream of its leucine at position 37. This post-translational modification occurs in cancer cells but also in normal cells such as peripheral blood leukocytes. The non-cleaved CD95 amino-terminal region consists in a disordered domain and its in silico reconstitution suggests that it might contribute to receptor aggregation and thereby, regulate the downstream death signaling pathways. In agreement with this molecular modeling analysis, the comparison of CD95-deficient cells reconstituted with full-length or N-terminally truncated CD95 reveals that the loss of the amino-terminal region of CD95 impairs the initial steps of the apoptotic signal while favoring the induction of pro-survival signals, including the PI3K and MAPK pathways.
Purification and structural characterization of the Na+-translocating ferredoxin: NAD+ reductase (Rnf) complex of Clostridium tetanomorphum
Authors: Vitt Stella , Prinz Simone , Eisinger Martin , Ermler Ulrich , Buckel Wolfgang
Published: October 2022

Various microbial metabolisms use H+/Na+-translocating ferredoxin:NAD+ reductase (Rnf) either to exergonically oxidize reduced ferredoxin by NAD+ for generating a transmembrane electrochemical potential or reversely to exploit the latter for producing reduced ferredoxin. For cryo-EM structural analysis, we elaborated a quick four-step purification protocol for the Rnf complex from Clostridium tetanomorphum and integrated the homogeneous and active enzyme into a nanodisc. The obtained 4.27 Å density map largely allows chain tracing and redox cofactor identification complemented by biochemical data from entire Rnf and single subunits RnfB, RnfC and RnfG. On this basis, we postulated an electron transfer route between ferredoxin and NAD via eight [4Fe-4S] clusters, one Fe ion and four flavins crossing the cell membrane twice related to the pathway of NADH:ubiquinone reductase. Redox-coupled Na+ translocation is provided by orchestrating Na+ uptake/release, electrostatic effects of the assumed membrane-integrated FMN semiquinone anion and accompanied polypeptide rearrangements mediated by different redox steps.
Antiferromagnetic insulating state in layered nickelates at half filling
Authors: Jung Myung-Chul , LaBollita Harrison , Pardo Victor , Botana Antia S.
Published: October 2022

We provide a set of computational experiments based on ab initio calculations to elucidate whether a cuprate-like antiferromagnetic insulating state can be present in the phase diagram of the low-valence layered nickelate family (R$$_{n+1}$$

n
+
1

Ni$$_n$$

n

O$$_{2n+2}$$

2
n
+
2

, R= rare-earth, $$n=1-\infty$$

n
=
1
-
∞

) in proximity to half-filling. It is well established that at $$d^9$$

d
9

filling the infinite-layer ($$n=\infty$$

n
=
∞

) nickelate is metallic, in contrast to cuprates wherein an antiferromagnetic insulator is expected. We show that for the Ruddlesden-Popper (RP) reduced phases of the series (finite n) an antiferromagnetic insulating ground state can naturally be obtained instead at $$d^9$$

d
9

filling, due to the spacer RO$$_2$$

2

fluorite slabs present in their structure that block the c-axis dispersion. In the $$n=\infty$$

n
=
∞

nickelate, the same type of solution can be derived if the off-plane R-Ni coupling is suppressed. We show how this can be achieved if a structural element that cuts off the c-axis dispersion is introduced (i.e. vacuum in a monolayer of RNiO$$_2$$

2

, or a blocking layer in multilayers formed by (RNiO$$_2$$

2

)$$_1$$

1

/(RNaO$$_2$$

2

)$$_1$$

1

).
$$\nu $$-Improved nonparallel support vector machine
Authors: Sun Fengmin , Lian Shujun
Published: October 2022

In this paper, a $$\nu $$
ν
-improved nonparallel support vector machine ($$\nu $$
ν
-IMNPSVM) is proposed to solve binary classification problems. In this model, we use related ideas of $$\nu $$
ν
-support vector machine($$\nu $$
ν
-SVM), the parameter $$\nu $$
ν
is introduced to control the limits of the support vectors percentage. In the objective function, the parameter $$\varepsilon $$
ε
is increased to ensure that $$\varepsilon $$
ε
-band is kept as small as possible. It has played a great role in the classification of unbalanced data sets. On the basis of maximizing the interval between two classes, $$\nu $$
ν
-IMNPSVM can fully fit the distribution of data points in the class by minimizing the $$\varepsilon $$
ε
-band, which enhances the generalization ability of the model. The results on the benchmark datasets testify that the proposed model has a good effect on the classification accuracy.
Safety monitoring method of moving target in underground coal mine based on computer vision processing
Authors: Xu Pengfei , Zhou Zhiqing , Geng Zexun
Published: October 2022

Coal is one of the main energy sources in China. The country attaches great importance to the development of coal mining industry, and coal production is on the rise. At the same time, mine safety accidents are becoming more and more frequent, and the country is paying more and more attention to mine safety accidents. The underground environment of coal mine is complex, noisy and uneven, and there will be problems such as occlusion and high false detection rate during video monitoring. In order to ensure the safety of underground personnel, moving target detection and tracking based on video monitoring information is of great significance for coal mine safety production. The purpose of this paper is to study how to analyze and study the monitoring of moving targets in coal mines based on computer vision processing, and describe the image processing methods. This paper puts forward the problem of target monitoring, which is based on image processing, and then elaborates on the concept of image enhancement and related algorithms. From the average gradient, the algorithm in this paper is 56.60% higher than the histogram equalization algorithm, and 68.26% higher than the dark primary color prior dehazing algorithm. and designs and analyzes cases of image enhancement in coal mines. The experimental results show that the information entropy of the algorithm in this paper is 31.10% higher than that of the dark primary color prior dehazing algorithm, and 18.72% higher than that of the histogram equalization algorithm. It can be seen that the algorithm in this paper can achieve better enhancement effect.
Mechanical properties, degree of sclerotisation and elemental composition of the gastric mill in the red swamp crayfish Procambarus clarkii (Decapoda, Crustacea)
Authors: Krings Wencke , Brütt Jan-Ole , Gorb Stanislav N.
Published: October 2022

The gastric mill of Decapoda is a unique feature, which comprises teeth, stabilizing ossicles, and particle sorting setae. Involved in the fragmentation and sorting of the food, this structure serves as interface between the organism and its environment. As material properties complement morphology and hold information about function and trophic preferences, we here provide a basis for more comparative research on gastric mills. For gastric mill components of the adult red swamp crayfishProcambarus clarkii, we studied (a) the micro-structure via scanning electron microscopy, (b) the elemental composition by energy-dispersive X-ray spectroscopy, (c) the heterogeneities in material properties and degree of tanning (autofluorescence) by confocal laser scanning microscopy, and (d) the mechanical properties hardness and elasticity by nanoindentation technique. The morphology and micro-structure were previously described for this species, but the mechanical properties and the autofluorescence were not studied before. As epicuticle and exocuticle could be analyzed individually, material property gradients, with values decreasing from the interacting surface towards interior, could be determined. Finally, we were able to relate the mechanical property data with the elemental composition and the degree of tanning. We found that the epicuticle of the teeth is among the hardest and stiffest biological materials in invertebrates due to the incorporations of high proportions of silicon.
A remaining useful life prediction method based on PSR-former
Authors: Zhang Huang , Zhang Shuyou , Qiu Lemiao , Zhang Yiming , Wang Yang , Wang Zili , Yang Gaopeng
Published: October 2022

The non-linear and non-stationary vibration data generated by rotating machines can be used to analyze various fault conditions for predicting the remaining useful life(RUL). It offers great help to make prognostic and health management(PHM) develop. However, the complexity of the mechanical working environment makes the vibration data collected easily affected, so it is hard to form an appropriate health index(HI) to predict the RUL. In this paper, a PSR-former model is proposed including a Phase space reconstruction(PSR) layer and a Transformer layer. The PSR layer is utilized as an embedding to deepen the understanding of vibration data after feature fusion. In the Transformer layer, an attention mechanism is adopted to give different assignments, and a layer-hopping connection is used to accelerate the convergence and make the structure more stable. The effectiveness of the proposed method is validated through the Intelligent Maintenance Systems (IMS) bearing dataset. Through analysis, the prediction accuracy is judged by the parameter RMSE which is 1.0311. Some state-of-art methods such as LSTM, GRU, and CNN were also analyzed on the same dataset to compare. The result indicates that the proposed method can effectively establish a precise model for RUL predictions.
Intracranial direct electrical mapping reveals the functional architecture of the human basal ganglia
Authors: Qi Lei , Xu Cuiping , Wang Xueyuan , Du Jialin , He Quansheng , Wu Di , Wang Xiaopeng , Jin Guangyuan , Wang Qiao , Chen Jia , Wang Di , Zhang Huaqiang , Zhang Xiaohua , Wei Penghu , Shan Yongzhi , Cui Zaixu , Wang Yuping , Shu Yousheng , Zhao Guoguang , Yu Tao , Ren Liankun
Published: October 2022

The basal ganglia play a key role in integrating a variety of human behaviors through the cortico–basal ganglia–thalamo–cortical loops. Accordingly, basal ganglia disturbances are implicated in a broad range of debilitating neuropsychiatric disorders. Despite accumulating knowledge of the basal ganglia functional organization, the neural substrates and circuitry subserving functions have not been directly mapped in humans. By direct electrical stimulation of distinct basal ganglia regions in 35 refractory epilepsy patients undergoing stereoelectroencephalography recordings, we here offer currently the most complete overview of basal ganglia functional characterization, extending not only to the expected sensorimotor responses, but also to vestibular sensations, autonomic responses, cognitive and multimodal effects. Specifically, some locations identified responses weren’t predicted by the model derived from large-scale meta-analyses. Our work may mark an important step toward understanding the functional architecture of the human basal ganglia and provide mechanistic explanations of non-motor symptoms in brain circuit disorders.
Non-LTE radiative transfer with Turbospectrum
Authors: Gerber Jeffrey M. , Magg Ekaterina , Plez Bertrand , Bergemann Maria , Heiter Ulrike , Olander Terese , Hoppe Richard
Published: October 2022

Physically realistic models of stellar spectra are needed in a variety of astronomical studies, from the analysis of fundamental stellar parameters, to studies of exoplanets and stellar populations in galaxies. Here we present a new version of the widely used radiative transfer code Turbospectrum, which we update so that it is able to perform spectrum synthesis for lines of multiple chemical elements in non-local thermodynamic equilibrium (NLTE). We use the code in the analysis of metallicites and abundances of the Gaia FGK benchmark stars, using 1D MARCS atmospheric models and the averages of 3D radiation-hydrodynamics simulations of stellar surface convection. We show that the new more physically realistic models offer a better description of the observed data, and we make the program and the associated microphysics data publicly available, including grids of NLTE departure coefficients for H, O, Na, Mg, Si, Ca, Ti, Mn, Fe, Co, Ni, Sr, and Ba.
Fox and cat responses to fox baiting intensity, rainfall and prey abundance in the Upper Warren, Western Australia
Authors: Geary William L. , Wayne Adrian F. , Tulloch Ayesha I. T. , Ritchie Euan G. , Maxwell Marika A. , Doherty Tim S.
Published: October 2022

Context Invasive predators are major drivers of global biodiversity loss. Red foxes (Vulpes vulpes) and feral cats (Felis catus) have contributed to the decline and extinction of many native species in Australia. The deployment of poison baits to control fox populations is a widespread conservation tool, but the effects of baiting intensity, rainfall and prey abundance on baiting effectiveness remain poorly understood. Aims We aimed to understand what influences the association between fox baiting intensity, red fox activity and feral cat activity, to provide inferences about what might affect the effectiveness of fox baiting in reducing fox activity. Methods We used generalised linear models to assess how fox and cat activity changes in relation to fox baiting intensity, rainfall, native prey availability and distance to agricultural land over a 6-year period (2006–13) in the forest ecosystems of the Upper Warren region of south-western Australia. Key results We found that fox activity was negatively associated with rainfall in the previous 12 months and positively associated with prey abundance and fox baiting intensity. We also found an interaction between fox baiting and prey abundance, with fox activity increasing with prey activity in areas of low and moderate baiting intensity, but remaining constant in areas of high baiting intensity. Feral cat activity was positively associated with prey abundance and fox baiting intensity. We found no clear relationship between fox and cat activity. Conclusions The drivers of the association between fox baiting and fox activity are unclear because intense fox baiting was targeted at areas of known high fox abundance. However, our results indicate that intense fox baiting may be effective at decoupling the positive association between fox activity and prey abundance. Our results also suggest a positive association between fox baiting intensity and feral cat activity, thus supporting the case for integrated fox and cat management. Implications We caution interpretation of our results, but note that management of invasive predators could be improved by adjusting the intensity of management in response to changes in environmental conditions and local context (e.g. strategically conducting intense predator management where prey abundance is highest). Improved understanding of these associations requires a monitoring program with sufficient replication and statistical power to detect any treatment effects.
Development of a novel high-performance readout circuit for α and β energy spectrum measurement
Authors: Hu Chuanhao , Li Chengyang , Deng Miao , Wang Nan , Zeng Guoqiang , Gu Min , Yang Xiaofeng , Yang Jian
Published: October 2022

A novel high-performance readout circuit with multi-Junction
field-effect transistors (Multi-JFETs) and high-speed integrated
operational amplifiers as the core was designed. By coupling the
circuit to a large area passivated ion injection planar silicon
(PIPS) detector, excellent α and β energy spectrum can
be obtained. Therefore, it can be applied to radon monitor,
radioactive aerosol monitor and other equipment to achieve high
precision information on radioactive substances in the
environment. The input stage of the circuit adopts the parallel
structure of JFETs to achieve the matching between the amplifier
circuit with the detector junction capacitance. The bias circuit
adopts JFETs to form a constant current source while using the
gate-source self-biased parallel structure to obtain large
transconductance gain and good amplification linearity. The main
amplifier circuit adopts a high-speed and low-noise operational
amplifier with the advantages of high open-loop gain and stable
quiescent point. The performance of this readout circuit was tested,
in which the rise time of the signal is 35 ns, the sensitivity of
charge-voltage conversion is better than 0.979 mV/fC when the input
capacitance is less than 100 pF, and the equivalent noise charge is
1.55 fC, noise slope is 0.00366 fC/pF. By coupling the readout
circuit to a PIPS detector with a sensitive area of 450 mm2,
the signal-to-noise ratio of the output signal is 116:1 for the 
241Am alpha source and 20:1 for the 90Sr-90Y beta
particles. The energy spectrum measurement of the 238Pu source
was performed, providing FWHM is 16.90 keV@5499 keV.
Testbeam results of the Picosecond Avalanche Detector proof-of-concept prototype
Authors: Iacobucci G. , Zambito S. , Milanesio M. , Moretti T. , Saidi J. , Paolozzi L. , Munker M. , Cardella R. , Martinelli F. , Picardi A. , Rücker H. , Trusch A. , Valerio P. , Cadoux F. , Cardarelli R. , Débieux S. , Favre Y. , Fenoglio C.A. , Ferrere D. , Gonzalez-Sevilla S. , Gurimskaya Y. , Kotitsa R. , Magliocca C. , Nessi M. , Pizarro-Medina A. , Sabater Iglesias J. , Vicente Barreto Pinto M.
Published: October 2022

The proof-of-concept prototype of the Picosecond Avalanche
Detector, a multi-PN junction monolithic silicon detector with
continuous gain layer deep in the sensor depleted region, was tested
with a beam of 180 GeV pions at the CERN SPS. The prototype
features low noise and fast SiGe BiCMOS frontend electronics and
hexagonal pixels with 100 μm pitch. At a sensor bias voltage
of 125 V, the detector provides full efficiency and average time
resolution of 30, 25 and 17 ps in the overall pixel area for a
power consumption of 0.4, 0.9 and 2.7 W/cm2, respectively. In
this first prototype the time resolution depends significantly on
the distance from the center of the pixel, varying at the highest
power consumption measured between 13 ps at the center of the pixel
and 25 ps in the inter-pixel region.
The clinical heterogeneity of subjective cognitive decline: a data-driven approach on a population-based sample
Authors: Ribaldi Federica , Rolandi Elena , Vaccaro Roberta , Colombo Mauro , Battista Frisoni Giovanni , Guaita Antonio
Published: October 2022

Background

subjective cognitive decline (SCD) refers to the subjective experience of cognitive decline in the absence of detectable cognitive impairment. SCD has been largely studied as a risk condition for cognitive decline. Empirical observations suggest that persons with SCD are heterogeneous, including individuals with early Alzheimer’s disease and others with psychological vulnerabilities and/or physical comorbidity. The semiology of SCD is still in its infancy, and the features predicting cognitive decline are poorly defined. The present study aims to identify subgroups of SCD using a data-driven approach and study their clinical evolution across 8 years.

Methods

the study population is the InveCe.Ab population-based cohort, including cognitively unimpaired people aged 70–74 years and followed for 8 years. Hierarchical cluster analysis (HCA) was carried out to identify distinct SCD subgroups based on nine clinical and cognitive features. Longitudinal changes by baseline SCD status were estimated using linear mixed models for cognitive decline and Cox proportional-hazard model for all-cause dementia risk.

Results

out of 956 individuals, 513 were female (54%); and the mean age was 72.1 (SD = 1.3), education was 7.2 (3.3), and 370 (39%) reported cognitive complaints (SCD). The HCA resulted in two clusters (SCD1 and SCD2). SCD2 were less educated and had more comorbidities, cardiovascular risk and depressive symptoms than SCD1 and controls. SCD2 presented steeper cognitive decline (Mini-Mental State Examination; β = −0.31) and increased all-cause dementia risk (hazard-ratio = 3.4).

Conclusions

at the population level, basic clinical information can differentiate individuals with SCD at higher risk of developing dementia, underlining the heterogeneous nature of this population even in a sample selected for a narrow age range, in a specific geographic area.
19 COMPARATIVE COST ANALYSIS OF ALTEPLASE VERSUS TENECTEPLASE FOR ISCHAEMIC STROKE IN A SINGLE CENTRE TERTIARY HOSPITAL
Authors: Kitt K , Noone I , Cassidy T
Published: October 2022

Background

Stroke thombolysis has been a proven effective treatment for acute stroke since 1995. Since then Alteplase has been the standard thrombolytic agent used in the hyperacute stroke patient, the dose being decided by body weight (0.9mg/kg). 10% of the dose is given as a bolus, and the remaining 90% given as an infusion. As the dose is weight based, more than one vial of Alteplase can be required.

Tenecteplase is a more recent thrombolytic agent, and the 2017 large multi-centre randomised control trial NOR-TEST 2 indicated that Tenecteplase is similarly effective compared to Alteplase. Tenecteplase is given entirely as a bolus dose, with a maximum dose of 40mg administered, equivalent to one vial. A single of vial of Alteplase (Actilyse) costs €536, and a single vial of Tenecteplase (Metalyse) costs €986. Our study was set up to compare potential costs of the two treatments based on our patient cohort.

Methods

We retrospectively looked at patients given Alteplase for acute ischaemic stroke in our institution in the year 2019 (n=29). We recorded the weight of the patient, and the number of vials used to administer the appropriate dose of Alteplase. We calculated the cost of the number of vials of Alteplase used over the year, and compared that to the cost of Tenectaplase, if that were to be used instead.

Results

Over the course of the calendar year, 29 patients received Alteplase. All 29 patients had a requirement for two vials of Alteplase based on their admission weight, at a total cost of €31,088 over the year 2019. The cost of Tenectaplase for the same patient cohort would have been €28,594, with a potential cost saving of €2,494.

Conclusion

Based on our acute ischaemic stroke patient cohort for the year 2019, there is a potential cost saving benefit in a move towards using Tenecteplase instead of Alteplase.
44 CONTENT VALIDITY OF THE DYSPHAGIA PREVALENCE AND PRACTICES IN RESIDENTIAL LONG-TERM CARE SETTINGS SURVEY
Authors: Artiles CE , Regan J , Donnellan C
Published: October 2022

Background

Dysphagia is common in older adults living in Residential Long-Term Care (RLTC) settings, requiring timely diagnosis and appropriate management to avoid potential complications and improve quality of life. Current dysphagia prevalence rates, screening and management practices in RLTC settings in the Republic of Ireland are not known.

Methods

An online survey was developed, consisting of 40 questions to determine dysphagia prevalence rates and associated nursing practices in screening and managing dysphagia in RLTC settings. An expert panel was formed with individuals having clinical experience in swallow screening and dysphagia management in older adults. We calculated Item-level Content Validity Index (I-CVI) and modified Kappa statistic (k), to adjust for chance agreement, for all 40 items in terms of representativeness and clarity. A survey item is considered relevant where I-CVI≥0.78, between 0.70 and 0.77 requires revision, and below 0.70, is eliminated. For k values, agreement levels are considered as low (k=< 0.40), fair (k=0.40–0.59), good (k=0.60–0.74) and high (k=≥ 0.75).

Results

The expert panel consisted of three nurse managers, two nurse specialists and three senior speech and language therapists with postgraduate qualifications, up to three years of experience in dysphagia related research and three to thirty-six years of clinical practice. For clarity, all items scored I-CVI≥0.78 and k=≥0.75 except four items, for which I-CVI=0.75 and k=0.72. For representativeness, only one item had an I-CVI=0.75 and k=0.72, with all other scoring I-CVI≥0.78 and k=≥ 0.75.

Conclusion

Findings suggest that the DPP-RLTCS has high content validity in terms of clarity and representativeness even after adjusting for chance agreement.
66 GRIP STRENGTH, ONLY A PHYSICAL TASK? ASSOCIATIONS BETWEEN RESTING-STATE BRAIN CONNECTIVITY AND GRIP STRENGTH
Authors: Davis JRC , Boyle R , Knight SP , Romero-Ortuño R , Zúñiga RG
Published: October 2022

Background

Grip strength (GS) is a simple measure used in the assessment of frailty and sarcopenia. Despite being physical, studies show that it is also related with depression and cognition. Our aim was to explore if brain connectivity is implicated in GS.

Methods

Participants from Wave 3 of TILDA with adequate resting-state functional-MRI data were included. Connectome-based predictive modelling was used on Shen parcellated brain connectivity matrices to find connections that are positively and negatively associated with grip strength: positive and negative networks (PN and NN). On each iteration of a randomized 10-fold cross-validation, the training folds were utilized to perform partial Spearman correlations (age-, sex-adjusted) between each connection and GS. Significant (p<0.001) connections were selected. PN and NN strengths were computed by summing across all significant correlations. Linear models regressing GS on network strengths were built on training data and used to predict GS in the test fold. After 10 folds were complete the performance was measured via Pearson R between predicted and true GS values. This 10-fold process was repeated 1000 times and a mean R obtained. Permutation significance testing was employed where the cross-validation procedure was repeated 1000 times, with GS randomly shuffled each time. The P-value was the proportion of permuted R values >= the mean R.

Results

317 participants were included (mean(SD) age 67.3(7.2) and 49.8% female). For PN: R[95% intervals]=0.29[0.26, 0.32], P<0.001 and for NN: R=0.24[0.20, 0.28], P<0.001. In both, the default mode, dorsal attention, and cerebellum networks were highly involved but with differing patterns: most notable was the presence of high connectivity between both cerebellar hemispheres in the PN but not in the NN.

Conclusion

Grip strength is related with different brain connectivity patterns suggesting the involvement of networks beyond motor areas. Further studies are required to disentangle the neuroscience behind this clinically relevant physio-cognitive task.
79 EXPERIENCES OF DIRECTORS OF NURSING IN RESIDENTIAL CARE OF OLDER PEOPLE DURING COVID 19
Authors: Phelan A , Louise D , Alice C , Kent S , Naughton C , Tuohy D , Ryan A , Byrne M
Published: October 2022

Background

COVID-19 was a global public health crisis and deaths in the over 65 age group represented a disproportionate number of deaths in older people. In particular, nursing homes experienced clusters of infection and high mortality rates. This paper discusses experiences of care homes’ Directors of Nursing/Persons in Charge (DoN) in their preparedness, management and control of care during COVID-19.

Methods

A mixed methods approach was used (survey- n=122) and semi-structured interviews (n=20) were conducted with DoNs in private and voluntary older person care homes in the Republic of Ireland. Survey data was analysed using descriptive and inferential statistics. Interviews were analysed using Braun & Clarke's thematic analysis.

Results

DoNs demonstrated an initial challenge in protecting residents from infection and also managing infection outbreak. However, over time they experienced more effectiveness in managing infection prevention and control as demanded at the level of a pandemic. Fifty percent of respondents experienced an infection outbreak and the data does not demonstrate any significant difference in preparedness and management in care homes which had outbreaks and those who had no outbreaks. Other challenges were related to financial sustainability of their facility while 47% of DoNs were either actively seeking other work, or thinking of leaving their post. In the interviews, the DoNs spoke of persistent concerns with the well-being of the staff and residents and a constant worry about meeting regulatory requirements and ensuring adequate staff cover for residents care needs. Moreover, the DoNs spoke of the difficulties when the media sensationalized poor care leading to a reduction of public confidence in the sector.

Conclusion

The DoNs were under constant alert and although had acclimatized to high level of infection control and prevention and managing emerging issues, the strain of the pandemic remained evident. Recommendations are given related to care homes and related to system level management for future public health crisis.
80 A PILOT POPS SERVICE (PERI-OPERATIVE CARE OF THE OLDER PERSON UNDERGOING SURGERY): A PROMISING START
Authors: Magee M , Leung S
Published: October 2022

Background

It is understood that older persons undergoing surgery benefit from Comprehensive Geriatric Assessment (CGA), however these services remain limited in Ireland. Latest guidelines recommend all patients over 65 undergoing surgery should be screened for frailty and receive a CGA if frailty is identified. Our pilot service was to implement this on our acute surgical in-patient ward.

Methods

Baseline data was gathered prior to implementation of our service. Interventions included education, dedicated sessions for geriatrician input on ward, single point of referral and increased signage. Patients identified as living with frailty (Rockwood Clinical Frailty Score (CFS) ≥5) then received CGA. Progress monitored with monthly audit and foundation doctor feedback surveys over a 6-month period.

Results

We have increased the percentage of patients over 65 being screened for frailty from 0% to a peak of 100% over our pilot 6-month period. Foundation doctor surveys showed an improvement in confidence in screening for frailty (19 to 100%) and managing frailty (13 to 80%). They also reported feeling more supported managing these patients (38% to 100%). Focusing on patients with CFS ≥5, we have shown a reduction in length of stay from a mean of 20 days to 11 days, albeit numbers remain small.

Conclusion

By increasing identification of frailty in older patients, we have managed to apply CGA to appropriate patients. Geriatrician input on the surgical ward has also allowed foundation doctors to feel supported and improve confidence in managing patients living with frailty. Furthermore, we have shown a trend towards reduced length of stay. However, our patient numbers remain low and there is a reliance on our team to screen all patients over 65. Our focus moving forward is for the surgical team to screen for frailty allowing us to expand the service to other surgical wards.
82 THE IMPACT OF THE COVID-19 PANDEMIC ON THE ACTIVITY OF A RAPID-ACCESS GERIATRIC DAY HOSPITAL SERVICE
Authors: Moloney K , Byrne T , Mathews S , Foran M , Conroy B , Molamphy A , Murphy N , Dillon A , Doyle K , Cunningham C , Romero-Ortuno R
Published: October 2022

Background

In the 1970s, Jack Flanagan developed the first Geriatric Day Hospital (GDH) in Ireland. Since, the GDH model of care has evolved to accommodate for the growing demands of our ageing population. Before the COVID-19 pandemic, the operational scope of our GDH was extended to allow for the rapid medical and multidisciplinary assessment and follow-up of older patients. During the pandemic, the GDH did not suspend operations and remained open as a COVID-negative ambulatory pathway. We evaluated the activity of this GDH service.

Methods

Retrospective Service Evaluation Approval was granted by our Research & Innovation Office (Reference: 7419). Pseudonymised data corresponding to all GDH attendances between January 2017 and December 2021 were retrieved from the hospital electronic records. Yearly trends in proportions were tested with the Chi-square for trend statistic. Trends in monthly attendances were assessed via Statistical Process Control (SPC) charts with three-sigma limits. Statistical significance was set at p<0.05.

Results

There were 27,278 attendances of patients aged 65 and over to the GDH over the 5-year period (6,362, 5,978, 6,115, 4,306, and 4,517, respectively). Mean age was 82 every year. Of the 7,813 new episodes, yearly proportions referred directly by primary care teams were 10.4%, 29.5%, 38.6%, 24.5%, and 16.3% (p<0.001). SPC charts showed that Apr-May 2020 and Jan-Feb 2021 had significantly lower numbers of review attendances (50-59 and 146-142, respectively, average 324 p/m). However, new appointments did not significantly decline (average 130 p/m). Of the 7,813 new episodes, 2,595 (33.2%) were seen by Physiotherapy, and 1,860 (23.8%) by Occupational Therapy.

Conclusion

Our GDH saw a sustained number of new attendances and demonstrated increased community availability during the unprecedented COVID-19 crisis, especially during the first wave of the pandemic when hospital access was most affected. A rapid access GDH model can facilitate integrated care at times of crisis to promote ageing in place.
95 EXPLORING HIP FRACTURE OUTCOMES IN POST-ACUTE REHABILITATION: A MULTI-SITE AUDIT
Authors: McDaid E , Long S , Curtin C , Burke C , O'Brien K , Cogan L , Ahern E , Mello S , O'Connor M
Published: October 2022

Background

In 2020, 28% of all hip fractures in Ireland were discharged to off-site rehabilitation. The annual Irish Hip Fracture Database (IHFD) report captures patient outcomes at the point of acute discharge however patient outcomes at discharge from offsite rehabilitation are unknown.

Methods

A multi-site retrospective audit was completed examining hip fracture outcomes for patients admitted to four post-acute rehabilitation hospitals during 2021, using IHFD HIPE portals as well as local databases. Descriptive statistics including demographics, pre-fracture mobility as well as outcomes measured including acute length of stay, rehabilitation length of stay, discharge destination and independence with mobility on discharge from rehabilitation. A comparison analysis between sites was completed.

Results

A total of 445 patients were admitted post hip fracture to the four rehabilitation hospitals in 2021. Most were female (69%, n=307), mean age 82.5, 49% lived alone and most (55%) had low pre-fracture mobility as measured by New Mobility Score of 0-6. The mean acute length of stay was 11.8 days and rehabilitation stay 37.6 days. Most (90.2% of complete data, n=333) discharged home, 4.5% (n=17) were transferred to hospital, 3.2% (n=12) were newly admitted to nursing home and 1% (n=4) died. Most (82.2% of complete data, n=256) were independently mobile (CAS 6) at discharge from rehabilitation. There was no significant difference in patient profile between sites however there were significant difference in both acute length of stay (median range 8-13days) as well as rehabilitation length of stay (median range 16-39days).

Conclusion

The findings of this audit provide a new perspective on recovery post hip fracture and insight into longer term hip fracture outcomes. It shows that data collection is feasible in off-site rehabilitation units and should be considered for inclusion in the IHFD. Further work could explore the establishment of standards of care in the post-acute phase of hip fracture rehabilitation.
108 TEIRIPE SA BHAILE TEAM (TSAB): AN EARLY SUPPORTED DISCHARGE SERVICE FOR HIP FRACTURES FROM AN ACUTE HOSPITAL
Authors: Cummiskey AG , Byrne A , Spencer M , Whelan M , Nee R
Published: October 2022

Background

Due to increasing bed strain in hospitals, Early Supported Discharge (ESD) programmes have helped to reduce length of stay for hip fracture patients. Teiripe sa Bhaile Team (TsaB) provides a multi-disciplinary, patient centred approach to care for patients over 60 with hip fractures, in their own home.

Methods

Patient demographics and data has been collected on all TsaB patients to date with consent from the patients. We measured length of intervention with TsaB, patient directed SMART (Specific, measurable, achievable, relevant, time bound) goals, Functional Independence Measure (FIM) sores. We recorded the number of visits required, medical complications and number of readmissions post discharge from our service.

Results

Since formation in 2018 until April 2022, 33 patients have been treated by TsaB. The average age is 78 years old. The average length of stay prior to discharge was 17 days, compared to 54 days for inpatient hip fracture rehabilitation. Patients received an average of 11 MDT visits during the 6 weeks of rehabilitation. The average improvement in FIM score was 42. All set SMART goals, and only 5 (17%) patients did not achieve these goals.

Only 5 (17%) patients were readmitted within 6 months. No patients required initiation of a home care package for discharge, or after our interventions. No patients developed pressure ulcers while on our service, or other medical complications.

Conclusion

Through TsaB, we are able to offer a rehabilitation service to patients based around their own needs in the home. Patients were able to set and achieve their own SMART goals. Patients were moderately frail on admission to our service, but after intervention were able to improve their FIM scores, marking reduced frailty after intervention. We had low readmission rates, and no patients required a change in home care package.
124 AN INTERDISCIPLINARY PREHABILITATION PILOT FOR FRAIL ADULTS UNDERGOING ELECTIVE ANTERIOR RESECTION AND HARTMANN’S REVERSAL SURGERIES IN AN IRISH ACUTE HOSPITAL
Authors: Treanor C , Smith J , McCabe M
Published: October 2022

Background

Frailty affects 21.5% of individuals aged 65 and over in Ireland (TILDA, 2017).Timely interventions can limit or reverse the impacts of frailty. Local HIPE data from 2016-2020 highlighted correlations between increased average Length of Stay (aLOS) and median age (>65 years) for those undergoing elective Anterior Resections and Hartmann’s reversal surgeries. Prehabilitation aims to identify and manage modifiable risk factors that may impact on LOS, as well as optimise patients’ resilience and physiological reserves to reduce postoperative complications. Modifiable factors include pre-operative function, co-morbidities and post-operative delirium. In the Republic of Ireland, surgical interdisciplinary Prehabilitation services exist only in one hospital.

Methods

An interdisciplinary prehabilitation pilot for individuals undergoing elective colorectal surgeries was developed. Patients are referred from surgical clinics to Physiotherapy, Occupational Therapy or Dietitian preoperatively. Interventions include respiratory optimisation, exercise prescription, discharge planning, equipment provision and pre-operative nutritional reviews.

Results

Three elective patients have completed the first phase of the pilot. Two underwent anterior resections and one underwent a Hartmann’s reversal. The LOS for each individual was 4 days respectively, 4 days under the KPIs. Patients received virtual assessment and individualised interventions including an interdisciplinary educational booklet. Interventions included: exercise programmes, nutritional support, discharge planning discussion and equipment as indicated. No post-operative complications were identified and no interim beds or home supports were required. Qualitative feedback surveys were completed by all participants. Subjective feedback from patients has been overwhelmingly positive.

Conclusion

Patients report feeling physically and psychologically better prepared for surgery with better knowledge of post-operative expectations. Patients are more proactive in their postoperative recovery meaning they can return home sooner. This pilot enhances evidence-based ERAS practice, improving the quality and safety of patients journey. Participants also had a 12 day cumulative reduction in aLOS with financial savings of €12000.
157 STAFF MEMBERS’ PERSPECTIVES OF HOW TO INCREASE DEMENTIA-FRIENDLINESS IN AN ACUTE IRISH HOSPITAL SETTING
Authors: Doyle C , Davis A , McNally S
Published: October 2022

Background

Key principles from The Irish National Dementia Strategy promote accessibility and ease of understanding for those with dementia. Those who provide services and care to people with dementia have a key role to play in identifying gaps in existing service provision. Reduced compliance with National dementia guidelines and overall reduced dementia-friendliness were noted in a hospital-wide audit. It is imperative to seek opinions from those providing direct care to dementia patients on how we can improve dementia-friendliness at a service level.

Methods

Random selection was used to distribute staff questionnaires. An open-ended question was used to gather their perceptions on how this hospital can improve its dementia-friendliness at a service level.

Results

Forty-seven suggestions were collated across the hospital. Thematic analysis identified 11 different themes; increased staffing, environmental changes, the introduction of dedicated day rooms, increased signage, and introduction of activity boxes were the most common suggestions (68% of answers). Other suggestions included use of sensory items, increased staff education, orientation boxes and improved communication with patients.

Conclusion

Healthcare workers have an important role in driving and implementing changes in healthcare settings. Collating staff members’ perceptions of improving dementia-friendliness is invaluable given their role in providing services to people with dementia. Implementation of the above-mentioned changes must be explored in order to increase dementia-friendliness, to maintain high-quality service provision, and to ensure compliance with National standards.