bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on intelligent substation secondary system fault diagnosis system based on fuzzy comprehensive judgment
Authors: Zhang Hongtao , Wang Ruohan , Zou Gang , Tang Dengfeng , Mei Xuewei , Wu Songlin 
Published: January 2025

Abstract
The safety and reliability of substations under the background of ‘double carbon’ is the key to ensuring the stable operation of new power systems. As an important part of the new power system, the construction scale of intelligent substations and the scale of the secondary system are constantly expanding, which puts forward higher requirements for the fault diagnosis of the secondary system of intelligent substations. In this paper, we first analyze the Substation Configuration Description (SCD) of the whole station of the intelligent substation and analyze the information of the secondary system of the intelligent substation and the topological relationship of the virtual terminals and virtual circuits. A secondary system fault localization method based on the combination of a diagnostic model and fuzzy fault tree theory is proposed. An intelligent substation secondary system fault diagnosis system is developed, which determines the faulty equipment based on the substation static configuration information, fault characteristic logical relationship, fault diagnosis model, and derivation through an intelligent algorithm. This paper comprehensively analyses the intelligent station secondary configuration, network status information, message information, and other aspects of information in the intelligent substation SCD. Through the real-time tracking of the communication data in the link layer and network layer in the communication system of the intelligent substation, when the optical sign alarm occurs, the accurate positioning of the fault is accomplished through the secondary equipment defect analysis expert system, and then the alarm information is displayed together, and finally, the solution for the fault is given. This study provides a certain scientific basis for the construction of fault diagnosis of secondary systems of intelligent substations in the future.
Operation state monitoring method of double column center fracture horizontal rotary disconnector based on laser point cloud
Authors: Lin Hongdong , Li Fupeng , Xie Xingsheng , Jiang Yuhuan 
Published: January 2025

Abstract
A technique utilizing laser point cloud data has been developed for the surveillance of the operational status of a double-column center fracture horizontal rotary disconnector switch. The method includes an action monitoring model for isolating switches to identify and segment point cloud data of isolating switch conducting arm. The model consists of a local feature extraction module, a point cloud feature dimension attention module, a classification module, and a segmentation module. The segmentation module realized the point cloud segmentation function by Interpolate and Unit Pointnet network. The classification module implements the point cloud classification function through a point net layer Pointnet and a fully connected layer (FC). Ultimately, the status of the disconnector’s operation is determined by analyzing the differences in the point cloud vectors of the conductive arm between successive frames.
eP1 External validation of HAS model in predicting mortality after emergency laparotomy: A retrospective cohort study
Authors: Smith Christopher , Soliman Hesham , Mena Jimmy , Yusuf Gibran Timothy , Helmy Ahmed Hazem 
Published: January 2025

Abstract

Aims
The HAS (Hajibandeh Index, American Society of Anaesthesiologists status, and sarcopenia) model has demonstrated superior predictive ability compared to the NELA (National Emergency Laparotomy Audit) score for mortality after emergency laparotomy. However, external validation of this model is lacking. This study aimed to validate the HAS model's performance in predicting mortality after emergency laparotomy and compare its predictive accuracy with the NELA score.

Methods
This retrospective cohort study included all adult patients (&gt;17 years) who underwent emergency laparotomy between January 2022 and June 2023 at an urban district general hospital. Receiver operating characteristic curve analysis was used to compare the HAS model and NELA score in predicting 30-day mortality. Subgroup analysis was conducted for age groups: ≥50, ≥60, ≥70, and ≥80.

Results
A total of 117 patients were included. The area under the curve (AUC) for the HAS model in predicting 30-day mortality was 0.90 (95% CI 0.83-0.95). There was no statistically significant difference in AUC between the HAS and NELA scores for all patients (0.90 vs 0.80, p = 0.097). However, the AUC of the HAS model was significantly superior to that of the NELA score in patients aged ≥50 (0.89 vs 0.75, p = 0.040), ≥60 (0.87 vs 0.69, p = 0.020), ≥70 (0.85 vs 0.67, p = 0.030), and ≥80 (0.90 vs 0.66, p &lt; 0.001).

Conclusions
This study provides external validation of the HAS model for predicting 30-day mortality after emergency laparotomy. Prospective studies with larger sample sizes are warranted to confirm these findings.
eP13 Gastrografin Use in Adhesive Small Bowel Obstruction: A Narrative Review
Authors: Balo Vanessa , Lam Tracy , Tan Jason 
Published: January 2025

Abstract

Background
Adhesive Small Bowel Obstructions (ASBO) account for a large number of annual emergency presentations. Conservative management of ASBO is possible in most cases and it commonly includes the use of the water-soluble contrast agent gastrografin (GG). This review aims to explore the diagnostic and therapeutic utility of GG and examine differences in GG protocols currently in use for ASBO management.

Methods
A narrative review of the existing literature was performed. Online databases MEDLINE, Emcare and Cochrane Central Register of Controlled Trials were searched for relevant studies in July 2023. Studies were screened using the inclusion and exclusion criteria and assessed for appropriateness for inclusion.

Results
From the 760 citations initially retrieved, 10 of the studies met the inclusion and exclusion criteria and were selected for review. The diagnostic utility of GG was well-evidenced with all six of the included studies which assessed this outcome finding supportive evidence. The therapeutic value of GG however remains unclear. Significant differences were also found between GG protocols currently in use, some of these differences led to differences in patient outcomes. Most importantly utilizing standard protocols led to better patient outcomes.

Conclusion
GG has been demonstrated as an ideal diagnostic agent in ASBO management, but its therapeutic role remains inconclusive. Variations in GG protocols exist across studies, and these may also account for differences in patient outcomes which warrants further comparative studies. Further research is also required using randomised controlled trials to directly assess GG’s therapeutic utility.
eP26 Enhancing Guideline Adherence in PR Bleeding: A Path to Better Patient Outcome
Authors: Wubetu Jonathan , de Andres Crespo Marta , Dilaver Nafi , Boulton Richard 
Published: January 2025

Abstract

Aims
Per rectal (PR) bleeding affects 10% of adults in the UK annually [1], necessitating prompt and accurate clinical assessment to prevent severe complications. This audit aimed to: 1) increase PR examination rates, 2) enhance the use of the Oakland score for hospitalisation decisions, and 3) eliminate the use of tranexamic acid (TXA), given its lack of benefit and potential for harm.

Methods
A prospective analysis was conducted, collating data on patients reviewed by surgical teams in A&E across two centres in East London. Data collected included the date of admission, initial assessment (PR examination, observations), Oakland scores and management (TXA, imaging studies, endoscopy). After the first cycle, we reported findings at our M&M session and created posters throughout the department to reiterate the learning points.

Results
Prospective observations of admission captured 20 patients in the first cyle and 22 patients in the second cycle between March-April 2024 and July-August 2024, respectively. The rate of PR examinations improved slightly, with a decrease in non-compliance from 15% to 13.6%. Documentation of Oakland scores saw a significant improvement from 5% to 22.7%, reflecting a 17.7% increase. TXA use significantly decreased from 35% to 9.1%, with one of the two cases in the second cycle being based on a hematology recommendation.

Conclusions
The interventions led to better adherence to PR bleeding guidelines, improved documentation, and reduced TXA use, suggesting that targeted strategies can enhance patient management and safety in these cases.
eP38 Diverticulitis follow up; are we adherent to ACPGBI guidelines
Authors: Abosheisha Mohamed Dorgham , Shalaby Amr , Mudigerenayaz Neman , Shishtawi Mohammad , Atalla Rasha , Ismaeil Mohamed , Omar Islam 
Published: January 2025

Abstract

Aim
To assess our adherence to The Association of ColoProctology of Great Britain and Ireland “ACPGBI” guidelines regarding follow up of Acute Diverticulitis “AD” (managed conservatively successfully) across our Trust.

Methods
ACPGBI guidelines presented in the Trust Audit Meeting. Data collected retrospectively over 18 months from admissions with AD in "hospital 1 in Health Board" showed that ACPGBI guidelines were not followed appropriately. Following this data were collected from 2 sites across The Trust (hospital 1, hospital 2) and presented again in the Trust Audit Meeting.

Results
The 1st cycle (hospital 1): 55.6% of complicated AD had follow up endoscopy, 100% follow up endoscopy in query malignant cases, and unnecessary follow up endoscopy done in uncomplicated AD in 60% of cases.
2nd cycle (hospital 1): improvement in follow up of complicated AD 62.5%, follow up of query malignant cases remained 100%, and reduction in unnecessary endoscopy in uncomplicated AD 27.3%.
Data from hospital 2 (collected during the 2nd cycle): 57.1% of complicated AD had follow up endoscopy, 33.3% follow up endoscopy in query malignant cases, and unnecessary follow up endoscopy done in uncomplicated AD in 66.7% of cases.

Conclusions
The need to improve adherence of our Trust to ACPGBI guidelines regarding follow up of AD patients, further efforts must be made to avoid unnecessary investigations of uncomplicated AD, to have posters with the guidelines in clinical areas, and finally to include all 3 sites of The Trust in re-audit.
eP45 Time to junior review: An analysis of the impact of an Advanced Clinical Practitioner service in a busy DGH
Authors: Olemu Temitope , Roberts Aisling , Alexander Roderick 
Published: January 2025

Abstract

Introduction
Surgical Assessment Units (SAUs) enable expeditious assessment of surgical patients. In response to the growing pressures on the NHS and our SAU, two advanced clinical practitioners (ACPs) were appointed in June 2022 and January 2023 respectively. ACPs are health professionals who exercise a defined level of autonomy across four pillars of advanced practice. They provide continuity in service delivery that the rotational medical workforce cannot. This study was to evaluate the impact of ACPs on time to junior review of patients on a busy District General Hospital’s SAU.

Method
A cross-sectional analysis of the time from patient arrival on the SAU, to junior review was carried out covering the period September 2022 to May 2024. All surgical patients attending SAU during this period were included. This data was obtained from the hospital’s electronic patient management system, Nerve Centre. The data was then matched with the shift times of the surgical ACPs on SAU, to examine the difference.

Results
A total of 8602 patients were analyzed. 4489 patients (70%) were seen within 2 hours of arrival on SAU when ACPs were on shift and 4113 (59%) were seen within 2 hours when ACPs were not on shift. Chi squared: P = &lt;0.0001.

Discussion
This short study shows that significantly more patients are seen quickly on the days we have ACPs on shift in our SAU. Currently, 4-5 days a week have ACPs on shift in our SAU. This strengthens the case for having ACPs present each day on the SAU.
eP69 Real Life Assessment of Diagnostic Imaging In Acute Appendicitis. A Multi-Centre Audit from The United Kingdom
Authors: Elsayed Hassan Tamer Hassan , Abushawaly Amr , Abdelmoneim Lina 
Published: January 2025

Abstract

Objectives
Ultra-sound scan (USS) and Computed Tomography (CT) are commonly used in the diagnosis of acute appendicitis (AA). This audit aims at assessing their sensitivity and implications on the rate of negative appendicectomy (NA) and the number of scans patients have.

Methods
This is a retrospective multi-centre audit from tertiary (TH) and secondary (SH) hospitals in the United Kingdom. We enrolled patients who underwent appendicectomy over the last year and compared their scans findings to the histopathological findings as the gold standard for AA.

Results
This is a preliminary report of the first 405 (49.4% females). 69% had USS and 51% had CT scan. USS sensitivity was 57.6%. This sensitivity did not change significantly with age, sex or the size of hospital. CT sensitivity was 95.7%. Females and SH patients tended to have more scans (p&lt; 0.001 for both). 26.4% of the patients had no scans and underwent appendicectomy based on clinical diagnosis. The positive predictive value of this clinical diagnosis was 85% which is equal to USS. 12.1% of the patients had NA, of which 16.4% were females Vs 7.8% males (p= 0.008). The mean age in NA was 26.96 years old Vs 34.12 years old in positive appendicectomy (p=0.009).

Conclusion
USS sensitivity is low and does not improve in females or younger patients who are also more likely to have NA. Females and SH patients are more likely to have more scans. Findings of USS should be interpreted with care, especially in young and female patients.
eP74 Splenic function following angioembolisation for blunt splenic injury: A systematic review
Authors: Broadhurst William , Gomm Timothy , De’Ath Henry 
Published: January 2025

Abstract

Background
Splenic artery angioembolisation (SAE) plays an important role in the nonoperative management of blunt splenic injury. In contrast to splenectomy, there is little guidance concerning immune function, and consequently the need for antimicrobial prophylaxis, following SAE. A systematic review was conducted to evaluate the current literature on the topic.

Method
A systematic review of the currently available literature was performed using the MEDLINE database. Original articles were eligible if they reported at least one marker of splenic function following SAE. Animal studies, literature reviews and case reports were excluded. Two researchers independently assessed the eligibility and quality of the articles and performed the data extraction; these studies were qualitatively analysed.

Results
Eleven studies were included. A total of 407 patients, of which 243 had undergone SAE, 80 who had undergone splenectomy and 84 healthy controls, were included. All studies used different parameters for assessing splenic function. None reported increased rates of infection or overwhelming postsplenectomy infection following SAE. There was no statistically significant difference between the markers of immunocompetence measured in the SAE group when compared to healthy controls. Ten of the studies concluded that, by the parameters they measured, splenic function was preserved after the procedure.

Conclusion
All but one of the included studies reported preserved splenic function following SAE. Whilst there is no single parameter that unequivocally demonstrates this, the best available evidence supports this. This may help inform clinical guidelines for post-SAE vaccination and prophylactic antibiotic practice; namely, that there is no indication to do so.
eP89 The Role of Frailty Assessment in Enhancing Surgical Outcomes in Emergency General Surgery
Authors: Homaee Lea 
Published: January 2025

Abstract

Aims
This study aims to investigate the critical role of frailty assessment in improving surgical outcomes for patients undergoing emergency general surgery (EGS). As frailty is associated with increased vulnerability and adverse postoperative events, early identification of frail patients is essential for optimising surgical care and enhancing recovery.

Methods
A comprehensive review of current literature was conducted, focusing on frailty assessment tools such as the Clinical Frailty Scale (CFS) and the Fried Frailty Phenotype. The review examined studies that explored the correlation between frailty status and postoperative outcomes, including complications, hospital length of stay, and mortality rates among older adults undergoing emergency surgical procedures.

Results
The findings indicate that frail patients are at a significantly higher risk for postoperative complications and prolonged recovery times compared to non-frail patients. Frailty assessments provide essential insights into a patient’s preoperative physiological status, enabling healthcare teams to implement targeted interventions. Strategies may include enhanced recovery protocols, individualised rehabilitation, and coordinated multidisciplinary care to address the unique needs of frail individuals.

Conclusions
Incorporating frailty assessments into EGS practice is vital for improving patient outcomes. Identifying frail patients preoperatively allows for tailored surgical planning and postoperative management, thereby reducing complications and enhancing recovery. Future research should focus on standardised frailty assessment protocols and the development of effective interventions to support this vulnerable population in clinical settings.
eP95 Peri-operative Analgesia Use in Emergency Surgery: A Single-Centre Audit
Authors: Boitnott Jasmine , Welch Joseph , Gibson Niamh , Pugsley Rebecca , Hollyman Marianne 
Published: January 2025

Abstract

Aims
Pain management is widely recognised as a key part of peri-operative care. National guidance recommends routine use of paracetamol peri-operatively and NSAIDs post-operatively. Intravenous (IV) and oral paracetamol have equivalent analgesic efficacy. IV paracetamol has a higher carbon footprint, increased financial and time cost yet remains commonly used. NSAIDs are safe and effective for post-operative pain and have been shown to reduce opioid consumption in this setting. This audit investigated peri-operative analgesia practices for patients undergoing emergency surgery at our centre.

Methods
Retrospective data was collected for 47 patients undergoing emergency surgery over a one-month period. Prescriptions were reviewed using Electronic Prescribing and Medicines Administration software. Electronic records were used to identify patients with contraindications for NSAIDs, including structural kidney disease, stage 4 or 5 CKD, concomitant anticoagulation, asthma, and allergies.

Results
89% of patients received paracetamol peri-operatively, 83% of which were regular prescriptions. Less than half received paracetamol at the maximum frequency. 83% of paracetamol prescriptions were for IV/oral route without preference for the oral. There were 44 (0.94 per patient) and 47 (1 per patient) pre- and post-operative IV administrations of paracetamol respectively. This included 34 avoidable IV administrations where patients were given oral medications concurrently. Only 28% of patients without contraindications were prescribed NSAIDs post-operatively, of which 15% were regular.

Conclusions
Prescribing and administration practices are crucial in ensuring optimal analgesic use. Further education regarding this topic and investigation into the barriers preventing maximal administration frequency, oral paracetamol & NSAID use is required.
eP98 Single Shot Rib block as a bridge to Catheter based Rib blocks to optimize analgesia in patients with Rib fractures: A single center study from a Major Trauma Center
Authors: Chandran Pradeep , Manoharan Gausal , Bew Duncan 
Published: January 2025

Abstract

Background
Rib fractures are common following blunt thoracic trauma and are a marker of injury severity. Overall mortality for patients with rib fractures is approximately 10%. Mortality and morbidity from rib fractures primarily derive from pain-induced hypoventilation, atelectasis, lobar collapse, pneumonia and subsequent respiratory failure. Regional analgesia catheter should ideally be sited within 6 hours and should be placed in theaters; and may remain in situ for up to 7 days.

Method
All patients admitted at Kings College Hospital, who underwent a rib block for rib fractures between September 2022 and August 2023 were studied initially; including time taken to get a rib block, incidence of respiratory infections and hospital stay. Single shot rib blocks carried out in the ED, were introduced at the end of this period. The same cohort of patients were then studied from August 2023 to November 2023.

Results
Mean Waiting time for rib blocks was found to have decreased from 31.5 hours to 15.2 hours after introduction of single shot rib blocks. Mean duration of admission decreased from 15.7 days to 9.6 days; while incidence of respiratory infections decreased from 39.5% to 27.3%.

Conclusion
Attaining catheter based rib blocks for patients with rib fractures is invariably met with delays owing to lack of space in emergency operating theaters in the NHS. Single shot rib blocks should be included as a mandatory bridge within the NHS, while patients wait for catheter based rib blocks to be conducted in theaters.
eP109 Assesment of factors contributing to delay of emergency laparotomies and potential solutions to optimize patient flow at a high volume centre. A Quality Improvement Project
Authors: Subramanian Atreya Mukund , Wijewardane Manula , Dias Almira , Khadka Abhinav , Rasool Shaik , Khan Usman 
Published: January 2025

Abstract

Aim
To identify factors resulting in delay of emergency laparotomies and offer potential solutions.

Methods
This was a retrospective study spanning 7 months including all laparotomies and major laparoscopic procedures excluding appendicectomies and cholecystectomeis. Data from the trust IT system was used to populate the various times of each procedure.

Results
265 patients were studied in total including 76 category 1 laparotomies. Transport time defined as the duration between completion of the briefing to patient arrival at the operating theatre was found to be inaccurately documented in 66 cases. Median time was 20 min with 15 patients needing more than 45 min for transport. Median anaesthetic time defined as time from patient arrival to initiation of surgery was 50 min. Median procedure duration was 113 min. Median post operative time defined as the duration between surgery completion and exiting the operating theatre was 17 min. Median post op recovery time was 137 min with 15 patients requiring more than 12 hours in recovery. Post changes of informal education the median transport time reduced to 17 min.

Conclusions
Factors that can be optimized to reduce delays are ensuring ward prepardeness before transferring to theatres, appropriate documentation of transport times so staff are aware they maybe audited and satisfactory communication between teams (including site/bed managers) to ensure adequate prepardeness and a smooth flow of patients to the ward and prevent a hold up in recovery.