Clinical and radiographic outcomes of acetabular impaction grafting without cage reinforcement for revision hip replacement : a minimum ten-year follow-up study

Impaction bone grafting for reconstitution of bone stock in revision hip surgery has been used for nearly 30 years. We used this technique, in combination with a cemented acetabular component, in the acetabula of 304 hips in 292 patients revised for aseptic loosening between 1995 and 2001. The only additional supports used were stainless steel meshes placed against the medial wall or laterally around the acetabular rim to contain the graft. All Paprosky grades of defect were included. Clinical and radiographic outcomes were collected in surviving patients at a minimum of 10 years following the index operation. Mean follow-up was 12.4 years (SD 1.5; range 10.0-16.0). Kaplan-Meier survivorship with revision for aseptic loosening as the endpoint was 85.9% (95% CI 81.0 to 90.8%) at 13.5 years. Clinical scores for pain relief remained satisfactory, and there was no difference in clinical scores between cups that appeared stable and those that appeared loose radiographically.

Replacement of healthcare-associated MRSA by community-associated MRSA in Queensland : confirmation by genotyping

Objective To describe the changing prevalence of healthcare- and community-associated MRSA. Methods Susceptibility phenotypes of MRSA were observed from 2000 to 2012 using routine susceptibility data. Phenotypic definitions of major clones were validated by genotyping isolates from a nested period prevalence survey in 2011. Results The predominant healthcare-associated (AUS-2/3 like) MRSA phenotype decreased from 42 to 14 isolates per million occasions of service in outpatients (P < 0.0001) and from 650 to 75 isolates per million accrued patient days in inpatients (P 0.0005), while the respective rates of the healthcare-related EMRSA-15 like phenotype increased from 1 to 19 in outpatients (P < 0.0001) and from 11 to 83 in inpatients (P < 0.0001) and those of the community-associated MRSA phenotype increased from 17 to 296 in outpatients (P < 0.0001) and from 71 to 486 in inpatients (P < 0.0001). When compared with single nucleotide polymorphism genotyping the AUS-2/3 like phenotype had a sensitivity and positive predictive value (PPV) for CC239 of 1 and 0.791 respectively, while the EMRSA-15 like phenotype had a sensitivity and PPV for CC22 of 0.903 and 0.774. PVL-positive CA-MRSA, predominantly ST93 and CC30, accounted for 60.8% of MRSA, while PVL-negative CA-MRSA, mainly CC5 and CC1, accounted for 21.4%. Conclusions The initially dominant healthcare-associated MRSA clone has been progressively replaced, mainly by four community-associated lineages.

Estimating benefits of energy storage for aggregate storage applications in electricity distribution networks in Queensland

Electric Energy Storage (EES) is considered as one of the promising options for reducing the need for costly upgrades in distribution networks in Queensland (QLD). However, It is expected, the full potential for storage for distribution upgrade deferral cannot be fully realized due to high cost of EES. On the other hand, EES used for distribution deferral application can support a variety of complementary storage applications such as energy price arbitrage, time of use (TOU) energy cost reduction, wholesale electricity market ancillary services, and transmission upgrade deferral. Aggregation of benefits of these complementary storage applications would have the potential for increasing the amount of EES that may be financially attractive to defer distribution network augmentation in QLD. In this context, this paper analyzes distribution upgrade deferral, energy price arbitrage, TOU energy cost reduction, and integrated solar PV-storage benefits of EES devices in QLD.

Control strategies to prevent total hip replacement-related infections : a systematic review and mixed treatment comparison

OBJECTIVE: To synthesise the available evidence and estimate the comparative efficacy of control strategies to prevent total hip replacement (THR)-related surgical site infections (SSIs) using a mixed treatment comparison. DESIGN: Systematic review and mixed treatment comparison. SETTING: Hospital and other healthcare settings. PARTICIPANTS: Patients undergoing THR. PRIMARY AND SECONDARY OUTCOME MEASURES: The number of THR-related SSIs occurring following the surgical operation. RESULTS: 12 studies involving 123 788 THRs and 9 infection control strategies were identified. The strategy of 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation' significantly reduced the risk of THR-related SSI compared with the referent strategy (no systemic antibiotics+plain cement+conventional ventilation), OR 0.13 (95% credible interval (CrI) 0.03-0.35), and had the highest probability (47-64%) and highest median rank of being the most effective strategy. There was some evidence to suggest that 'systemic antibiotics+antibiotic-impregnated cement+laminar airflow' could potentially increase infection risk compared with 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation', 1.96 (95% CrI 0.52-5.37). There was no high-quality evidence that antibiotic-impregnated cement without systemic antibiotic prophylaxis was effective in reducing infection compared with plain cement with systemic antibiotics, 1.28 (95% CrI 0.38-3.38). CONCLUSIONS: We found no convincing evidence in favour of the use of laminar airflow over conventional ventilation for prevention of THR-related SSIs, yet laminar airflow is costly and widely used. Antibiotic-impregnated cement without systemic antibiotics may not be effective in reducing THR-related SSIs. The combination with the highest confidence for reducing SSIs was 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation'. Our evidence synthesis underscores the need to review current guidelines based on the available evidence, and to conduct further high-quality double-blind randomised controlled trials to better inform the current clinical guidelines and practice for prevention of THR-related SSIs.

Laboratory study on the performance of recycled concrete aggregates blended with reclaimed asphalt pavement as pavement granular material

Production of recycled concrete aggregates (RCA) from construction and demolition (C&D) waste has become popular all over the world since the availability of land spaces are limited to dispose. Therefore it is important to seek alternative applications for RCA. The use of RCA in base and sub-base layers in granular pavement is a viable solution. In mechanistic pavement design, rutting (permanent deformation) is considered as the major failure mechanisms of the pavement. The rutting is the accumulation of permanent deformation of pavement layers caused by the repetitive vehicle load. In Queensland, Australia, it is accepted to have the maximum of 20% of reclaimed asphalt pavement (RAP) in RCA and therefore, it is important to investigate the effect of RAP on the permanent deformation properties of RCA. In this study, a series of repeated load triaxial (RLT) tests were conducted on RCA blended with different percentage of RAP to investigate the permanent deformation and resilient modulus properties of RCA. The vertical deformation and resilient modulus values were used to determine the response of RCA for the cyclic loading under standard pressure and loading conditions.

Assessment of recycled concrete aggregates as a pavement material

Population increase and economic developments can lead to construction as well as demolition of infrastructures such as buildings, bridges, roads, etc resulting in used concrete as a primary waste product. Recycling of waste concrete to obtain the recycled concrete aggregates (RCA) for base and/or sub-base materials in road construction is a foremost application to be promoted to gain economical and sustainability benefits. As the mortar, bricks, glass and reclaimed asphalt pavement (RAP) present as constituents in RCA, it exhibits inconsistent properties and performance. In this study, six different types of RCA samples were subjected classification tests such as particle size distribution, plasticity, compaction test, unconfined compressive strength (UCS) and California bearing ratio (CBR) tests. Results were compared with those of the standard road materials used in Queensland, Australia. It was found that material type ‘RM1-100/RM3-0’ and ‘RM1-80/RM3-20’ samples are in the margin of the minimum required specifications of base materials used for high volume unbound granular roads while others are lower than that the minimum requirement.

Generalized aggregate Quality of Service computation for composite services

This article addresses the problem of estimating the Quality of Service (QoS) of a composite service given the QoS of the services participating in the composition. Previous solutions to this problem impose restrictions on the topology of the orchestration models, limiting their applicability to well-structured orchestration models for example. This article lifts these restrictions by proposing a method for aggregate QoS computation that deals with more general types of unstructured orchestration models. The applicability and scalability of the proposed method are validated using a collection of models from industrial practice.

Aggregate quality of service computation for composite services

This paper addresses the problem of computing the aggregate QoS of a composite service given the QoS of the services participating in the composition. Previous solutions to this problem are restricted to composite services with well-structured orchestration models. Yet, in existing languages such as WS-BPEL and BPMN, orchestration models may be unstructured. This paper lifts this limitation by providing equations to compute the aggregate QoS for general types of irreducible unstructured regions in orchestration models. In conjunction with existing algorithms for decomposing business process models into single-entry-single-exit regions, these functions allow us to cover a larger set of orchestration models than existing QoS aggregation techniques.

Handmade clay balls and recycled crush glass as alternative media in water filtration

For many years materials such as quarried sand, anthracite, and granular activated carbon have been the principal media-products traditionally used in water and wastewater filtration plants. Pebble Matrix Filtration (PMF) is a novel non-chemical, sustainable pre-treatment method of protecting Slow Sand Filters (SSF) from high turbidity during heavy monsoon periods. PMF uses sand and pebbles as the filter media and the sustainability of this new technology might depend on availability and supply of pebbles and sand, both finite resources. In many countries there are two principal methods of obtaining pebbles and sand, namely dredging from rivers and beaches, and due to the scarcity of these resources in some countries the cost of pebbles is often 4-5 times higher than that of sand. In search for an alternative medium to pebbles after some preliminary laboratory tests conducted in Colombo-Sri Lanka, Poznan-Poland and Cambridge-UK, a 100-year-old brick factory near Sudbury, Suffolk, has produced hand-made clay pebbles satisfying the PMF quality requirements. As an alternative to sand, crushed recycled glass from a UK supplier was used and the PMF system was operated together with hand-made clay balls in the laboratory for high turbidity removal effectively. The results of laboratory experiments with alternative media are presented in this paper. There are potential opportunities for recycled crushed glass and clay ball manufacturing processes in some countries where they can be used as filter media.

Measuring the biases in self-reported disability status : Evidence from aggregate data

Self-reported health status measures are generally used to analyse Social Security Disability Insurance's (SSDI) application and award decisions as well as the relationship between its generosity and labour force participation. Due to endogeneity and measurement error, the use of self-reported health and disability indicators as explanatory variables in economic models is problematic. We employ county-level aggregate data, instrumental variables and spatial econometric techniques to analyse the determinants of variation in SSDI rates and explicitly account for the endogeneity and measurement error of the self-reported disability measure. Two surprising results are found. First, it is shown that measurement error is the dominating source of the bias and that the main source of measurement error is sampling error. Second, results suggest that there may be synergies for applying for SSDI when the disabled population is larger. © 2011 Taylor & Francis.

Department of Social Services Options Paper : Options for Replacement Arrangements Following the Abolition of the Australian Charities and Not-for-profits Commission : Response

Submission in response to government options paper regarding arrangements for regulation of charities following abolition of the Australian Charities and Not-for-profits Commission.

Better cars or older cars?: Assessing CO2 emission reduction potential of passenger vehicle replacement programs

The primary motivation for the vehicle replacement schemes that were implemented in many countries was to encourage the purchase of new cars. The basic assumption of these schemes was that these acquisitions would benefit both the economy and the environment as older and less fuel-efficient cars were scrapped and replaced with more fuel-efficient models. In this article, we present a new environmental impact assessment method for assessing the effectiveness of scrappage schemes for reducing CO2 emissions taking into account the rebound effect, driving behavior for older versus new cars and entire lifecycle emissions for during the manufacturing processes of new cars. The assessment of the Japanese scrappage scheme shows that CO2 emissions would only decrease if users of the scheme retained their new gasoline passenger vehicles for at least 4.7 years. When vehicle replacements were restricted to hybrid cars, the reduction in CO2 achieved by the scheme would be 6-8.5 times higher than the emissions resulting from a scheme involving standard, gasoline passenger vehicles. Cost-benefit analysis, based on the emission reduction potential, showed that the scheme was very costly. Sensitivity analysis showed that the Japanese government failed to determine the optimum, or target, car age for scrapping old cars in the scheme. Specifically, scrapping cars aged 13 years and over did not maximize the environmental benefits of the scheme. Consequently, modifying this policy to include a reduction in new car subsidies, focused funding for fuel-efficient cars, and modifying the target car age, would increase environmental benefits. © 2013 Elsevier Ltd.

Distribution of fitness in populations of dengue viruses

Genetically diverse RNA viruses like dengue viruses (DENVs)segregate into multiple, genetically distinct, lineages that temporally arise and disappear on a regular basis. Lineage turnover may occur through multiple processes such as, stochastic or due to variations in fitness. To determine the variation of fitness, we measured the distribution of fitness within DENV populations and correlated it with lineage extinction and replacement. The fitness of most members within a population proved lower than the aggregate fitness of populations from which they were drawn, but lineage replacement events were not associated with changes in the distribution of fitness. These data provide insights into variations in fitness of DENV populations, extending our understanding of the complexity between members of individual populations.