bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-monotonic flow variations in a stylized (TASEP-based) traffic model featuring cars searching for parking
Authors: Anfray Valentin , Nicolas Alexandre 
Published: August 2024

Abstract
The Totally Asymmetric Simple Exclusion Process (TASEP) is a paradigm of out-of-equilibrium Statistical Physics that serves as a simplistic model for one-way vehicular traffic. Since traffic is perturbed by cars cruising for parking in many metropolises, we introduce a variant of TASEP, dubbed SFP, in which particles are initially cruising at a slower speed and aiming to park on one of the sites adjacent to the main road, described by a unidimensional lattice. After parking, they pull out at a finite rate and move at a normal speed. We show that this stylized model, which breaks many of the conservation rules applicable in other TASEP variants, exhibits singular features, in particular non-monotonic variations of the steady-state current with the injection rate and re-entrant transitions in the phase diagram, for some range of parameters. These features are robust to variations in the update rule and the boundary conditions. Neither the slow speed of cruising cars nor the perturbation of the flow due to pull-out maneuvers, taken in isolation, can rationalize these observations. Instead, they originate in a cramming (or ‘paper jam’) effect which results from the coupling of these mechanisms: injecting too many cars into the system saturates the first sites of the road, which prevents parked cars from pulling out, thus forcing cruising cars to travel farther along the road. These strong discrepancies with even the qualitative trends of the baseline TASEP model highlight the importance of considering the effect of perturbations on traffic.
Data-driven acceleration of multi-physics simulations
Authors: Meinecke Stefan , Selig Malte , Köster Felix , Knorr Andreas , Lüdge Kathy 
Published: August 2024

Abstract
Multi-physics simulations play a crucial role in understanding complex systems. However, their computational demands are often prohibitive due to high dimensionality and complex interactions, such that actual calculations often rely on approximations. To address this, we introduce a data-driven approach to approximate interactions among degrees of freedom of no direct interest and thus significantly reduce computational costs. Focusing on a semiconductor laser as a case study, we demonstrate the superiority of this method over traditional analytical approximations in both accuracy and efficiency. Our approach streamlines simulations, offering promise for complex multi-physics systems, especially for scenarios requiring a large number of individual simulations.
Training coupled phase oscillators as a neuromorphic platform using equilibrium propagation
Authors: Wang Qingshan , Wanjura Clara C , Marquardt Florian 
Published: August 2024

Abstract
Given the rapidly growing scale and resource requirements of machine learning applications, the idea of building more efficient learning machines much closer to the laws of physics is an attractive proposition. One central question for identifying promising candidates for such neuromorphic platforms is whether not only inference but also training can exploit the physical dynamics. In this work, we show that it is possible to successfully train a system of coupled phase oscillators—one of the most widely investigated nonlinear dynamical systems with a multitude of physical implementations, comprising laser arrays, coupled mechanical limit cycles, superfluids, and exciton-polaritons. To this end, we apply the approach of equilibrium propagation, which permits to extract training gradients via a physical realization of backpropagation, based only on local interactions. The complex energy landscape of the XY/Kuramoto model leads to multistability, and we show how to address this challenge. Our study identifies coupled phase oscillators as a new general-purpose neuromorphic platform and opens the door towards future experimental implementations.
Improvement in Early Scar Maturation by Nanofat Infiltration: Histological and Spectrophotometric Preliminary Results From a Split Scar–Controlled, Randomized, Double-Blinded Clinical Trial
Authors: Ramaut Lisa , Moonen Linde , Geeroms Maxim , Leemans Gaelle , Peters Ellen , Forsyth Ramses , Gutermuth Jan , Hamdi Moustapha 
Published: August 2024

Abstract

Background
The regenerative properties of stromal vascular fraction (SVF) in wound healing and scar formation are a subject of increasing clinical interest.

Objectives
Although preclinical studies have confirmed the angiogenetic, proliferative, and antifibrotic properties of SVF, there is limited clinical evidence from randomized controlled clinical trials.

Methods
Twelve patients who underwent abdominoplasty were included in this clinical study. Nanofat was mechanically obtained intraoperatively and infiltrated intradermally in the sutured surgical wound, randomly assigned to either the left or the right side. The abdominal scar was evaluated with the Patient and Observer Scar Assessment Scale, whereas erythema and pigmentation were measured with a reflectance spectrophotometry device (Mexameter, Courage + Khazaka electronic GmbH, Köln,Germany). Histological analysis and electron scan microscopy of tissue biopsies were performed at 8 months.

Results
The treated side of the scar showed significantly less erythema at 3- and 6-month follow-ups, but this difference reduced after 12 months. Patients reported better scar scores at the 6-month follow-up with a significantly better color at the treated side. Observers reported better overall scar scores at the treated side at 3-, 6-, and 12-month follow-ups, with better vascularization, pigmentation, and thickness. There was no statistically significant difference in terms of histological analysis between the 2 groups. There was no difference in the occurrence of adverse events between both sides.

Conclusions
Infiltration of nanofat exhibited promising results in surgical scar maturation characterized by less erythema and better texture. More clinical trials with a larger sample size are warranted to better elucidate the possible benefits of SVF on surgical scar formation.

Level of Evidence: 5
Signature Search Polestar: a comprehensive drug repurposing method evaluation assistant for customized oncogenic signature
Authors: Zhang Jinbo , Yuan Shunling , Cao Wen , Jiang Xianrui , Yang Cheng , Jiang Chenchao , Liu Runhui , Yang Wei , Tian Saisai 
Published: August 2024

Abstract

Summary
The burgeoning high-throughput technologies have led to a significant surge in the scale of pharmacotranscriptomic datasets, especially for oncology. Signature search methods (SSMs), utilizing oncogenic signatures formed by differentially expressed genes through sequencing, have been instrumental in anti-cancer drug screening and identifying mechanisms of action without relying on prior knowledge. However, various studies have found that different SSMs exhibit varying performance across pharmacotranscriptomic datasets. In addition, the size of the oncogenic signature can also significantly impact the result of drug repurposing. Therefore, finding the optimal SSMs and customized oncogenic signature for a specific disease remains a challenge. To address this, we introduce Signature Search Polestar (SSP), a webserver integrating the largest pharmacotranscriptomic datasets of anti-cancer drugs from LINCS L1000 with five state-of-the-art SSMs (XSum, CMap, GSEA, ZhangScore, XCos). SSP provides three main modules: Benchmark, Robustness, and Application. Benchmark uses two indices, Area Under the Curve and Enrichment Score, based on drug annotations to evaluate SSMs at different oncogenic signature sizes. Robustness, applicable when drug annotations are insufficient, uses a performance score based on drug self-retrieval for evaluation. Application provides three screening strategies, single method, SS_all, and SS_cross, allowing users to freely utilize optimal SSMs with tailored oncogenic signature for drug repurposing.

Availability and implementation
SSP is free at https://web.biotcm.net/SSP/. The current version of SSP is archived in https://doi.org/10.6084/m9.figshare.26524741.v1, allowing users to directly use or customize their own SSP webserver.
Diffusion models for medical image reconstruction
Authors: Webber George , Reader Andrew J 
Published: August 2024

Abstract
Better algorithms for medical image reconstruction can improve image quality and enable reductions in acquisition time and radiation dose. A prior understanding of the distribution of plausible images is key to realising these benefits. Recently, research into deep-learning image reconstruction has started to look into using unsupervised diffusion models, trained only on high-quality medical images (ie, without needing paired scanner measurement data), for modelling this prior understanding. Image reconstruction algorithms incorporating unsupervised diffusion models have already attained state-of-the-art accuracy for reconstruction tasks ranging from highly accelerated MRI to ultra-sparse-view CT and low-dose PET. Key advantages of diffusion model approach over previous deep learning approaches for reconstruction include state-of-the-art image distribution modelling, improved robustness to domain shift, and principled quantification of reconstruction uncertainty. If hallucination concerns can be alleviated, their key advantages and impressive performance could mean these algorithms are better suited to clinical use than previous deep-learning approaches. In this review, we provide an accessible introduction to image reconstruction and diffusion models, outline guidance for using diffusion-model-based reconstruction methodology, summarise modality-specific challenges, and identify key research themes. We conclude with a discussion of the opportunities and challenges of using diffusion models for medical image reconstruction.
A case of MRI-induced headache caused by an intracranial foreign body
Authors: Tokue Hiroyuki , Tokue Azusa , Tsushima Yoshito 
Published: August 2024

Abstract
This case report delves into a unique occurrence of MRI-induced headaches attributed to an unsuspected intracranial foreign body. A male patient, presenting persistent headaches, experienced exacerbation of pain upon entering the MRI suite, hindering the imaging procedure. A subsequent head CT scan revealed a nail within the cranial cavity, stemming from a previous nail gun injury. Surgical removal was deemed unsafe, leading to continued observation. This case emphasizes the need for cautious exploration of abnormal symptoms in the MRI suite, urging healthcare professionals to consider potential foreign bodies. The incident underscores the risk of metallic fragments causing complications during MRI procedures and highlights the importance of thorough patient assessment before resorting to MRI imaging.
60 Audit of Outpatient Management of Sudden Sensorineural Hearing Loss at St George’s Hospital
Authors: Li A , Jaikaransingh D , Watters C 
Published: August 2024

Abstract

Introduction
Sudden sensorineural hearing loss (SSNHL) is an acute otological problem and early treatment is thought to improve prognosis. ENT UK guidelines advise oral steroids as first-line treatment, followed by intra-tympanic steroids if there is no improvement. The aim of this audit was to assess outpatient management of SSNHL at St George’s Hospital.

Method
Data was collated from January – March 2023 of ENT emergency outpatient clinics for patients referred for SSNHL. Those without confirmation of SSNHL on pure tone audiometry (PTA) were excluded. Further analysis was made regarding treatment received and response.

Results
Our results showed that 36 patients were referred for SSNHL. 50% (18) were confirmed to be SSNHL on PTA. 83.3% (15) received a course of oral prednisolone with 20% (3) showing significant improvement in hearing. Of the 87% (13) who did not or had partial response to corticosteroid treatment, 38% (5) subsequently received IT steroid injections. 1 patient had an isolated IT steroid injection as they presented late. Of all those who received IT Injections (6), 67% (4) showed improvement in hearing.

Conclusions
Despite a poor response rate to oral prednisolone, 62% (8) were not subsequently treated with IT steroid injections. For 6 patients, the time delay from onset of symptoms was too great suggesting IT injection would be futile, 1 patient declined, 1 patient moved out of area. Further analysis into time delay from onset of SSNHL to ENT assessment would be beneficial. Consensus on maximum time limit to benefit from intratympanic steroid injection would also be of benefit.
184 Closed-Loop Audit on Upper Limb Bite Injuries at a Major Trauma Centre
Authors: Yousefi Azimi D , Paraoan V , Jones M 
Published: August 2024

Abstract

Aim
To assess compliance of management of upper limb bite injuries with Departmental guidelines, generate an action plan to address areas requiring improvement, and close the loop to review outcomes.

Method
A total of 38 patients in April 2023 and 27 patients in October 2023 presented to University Hospital Coventry. Trust electronic software was used to identify patients and collect data that reflected the standards set by the Departmental guideline, including treatment given at first presentation and subsequent management.

Results
The Departmental guideline was updated in accordance with The British Society for Surgery of the Hand. This resulted in an improved 86% of all patients, including 100% with infection, who required an operation to be completed within 24 hours. First contact practitioners provided a thorough washout in 25% of patients in the Emergency Department. An overall 30% required a formal washout in theatre by a surgeon, of which 25% required a second operation. Further, all but one patient initially discharged from the Emergency Department to Hand Trauma Clinic were managed conservatively, and 23% required more than one follow-up appointment. Additional recommendations focused on enabling better care by first contact practitioners, including clinical training for simple wound excision and washout in ED and encouraging improved documentation, as well as providing a dedicated minor ops room with accessible equipment.

Conclusions
A closed-loop audit on the management of upper limb bite injuries showed a marked improvement in achieving compliance with a revised Departmental guideline, with further recommendations targeted at enabling first contact practitioners.
249 High Output Stoma Management – a 3-Cycle Audit
Authors: Mollier J , Benroy B , Jacob M 
Published: August 2024

Abstract

Aim
High output stoma (HOS), defined as stoma output over 1500ml per day, occurs commonly in surgical inpatients. HOS leads to complications including dehydration, electrolyte imbalances, acute kidney injury and increased hospital stay. The Association of Stoma Care nurses (ASCN) provide guidelines for their management and prevention of complications. This 3-cycle audit aims to increase awareness of these guidelines amongst the junior doctors at Southend University Hospital.

Method
20 junior doctors were surveyed on their knowledge of HOS management. A poster and checklist were created, summarising the ASCN guidelines. The third cycle consisted of provision of teaching sessions for junior doctors working in the surgical department and improvement of the checklist. Junior doctors were re-surveyed after each intervention, looking for an improvement in knowledge and application of ASCN guidelines.

Results
The audit resulted in an overall positive impact; participants got 51% of answers correct in May 2022, then 72% of answers correct in September 2022 and 91% of answers correct in September 2023, representing improvement in reported use of IV fluids, appropriate medications, optimisation of oral intake and monitoring of electrolytes. 85% of junior doctors reported applying knowledge gained during the HOS teaching session when managing patients with HOS.

Conclusions
The audit led to good improvement in knowledge and application of the ASCN guidelines when managing HOS amongst junior doctors working in Surgery. Next steps include maintaining knowledge of HOS management among rotating junior doctors by expanding to other specialities, providing posters for non-surgical wards and delivering teaching sessions to all foundation doctors.
322 Correlation Between Quantitative Faecal Immunochemical Test (qFIT) and Colorectal Operation - Clinical Audit
Authors: Earwicker S , Foy C , McBride R , Lindsay K 
Published: August 2024

Abstract

Aim
To uncover any potential link between quantitative faecal immunochemical test (qFIT) result, and the colorectal operation performed; and to give insight that could assist future work in creating a tool clinicians could use to earlier predict tumour site or guide the treatment and management of colorectal cancer. Preliminary search does not show this has been studied before.

Method
Data was collected through a clinical audit with the Centre for Colorectal Surgery in Belfast City Hospital. This retrospective study into 208 patients who had an operation with the centre during 2022, manually checked the available 161 case notes of which 63 had a qFIT result. Then explored for any correlations between qFIT result to operation, tumour location, stage, and age.

Results
Patients that got a positive qFIT&lt;100, 47.1% had a R Hemi or Extended R Hemi. 41.2% of positive qFIT&lt;100 had an R hemi. 40% of positive qFIT&lt;200 had a R hemi. 47.6% of qFIT results were 400+. 27.0% of the patient population got a qFIT&lt;100. qFIT correlated with tumour stage and of the patients studied, 0 had died at the time of audit.

Conclusions
A link between positive qFIT&lt;100 and Right Hemicolectomy was observed. A finding that could impact care of patients with colorectal cancer.
592 Standardising General Surgery Operation Notes According to Royal College of Surgeons England Guidelines
Authors: Chaudhari V , Mandal I , Mathew A 
Published: August 2024

Abstract

Aim
In this audit cycle, we assessed the quality of operation notes in both emergency and elective general surgery operations against the standards set by the Royal College of Surgeons of England. We particularly focussed on improving documentation with respect to operative diagnosis, estimated blood loss, whether it was an elective or emergency procedure and documentation of VTE prophylaxis in the post operative instructions.

Method
We collected data over a ten-day period of all elective and emergency general surgery theatre cases looking specifically at the four domains listed above. Following this we sent department wide emails and placed posters strategically next to the general surgery theatre computers where operation notes are written. Once this was done, we looked at the quality of documentation over a further ten-day period to see if our compliance with Royal College of Surgeons Guidelines had improved.

Results
Our compliance in regard to documentation of operative diagnosis improved from 34.88% to 60.53%. Estimated blood loss rose to 36.84% from 0%. 15.79% of operation notes included the type of procedure from 4.60% pre intervention and finally 61.54% of post operative plans now included VTE prophylaxis compared with 30% pre intervention.

Conclusions
Simple measures such as posters and department wide emails have slightly improved our compliance with national guidelines, but there is still some way to go. Our next steps will include forming proformas with the necessary information included to aid surgeons to document the necessary details for medico-legal, research and audit purposes.
639 Good Surgical Practice: Operation Notes in a Mixed EPR/Paper System
Authors: Tan J , Hui Fen K , Choudhry M 
Published: August 2024

Abstract

Aim
Operation notes are essential in ensuring continuity of care across different clinicians and admissions. 88% of NHS trusts have Electronic Patient Record (EPR) systems, however, 75% remain reliant on paper documentation. The Royal College of Surgeons of England details Good Surgical Practice standards which include clear and accessible operation notes. This audit aimed to measure and improve adherence to these standards in our trust, which uses a mix of paper and EPR systems.

Method
A retrospective analysis was performed on all general surgical procedures performed in Barking, Havering and Redbridge University Hospitals Foundation Trust (BHRUT) from 01 July to 19 July 2023. Data on the type of procedure, availability of the operative note on EPR, and mode of documentation was collected. A decision for early intervention was made, and a re-audit was started prospectively from 16 November 2023.

Results
197 operations were included, with 64% elective, and 36% emergency procedures. 54.8% (n= 108) had operative notes uploaded onto EPR, and 56.4% of these were typed. Following intervention, 126 operations were included in the re-audit, with 63.5% elective and 36.5% emergency procedures. 64.3% (n=81) were uploaded, and 59.3% were typed.

Conclusions
Adherence to national standards for operative documentation were suboptimal. Operative notes were not consistently uploaded onto EPR for accessibility and continuity of care beyond theatre. Early intervention including education of surgical juniors and troubleshooting of IT issues can help bridge the gap caused by the mixed use of paper and EPR systems. Current re-audit data appears promising with regards to improved adherence.
779 "Straight to Test"- Evaluating a Newly Established Cancer Referral Pathway in Weston General Hospital
Authors: Stephanos M , Roberts M , Orchard M 
Published: August 2024

Abstract

Background
Straight-to-test Is a relatively new way to refer suspected cancer patients from the primary care to get tested without being seen in clinic first. However, there is still confusion regarding its regulating guidelines in different NHS trusts. The rationale is that highly suspicious, fit for colonoscopy patients are referred via the pathway to get scoped without the added logistics, wait and costs of being seen in clinic first. This was introduced in Weston General hospital in January 2023.

Aim
Our aim was to audit the effectiveness of the pathway objectively by estimating cancer pickup rate, waiting times and what percentage of all diagnosed bowel cancers it identified, and at what stage.

Method
We collected the data of all patients referred via the pathway since implementation till mid-August 2023, investigated the indications for referrals, the outcomes, and the results of any performed investigations.

Results
Over 8 and half months, 140 patients were referred, with the commonest indication being a Positive FIT test (94, 67%), 99 were accepted and scoped (71%), 9 cancer patients were diagnosed in various stages, 6 of whom were operable. The average referral to endoscopy waiting time was 26 days. The pathway’s pick-up rate was one in 12, and the pathway diagnosed 15% of all bowel cancers presenting to the hospital during that period.

Conclusions
STT is a very promising tool to cut down waiting times and costs associated with cancer diagnosis between primary and secondary care, however, standard guidelines are still needed for better efficiency and performance.