bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine learning classification of non-Markovian noise disturbing quantum dynamics
Authors: Martina Stefano , Gherardini Stefano , Caruso Filippo 
Published: January 2023

Abstract
In this paper machine learning and artificial neural network models are proposed for the classification of external noise sources affecting a given quantum dynamics. For this purpose, we train and then validate support vector machine, multi-layer perceptron and recurrent neural network models with different complexity and accuracy, to solve supervised binary classification problems. As a result, we demonstrate the high efficacy of such tools in classifying noisy quantum dynamics using simulated data sets from different realizations of the quantum system dynamics. In addition, we show that for a successful classification one just needs to measure, in a sequence of discrete time instants, the probabilities that the analysed quantum system is in one of the allowed positions or energy configurations. Albeit the training of machine learning models is here performed on synthetic data, our approach is expected to find application in experimental schemes, as e.g. for the noise benchmarking of noisy intermediate-scale quantum devices.
Power-efficient in vivo brain-machine interfaces via brain-state estimation
Authors: Valencia Daniel , Leone Gianluca , Keller Nicholas , Mercier Patrick P , Alimohammad Amir 
Published: January 2023

Abstract

Objective. Advances in brain–machine interfaces (BMIs) can potentially improve the quality of life of millions of users with spinal cord injury or other neurological disorders by allowing them to interact with the physical environment at their will. Approach. To reduce the power consumption of the brain-implanted interface, this article presents the first hardware realization of an in vivo intention-aware interface via brain-state estimation. Main Results. It is shown that incorporating brain-state estimation reduces the in vivo power consumption and reduces total energy dissipation by over 1.8× compared to those of the current systems, enabling longer better life for implanted circuits. The synthesized application-specific integrated circuit (ASIC) of the designed intention-aware multi-unit spike detection system in a standard 180 nm CMOS process occupies 0.03 mm2 of silicon area and consumes 0.63 µW of power per channel, which is the least power consumption among the current in vivo ASIC realizations. Significance. The proposed interface is the first practical approach towards realizing asynchronous BMIs while reducing the power consumption of the BMI interface and enhancing neural decoding performance compared to those of the conventional synchronous BMIs.
Large mitigation potential of smoke PM2.5 in the US from human-ignited fires
Authors: Carter Therese S , Heald Colette L , Selin Noelle E 
Published: January 2023

Abstract
Increasing fire activity and the associated degradation in air quality in the United States has been indirectly linked to human activity via climate change. In addition, direct attribution of fires to human activities may provide opportunities for near term smoke mitigation by focusing policy, management, and funding efforts on particular ignition sources. We analyze how fires associated with human ignitions (agricultural fires and human-initiated wildfires) impact fire particulate matter under 2.5 µm (PM2.5) concentrations in the contiguous United States (CONUS) from 2003 to 2018. We find that these agricultural and human-initiated wildfires dominate fire PM2.5 in both a high fire and human ignition year (2018) and low fire and human ignition year (2003). Smoke from these human levers also makes meaningful contributions to total PM2.5 (∼5%–10% in 2003 and 2018). Across CONUS, these two human ignition processes account for more than 80% of the population-weighted exposure and premature deaths associated with fire PM2.5. These findings indicate that a large portion of the smoke exposure and impacts in CONUS are from fires ignited by human activities with large mitigation potential that could be the focus of future management choices and policymaking.
Band structure for relativistic charge carriers submitted to a helical electric field
Authors: Martínez D , Reyes J A 
Published: January 2023

Abstract
We study the relativistic dynamics of electrons submitted to a uniform harmonic electric fields longitudinally applied to the electron velocity. In order to obtain explicitly the set of time-dependent equations for the bi-spinors components, we write down the corresponding Dirac equation for this system. By performing a suitable transformation to this set of equations, we get a matrix equation whose eigenvalues can be found directly. We found analytically the band structure and show a break of degeneracy and the existence of three bands: two total and one partial. The thicker band preventing from the Schwinger mechanisms can be shortened by proper combination of the frequency and amplitude of the applied electric field.
1344 UNDERSTANDING PATHWAYS INTO CARE HOMES USING DATA (THE UNPICD STUDY)
Authors: Burton J K , Ciminata G , Lynch E , Shenkin S D , Geue C , Quinn T J 
Published: January 2023

Abstract

Introduction
Moving into a care home is a significant, life-changing experience which occurs to address care needs which cannot be supported elsewhere. UK health policy recommends against moving into a care home from the acute hospital. However, this occurs in practice. Better understanding pathways into care homes could improve support for individuals and families, service planning and policymaking. Our aim was to characterise individuals who move-in to a care home from hospital and those moving-in from the community, identifying factors associated with moving-in from hospital.

Method
A retrospective observational cohort study was conducted involving adults moving into care homes in Scotland between 1/3/13-31/3/16 using the Scottish Care Home Census (SCHC), a national individual-level social care dataset. SCHC data were linked to routine data sources including hospital admissions, community prescribing and mortality. The data were split into those moving-in from hospital and those moving-in from the community. Descriptive statistics characterising the two groups were generated and multivariate regression undertaken to identify factors associated with moving-in from hospital.

Results
A total of 23,892 individuals were included in the analysis, of whom 13,564 (56.8%) moved-in from hospital. A third came directly from an acute hospital, with 57.7% from rehabilitation or community hospitals and 7.1% from inpatient psychiatry. Being male, receiving nursing care, high frailty risk, increasing numbers of hospital admissions and diagnoses of any fracture or stroke in the six months before moving-into the care home were all significant predictors of moving-in from hospital.

Conclusions
The population moving-in to care homes from hospital are clinical distinct from those moving-in from the community. National cross-sectoral data linkage of health and social care data is feasible, but the available data are dominated by health characteristics. There is an urgent need to operationalise other meaningful variables which shape care pathways to enhance understanding and evidence.
1319 INTERACTION BETWEEN DISTINCT MULTIMORBIDITY PATTERNS AND DISABILITY AND ITS ASSOCIATION WITH FUTURE MORTALITY AMONG OLDER ADULTS
Authors: Ho H-E , Yeh C-J , Wei J C-C , Chu W-M , Lee M-C 
Published: January 2023

Abstract

Background
Multimorbidity patterns is associated with future mortality among older adults. However, the addictive effect of disability for distinct multimorbidity patters is unclear. Our aim was to identify the multimorbidity patterns of Taiwanese people aged over 50 years and to explore their association between multimorbidity patterns with/without disability and future mortality.

Methods
This longitudinal cohort study used data from the Taiwan Longitudinal Study on Aging. The data were obtained from wave 3, and the multimorbidity patterns in 1996, 1999, 2003, 2007, and 2011 were analysed separately by latent class analysis (LCA). The association between each disease group with/without disability and mortality was examined using logistic regression.

Results
5124 older adults with average age of 66.7 years old were included. Four disease patterns were identified in 1996, namely, the cardiometabolic (21.6%), arthritis-cataract (11.6%), relatively healthy (61.2%), and multimorbidity (5.6%) groups. After adjusting all the confounders, the cardiometabolic group with disability showed the highest risk for mortality (odds ratio: 2.83, 95% CI: 1.70-4.70), followed by Multimorbidity group with disability (odds ratio: 2.33, 95% CI: 1.17-4.64) and relatively health group with disability (odds ratio: 1.79, 95% CI: 1.22-2.62) and cardiometabolic group without disability (odds ratio: 1.21, 95% CI: 1.01-1.45).

Conclusion
This longitudinal study reveals disability plays an important role on mortality among older adults with distinct multimorbidity patterns. Older adults with a cardiometabolic multimorbidity pattern with disability had a dismal outcome. Thus, healthcare professionals should put more emphasis on the prevention and identification of cardiometabolic multimorbidity, with routine check-up of their functional limitation.
1195 EFFECTIVENESS OF A NEW PROACTIVE MULTIDISCIPLINARY CARE SERVICE FOR OLDER PEOPLE WITH FRAILTY: A NON-RANDOMISED CONTROLLED TRIAL
Authors: Murtagh F E M , Okoeki M , Ukoha-kalu B O , Khamis A , Clark J , Boland J W , Pask S , Nwulu U , Elliott-Button H , Folwell A , Johnson M J , Harman D 
Published: January 2023

Abstract

Introduction
Integrated care potentially improves health outcomes for older people with frailty. We aimed to assess the effectiveness of a new, proactive, multidisciplinary care service in improving the wellbeing and quality-of-life of older people with frailty.

Methods
A community-based non-randomised controlled trial. Participants (≥65 years, electronic Frailty Index ≥0.36) received either this new integrated care service plus usual care, or usual care alone. Data collection was at 3 time points: baseline, 2-4 weeks, and 10-14 weeks; the primary outcome was patient well-being at 2-4 weeks, measured using the Integrated Patient Outcome scale, IPOS. The secondary outcome was quality-of-life, measured using EQ-5D. Wellbeing and quality-of-life at 10-14 weeks were measured to test safety and duration of effect. Data was analysed with STATA v17.

Results
199 intervention and 54 control participants were recruited. At baseline, participants were similar in age/gender/body mass index/ethnicity/living status. At 2-4 weeks, the intervention group had improved well-being (median IPOS reduction 5, versus control group increase 2, p&lt;0.001) and improved quality of life (median EQ-5D index values increase 0.12, versus control 0.00, p&lt;0.001); these were clinically significant. After adjusting for age, gender and living status, intervention group had an average total IPOS score reduction of 6.34 (95% CI: -9.01: -4.26, p&lt;0.05). Propensity score matching analysis based on functional status/deprivation score showed similar results (reduction in IPOS score in intervention group 7.88 (95% CI: -12.80: -2.96, p&lt;0.001). At 10-14 weeks, the intervention group sustained well-being improvement (median IPOS score reduction 4, versus control increase 2, p&lt;0.001) and improved quality of life (median EQ-5D index values increase 0.06, versus control -0.01, p&lt;0.001).

Conclusion
This new integrated care service improves the overall wellbeing and quality of life of older people with frailty at 2-4 weeks; improvement was sustained at 3 months.
Ethics Approval: IRAS-250981 and NHS Research Ethics Committee 18/YH/0470.
1199 PREVENTION AND TREATMENT OF CRITICAL ILLNESS ACQUIRED WEAKNESS IN THE ELDERLY
Authors: Costa C , Moniati F 
Published: January 2023

Abstract

Introduction
Critical Illness Acquired weakness (ICU-Acquired Weakness (ICU-AW)) is an umbrella term used to describe Critical Illness Myopathy (CIM) and Critical Illness Polyneuropathy (CIP). The condition exerts high prevalence in the elderly admitted in the ICU and is associated with deteriorating patient outcomes, namely mortality and morbidity. The prevalence of the syndrome is highly variable in the current literature hindering our ability to objectively quantify the scale of the problem. Moreover, several preventative methods and treatment for ICU-AW as a result of sarcopenia have been proposed in literature with some of them providing favourable outcomes.

Objectives
1. Evaluate the prevalence of ICU-AW in the elderly through a systematic review; and 2. Explore the treatment options currently available.

Methods
We conducted a systematic review using the PubMed, Embase and Cochrane databases to explore the current studies available on the diagnosis of ICU-AW syndromes. Cochrane’s Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was our template.

Results
Overall, twenty-one studies (1544 patients) were included. The minimum reported prevalence is 20%, whereas the maximum is 76%. The overall median prevalence was 52% (Q1: 32% and Q3: 61%) with an interquartile range (IQR) of 29%. The highest IQR was found in studies using clinical examination (IQR=37%) whereas the lowest in studies using electrophysiological assessment (IQR= 21%). Moreover, several preventative measures for ICU-AW were identified and analyzed namely: nutritional alterations (high protein dies), glucose control, early mobilization, neuromuscular electrical stimulation and the ABCDEF bundle.

Conclusion
The variability in the diagnostic modalities used to measure the syndrome as well as the inconsistency in the diagnostic parameters within each modality prevent us from objectively quantifying the prevalence of ICU-AW. With regards to treatment early mobilization protocols offer promising evidence.

Reference
Vanhorebeek, Latronico, Van den Berghe G. ICU-acquired weakness. Intensive Care Med. 2020;46(4):637-53.
1203 SUPPORTING SAFE SWALLOWING OF CARE HOME RESIDENTS WITH DYSPHAGIA: HOW DOES CARE COMPARE WITH GUIDANCE?
Authors: Wilson J , Loveday H , Tingle A , Griffin H , Goerzig A 
Published: January 2023

Abstract

Introduction
Dysphagia affects up to 70% of nursing home residents, causes significant morbidity and increased hospital admissions. Speech and language therapists (SLT) make recommendations to reduce the risk of aspiration and support safe eating and drinking but have limited capacity to offer ongoing guidance to care home staff. This study aimed to measure the mealtime experience of residents with dysphagia, how this compared with SLT advice and what factors influenced care.

Methods
The safety of nutrition/hydration care of residents with dysphagia in 2 care homes was observed using a structured tool capturing 12 elements of expected practice. Observed practice was compared to recommendations in SLT/care-plans. Interviews with staff aimed to understand factors that contributed to how dysphagia care was delivered.

Results
SLT recommendations for 18 residents with dysphagia were predominantly focused on food/fluid modification, other safe swallowing strategies were mentioned less frequently. 66 episodes of mealtime care for 11 residents were observed. Adherence to SLT/care-plan recommendations for food texture, posture and alertness of the resident was observed on 90% of occasions, but on less than 60% of occasions for alternating food and drink, prompting resident during feeding, ensuring swallow completed and throat/mouth clear. Compliance with recommended fluid thickness was 68%; thickening was frequently not aligned to required IDDSI level. Nutrition care was less safe when residents were fed in the dining room when multiple care staff were present. Interviews with 11 care home staff found care-plans were rarely consulted, care needs were communicated verbally during handover, and training was targeted at fluid modification but not at other safer swallowing strategies. Limited knowledge about causes of coughing whilst eating/drinking drove inappropriate SLT referrals.

Conclusions
A safe swallowing culture that addresses system and workforce issues in care homes would improve the experience of residents with dysphagia and reduce their risk of aspiration.
1323 VOLUNTEER-LED ONLINE GROUP EXERCISE FOR OLDER ADULTS: A FEASIBILITY AND ACCEPTABILITY STUDY
Authors: Lim S , Meredith S , Agnew S , Clift E , Ibrahim K , Roberts H C 
Published: January 2023

Abstract

Introduction
The health benefits of physical activity for older people are well recognised and include reduction in falls, improvement in frailty status and physical function. Nonetheless, physical inactivity remains a significant problem among older adults. This study aimed to determine the feasibility and acceptability of implementing online volunteer-led group exercise for community-dwelling older adults.

Methods
This pre-post mixed methods study was conducted among older adults attending community social clubs. Eligible participants were aged ≥ 65 years, able to walk independently, and able to provide written consent. The intervention consisted of a once weekly volunteer-led online group chair-based exercise. The primary outcomes were the feasibility and acceptability of the intervention. Secondary outcomes included physical activity levels measured using the Community Health Model Activities Program for Seniors (CHAMPS) questionnaire, functional status (Barthel Index), and health-related quality of life (EQ-5D-5L). Outcomes were measured at baseline and at 6 months. Trials registration: NCT04672200.

Results
Nineteen volunteers were recruited, 15 completed training and 9 were retained (mean age 68 years, 7 female). Thirty participants (mean age 77 years, 27 female) received the intervention and attended 54% (IQR 37-67) of exercise sessions. One minor adverse event was reported. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels. The intervention was acceptable to volunteers, participants, and staff. The seated exercises were perceived as safe, manageable and enjoyable. Volunteers were relatable role models providing positive vicarious experiences that improved participants confidence to exercise within a friendly, non-judgmental environment. Technological issues, or reluctance to learn how to use technology were barriers to the intervention. The social interactions and sense of belonging motivated participation.

Conclusions
Trained volunteers can safely deliver online group exercise for community-dwelling older adults and the intervention was feasible and acceptable to older adults, volunteers and club staff.
1358 USING THE SUPPORTIVE AND PALLIATIVE CARE INDICATORS TOOL (SPICT) TO PRIORITISE FRAIL INPATIENTS FOR ANTICIPATORY CARE PLANNING
Authors: Boothroyd K , Nicholson A , Tevendale E 
Published: January 2023

Abstract

Introduction
Patients with frailty who have emergency admissions are at risk of mortality and may benefit from Anticipatory Care Planning (ACP). Appropriate identification, to target limited resource in an in-patient environment can be challenging. We conducted a prospective study on a cohort of frail in-patients with a hospital admission of ≥ 72 hours duration. We aimed to evaluate the effectiveness of the SPICT tool alongside CFS as a predictor of mortality to improve our targeting of patients for ACP.

Method
On a single day a SPICT form was completed prospectively for each inpatient on 3 hospital inpatient wards (Complex Frailty Unit, General/Orthopaedic Rehabilitation, Step-Down Unit). Patients were deemed SPICT positive if they scored on ≥ 2 General Indicators and ≥ 2 Clinical Indicators. CFS was also recorded. Electronic records of this patient cohort were followed up for 9 months.

Results
Of 66 inpatients, 58 (87.9%) were aged ≥ 65 years and had a CFS ≥ 4. Mode CFS value = 6 (23 patients, 39.7%). 32 (55.2%) were SPICT positive; 26 (44.8%) SPICT negative. At 3 months follow-up SPICT had Positive Predictive Value (PPV) 40.6% and Negative Predictive Value (NPV) 84.6% for mortality. At 6 months PPV = 56.3%; NPV = 80.8%. At 9 months PPV = 59.4%; NPV = 76.9%. SPICT negative patients with CFS 6 had mortality risk of 14.3% at 3, 6 and 9 months follow-up respectively. SPICT positive patients with CFS 6 had mortality risks of 50% at 3 months and 62.5% at 6 and 9 months.

Conclusion
SPICT is a predictor of mortality in patients with frailty during unplanned admissions to hospital of ≥ 72 hours duration. It is now used alongside CFS for all patients admitted to our Complex Frailty Unit, identifying patients most likely to benefit from inpatient ACP on discharge.
1213 IMPROVING INITIAL SCREENING, INVESTIGATION AND INTERVENTION OF BONE HEALTH IN A DAY REHABILITATION UNIT
Authors: Turkington S , Sedek H , McLoughlin A 
Published: January 2023

Abstract

Topic
We identified a deficiency in the identification and treatment of bone health in the Day Rehabilitation Unit. DRU is an Out-patient clinic where older people with falls or reduced mobility receive comprehensive geriatric assessment. We aimed to improve early screening for osteoporosis, prompting targeted investigation and intervention to improve patient outcomes.

Intervention
Our first intervention was consultant teaching specifically to the junior doctors working in clinic. This was followed up by the introduction of a Medical Assessment Proforma to include osteoporosis risk assessment. Finally, we had departmental wide teaching on bone health assessment. We hypothesised that a combination of clinical education and prompts in the proforma would improve our practice. A total of 205 patients where audited across an 18-month period from Sept 20 to Feb 22. We reviewed the electronic care record of patients seen in clinic to determine if bone health had been considered. A spreadsheet was designed in accordance with the NICE1 guidelines to record data. This included what supplements were prescribed, if a FRAX score had been recorded and the outcome of this.

Improvement
We noted an improvement in supplements prescribed (from 27% to 83%), FRAX score recorded (from 0% to 100%). Routine bloods including serum calcium remained unchanged (100%). Recording of Rockwood score also saw an improvement (from 0% to 49%).

Discussion
Increased use of a structured screening tool, supported by targeted education improves recognition and intervention of bone health. 54% of people who had a FRAX score done required a DEXA as per guidelines, of these 26% have osteoporosis. This early intervention helps to prevent osteoporotic fractures, therefore improving the quality of life of our elderly population.

Reference
1. Nice.org.uk. (2017). Osteoporosis: assessing the risk of fragility fracture | Guidelines| NICE. [Online] Available at: https://www.nice.org.uk/guidance/cg146.