bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancing electron microscopy using deep learning
Authors: Chen K , Barnard A S 
Published: January 2024

Abstract
Electron microscopy, a sub-field of microanalysis, is critical to many fields of research. The widespread use of electron microscopy for imaging molecules and materials has had an enormous impact on our understanding of countless systems and has accelerated impacts in drug discovery and materials design, for electronic, energy, environment and health applications. With this success a bottleneck has emerged, as the rate at which we can collect data has significantly exceeded the rate at which we can analyze it. Fortunately, this has coincided with the rise of advanced computational methods, including data science and machine learning. Deep learning (DL), a sub-field of machine learning capable of learning from large quantities of data such as images, is ideally suited to overcome some of the challenges of electron microscopy at scale. There are a variety of different DL approaches relevant to the field, with unique advantages and disadvantages. In this review, we describe some well-established methods, with some recent examples, and introduce some new methods currently emerging in computer science. Our summary of DL is designed to guide electron microscopists to choose the right DL algorithm for their research and prepare for their digital future.
Bounds on 10th moments of (𝑥,𝑥³) for ellipsephic sets
Authors: Anderson Theresa , Hu Bingyang , Liu Yu-Ru , Talmage Alan 
Published: January 2024

Let

A

\mathcal {A}

be an ellipsephic set which satisfies digital restrictions in a given base. Using the method developed by Hughes and Wooley, we bound the number of integer solutions to the system of equations

a
m
p
;

∑

i
=
1

2

(

x
i
3

−

y
i
3

)

=

∑

i
=
3

5

(

x
i
3

−

y
i
3

)

a
m
p
;

∑

i
=
1

2

(

x
i

−

y
i

)
=

∑

i
=
3

5

(

x
i

−

y
i

)
,

\begin{equation*} \begin {split} & \sum _{i=1}^2 \left (x_i^3-y_i^3 \right )=\sum _{i=3}^5 \left (x_i^3-y_i^3 \right )\\ & \sum _{i=1}^2 (x_i-y_i)=\sum _{i=3}^5 (x_i-y_i), \end{split} \end{equation*}

with

x
,
y

∈

A

5

\mathbf {x, y} \in \mathcal {A}^5

. The fact that ellipsephic sets with small digit sumsets have fewer solutions of linear equations allows us to improve the general bounds obtained by Hughes and Wooley and also the corresponding efficient congruencing estimates. We also generalize our result from the curve

(
x
,

x
3

)

(x, x^3)

to

(
x
,
ϕ
(
x
)
)

(x, \phi (x))

, where

ϕ
\phi

is a polynomial with integer coefficients and

deg
⁡
(
ϕ
)
≥
3

\deg (\phi ) \ge 3

.
Classifying solutions of 𝑆𝑈(𝑛+1) Toda system around a singular source
Authors: Mu Jingyu , Shi Yiqian , Sun Tianyang , Xu Bin 
Published: January 2024

Consider a positive integer

n
n

and

γ
1

>
−
1
,
⋯
,

γ
n

>
−
1

\gamma _1>-1,\cdots ,\gamma _n>-1

. Let

D
=
{
z
∈

C

:

|

z

|

>
1
}

D=\{z\in \mathbb {C}:|z|>1\}

, and let

(

a

i
j

)

n
×
n

(a_{ij})_{n\times n}

denote the Cartan matrix of

s
u

(
n
+
1
)

\frak {su}(n+1)

. Utilizing the ordinary differential equation of

(
n
+
1
)

(n+1)

th order around a singular source of

S
U

(
n
+
1
)

{SU}(n+1)

Toda system, as discovered by Lin-Wei-Ye [Invent. Math. 190 (2012), pp. 169–207], we precisely characterize a solution

(

u
1

,
⋯
,

u
n

)

(u_1,\cdots , u_n)

to the

S
U

(
n
+
1
)

{SU}(n+1)

Toda system

{

∂
2

u
i

∂
z
∂

z
¯

+

∑

j
=
1

n

a

i
j

e

u
j

a
m
p
;
=
π

γ
i

δ
0

on
D

−
1

2

∫

D
∖
{
0
}

e

u

i

d

z
∧

d

z
¯

a
m
p
;
>
∞

for all

i
=
1
,
⋯
,
n

\begin{equation*} \begin {cases} \frac {\partial ^2 u_i}{\partial z\partial \bar z}+\sum _{j=1}^n a_{ij} e^{u_j}&=\pi \gamma _i\delta _0\text { on } D\\ \frac {\sqrt {-1}}{2}\,\int _{D\backslash \{0\}} e^{u_{i} }{d}z\wedge {d}\bar z &> \infty \end{cases} \quad \text {for all}\quad i=1,\cdots , n \end{equation*}

using

(
n
+
1
)

(n+1)

holomorphic functions that satisfy the normalized condition. Additionally, we demonstrate that for each

1
≤
i
≤
n

1\leq i\leq n

,

0
0

represents the cone singularity with angle

2
π
(
1
+

γ
i

)

2\pi (1+\gamma _i)

for the metric

e

u
i

|

d

z

|

2

e^{u_i}|{d}z|^2

on

D
∖
{
0
}

D\backslash \{0\}

, which can be locally characterized by

(
n
−
1
)

(n-1)

non-vanishing holomorphic functions at

0
0

.
1770 Assessment of lying and standing blood pressure; an audit leading to an improved clinical effectiveness and quality improvement
Authors: Singh K , Sethi D 
Published: January 2024

Abstract

Introduction
Assessment of lying and standing blood pressure is commonly undertaken in geriatric medicine to make a diagnosis of orthostatic or postural hypotension. We carried out the audit to review the clinical practice and assess its adherence to the Royal College of Physicians (RCP) guidance on how to accurately measure the lying and standing blood pressure (Falls and Fragility Fracture Audit Programme).

Method
It was a prospective audit. The first audit cycle was conducted in July 2020 and the second cycle in April 2021

Results
During the first data collection, the practice was reviewed in 69 patients. 35 were female (age range 63-92 years) and 34 male (age range 72-95 years). The lying and standing blood pressures were measured in 27 patients. Only 4 were performed as per the RCP guidance. 34 team members (including doctors, nurses, healthcare assistants, etc.) were randomly surveyed on how to correctly measure lying and standing blood pressure. None were aware of the RCP guidance in this context. We delivered local presentations of the results of the audit and RCP guidance flyers were displayed on the bulletin boards in the department. During the second cycle, the practice was reviewed in 58 patients. 30 were female (aged 67-94 years) and 28 male (aged 68-96 years). The lying and standing blood pressures were measured in 32 patients, of which 20 were recorded according to the RCP guidance. There was an increase of adherence to the guidance from 14.8% to 62.5% after undertaking the aforementioned interventions.

Conclusions
Following dissemination of the RCP guidance on how to accurately measure the lying and standing blood pressures, we witnessed an improvement in the practice suggestive of an improved clinical effectiveness. Robustly evaluating a service followed by education of the staff can lead to enhanced clinical care and quality improvement.
1756 Improvement in the number of discharges prior to 3 p.m. using quality improvement methodology
Authors: England S , Guthrie K , Winfield A 
Published: January 2024

Abstract

Introduction
Under current nationwide clinical pressures, hospitals are running at full capacity. Late discharges can lead to poor flow throughout the hospital, overcrowding in the emergency department and out of hours transfers, leading to a poor patient experience and impacts on patient safety. Early morning and afternoon discharges create better flow and improve patient satisfaction, by being home in time for tea. The discharge collaborative within Leeds Teaching Hospitals NHS Trust is a multidisciplinary team (MDT) of junior doctors, pharmacists, nurses and discharge co-ordinators. The aim of the team is to improve discharges in the trust prior to 3 p.m. to 70%. Discharging patients earlier in the day is a complex multifactorial issue which requires an MDT approach.

Method
To understand this further a retrospective case note review was conducted to look at avoidable and unavoidable causes of delayed discharges. Each team also received a questionnaire, to discover their perceived barriers to early discharges. This was communicated to teams to empower them to develop their own solutions which were shared within the trust. Run charts of discharges before 3 p.m. are published for each ward in the hospital every two weeks, which is available to wards, but also monitored by the discharge collaborative. Changes to practice include; education of the medical team regarding importance of timely discharge, use of discharge boards, the increase use of discharge lounge, identifying ‘golden patients’ for early morning discharges, prioritisation of community discharges the previous day and achievement recognition for wards with the most improvement.

Results/Conclusions
Within the trust, several departments have improved their discharges prior to 3 p.m. through the improvements implemented from the discharge collaborative, including speciality and integrated medicine (SIM), oncology, and trauma services. This project resulted in two step improvements within the Trust with 40% of patients being discharged before 3 p.m.
1721 Enhancing the recognition of sensory impairment on the Care of the Elderly wards
Authors: Hackney A , Ball G , Brown J , Wharton C 
Published: January 2024

Abstract

Introduction
Although hearing loss is the foremost cause of years lived with disability in people over 70, it remains commonly under-recognised. Health of the UK signing deaf community is reportedly worse than the general population, often due to resulting undertreatment of associated co-morbidities including visual impairment, falls and dementia.

Local Problem
There is an estimated 21% prevalence of ≥25dBHL hearing loss within the Wolverhampton adult population, this increasing with age. A large number of inpatients admitted to the Older Adult Medicine (OAM) wards at New Cross Hospital have clinically evident sensory impairment, impacting upon interactions with healthcare staff. This project identified the current methods through which hearing and/or visual impairment is formally screened for and documented within the OAM Department of a large district general hospital, targeting interventions towards mitigating barriers faced in sensory assessment.

Methods and Intervention
Baseline and post-intervention documentation of sensory impairment was collected from admission and bedside notes of 23 inpatients during each cycle. A multidisciplinary focus group of medical, nursing and practice education facilitators identified a marked underutilisation of bedside alert signs (4%), prompting creation of a redesigned bedside poster with a greater focus on sensory aid functionality.

Results
60% of posters were utilised 10 days after introduction, with an increase from 4% to 36% in recording of known sensory impairment being observed. 100% and 25% of inpatients with correctly functioning hearing aids and spectacles were documented respectively. 100% of patients admitted through frailty intervention streams were assessed for sensory loss, compared to 0% admitted via the unselected medical take.

Conclusions
Improved bedside alert posters provided initial evidence as a sustainable improvement in supporting inpatients with sensory impairment. Incorporating positive lessons from frailty team practice will assist in developing future education sessions, highlighting intended sign usage and transferrable sensory assessment methods for involved healthcare teams.
2033 ``Polyclinics'' - a concept of multiple clinic attendance. A pilot quantitative and qualitative review
Authors: Stross M , Laraman J , Begum A , Punniamoorthy M 
Published: January 2024

Abstract

Introduction
The concept of “polypharmacy” is a well-recognised phenomenon, forming a keystone of any comprehensive geriatric assessment. We considered whether a similar concept could be applied to the number of outpatient clinics that patients may attend - a concept we have coined “polyclinic”. We recognise that older populations may have a greater number of comorbidities and, as a result, have more healthcare professionals inputting into their care. Similar to the potential detrimental effects of multiple medications, we were interested to explore if a similar detrimental effect may apply to patients attending multiple clinics. We also attempted to consider environmental and financial impacts. We approached this in both a quantitative and qualitative manner.

Method
A cohort was selected from all admissions to a subacute Geriatrics ward at University Hospital of Wales during the month of April 2023. National records were used to review the last decade of clinic attendances. For interviews every 4th patient was contacted

Results
66 patients (75% female) were identified with 3 exclusions. The average number of clinics attended was 18.4 with 0.36 new diagnoses being made per clinic and 0.69 interventions per attendance. Geriatric clinic attendance yielded both a higher average number of diagnoses and interventions (0.93 and 1.4 respectively). Patient feedback was limited to 8 patients and 7 next of kin. Feedback regarding ‘worthwhileness’ was very positive with ratings &gt;8/10. Feelings about possible cutting back on clinics or virtual clinic attendance were mixed with concerns regarding suitability and access to technology

Conclusions
We identified several limitations to this pilot project but overall feedback was positive. This study does not have the scope to suggest that attending multiple clinics are detrimental but aims to raise the concept of “polyclinic” that may be overlooked, particularly in a comorbid population and considers potential patient impact and concerns.
2011 Review of the requirement and impact of the medicine for the Elderly Major Trauma Service in South-East Scotland
Authors: Quarm M L , Johnston C S , Kilgour A H M 
Published: January 2024

Abstract

Introduction
It is well established that older adults with hip fracture benefit from comprehensive geriatric assessment (CGA), but there is less evidence for its use in major trauma. Since 2012 Major Trauma Centres (MTCs) have opened across the UK, with varying access to CGA. We report the requirement and impact of CGA in a MTC in its first year of opening.

Methods
We reviewed all adult patients admitted under the South-East Scotland MTC included in the Scottish Trauma Audit Group (STAG) database from 1st November 2021 – 31st October 2022. We compared: patients under 65y, patients ≥65y who did not undergo CGA, and patients ≥65y who underwent CGA. Outcomes were: review by ED consultant within one hour of presentation, trauma team activation, injury severity score (ISS), CGA within 7 days when CFS≥5, and mortality at 30 days.

Results
1323 patients were identified (mean age 63.7y, SD20.9): &lt;65y (n=690, 45.5y, SD14.0), ≥65y without CGA (n=401, 77.2y, SD8.2), and ≥65y with CGA (n=289, 84.6y, SD 7.3). The commonest mechanism of injury in all three groups was fall from standing height (29.1%, 59.6%, and 73.4% respectively). ED consultant review within 1 hour occurred in 37%, 25% and 18% of cases, with trauma team activation occurring in 32%, 18% and 7%. Average ISS were: 13, 12 and 11, and commonest sites of injury in those over 65 were external (e.g. skin), chest and limb. CGA was undertaken within 7 days in 95.1% of those with a documented CFS≥5. Mortality at 30 days was 2.9%, 12% and 8%.

Conclusions
A fifth of patients admitted to our MTC in the first year were older adults with CFS≥5. These patients were under-triaged at several stages despite comparable average ISS across groups. CGA may reduce 30-day mortality. We recommend further research into the benefit of CGA within MTCs.
1883 The Psychological Impact of Hospital Discharge on the Older Person
Authors: Hussein Y , Edwards S , Patel H P 
Published: January 2024

Abstract

Introduction
Older people often require hospitalisation but prolonged length of stay and deconditioning in the acute setting is associated with adverse outcomes. 35% of older people do not recover functionally after discharge. Less is known on the psychological impact and coping mechanisms of vulnerable older people after discharge. Our aim was to explore factors signalling psychological vulnerability in older patients, post-discharge to inform better discharge planning.

Methods
A systematic search for studies reporting poor discharge outcomes in older people was performed in Medline, CINAHL, PsycInfo between 2010-2022. The search terms were ’older patients &gt;65 year’, ‘post-discharge’, ’psychological distress’, ’loneliness’, ‘anxiety’, ‘depression’, and ‘length of hospital stay’. Exclusion criteria included COVID-19 disease, dementia (+/- severe cognitive impairment), individuals aged &lt;65 and those under palliative care services.

Results
1,666 records were identified of which 878 were excluded as they were outside of our date limits or were not in English Language. 681 were excluded after application of exclusion criteria and 699 were excluded because of insufficient details. 31 duplicates were removed leaving 38 articles that were assessed for eligibility. 7 of these reports were found suitable, comprising of 1,131 patients. Three highly relevant themes identified relating to post-discharge outcomes across all studies were social isolation, lack of support, depression, apathy and fear, which led to further psychological distress. Older patients with tendency toward depressive symptoms had an increase likelihood of death.

Conclusion
It appears discharge processes fail to address psychological factors that permit successful transition from hospital. Pre-discharge screening of psychological symptoms and coping ability may assist in identifying older patients who are at risk of mental as well as subsequent physical deterioration. Better knowledge of positive and negative predictors of a successful transition from hospital to home would enable more holistic, effective, and inclusive discharge planning processes for older people.
1724 Age is just a number: Cardiac resynchronisation therapy in older patients has comparable outcomes to those that are younger
Authors: Safdar N Z , Kamalathasan S , Gupta A , Wren J , Bird R , Papp D , Latto R , Ahmed A , Palin V , Gierula J , Witte K K , Straw S 
Published: January 2024

Abstract

Introduction
Older people may be less likely to receive cardiac resynchronisation therapy (CRT) for the management of chronic heart failure. We aimed to describe differences in clinical response, complications, and subsequent outcomes following CRT implantation in older patients when compared to those that were younger.

Methods
We conducted a retrospective cohort study of consecutive patients implanted with CRT between March 2008 and July 2017. We recorded complications, symptomatic and echocardiographic response, hospitalisations for heart failure, and all-cause mortality comparing patients aged &lt;70, 70-79, and ≥80 years.

Results
During the study period, 574 patients (median age 76 years [IQR 68-81], 73.3% male) received CRT. Patients aged ≥80 years had worse symptoms at baseline and were more likely to have co-morbidities. Although the provision of guideline-directed medical therapy for heart failure was less optimal in those ≥80 years old, left ventricular function was similar at baseline. Older patients were less likely to receive CRT-defibrillators (which were twice as likely to require generator replacement) compared to CRT-pacemakers. Complications were infrequent and not more common in older patients. Age was not a predictor of symptomatic or echocardiographic response to CRT (67.2%, 71.2%, and 62.6% responders in patients aged &lt;70, 70-79, and ≥80 years, respectively; p=0.43) and time to first heart failure hospitalisation was similar across all groups (p=0.28). Finally, estimated 10-year survival was lower for older patients (49.9%, 23.9%, and 6.8% for patients aged &lt;70, 70-79, and ≥80 years, respectively; p&lt;0.001).

Conclusions
The benefits of CRT were consistent in selected older patients (≥80 years) despite a greater burden of co-morbidities and less optimal provision of guideline-directed medical therapy. These findings support the use of CRT in an aging population.
1903 Barriers perceived by medical students when considering a career in geriatric medicine
Authors: Fisher G , True S 
Published: January 2024

Abstract

Introduction
Despite the UK’s increasing life expectancy, and increase in the elderly population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8,031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have towards Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality.

Method
The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a career in Geriatric Medicine and then, from identifying these, generate a set of comprehensive suggestions as to how to tackle these barriers at a medical school level to increase the interest and ultimately uptake of Geriatric Medicine. The qualitative review contains literature published between 2003 and 2023 accessed using MedLine.

Results
Six themes were identified in answering our question: (a) high emotional burden, (b) caring for patients with complex needs, (c) negative preconceptions of non-clinical factors (prestige, salary, career progression), (d) negative influence of clinical educators, (e) lack of intellectual stimulation and (f) lack of exposure to the speciality and the elderly.

Conclusion
The barriers perceived by medical students when considering Geriatrics as a speciality are complex and multifaceted; these barriers must be tackled promptly in order to secure the next generation of Geriatricians. We suggest that this work can be used as a foundation for further qualitative studies with UK medical students to investigate barriers that are specific to UK students. From this, interventional courses designed to increase Geriatric Medicine uptake could be developed to strengthen the UK Geriatric Medicine workforce.
2000 Cause of death amongst frail and non-frail older people post-hospital admission in northern Tanzania
Authors: Moore D T , Davidson S L , Murray A , Randall T , Hardy J , Lyimo G , Kilasara J , Urasa S , Walker R W , Dotchin C L 
Published: January 2024

Abstract

Introduction
Verbal autopsy (VA) is a tool used to determine cause of death (COD) in regions lacking routine medical certification. Automated algorithms are widely used to interpret VA data. This study aimed to investigate potential differences in COD between frail and non-frail older people in northern Tanzania.

Method
This work forms part of a longitudinal study investigating the clinical outcomes of 308 consecutive adults aged ≥60 years following admission to four hospitals in northern Tanzania. Frailty status was established on admission using the Clinical Frailty Scale (CFS) and dichotomised with CFS ≥5 indicating frailty. For participants who passed away in the 10-12 months following admission, VA data were collected through telephone interview using the 2022 World Health Organization (WHO) VA instrument. COD estimates were established using the SmartVA-Analyze program, implementing the Tariff 2.0 Method.

Results
After a mean follow-up period of 10.8 (±0.9) months, VA data were available for 69 participants. At admission screening, 51 (73.9%) were frail, while 18 (26.1%) were non-frail. SmartVA produced COD estimates for 42 (60.9%) participants, while 27 (39.1%) remained undetermined. Cause Specific Mortality Fractions (CSMFs) for non-communicable disease were higher for those with frailty than the non-frail group (70.6% vs. 54.0%, respectively). An undetermined COD was more likely in those with frailty. Of the 27 undetermined COD, 22 (81.5%) were attributed to frail individuals and 5 (18.5%) to non-frail. These undetermined COD represent 43.1% of frailty-related deaths and 27.8% of non-frailty-related deaths.

Conclusions
Older people with frailty living in Tanzania are more likely to die from non-communicable diseases compared to non-frail older people. Although employing SmartVA to analyse VA data from this population was feasible, it faced challenges ascribing COD to all participants. This limitation may be due to the multi-morbidity often present in older populations where multiple factors combine to cause mortality.