Reverse Rate Research Articles

Synthesis of nano cubic microstructure LiNi0.8Co0.1Mn0.1O2 cathode materials via rapid precipitation assisted with hydrothermal treatment

In this work, a modified Ni-rich cathode material LiNi0.8Co0.1Mn0.1O2 with a unique nano cubic microstructure is successfully synthesized via a rapid precipitation assisted with hydrothermal treatment. The formation of this distinctive microstructure is attributed to the homogeneous rapid precipitation in microreactor, which predominantly generates uniform crystal nuclei. The as-prepared material with nano-/microstructure shows superior initial reversible capacity (205.3 mAh·g−1 at 2.7–4.3 V) and rate capability (163.9 mAh·g−1 at 5 C). Additionally, it maintains a high capacity (188.2 mAh·g−1) with a retention of 87.2 % at 1 C after 200 cycles, demonstrating outstanding cycling stability. Our work presents a straightforward and efficient approach for producing nano-cubic microstructure layered cathode materials.

Combining motivational and exercise intervention components to reverse pre-frailty and promote self-efficacy among community-dwelling pre-frail older adults: a randomized controlled trial

BackgroundExercise is effective in preventing frailty status in older adults, but the effect of an exercise program based on Wellness Motivation Theory (WMT) on the frailty status, self-efficacy for exercise, and quality of life for older adults with pre-frailty remains unclear. Our objective was to examine the efficacy of a multicomponent exercise program based on WMT on frailty status, self-efficacy, and quality of life among pre-frail older adults.MethodsThis was a randomized controlled trial of pre-frail older adults aged from 60 years to 85 years. Participants in the intervention group performed exercise three times a week for 24 weeks, once at a community health service station instructed by two researchers and two times at home. Participants in the control group were given one-time advice on physical activity. The assessor was the only one blinded. The primary outcome was the reversal rate of pre-frailty. The secondary outcomes included self-efficacy and quality of life.ResultsOne hundred and forty-four participants were randomized into two groups (n = 72 in the intervention group and n = 72 in the control group) and analyzed. After 24 weeks, the proportion of pre-frailty was significantly lower in the intervention group than in control (31.8% versus 74.6%, P < 0.001). The absolute risk reduction was 42.8% [95% CI, 25.1–57.1]. In the 8th week and the 24th week, the frailty score of the intervention group was significantly lower than that of the control group. There were significant improvements in self-efficacy at week 2, week 8, and week 24. In weeks 8 and 24, participants in the intervention group reported a higher quality of life than the control group. There were no exercise-related injuries or falls among the participants.ConclusionsThe exercise intervention based on WMT for pre-frail older adults could reverse pre-frailty, increase self-efficacy for exercise, and improve the quality of life in older Chinese.Study registration detailsThis study was registered in www.ClinicalTrials.gov on the 25th of July, 2024, with the identifier NCT06519695.Reporting methodThe Consolidated Standards of Reporting Trials (CONSORT) checklist was used in this study for properly reporting how the randomized trial was conducted.

Complexity in Chick‐a‐Dee Calls of Mountain Chickadees (Poecile gambeli): Call Variation Associated With Flock Size and Flight

ABSTRACTThe chick‐a‐dee call of chickadees, tits, and titmice is a vocal system used in a wide range of social contexts by both sexes throughout the year and is one of the more structurally complicated vocal systems outside of human language. Relatively little is known about the chick‐a‐dee calls of mountain chickadees, Poecile gambeli, however. This is an important species for increasing our comparative understanding of variation in chick‐a‐dee calls as they are one of the chickadee species with the largest naturally occurring flock sizes. Flock size relates to the social complexity of flocks, and the social complexity hypothesis for communication predicts that individuals in more complex social groups should communicate with greater complexity than individuals in simpler social groups. Correlational and experimental evidence in support of the hypothesis has been found in the calls of a wide range of species, including Carolina chickadees, P. carolinensis. Here, we provide the first description of the variation in note composition and note‐ordering rules in calls from mountain chickadee flocks in California and Colorado. California flocks were found to be significantly larger than Colorado flocks. Analysis of note‐type usage and transition probabilities between note types found that calls of California birds were more complex than calls of Colorado birds, supporting a key prediction of the social complexity hypothesis for communication. We also found relatively high rates of reversals of note‐ordering rules in mountain chickadee calls, which might help explain the complexity of the chick‐a‐dee calls of this species. Additionally, birds in flight produced calls with different note compositions when compared to perched birds. Generally, the note‐type ordering and transition probabilities of calls of mountain chickadees seem comparable to other better‐studied chickadee species, although their frequent note‐type order rule reversals suggest potential syntax‐like properties in this call system.

METODE MEAN-SEMIVARIANCE DALAM PEMBENTUKAN PORTOFOLIO REKSA DANA SAHAM TERBAIK BAROMETER BAREKSA

The most popular investment product today is mutual funds. One of the factors in selecting mutual funds is the low investment risk. This risk can be minimized again by combining several assets and then compiling them into a portfolio. The portfolio formation method used in this study is the Mean-Semivariance method and the Sharpe Index to calculate portfolio performance. The data used is the daily net asset value per unit of Mandiri Investa Atraktif Syariah, Rencana Cerdas, Manulife Saham SMC Plus and BNP Paribas Solaris for the period January 3 2022 to March 9 2023, Jakarta Composite Index (IHSG) data as a benchmark and BI-7 Day Reverse Repo Rate as a riskfree interest rate. The minimum risk of the portfolio will be achieved by compiling a portfolio of two mutual funds, namely Mandiri Investa Atraktif Syariah with a weight of 92,50% and the Smart Plan with a weight of 7,50% with an expected return rate of 0,00019 and a risk of 0,000000663. The Sharpe Index is 0.08971 indicating that the portfolio formed has good performance and can be used as a choice of investment assets by investors.

Is It Worth Performing Intersphincteric Resection in Patients Having Rectal Adenocarcinoma with Oligometastasis

AbstractIntersphincteric resection (ISR) is being increasingly performed in metastatic rectal adenocarcinoma (with oligometastasis) patients. There has been a trend towards worse prognosis in this group. This study compares the oncological and surgical outcomes of patients with and without pre-operative oligometastasis who underwent ISR. The outcomes compared include prognostic factors like margin positivity, recurrence rates, stoma reversal rate, and surgical failure rate (defined as a combination of one or more of the aforestated factors). The demographic pattern, American Society of Anaesthesia grade (ASA), treatment received, clinical and histopathological T and N stage, grade, type of minimally invasive surgery (MIS) approach, neoadjuvant therapy, and pathological high-risk features are also studied. Patients who underwent minimally invasive ISR over 10 years at a high-volume tertiary cancer center were selected for the study. Factors used for the assessment of oncological outcomes were margin positivity (circumferential resection and distal margin), recurrence (both local and systemic), and stoma reversal rate. A descriptive and comparative analyses were performed. Four hundred and eight patients underwent minimally invasive ISR of which 25 (6.12%) patients were oligometastatic. While R0 resection was similar in both groups, higher overall recurrence (24% versus 18.5%) and low stoma reversal rate (36.8% versus 67.3%) were observed in the oligometastatic group with statistically significant differences. No local recurrence was seen in the oligometastatic group, and the difference compared to non-metastatic group was not statistically different. This study indicates that oligometastatic patients who underwent ISR experienced lower stoma reversal rates, maintaining similar local control but facing higher rates of systemic recurrence.

Charge transfer between layers of polymeric carbon nitride driven by surface grafting phosphotungstic polyanions toward efficient photocatalytic hydrogen evolution

It is a challenging issue to achieve efficient charge transfer between layers for the layered polymer photocatalysts, because the photogenerated carriers would prefer random migration within layers and thus have high reverse recombination rate due to their inherent anisotropy and high exciton binding energy. Herein, an innovative surface grafting strategy is developed to modify the layered polymeric carbon nitride (PCN) making use of phosphotungstic (PWO) polyanions. The surface coupling effect of PWO on PCN effectively improves reduction ability and utility rate of luminous energy through shifting the conduction band (CB) upward and broadening light absorption range to cover near infrared region up to 1000 nm, respectively. In especial, the strong electron-withdrawing effect of surface PWO moieties can reduce layer spacing to shorten electron transfer path and attract the photogenerated electrons transfer from PCN matrix to surface, thus conquering the charge transfer restriction between layers to improve the carrier separation efficiency. As a result, the photocatalytic hydrogen evolution (PHE) performance is dramatically enhanced. The optimal PWO-PCN-1% sample achieves an average PHE rate of 9.6 times that of PCN, stable operation for a total of 28 h on 7 cycles, and an AQY up to 22.3% at 400 nm. This contribution affords a viable modification avenue to overcome the limitation of charge transfer between layers for layered polymer photocatalysts.

A novel merocyanine photoacid for visible light-controlled pH modulation

Merocyanine-based photoacids generate high proton concentrations under visible light irradiation. In the past decade, it has been established that these photoacids offer significant advantages over photoacid generators (PAGs) and hydroxyaryl photoacids, enabling better spatiotemporal control of proton transfer reactions in bulk media. In this study, we modified the core structure of the first generation of meroyanine photoacids. We developed a novel photoacid with color tuning capabilities and high solubility in polar organic solvents. Specifically, by incorporating a cationic benzoindolium moiety as an acceptor, we have altered the photoacid’s light absorption properties. Unlike the first generation of indolium-based merocyanine photoacids, this photoacid can now be activated with green light (λmax = 525 nm) as well as blue (λmax = 450 nm) and ultraviolet (λmax = 365 nm) lights. Furthermore, the novel photoacid exhibits high photo stability, photo-acidity (Π = 3.28 ± 0.08) and moderate reverse reaction rate (k = 1.08 × 10−3 ± 0.00017 s−1) in solution. We envision that with improved color tuning capabilities, this class of photoacids will be a more versatile tool for controlling proton-induced reactions in different systems, including biological reactions.

Effectiveness of a Triple Antiarrhythmic Drug Strategy for Arrhythmia Recurrence after Persistent Atrial Fibrillation Ablation.

Treating recurrent atrial arrhythmias after persistent atrial fibrillation (PeAF) ablation is often challenging. This single-center, prospective study aimed to observe the effectiveness of different combinations of oral antiarrhythmic drugs (AADs) in reverting to sinus rhythm (SR) in patients with recurrent atrial arrhythmias after PeAF ablation. Forty-five patients who experienced recurrent atrial arrhythmias after PeAF ablation were included. Based on their medication regimens, patients were divided into two groups, with the study group being a triple-drug group (digoxin combined with amiodarone/ propafenone and β-blocker), and the control group being a non-triple-drug group. The rate of reversion to SR was significantly higher in the study group (n = 29) than in the control group (n = 16) at 3 weeks (34.48% vs. 0%, p<0.01) and 1 month (44.84% vs. 6.25%, p = 0.02) after initiating AADs. No patients with asymptomatic bradycardia were observed in either group. For patients with recurrent atrial arrhythmias after PeAF ablation, a regimen of low-dose digoxin combined with amiodarone/propafenone and β-blocker may effectively improve short-term reversion rates.

FROM CALENDAR TIME TO BUSINESS TIME: THE CASE OF COMMODITY MARKETS

We address the problem of modeling commodity forward curves, while preserving empirical features observed in commodity markets. By letting a commodity market to “ live” in the tempo of a business rather than calendar clock, we create a model with a rich but realistic set of features, such as stochastic volatility, stochastic rate of mean reversion and various shapes of forward curves such as backwardation and contango. The model, when applied to extensive historical datasets of crude oil and natural gas forward curves, shows a remarkably good fit to the observed futures prices, also in periods of high volatility and negative prices. The model is developed in such a way that it can be used for a wide variety of applications, ranging from exotic derivatives pricing to risk management of commodity portfolios.

HIV-1 Reverse Transcriptase Error Rates and Transcriptional Thresholds Based on Single-strand Consensus Sequencing of Target RNA Derived From In Vitro-transcription and HIV-infected Cells

Nucleotide incorporation and lacZ-based forward mutation assays have been widely used to determine the accuracy of reverse transcriptases (RTs) in RNA-dependent DNA polymerization reactions. However, they involve quite complex and laborious procedures, and cannot provide accurate error rates. Recently, NGS-based methods using barcodes opened the possibility of detecting all errors introduced by the RT, although their widespread use is limited by cost, due to the large size of libraries to be sequenced. In this study, we describe a novel and relatively simple NGS assay based on single-strand consensus sequencing that provides robust results with a relatively small number of raw sequences (around 60 Mb). The method has been validated by determining the error rate of HIV-1 (BH10 strain) RT using the HIV-1 protease-coding sequence as target. HIV-1 reverse transcription error rates in standard conditions (37 °C/3 mM Mg2+) using an in vitro-transcribed RNA were around 7.3 × 10−5. In agreement with previous reports, an 8-fold increase in RT’s accuracy was observed after reducing Mg2+ concentration to 0.5 mM. The fidelity of HIV-1 RT was also higher at 50 °C than at 37 °C (error rate 1.5 × 10−5). Interestingly, error rates obtained with HIV-1 RNA from infected cells as template of the reverse transcription at 3 mM Mg2+ (7.4 × 10−5) were similar to those determined with the in vitro-transcribed RNA, and were reduced to 1.8 × 10−5 in the presence of 0.5 mM Mg2+. Values obtained at low magnesium concentrations were modestly higher than the transcription error rates calculated for human cells, thereby suggesting a realistic transcriptional threshold for our NGS-based error rate determinations.

Comparing optimum prosthesis combinations of total stemmed, stemless and reverse shoulder arthroplasty revision rates for men and women with glenohumeral osteoarthritis

BackgroundThis study investigated prostheses from a large national arthroplasty registry with the lowest rates of revision, defined as optimum. We compared optimum shoulder arthroplasty revision rates for osteoarthritis (OA) to determine the most suitable/effective procedure for men and women. MethodsThere were three cohort groups of optimum primary shoulder arthroplasties for OA undertaken between 1st January 2008 and 31 December 2022: stemless shoulder arthroplasty with cemented polyethylene glenoids (slTSA), stemmed shoulder arthroplasty with modified central peg polyethylene glenoids (stTSA), and cementless reverse shoulder arthroplasty (rTSA). The cumulative percent revision (CPR) was determined using Kaplan-Meier estimates of survivorship and hazard ratios (HR) from Cox proportional hazard models adjusted for age, gender, humeral head/glenosphere size, polyethylene type, and surgeon volume. Possible interactions were examined. A sub-analysis from 1 January 2017 captured additional patient demographics, ASA score, BMI and glenoid morphology. ResultsThe CPR at 7 years was 4.0%(95% confidence interval (CI) 3.1, 5.1) for slTSA (n=3,041), 3.8%(95%CI 2.7, 5.5) for stTSA (n=1,259) and 4.1%(95%CI 3.7, 4.6) for rTSA (n=12,341). slTSA had a higher rate of revision compared to rTSA after the first 9 months (p<0.001). rTSA had a lower revision rate compared to stTSA from 3 months on (p=0.004). After adjusting for other confounders, prosthesis type and gender were associated with revision rates (p<0.001) whereas surgeon volume was not. Additionally, gender and prosthesis type strongly interacted (p=0.013) and the combined model exhibited greater predictive performance when including this interaction. Women had lower rates of revision than men for both stTSA and rTSA, but not slTSA. Most revisions were for infection in men, especially rTSA. After 3 months, the rate of revision for slTSA vs rTSA for women was increased (p<0.001) and revision rates for men did not significantly differ. However, in a sub-analysis of procedures in males since 2017 with additional adjustments, slTSA had a lower revision rate than stTSA (p=0.010). ConclusionsThe optimum shoulder arthroplasty revision rates vary for both the gender and implant type for the diagnosis of OA. A model combining optimum prostheses and gender predicted revision better than optimum implants alone. After 3 months, rTSA was associated with lower revision rates compared to slTSA in women, whereas there were no significant differences between optimum prostheses in men. However, surgeons may also consider lower revision risk of optimum slTSA at sub analysis and increased cumulative incidence of infection for rTSA requiring revision to resolve decision making for male patients.

Factors Limiting Ostomy Reversal After Cytoreductive Surgery for Ovarian Cancer: A Retrospective Study.

To investigate the factors related to non-reversal of ostomy after cytoreductive surgery in ovarian cancer. In many women with ovarian cancer, transitory ostomies are performed to limit the consequences of anastomotic leak. Although intended to be temporary, a proportion of these ostomies might never be reversed. This was a retrospective study of patients with 2014 International Federation of Obstetrics and Gynecology stage IIB-IVB ovarian cancer requiring a transitory ostomy during primary or secondary cytoreductive surgery at the Bergonie Institute, France, and the University Hospital of Las Palmas, Spain, between January 2012 and December 2022. Rate of ostomy reversal, its timing (weeks) and postoperative complications were assessed. Multivariate logistic regression analysis was performed to identify limiting factors for ostomy reversal. During the study period, we reviewed data on 181 consecutive patients with ovarian cancer with transitory ostomy creation; 89 (49.2%) patients were not candidates for an ostomy reversal surgery because of disease progression (n=65), death (n=16), and patient's refusal of surgery (n=8). A total of 92 patients were candidates for reversal surgery and were therefore included in the final analysis. In total, 57 (62%) patients had their ostomy reversed. The mean time from ostomy creation to ostomy closure was 47.7 (standard deviation=33.1) weeks. Hartmann's procedure (leaving a rectal stump of 5-6 cm) was identified as an independent predictive factor for non-reversal of ostomy (odds ratio=6.42, 95% confidence interval=1.61-25.53; p=0.008). Complications after ostomy reversal occurred in 32 patients (34.8%). Hartmann's procedure is a limiting factor for ostomy reversal in patients with ovarian cancer. We recommend avoiding Hartmann's procedure during cytoreductive surgery, even after colorectal anastomotic leak.

Determinants of the Developed Country Index and Indonesian Macroeconomic on the IDX Growth 30 and IDX Value 30

This study analyzes the determinants of the Developed Country Index (Hang Seng Index, Dow Jones Index) and Indonesian macroeconomic variables (10-Year Government Bond Yield, Foreign Ownership in Government Bonds, and the BI-7 Day Reverse Repo Rate, BI7DRR) on the movement of the IDX Growth 30 Index (IDXG30) and IDX Value 30 Index (IDXV30) from 2018–2022. Monthly time series data is used with a saturated sampling technique, processed via Eviews 12 using VECM analysis. The study conducts Stationarity, Optimal Lag, VAR Stability, and Cointegration Tests, along with Impulse Response Function (IRF) and Forecast Error Variance Decomposition (FEVD) analyses Results show that the Hang Seng Index and Foreign Ownership in Government Bonds negatively affect IDXG30 and IDXV30, while BI7DRR positively influences both. The Dow Jones Index positively affects IDXG30 but negatively impacts IDXV30. Meanwhile, the 10-Year Government Bond Yield negatively affects IDXG30 and positively influences IDXV30. Additionally, the performance of IDXG30 and IDXV30 themselves and BI7DRR significantly contribute to both indices' movements.

REVERSIBILITY OF COMPLETE HEART BLOCK AFTER ACUTE ANTERIOR WALL MI

Acute myocardial infarction (MI) can result in varying degrees of heart block, most commonly in inferior wall MI. Identifying the reversibility of complete heart block (CHB) is crucial for guiding clinical management, particularly in determining the need for temporary or permanent pacemaker implantation. Objective: To determine the frequency of reversibility of complete heart block in patients presenting with acute myocardial infarction at Bolan Medical Complex, Quetta. Methods: This cross-sectional study was conducted at Bolan Medical Complex, Quetta, from March 2022 to June 2023. A total of 100 patients aged 18–65 years presenting with syncope and atypical chest pain were included. All patients underwent coronary angiography to identify ischemic causes of bradyarrhythmias. Temporary pacemaker dependency was monitored for two weeks, and permanent pacemaker implantation was performed if necessary. Data on demographic and clinical characteristics were collected and analyzed using SPSS version 22.0. Descriptive statistics were calculated, and the association between heart block reversibility and clinical variables was assessed using the Chi-square test, with p ≤ 0.05 considered significant. Results: The mean age of the patients was 52.5 ± 14.8 years, with 60% male and 40% female patients. The prevalence of diabetes, hypertension, and smoking was 40%, 55%, and 43%, respectively. CHB occurred in 7% of patients aged 16-35 years and 8% in those aged 36-65 years. The overall reversibility rate of CHB was 48%. A statistically significant association (p &lt; 0.05) was found between second-degree atrioventricular (AV) block and CHB in relation to reversibility. Conclusion: Complete heart block in patients with acute myocardial infarction is often reversible, particularly in those with mild coronary artery disease. Temporary pacemaker use should be considered before deciding on permanent pacemaker implantation to allow time for potential spontaneous recovery.

Constructing a Janus Catholyte/Cathode Structure: A New Strategy for Stable Zn-Organic Batteries.

Organic materials are promising candidates for the electrodes of aqueous zinc-ion batteries due to their nonmetallic nature, environmental friendliness, and cost-effectiveness. However, they often suffer from significant dissolution during the charge-discharge process, which poses a major hurdle to their practical applications. Inspired by membrane-less organelles in cells, a simple and versatile strategy is proposed-constructing a Janus catholyte/cathode structured electrode based on liquid-liquid phase separation, in which redox-active organic molecules are confined in the liquid state within the activated carbon, thereby eliminating the volume effect and preventing their diffusion into the electrolyte. The customization of phase separation systems by leveraging the hydrophobicity/hydrophilicity differences of various anions is successfully demonstrated. This approach allows for precise regulation of ion cluster/coordination structures, enabling the confinement of active substances while ensuring efficient ion transport. Consequently, the as-constructed Zn||Janus catholyte/cathode cells exhibit superior reversible rate capacity (186mAhg-1 at 5.0Ag-1) and remarkable cycling performance (retention of 72.5% after 12000 cycles). The strategy in building Janus catholyte/cathode structured electrodes breaks free from the limitations imposed by traditional solid-state electrodes, offering tremendous opportunities for exploring diverse advanced battery systems.

Unraveling Energy Storage Performance and Mechanism of Metal-Organic Framework-Derived Copper Vanadium Oxides with Tunable Composition for Aqueous Zinc-Ion Batteries.

Achieving high-performance aqueous zinc (Zn)-ion batteries (AZIBs) requires stable and efficient cathode materials capable of reversible Zn-ion intercalation. Although layered vanadium oxides possess high Zn-ion storage capacity, their sluggish kinetics and poor conductivity present significant hurdles for further enhancing the performance of AZIBs. In response to this challenge, a dissolution-regrowth and conversion approach is formulated using metal-organic frameworks (MOFs) as a sacrificial template, which enables the in situ creation of copper vanadium oxides (CuVOx) with porous 1D channels and distinctive nanoarchitectures. Owing to their distinctive structure, the optimized CuVOx cathode experiences a reaction involving the synergistic insertion/extraction of Zn2+, resulting in rapid Zn2+ diffusion kinetics and enhanced electrochemical activity postactivation. Specifically, the activated electrode delivers a reversible capacity of 519mAhg-1 at 0.5Ag-1 for AZIBs. It is noteworthy that the electrode exhibits a remarkable reversible rate capacity of 220mAhg-1 at 5Ag-1 with excellent durable cycleability, retaining 88% of its capacity even after 3000 cycles. Various ex situ testing methods endorse the reversible insertion/extraction of Zn2+ in the CuVOx cathode. This study provides a novel insight into high-performance MOF-derived unique structure designs for AZIB electrodes.

On Positive Inflated Geometric Distribution: Properties and Applications

One-inflation in zero-truncated count data has recently found considerable attention. In this regard, zero-truncated Geometric distribution and distribution to a point mass at one are used to create a one-inflated model, namely, one-inflated zero-truncated Geometric distribution. Its reliability characteristics, generating functions, and distributional properties are investigated in detail, which includes survival function, hazard rate function, reverse hazard rate function, probability generating function, characteristic function, variance, skewness, and kurtosis. Monte Carlo simulation have been undertaken to evaluate the effectiveness of the maximum likelihood estimators. To test the compatibility of our proposed model, the baseline model and the proposed model are distinguished by using the two different test procedures. The adaptability of the suggested model is demonstrated using two real-life datasets from separate domains by taking various performance measures into consideration.

Entropy production of the contact model

Abstract We propose an expression for the production of entropy for a system described by a stochastic dynamics which is appropriate for the case where the reverse transition rate vanishes but the forward transition is nonzero. The expression is positive definite and based on the inequality x ln ⁡ x − ( x − 1 ) ⩾ 0 . The corresponding entropy flux is linear in the probability distribution allowing its calculation as an average. The expression is applied to the one-dimensional contact process at the stationary state. We found that the rate of entropy production per site is finite with a singularity at the critical point with diverging slope.

WP5.17 - Stoma reversal after emergency surgery – an analysis of post-operative outcomes and the importance of timing

Abstract Introduction Approximately 20,000 people in the UK undergo stoma formation annually(1), with 20% being emergency procedures(2). The reversal rate for these stomas is widely variable, with restoration of continuity being reported in 33-70% of patients(3). Previous research in the elective setting has demonstrated that delayed reversal leads to increased complications and reduced quality of life, but there is a lack of evidence in the emergency cohort. Aim To describe post-operative outcomes of stoma reversal after emergency formation, and to determine whether those reversed within a ‘standard’ timeframe have better outcomes than those with ‘delayed’ reversal. Methods A retrospective review of a prospectively maintained national emergency laparotomy database (ELLSA) from 4 hospitals over a 3-year period (Dec ’19 - ’22) was performed in Dec ’23. All patients undergoing stoma reversal by time of follow-up were included. Those reversed within 18 months of index procedure were classified as ‘standard’. Results 455 patients were identified (Median follow-up 31 months), 95 of whom had died and 34 had a pre-existing permanent stoma. Of the remaining 326, 34.4% underwent reversal (Median age 59; median time to reversal 458 days; 55% ileostomies). 56% of those underwent ‘standard’ reversal (62% ileostomies, p=0.08), and had reduced length of stay (6 days v 7 days, p=0.041) and reduced post-operative ileus rates (23.8% v 44.9%,p=0.019) than those undergoing ‘delayed’ reversal. Conclusion The majority of stomas formed in the emergency setting remain permanent. Prompt reversal of an emergency stoma should be undertaken to reduce complication profile and length of stay. Further work to identify risk factors associated with non-reversal should be undertaken.

How do long combination vehicles perform in real traffic? A study using Naturalistic Driving Data

This paper evaluates the performance of two different types of long combination vehicles (A-double and DuoCAT) using naturalistic driving data across four scenarios: lane changes, manoeuvring through roundabouts, turning in intersections, and negotiating tight curves. Four different performance-based standards measures are used to assess the stability and tracking performance of the vehicles: rearward amplification, high-speed transient offtracking, low-speed swept path, and high-speed steady-state offtracking. Also, the steering reversal rate metric is employed to estimate the cognitive workload of the drivers in low-speed scenarios. In the majority of the identified cases of the four scenarios, both combination types have a good performance. The A-double shows slightly better stability in high-speed lane changes, while the DuoCAT has slightly better manoeuvrability at low-speed scenarios like roundabouts and intersections.