165 resultados para Total hemocyte counts


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Acoustic sensors provide an effective means of monitoring biodiversity at large spatial and temporal scales. They can continuously and passively record large volumes of data over extended periods, however these data must be analysed to detect the presence of vocal species. Automated analysis of acoustic data for large numbers of species is complex and can be subject to high levels of false positive and false negative results. Manual analysis by experienced users can produce accurate results, however the time and effort required to process even small volumes of data can make manual analysis prohibitive. Our research examined the use of sampling methods to reduce the cost of analysing large volumes of acoustic sensor data, while retaining high levels of species detection accuracy. Utilising five days of manually analysed acoustic sensor data from four sites, we examined a range of sampling rates and methods including random, stratified and biologically informed. Our findings indicate that randomly selecting 120, one-minute samples from the three hours immediately following dawn provided the most effective sampling method. This method detected, on average 62% of total species after 120 one-minute samples were analysed, compared to 34% of total species from traditional point counts. Our results demonstrate that targeted sampling methods can provide an effective means for analysing large volumes of acoustic sensor data efficiently and accurately.

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The technique of femoral cement-in-cement revision is well established, but there are no previous series reporting its use on the acetabular side at the time of revision total hip arthroplasty. We describe the surgical technique and report the outcome of 60 consecutive cement-in-cement revisions of the acetabular component at a mean follow-up of 8.5 years (range 5-12 years). All had a radiologically and clinically well fixed acetabular cement mantle at the time of revision. 29 patients died. No case was lost to follow-up. The 2 most common indications for acetabular revision were recurrent dislocation (77%) and to compliment a femoral revision (20%). There were 2 cases of aseptic cup loosening (3.3%) requiring re-revision. No other hip was clinically or radiologically loose (96.7%) at latest follow-up. One case was re-revised for infection, 4 for recurrent dislocation and 1 for disarticulation of a constrained component. At 5 years, the Kaplan-Meier survival rate was 100% for aseptic loosening and 92.2% (95% CI; 84.8-99.6%) with revision for all causes as the endpoint. These results support the use of the cement-in-cement revision technique in appropriate cases on the acetabular side. Theoretical advantages include preservation of bone stock, reduced operating time, reduced risk of complications and durable fixation.

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Background Total hip arthroplasty (THA) is a commonly performed procedure and numbers are increasing with ageing populations. One of the most serious complications in THA are surgical site infections (SSIs), caused by pathogens entering the wound during the procedure. SSIs are associated with a substantial burden for health services, increased mortality and reduced functional outcomes in patients. Numerous approaches to preventing these infections exist but there is no gold standard in practice and the cost-effectiveness of alternate strategies is largely unknown. Objectives The aim of this project was to evaluate the cost-effectiveness of strategies claiming to reduce deep surgical site infections following total hip arthroplasty in Australia. The objectives were: 1. Identification of competing strategies or combinations of strategies that are clinically relevant to the control of SSI related to hip arthroplasty 2. Evidence synthesis and pooling of results to assess the volume and quality of evidence claiming to reduce the risk of SSI following total hip arthroplasty 3. Construction of an economic decision model incorporating cost and health outcomes for each of the identified strategies 4. Quantification of the effect of uncertainty in the model 5. Assessment of the value of perfect information among model parameters to inform future data collection Methods The literature relating to SSI in THA was reviewed, in particular to establish definitions of these concepts, understand mechanisms of aetiology and microbiology, risk factors, diagnosis and consequences as well as to give an overview of existing infection prevention measures. Published economic evaluations on this topic were also reviewed and limitations for Australian decision-makers identified. A Markov state-transition model was developed for the Australian context and subsequently validated by clinicians. The model was designed to capture key events related to deep SSI occurring within the first 12 months following primary THA. Relevant infection prevention measures were selected by reviewing clinical guideline recommendations combined with expert elicitation. Strategies selected for evaluation were the routine use of pre-operative antibiotic prophylaxis (AP) versus no use of antibiotic prophylaxis (No AP) or in combination with antibiotic-impregnated cement (AP & ABC) or laminar air operating rooms (AP & LOR). The best available evidence for clinical effect size and utility parameters was harvested from the medical literature using reproducible methods. Queensland hospital data were extracted to inform patients’ transitions between model health states and related costs captured in assigned treatment codes. Costs related to infection prevention were derived from reliable hospital records and expert opinion. Uncertainty of model input parameters was explored in probabilistic sensitivity analyses and scenario analyses and the value of perfect information was estimated. Results The cost-effectiveness analysis was performed from a health services perspective using a hypothetical cohort of 30,000 THA patients aged 65 years. The baseline rate of deep SSI was 0.96% within one year of a primary THA. The routine use of antibiotic prophylaxis (AP) was highly cost-effective and resulted in cost savings of over $1.6m whilst generating an extra 163 QALYs (without consideration of uncertainty). Deterministic and probabilistic analysis (considering uncertainty) identified antibiotic prophylaxis combined with antibiotic-impregnated cement (AP & ABC) to be the most cost-effective strategy. Using AP & ABC generated the highest net monetary benefit (NMB) and an incremental $3.1m NMB compared to only using antibiotic prophylaxis. There was a very low error probability that this strategy might not have the largest NMB (<5%). Not using antibiotic prophylaxis (No AP) or using both antibiotic prophylaxis combined with laminar air operating rooms (AP & LOR) resulted in worse health outcomes and higher costs. Sensitivity analyses showed that the model was sensitive to the initial cohort starting age and the additional costs of ABC but the best strategy did not change, even for extreme values. The cost-effectiveness improved for a higher proportion of cemented primary THAs and higher baseline rates of deep SSI. The value of perfect information indicated that no additional research is required to support the model conclusions. Conclusions Preventing deep SSI with antibiotic prophylaxis and antibiotic-impregnated cement has shown to improve health outcomes among hospitalised patients, save lives and enhance resource allocation. By implementing a more beneficial infection control strategy, scarce health care resources can be used more efficiently to the benefit of all members of society. The results of this project provide Australian policy makers with key information about how to efficiently manage risks of infection in THA.

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This article is a brief introduction to the total solar eclipse Wed 14 November 2012 in north Queensland that will be seen in a narrow strip of land just 140 km wide in the vicinity of Cairns.

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OBJECTIVE: To determine the point at which differences in clinical assessment scores on physical ability, pain and overall condition are sufficiently large to correspond to a subjective perception of a meaningful difference from the perspective of the patient. METHODS: Forty patients with a diagnosis of rheumatoid arthritis participated in an evening of clinical assessment and one-on-one conversations with each other regarding their arthritic condition. The assessments included tender and swollen joint counts, clinician and patient global assessments, participant assessment of pain and the Health Assessment Questionnaire (HAQ) on physical ability. After each conversation, participants rated themselves relative to their conversational partner on physical ability, pain and overall condition. These subjective comparative ratings were compared to the differences of the individual clinical assessments. RESULTS: In total there were 120 conversations. Generally participants judged themselves as less disabled than others. They rated themselves as "somewhat better" than their conversation partner when they had a (mean) 7% better score on the HAQ, 6% less pain, and 9% better global assessment. In contrast, they rated themselves as "somewhat worse" when they had a (mean) 16% worse score on the HAQ, 16% more pain, and 29% worse global assessment. CONCLUSIONS: Patients view clinically important differences in an asymmetric manner. These results can provide guidance in interpreting results and planning clinical trials.

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Bleeding related wound complications cause significant morbidity in lower limb arthroplasty surgery. Patients who require therapeutic anticoagulation in the peri operative period are potentially at higher risk of these complications. This is a retrospective case control study reviewing all primary total hip replacements performed in a single center over a five year period and comparing outcomes of the patients on warfarin with a double-matched control group of patients not on warfarin. The warfarin group had significantly higher risk of deep joint infection (9% vs 2.2%), haematoma/ wound ooze (28% vs 4%) and superficial infection (13.5% vs 2.2%). Managing the total hip arthroplasty patient with therapeutic anticoagulation is a balance between the risk of thromboembolic disease and bleeding related complications. Improved understanding of this risk will better allow the patient to make an informed decision regarding their elective arthroplasty surgery.

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Readily accepted knowledge regarding crash causation is consistently omitted from efforts to model and subsequently understand motor vehicle crash occurrence and their contributing factors. For instance, distracted and impaired driving accounts for a significant proportion of crash occurrence, yet is rarely modeled explicitly. In addition, spatially allocated influences such as local law enforcement efforts, proximity to bars and schools, and roadside chronic distractions (advertising, pedestrians, etc.) play a role in contributing to crash occurrence and yet are routinely absent from crash models. By and large, these well-established omitted effects are simply assumed to contribute to model error, with predominant focus on modeling the engineering and operational effects of transportation facilities (e.g. AADT, number of lanes, speed limits, width of lanes, etc.) The typical analytical approach—with a variety of statistical enhancements—has been to model crashes that occur at system locations as negative binomial (NB) distributed events that arise from a singular, underlying crash generating process. These models and their statistical kin dominate the literature; however, it is argued in this paper that these models fail to capture the underlying complexity of motor vehicle crash causes, and thus thwart deeper insights regarding crash causation and prevention. This paper first describes hypothetical scenarios that collectively illustrate why current models mislead highway safety researchers and engineers. It is argued that current model shortcomings are significant, and will lead to poor decision-making. Exploiting our current state of knowledge of crash causation, crash counts are postulated to arise from three processes: observed network features, unobserved spatial effects, and ‘apparent’ random influences that reflect largely behavioral influences of drivers. It is argued; furthermore, that these three processes in theory can be modeled separately to gain deeper insight into crash causes, and that the model represents a more realistic depiction of reality than the state of practice NB regression. An admittedly imperfect empirical model that mixes three independent crash occurrence processes is shown to outperform the classical NB model. The questioning of current modeling assumptions and implications of the latent mixture model to current practice are the most important contributions of this paper, with an initial but rather vulnerable attempt to model the latent mixtures as a secondary contribution.

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Chinese Australians consistently outperform their peers in mathematics and according to QUT researcher Michael Mu this is not only because of pushy parents or motivated students.

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This report discusses the geologic framework and petroleum geology used to assess undiscovered petroleum resources in the Bohaiwan basin province for the 2000 World Energy Assessment Project of the U.S. Geological Survey. The Bohaiwan basin in northeastern China is the largest petroleum-producing region in China. Two total petroleum systems have been identified in the basin. The first, the Shahejie–Shahejie/Guantao/Wumishan Total Petroleum System, involves oil and gas generated from mature pods of lacustrine source rock that are associated with six major rift-controlled subbasins. Two assessment units are defined in this total petroleum system: (1) a Tertiary lacustrine assessment unit consisting of sandstone reservoirs interbedded with lacustrine shale source rocks, and (2) a pre-Tertiary buried hills assessment unit consisting of carbonate reservoirs that are overlain unconformably by Tertiary lacustrine shale source rocks. The second total petroleum system identified in the Bohaiwan basin is the Carboniferous/Permian Coal–Paleozoic Total Petroleum System, a hypothetical total petroleum system involving natural gas generated from multiple pods of thermally mature coal beds. Low-permeability Permian sandstones and possibly Carboniferous coal beds are the reservoir rocks. Most of the natural gas is inferred to be trapped in continuous accumulations near the center of the subbasins. This total petroleum system is largely unexplored and has good potential for undiscovered gas accumulations. One assessment unit, coal-sourced gas, is defined in this total petroleum system.

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Bird communities were studied in two subregional areas of Cravens Peak, the Toko Plains and the Simpson-Strzelecki Dunefields, using the point counts method. A total of 42 2ha 20 minute surveys, 46 five-hundred metre radius area surveys and 170 5km drive through area surveys were conducted and observations made. Bird species were identified, counted and recorded. The data were compared in the two subregions and, as a whole, considering species groups according to land system on which the ecosystem occurs, the specific ecosystem and according to their general feeding habits (insectivore, omnivore, frugivore, granivore, nectarivore and carnivore). Species richness and species relative abundance were compared using Simpson’s Diversity Index and the data revealed that species are distributed largely on the basis of habitat. In general, areas with a greater number of vegetation strata recorded greater species diversity. Overall, the Tall Open Acacia georginae Shrubland on alluvial floodplains has a greater diversity of birds in a 2ha area (0.87, Simpson’s Index of Diversity 1-D) compared to the other survey sites.

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Bird coastal communities were studied along Bribie Island and Moreton Island, two islands within Moreton Bay, Brisbane, Queensland, Australia, using the point counts method. A total of 128 five-hundred metre radius area surveys and 81 beach drive surveys were conducted and observations made over four seasons. Bird species were identified, counted and recorded. The data was compared between the two islands and, between sites on each island as oil-spill affected sites to non-oil spill affected sites. Species such as waders, shorebirds, terns/gulls and raptors were identified as species at most risk from an oil spill and the data was selected to look mainly at these species. The data indicated that sites affected by the oil spill contained 50% less oil-affected species than sites not affected by the oil spill. Bribie Island held on average 5 species per site in the oil affected sites compared to 12 species in non-oil affected sites. This same trend was observed on Moreton Island which held 6 species compared to 14 species. Bird data will continue to be counted over several years to determine whether the observed data is a true reflection of the affects of an oil spill on the habitat of shorebirds.

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Total Dik! is a collaborative project between the Queensland University of Technology (QUT) and Queensland Theatre Company (QTC). Total Dik! explores transmedia storytelling in live performance from concept development to delivery and builds on works, By the Way, Meet Vera Stark, (Forrester2012), Hotel Modern’s Kamp (2005) and God’s Beard (2012) that use visual art, puppetry, music and film. The project’s first iteration enabled an interrogation of the integration of media-rich elements with live performers in a theatrical environment. Performative transmedia storytelling draws on the tenets of convergent media theory developed by Jenkins (2007, 2012), Dena (2010) and Philips (2012). This exploratory work, juxtaposing transmedia storytelling techniques with live performance, draws on Samuel Becket’s challenges to theatre orthodoxy, and touches on Brechtian notions of alienation through ‘sleight-of-hand’ or processual unpacking and deconstruction during performance. Total Dik! blends a convergence of technologies, models, green screen capture, and live dimensions of performance in one narrative allowing the work’s creators to test new combinations of transmedia storytelling techniques on a traditional performance platform.

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Background: Surgical site infection (SSI) is associated with substantial costs for health services, reduced quality of life, and functional outcomes. The aim of this study was to evaluate the cost-effectiveness of strategies claiming to reduce the risk of SSI in hip arthroplasty in Australia. Methods: Baseline use of antibiotic prophylaxis (AP) was compared with no antibiotic prophylaxis (no AP), antibiotic-impregnated cement (AP þ ABC), and laminar air operating rooms (AP þ LOR). A Markov model was used to simulate long-term health and cost outcomes of a hypothetical cohort of 30,000 total hip arthroplasty patients from a health services perspective. Model parameters were informed by the best available evidence. Uncertainty was explored in probabilistic sensitivity and scenario analyses. Results: Stopping the routine use of AP resulted in over Australian dollars (AUD) $1.5 million extra costs and a loss of 163 quality-adjusted life years (QALYs). Using antibiotic cement in addition to AP (AP þ ABC)generated an extra 32 QALYs while saving over AUD $123,000. The use of laminar air operating rooms combined with routine AP (AP þ LOR) resulted in an AUD $4.59 million cost increase and 127 QALYs lost compared with the baseline comparator. Conclusion: Preventing deep SSI with antibiotic prophylaxis and antibiotic-impregnated cement has shown to improve health outcomes among hospitalized patients, save lives, and enhance resource allocation. Based on this evidence, the use of laminar air operating rooms is not recommended.

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Between 1995 and 2003, 129 cemented primary THRs were performed using full acetabular impaction grafting to reconstruct acetabular deficiencies. These were classified as cavitary in 74 and segmental in 55 hips. Eighty-one patients were reviewed at mean 9.1 (6.2-14.3) years post-operatively. There were seven acetabular component revisions due to aseptic loosening, and a further 11 cases that had migrated >5mm or tilted >5° on radiological review - ten of which reported no symptoms. Kaplan-Meier analysis of revisions for aseptic loosening demonstrates 100% survival at nine years for cavitary defects compared to 82.6% for segmental defects. Our results suggest that the medium-term survival of this technique is excellent when used for purely cavitary defects but less predictable when used with large rim meshes in segmental defects.

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La varianza estadística del costo total de un proyecto usualmente se estima por medio de la simulación de Monte Carlo, bajo el supuesto de que los acercamientos analíticos son demasiado complicados. Este artículo analiza este supuesto y muestra que, contrario a lo esperado, la solución analítica es relativamente directa. También se muestra que el coeficiente de variación no se ve afectado por el tamaño (área superficial) del proyecto cuando se usan los costos de los componentes estandarizados. Se provee un caso de estudio en el cual se analizan los costos reales de los componentes para obtener la varianza del costo total requerida. Los resultados confirman trabajos previos al mostrar que la aproximación del segundo momento (varianza) bajo el supuesto de independencia subestima considerablemente el valor exacto. El análisis continua examinando los efectos del juicio profesional y con los datos simulados utilizados, la aproximación resulta razonablemente exacta - el juicio profesional absorbe la mayor parte de las intercorrelaciones involucradas. También se da un ejemplo en el cual las cantidades de los componentes unitarios son valoradas por sus costos unitarios promedios y muestra, una vez más, que la aproximación es cercana al valor real. Finalmente, el trabajo se extiende mostrando cómo obtener, para cada proyecto, las varianzas exactas del costo total.