bluuebunny/crossref_metadata_2025_split huggingface dataset:
The bioprinting roadmap
Authors: Sun Wei , Starly Binil , Daly Andrew C , Burdick Jason A , Groll Jürgen , Skeldon Gregor , Shu Wenmiao , Sakai Yasuyuki , Shinohara Marie , Nishikawa Masaki , Jang Jinah , Cho Dong-Woo , Nie Minghao , Takeuchi Shoji , Ostrovidov Serge , Khademhosseini Ali , Kamm Roger D , Mironov Vladimir , Moroni Lorenzo , Ozbolat Ibrahim T 
Published: February 2020

Abstract
This bioprinting roadmap features salient advances in selected applications of the technique and highlights the status of current developments and challenges, as well as envisioned advances in science and technology, to address the challenges to the young and evolving technique. The topics covered in this roadmap encompass the broad spectrum of bioprinting; from cell expansion and novel bioink development to cell/stem cell printing, from organoid-based tissue organization to bioprinting of human-scale tissue structures, and from building cell/tissue/organ-on-a-chip to biomanufacturing of multicellular engineered living systems. The emerging application of printing-in-space and an overview of bioprinting technologies are also included in this roadmap. Due to the rapid pace of methodological advancements in bioprinting techniques and wide-ranging applications, the direction in which the field should advance is not immediately clear. This bioprinting roadmap addresses this unmet need by providing a comprehensive summary and recommendations useful to experienced researchers and newcomers to the field.
Study on microstructure and properties of TA1-304 stainless steel explosive welding cladding plate
Authors: Liangyu Lu , Yong Su , Jian Chen , Yu Fang , Xiaoyuan Xia , Jin Yu 
Published: February 2020

Abstract
Bonding TA1 and 304 stainless steel by explosive welding to obtain cladding plate. the microstructure of the bonded interface of the cladding plate was analyzed and its properties were tested. It was observed that the bonding interface of the cladding plate was periodically wavy. There is a large melting zone at the end of the interface waveform, and a vortex exists near the melting zone. The EDS surface scanning of the interface shows that there is element diffusion at the interface, and it is speculated that the bonding at the interface of the cladding plate belongs to metallurgical bonding. The microhardness measurement results show that the Vickers hardness (HV) at the interface is up to 413.10, and then the microhardness is lower with the distance from the interface junction, and gradually decreases to the same raw material. The tensile strength of 304 material after explosive welding reached 865MPa; the longitudinal shear strength of titanium-stainless steel cladding plate was 325MPa, and the transverse shear strength was 309MPa; The tested cladding plate has excellent corrosion resistance, and its corrosion resistance is between TA1 and 304. The self-corrosion current of the cladding plate is 233 μA.
Preparation of fluorine and carbon co-introduced TiO2 at low temperature with enhanced visible-light degradation performance for 2,4,6-trichlorophenol
Authors: Tang Yang , Shen Fang , Huang Hao , Shang Hongyan , Mao Hui , Ma Jun , Liao Yang , Zhao Shilin 
Published: February 2020

Abstract
Traditional TiO2 photocatalyst has the disadvantages of weak visible-light responsibility, fast combination of photo-generated electron and hole, which significantly degrade its photocatalytic degradation activity. Therefore, fluorine and carbon co-introduced TiO2 was synthesized at a relatively low calcination temperature via a modified sol-gel method, and then be thoroughly characterized to explore the structure-performance relationship. It was found the optimum catalyst FCT-200 prepared at calcination temperature of 200 °C exhibited remarkably enhanced visible-light absorption and restrained photo-generated carrier combination, which should be attributed to the F, C elements co-introduction, lower crystallization degree, and smaller particle size of anatase TiO2. With such advantages, the catalyst therefore demonstrated satisfactory photocatalytic degradation activity for 2,4,6-trichlorophenol (2,4,6-TCP) under visible-light irradiation. The apparent degradation rate reached as high as 0.41971 h−1, almost 42 folds higher than P25. It is anticipated that the fluorine and carbon co-introduced TiO2 photocatalyst presented in this work could provide a new insight into significantly improving the photocatalytic performance of TiO2.
An Applied Empirical Framework for Invasion Science: Confronting Biological Invasion Through Collaborative Research Aimed at Tool Production
Authors: Blackburn Gwylim S , Bilodeau Pierre , Cooke Tracey , Cui Mingming , Cusson Michel , Hamelin Richard C , Keena Melody A , Picq Sandrine , Roe Amanda D , Shi Juan , Wu Yunke , Porth Ilga 
Published: February 2020

AbstractGlobal ecosystem functions, services, and commodities are increasingly threatened by biological invasions. As a result, there is an urgent need to manage invasive species through global collaborative research. We propose an ‘applied empirical framework’ (AEF) to aggressively confront the current global biological invasion crisis. The AEF builds on existing models for invasion science that advocate 1) standardized research designs to reveal key aspects of biological invasion, and 2) collaborative research to facilitate the sharing of resources and information. The AEF further emphasizes the need for 3) the production of research ‘tools’ (e.g., data, methodologies, technical instruments) designed for direct uptake by agencies that manage biological invasion, and 4) a taxonomically targeted approach in which task forces conduct rapid, in-depth research on top-priority invasive species across their entire geographic range. We review collaborative science and the distinctive roles played by different collaborator types. We then provide an example of the AEF in action through the BioSAFE initiative (Biosurveillance of Alien Forest Enemies), a highly collaborative project aimed at developing genomic research tools to facilitate biosurveillance and intervention for forest invasive species. We illustrate the BioSAFE approach through our research on two polyphagous insect species: the wood-borer Anoplophora glabripennis, Motschusky (Coleoptera: Cerambycidae; Asian longhorned beetle) and the defoliator Lymantria dispar, Linnaeus spp. (Lepidoptera: Lymantriidae; gypsy moth). These examples illustrate how the AEF can focus and accelerate our response to the global biological invasion crisis by applying the resource capabilities of collaborative research groups to generate management tools for top-priority invasive species.
9 The ‘Colchester Older Persons’ Evaluation for Surgery (COPES)’ Clinic: A Multidisciplinary Approach to Preoperative Management of Frail, Older Patients
Authors: Jiang Z , Mathew A , Peck L , Rudra P , Simpson J 
Published: February 2020

Abstract

Introduction
In 2014-15, 2.5 million patients over 75 years old underwent surgery compared to 1.5 million in 2006-7. The population is aging with increasing numbers of comorbidities, and associated frailty.1 The Royal College of Anaesthetists recommends that preoperative assessment for these complex older patients takes a “cross-specialty approach.”2 In Colchester the COPES clinic has been introduced in which selected high-risk patients are seen by a Consultant Anaesthetist and Consultant Geriatrician. This aims to medically optimise patients prior to surgery and to facilitate shared decision making.

Methods
The new clinic was introduced in October 2018. The following data was collected from COPES clinic letters from October to February 2018-19 (n=46):Patient/ surgery characteristics: age, comorbidities, frailty score and any cognitive impairmentInterventions: changes to medication, specialty referral, intravenous iron, diabetes optimisation, otherOutcomes of surgery following the COPES clinic
Patients were asked to complete feedback forms to evaluate the service.

Results
52% of patients had 4-6, and 28% had 7-9 comorbidities. The majority had Rockwood frailty scores of 4 or 5. 28% of patients had medications changed, 48% had specialty referrals, 17% received intravenous iron, 8.7% required diabetes optimisation and 28% of patients had investigations including echocardiograms, MRI and CT scans. 12/46 patients had surgery deemed unlikely to go ahead after shared decision making with patients in conjunction with the multidisciplinary team involved in their care. 2 patients died of their comorbidities after deciding not to proceed with surgery. 12/46 patients underwent surgery; 4 developed post-operative complications, none died and the mean length of stay was 3.38 days. The remaining 22/46 patients are awaiting surgery. Patient feedback questionnaires (n=10) were overwhelmingly positive. Everyone felt that they were treated with respect and that their fears were addressed and they were clear in the next steps in management.

Conclusions
The introduction of the ‘COPES’ clinic has helped address frailty and multiple comorbidities by optimising patients’ medical conditions and allowing alternatives to surgery to be considered. Patients were very satisfied with the COPES clinic and felt it has prepared them for upcoming surgery.

References
1. Lin H. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatrics, 2016.
2. RCoA. Guidelines for the Provision of Anaesthesia Services. www.pre-op.org/sites/default/files/GPAS%202016.pdf
12 Exploring Hospital Discharge as An Opportunity for Falls Prevention Exercise Referral
Authors: Buckland C , Whitney J 
Published: February 2020

Abstract

Topic
Proactive prevention is at the core of the NHS Long Term plan and falls prevention is an important public health priority. National guidance recommends that all health professionals have competence in falls assessment and prevention and advise that older adults at risk of falls are considered for strength and balance exercise.
With rising numbers of older adults occupying inpatient beds, some clinicians may not have the skills to identify these opportunities to prevent falls. Previously, physiotherapy staff on a respiratory medicine ward were not delivering best practice in falls prevention.

Aim
Within 3 months, to achieve a 30% increase in older adults at risk of falls, being offered exercise referral at hospital discharge.

Intervention
Quality improvement methodology including stakeholder engagement and Plan-Do-Study-Act cycles were used to influence behaviour change amongst physiotherapy staff on a respiratory ward. Interventions included training and a documentation sticker. For evaluation, the weekly number of older adults at risk of falls with evidence of offer for falls prevention exercise was collected over 13 weeks and evaluated on a Statistical Process Control chart. Staff confidence scores and cohort data were also recorded and described using descriptive statistics. The NHS Improvement Sustainability Model was used to measure project sustainability.

Improvement
At baseline, 0/18 (0%) older adults had an offer for fall prevention exercise. Over the intervention period, this increased to 22/37 (59.5%) and demonstrated special cause variation that was confidently assigned to the interventions. There was a 44.5% improvement in staff confidence in offering fall prevention exercise. The project scored 53.7% using the NHS sustainability model.

Discussion
This project demonstrated favourable behaviour change in falls prevention practice amongst physiotherapy staff on a respiratory ward. There was variability in the improvement possibly as a result of contextual influences of staffing and seasonality. Hospital discharge is a good opportunity to assess falls risk in older adults and offer information and referral for exercise. Wider implementation may be useful to help older adults optimise health outcomes but will depend on organisational stakeholder support to improve sustainability.
15 Structured Geriatric Liaison Services in Mental Health Inpatient Facilities
Authors: Babu B , Khalid A , Sadiq S , Essem J , Ruiz-Mendoza E 
Published: February 2020

Abstract

Introduction
Older people admitted to mental health facilities may be at increased risk of deterioration in the physical co-morbidities and increased rates of mortality when admitted in acute medical settings. Our model of care focuses on intervening in the physical aspect of patients admitted in the mental health unit addressing their comorbidities and polypharmacy and offering staff support during the admission process. Our Older Mental Health Unit is based in the district hospital with a total of 22 beds for people over 65 years old distributed in two areas: dementia with behavioral and psychological symptoms (BPS) and functional disorders.

Methods
Allocated geriatrician once a week to attend MDT and medical ward rounds. 5 working days telephone consultations for advice and supporting trainees in teaching and research. We measure the impact of our intervention comparing the data predating our intervention comparing 20 patients in each period 2016 and 2018.

Results
Mean age increased from 74.3 to 77.8 in a two year period with an average of 3.5 medical co-morbidities. Reduction in polypharmacy from 7.15 to 5.5 number of medication, 58% reduction in the number of hospital transfers and 90% reduction in specialty referrals.

Conclusions
Structured Geriatric Liaison Services in Mental Health in inpatient facilities are shown to be effective in reducing acute hospital and outpatient clinic attendances minimising the challenges of management of these patients in non-mental health facilities.
18 The Use of A Multifactorial Intervention to Improve Bowel Chart Recording and Laxative Prescription in A Tertiary Geriatrics Department
Authors: Ji-Xu A , Moezinia C , Lovett N , Sharma D Krishan 
Published: February 2020

Abstract

Introduction
Constipation has a high prevalence of 30-40% in those aged over 65. It can lead to complications including delirium, faecal impaction, stercoral ulceration, and bowel obstruction. Although stool charts are used in geriatric wards to monitor bowel movements to guide management of constipation, they are often inconsistently recorded. Similarly, regular laxatives are often not prescribed for constipated patients due to ward pressures or unawareness regarding their importance.

Aims
Our aims were to audit the rates of recording on stool charts and laxative prescription in a geriatrics department, and to assess whether a multifactorial intervention aimed at both doctors and nursing staff improved these rates.

Methods
Two independent assessors audited the recording of stool charts, and rates of constipating medications and laxative prescription in two geriatrics wards in a tertiary UK hospital. A multifactorial intervention was implemented, consisting of didactic sessions for doctors and nurses, healthcare assistant champions to promote the recording of stool charts, and consolidation of bowel movement recording onto a single paper stool chart by the bedside rather than multiple charts. After the intervention, the data was re-audited on the same wards. Descriptive statistics and frequency tabulation were used for data analysis.

Results
Data was collected from 33 patients. Pre-intervention, stool charts were recorded daily in 13 patients, 10 patients had no stool chart record, 20 patients were on at least one constipating medication, 12 patients were prescribed at least one laxative, and 5 out of 7 patients with opiates had laxatives co-prescribed. Post-intervention, stool charts were recorded daily in 21 patients, all patients had a stool chart record, 20 patients were on at least one constipating medication, 23 patients were prescribed at least one laxative, and 2 out of 4 patients with opiates had laxatives co-prescribed. Our intervention improved daily recording on stool charts by 24%, resulted in all patients having a current stool chart and improved prescription of regular laxatives by 34%.

Conclusions
A multifactorial intervention based on educational sessions, healthcare assistants acting as champions, and consolidation of recording of bowel movements into a single chart, improved stool chart recording and prescription of regular laxatives in a tertiary geriatrics department. Future auditing will extend the sample size and generalise the intervention to other hospital departments.
38 Improving Access to Outpatient Services for Older People Using A Clinical Microsystems Approach
Authors: Tullo E , Smith A , Ridden J , Ross R , Curless R , Doshi M 
Published: February 2020

Abstract

Background
Northumbria Healthcare NHS Foundation Trust provides services to more than 500,000 residents in the North-East of England across multiple sites.

Local problem
Outpatient services for older people across Northumbria include specialist (eg falls) and generic clinics with differing referral routes, demands and waiting times. Referrals derive from primary care, emergency services and elsewhere; some are complex patients requiring a comprehensive geriatric assessment (CGA). Existing pathways led to variable waits for clinics, duplication and delays.
Aim was to improve the timeliness, efficiency and access to appropriate assessment first time.

Methods
We adopted a Clinical Microsystems approach (Sheffield Microsystems Coaching Academy) for improvement. Main components were team coaching, weekly “Big Room” meeting of involved staff to share understanding of current process, agree change ideas, and test these with multiple plan, do, study, act (PDSA) cycles. Impacts of each PDSA cycle were discussed in Big Room, leading to refinement of the pathway.

Interventions
Results: PDSA interventions were tested over 6 months: Development of a single triage systemCGA clinic for frail older patients.Development of shared documentation for CGA.Improved cycle and lead times for assessment

Conclusions
Our quality improvement work supported the development and implementation of a new referral triage process with CGA assessment for complex frail patients. The change has reduced patient wait times, provided early intervention and reduced duplication. Work is ongoing to determine impact on patient satisfaction and time to discharge from clinic. The approach taken by this project could be applied elsewhere to improve outpatient referral processes.
41 Using Patient Centred Care to Redesign Integrated Discharge Services in Derby
Authors: Youde J , Rawlings J , Knight J 
Published: February 2020

Abstract

Background
Discharge to Assess as outlined by the Department of Health was adopted in Derby in 2016. Previously the discharge pathways to community settings from the acute trust were complex. Challenges included: Operating from a traditional residential care home.No integration of community health staff and social care teams leading to delays in treatment and decision making as well as multiple referrals and hand-overs and no joint communication which was confusing for patients.Stakeholder anticipation of 6 weeks length of stay.Limited responsiveness to capacity demand within planned and unplanned community physiotherapy.Changing the culture and mind-set of staff.Different health and social care processes and procedures, IT systems, working patterns, contracts and pay scales.

Methods
A new service model, joint processes and standard operating procedures was developed with the patient at the centre of the design. Trusted assessment and information sharing reduce multiple assessments and hand overs, ensuring a smoother and improved patient experience.

Outcomes
Triage of patients from the Integrated Discharge Hub to the appropriate pathway, early discharge planning, board rounds and MDT's and timely assessments combined with an enablement ethos have increased the flow of patients through the service, decreased care package hours and increased capacity through reducing both length of stay and delayed transfers of care. The health and social care teams are now delivering fully integrated care and undertaking joint training. This has led to a reduction in treatment times from 20 days to 12 days, reductions in DTOC to average of 8 days per month and improved access to community based routine therapy from 85% of referrals being seen by 6 weeks 2017-18 to 99% in 2018-19.

Conclusions
The integrated service delivers more for less resulting in significant savings in the healthcare and social care system while maintaining quality standards and outcomes.
55 Quality Improvement Project to Assess How Informed Patients are About do not Attempt Cardiopulmonary (DNACPR) Decisions?
Authors: Jayasuriya P , Amanullah Y , Kumar A , Hookey C 
Published: February 2020

Abstract

Introduction
Despite growing evidence regarding DNACPR decisions, there is a paucity of information given to patients regarding resuscitation decisions. The main aim of this quality improvement project was to assess and improve patients’ and their relatives’ understanding about DNACPR decisions.

Intervention
We initially surveyed 30 inpatients or their next-of-kin (if the patient lacked capacity) in a geriatric ward who had DNACPR decisions in place. Although, 86% knew the implications of a DNACPR decision, only 50% knew that a DNACPR decision would not limit them from receiving other treatment. 66% reported that the information given by the healthcare professional is “too little”.
35 questionnaires were also given to doctors of all grades to assess their practice of DNACPR discussions and barriers for discussion. Majority (95%) of doctors knew what should be included in a DNACPR discussion. Medical staff not considering DNACPR discussions during assessment, medical staff not comfortable to make the DNACPR decision and the fear of distressing the patient are the three main issues that were highlighted as barriers. 17% of doctors reported that they would have attended a cardiac arrest at least on 2-5 occasions for a patient when resuscitation was futile.
We presented this data and educated doctors on effective DNACPR discussions using video demonstrations in weekly journal clubs. All doctors were informed to distribute DNACPR

Improvement
After the intervention, only 80% understood the DNACPR discussion. 76% knew that DNACPR does not limit them from receiving other treatment. 73% reported that this was not stressful and 76% were satisfied with the discussion and reported that their questions were answered adequately. 11 out of 30 patients had received the information leaflets and all found it useful.

Discussion
Although after the intervention the percentage who understood the DNACPR decision had reduced compared to the initial audit, there was a 20% improvement in who knew that DNACPR decisions did not limit other treatment. We hope to extend this study by carrying out training sessions for doctors to improve the quality of these conversations and thereby enhance adherence to expected practice in DNACPR decision making.