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.

Non-response bias in randomized control experiments in criminology : putting the Queensland Community Engagement Trial (QCET) under a microscope

Objectives The goal of this article is to examine whether or not the results of the Queensland Community Engagement Trial (QCET)-a randomized controlled trial that tested the impact of procedural justice policing on citizen attitudes toward police-were affected by different types of nonresponse bias. Method We use two methods (Cochrane and Elffers methods) to explore nonresponse bias: First, we assess the impact of the low response rate by examining the effects of nonresponse group differences between the experimental and control conditions and pooled variance under different scenarios. Second, we assess the degree to which item response rates are influenced by the control and experimental conditions. Results Our analysis of the QCET data suggests that our substantive findings are not influenced by the low response rate in the trial. The results are robust even under extreme conditions, and statistical significance of the results would only be compromised in cases where the pooled variance was much larger for the nonresponse group and the difference between experimental and control conditions was greatly diminished. We also find that there were no biases in the item response rates across the experimental and control conditions. Conclusion RCTs that involve field survey responses-like QCET-are potentially compromised by low response rates and how item response rates might be influenced by the control or experimental conditions. Our results show that the QCET results were not sensitive to the overall low response rate across the experimental and control conditions and the item response rates were not significantly different across the experimental and control groups. Overall, our analysis suggests that the results of QCET are robust and any biases in the survey responses do not significantly influence the main experimental findings.

Benthic shift in a Solomon Islands' lagoon : corals to cyanobacteria

In June 2011 a large phytoplankton bloom resulted in a catastrophic mortality event that affected a large coastal embayment in the Solomon Islands. This consisted of an area in excess of 20 km2 of reef and soft sandy habitats in Marovo Lagoon, the largest double barrier lagoon in the world. This embayment is home to over 1200 people leading largely subsistence lifestyles depending on the impacted reefs for majority of their protein needs. A toxic diatom (Psuedo-nitzchia spp.) and toxic dinoflagellate (Pyrodinium bahamense var. compressum) reached concentrations of millions of cells per litre. The senescent phytoplankton bloom led to complete de-oxygenation of the water column that reportedly caused substantial mortality of marine animal life in the immediate area within a rapid timeframe (24 h). Groups affected included holothurians, crabs and reef and pelagic fish species. Dolphins, reptiles and birds were also found dead within the area, indicating algal toxin accumulation in the food chain. Deep reefs and sediments, whilst initially unaffected, have now been blanketed in large cyanobacterial mats which have negatively impacted live coral cover especially within the deep reef zone (> 6 m depth). Reef recovery within the deep zone has been extremely slow and may indicate an alternative state for the system.

Constrained control design for dynamic positioning of marine vehicles with control allocation

In this paper, we address the control design problem of positioning of over-actuated marine vehicles with control allocation. The proposed design is based on a combined position and velocity loops in a multi-variable anti-windup implementation together with a control allocation mapping. The vehicle modelling is considered with appropriate simplifications related to low-speed manoeuvring hydrodynamics and vehicle symmetry. The control design is considered together with a control allocation mapping. We derive analytical tuning rules based on requirements of closed-loop stability and performance. The anti- windup implementation of the controller is obtained by mapping the actuator-force constraint set into a constraint set for the generalized forces. This approach ensures that actuation capacity is not violated by constraining the generalized control forces; thus, the control allocation is simplified since it can be formulated as an unconstrained problem. The mapping can also be modified on-line based on actuator availability to provide actuator-failure accommodation. We provide a proof of the closed-loop stability and illustrate the performance using simulation scenarios for an open-frame underwater vehicle.

A survey of control allocation methods for underwater vehicles

A control allocation system implements a function that maps the desired control forces generated by the vehicle motion controller into the commands of the different actuators. In this article, a survey of control allocation methods for over-actuated underwater vehicles is presented. The methods are applicable for both surface vessels and underwater vehicles. The paper presents a survey of control allocation methods with focus on mathematical representation and solvability of thruster allocation problems. The paper is useful for university students and engineers who want to get an overview of state-of-the art control allocation methods as well as advance methods to solve more complex problems.

Analysis of temporary traffic control cost items in transportation construction bidding process

Temporary Traffic Control Plans (TCP’s), which provide construction phasing to maintain traffic during construction operations, are integral component of highway construction project design. Using the initial design, designers develop estimated quantities for the required TCP devices that become the basis for bids submitted by highway contractors. However, actual as-built quantities are often significantly different from the engineer’s original estimate. The total cost of TCP phasing on highway construction projects amounts to 6–10% of the total construction cost. Variations between engineer estimated quantities and final quantities contribute to reduced cost control, increased chances of cost related litigations, and bid rankings and selection. Statistical analyses of over 2000 highway construction projects were performed to determine the sources of variation, which later were used as the basis of development for an automated-hybrid prediction model that uses multiple regressions and heuristic rules to provide accurate TCP quantities and costs. The predictive accuracy of the model developed was demonstrated through several case studies.

Ghrelin and the brain-gut axis as a pharmacological target for appetite control

Appetite regulation is highly complex and involves a large number of orexigenic and anorexigenic peptide hormones. These are small, processed, secreted peptides derived from larger prepropeptide precursors. These peptides are important targets for the development of therapeutics for obesity, a global health epidemic. As a case study, we consider the ghrelin axis. The ghrelin axis is likely to be a particularly useful drug target, as it also plays a role in energy homeostasis, adipogenesis, insulin regulation and reward associated with food intake. Ghrelin is the only known circulating gut orexigenic peptide hormone. As it appears to play a role in diet-induced obesity, blocking the action of ghrelin is likely to be effective for treating and preventing obesity. The ghrelin peptide has been targeted using a number of approaches, with ghrelin mirror-image oligonucleotides (Spiegelmers) and immunotherapy showing some promise. The ghrelin receptor, the growth hormone secretagogue receptor, may also provide a useful target and a number of antagonists and inverse agonists have been developed. A particularly promising new target is the enzyme which octanoylates ghrelin, ghrelin O-acyltransferase (GOAT), and drugs that inhibit GOAT are likely to circumvent pharmacological issues associated with approaches that directly target ghrelin or its receptor.

Tracking spatio temporal movement of human in terms of space utilization using media access control address data

Using Media-Access-Control (MAC) address for data collection and tracking is a capable and cost effective approach as the traditional ways such as surveys and video surveillance have numerous drawbacks and limitations. Positioning cell-phones by Global System for Mobile communication was considered an attack on people's privacy. MAC addresses just keep a unique log of a WiFi or Bluetooth enabled device for connecting to another device that has not potential privacy infringements. This paper presents the use of MAC address data collection approach for analysis of spatio-temporal dynamics of human in terms of shared space utilization. This paper firstly discuses the critical challenges and key benefits of MAC address data as a tracking technology for monitoring human movement. Here, proximity-based MAC address tracking is postulated as an effective methodology for analysing the complex spatio-temporal dynamics of human movements at shared zones such as lounge and office areas. A case study of university staff lounge area is described in detail and results indicates a significant added value of the methodology for human movement tracking. By analysis of MAC address data in the study area, clear statistics such as staff’s utilisation frequency, utilisation peak periods, and staff time spent is obtained. The analyses also reveal staff’s socialising profiles in terms of group and solo gathering. The paper is concluded with a discussion on why MAC address tracking offers significant advantages for tracking human behaviour in terms of shared space utilisation with respect to other and more prominent technologies, and outlines some of its remaining deficiencies.

Alternation of chemoselective control in Stille-Heck and Heck-Stille reaction sequences

Sequential and one-pot Stille–Heck and Heck–Stille reaction processes have been invoked to give divergent access to polycyclic ring systems. Both reaction conditions and substrate structure are important in determining the nature of the reaction products formed. The Heck–Stille reactions have involved a reversal of the usual Heck regioselectivity and both cine- and ipso-substitutions have been observed in the Stille reaction.

Taxonomy and control measures of SPAM and SPIM

In this age of electronic money transactions, the opportunities for electronic crime expanded at the same rate as ever expanding rise of on-line services. With world becoming a global village, crime over the internet transcends no boundaries, borders or jurisdictions. This paper critically examines the available literature on spam, and the control measures available to control spam. This study is followed by the literature overview related to mobility of devices and how the application of mobile technologies as communication medium has impacted the handling of spam. The conclusion of this literature review with proposed direction of study is summarized.

Acacia Light Wall

The Acacia Light Wall is a permanent public artwork within the 3 stage Eden on the Yarra – a residential / commercial development on Victoria Street Abbotsford, Melbourne. The work was commissioned by the Hampton Group for Acacia Place, the first building in the development. The stylised screen was inspired by tangled wattle trees (Australia’s most common Acacia). The work consists of two walls, made from laser cut aluminium screen, acrylic ‘windows” Philips Colour Kinetic controllable LED (1250 nodes), Philips Colour Kinetics control ‘iPlayers”. One wall is 10 m long x 3 to 5 metres and the second is 12m by 3m. The windows are lit by an array of 600+ LED’s in each wall. These lights change colour from week to week marking the progress of the seasons. We worked with the project horticulturalist to develop a palate of colours for each week’s ‘light show’ that was drawn from local flowers and foliage likely to be in bloom that week. The lighting display is not static but rather a very slow moving (morphing) light show. It isn’t fast and flashy. Instead it’s restful and profound.

Ship Motion Control : Course Keeping and Roll Stabilisation Using Rudder and Fins

Motion control systems have a significant impact on the performance of ships and marine structures allowing them to perform tasks in severe sea states and during long periods of time. Ships are designed to operate with adequate reliability and economy, and in order to achieve this, it is essential to control the motion. For each type of ship and operation performed (transit, landing a helicopter, fishing, deploying and recovering loads, etc.), there are not only desired motion settings, but also limits on the acceptable (undesired) motion induced by the environment. The task of a ship motion control system is therefore to act on the ship so it follows the desired motion as closely as possible. This book provides an introduction to the field of ship motion control by studying the control system designs for course-keeping autopilots with rudder roll stabilisation and integrated rudder-fin roll stabilisation. These particular designs provide a good overview of the difficulties encountered by designers of ship motion control systems and, therefore, serve well as an example driven introduction to the field. The idea of combining the control design of autopilots with that of fin roll stabilisers, and the idea of using rudder induced roll motion as a sole source of roll stabilisation seems to have emerged in the late 1960s. Since that time, these control designs have been the subject of continuous and ongoing research. This ongoing interest is a consequence of the significant bearing that the control strategy has on the performance and the issues associated with control system design. The challenges of these designs lie in devising a control strategy to address the following issues: underactuation, disturbance rejection with a non minimum phase system, input and output constraints, model uncertainty, and large unmeasured stochastic disturbances. To date, the majority of the work reported in the literature has focused strongly on some of the design issues whereas the remaining issues have been addressed using ad hoc approaches. This has provided an additional motivation for revisiting these control designs and looking at the benefits of applying a contemporary design framework, which can potentially address the majority of the design issues.