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0.72). In the base case scenario, there was a cost of AU$26 424 per patient, with an open conversion rate of 11%. Increasing robotic-assisted case percentage resulted in reduced cost, open conversion rates and length of stay. Extrapolation of cost model data indicated if 50% were robotic-assisted cases, then the initial capital investment (assumed at AU$4 000 000) could be recovered in 10 years.
Our model highlights potential advantages of performing greater numbers of robotic-assisted operations in a collaborative environment. Cost-effective analysis with prospective data could evaluate if these results are translatable and potentially support acquisition of robotic systems in the public sector.
Our model highlights potential advantages of performing greater numbers of robotic-assisted operations in a collaborative environment. Cost-effective analysis with prospective data could evaluate if these results are translatable and potentially support acquisition of robotic systems in the public sector.
Few options are available for cytomegalovirus (CMV) treatment in transplant recipients resistant, refractory, or intolerant to approved agents. Letermovir (LET) is approved for prophylaxis in hematopoietic cell transplant (HCT) recipients, but little is known about efficacy in CMV infection. We conducted an observational study to determine the patterns of use and outcome of LET treatment of CMV infection in transplant recipients.
Patients who received LET for treatment of CMV infection were identified at 13 transplant centers. Demographic and outcome data were collected.
Twenty-seven solid organ and 21 HCT recipients (one dual) from 13 medical centers were included. Forty-five of 47 (94%) were treated with other agents prior to LET, and 57% had a history of prior CMV disease. Seventy-seven percent were intolerant to other antivirals; 32% were started on LET because of resistance concerns. Among 37 patients with viral load<1000 international units (IU)/ml at LET initiation, two experienced>1 log rise in viral load by week 12, and no deaths were attributed to CMV. Ten patients had viral load>1000 IU/ml at LET initiation, and six of 10 (60%) had a CMV viral load<1000 IU/ml at completion of therapy or last known value. LET was discontinued in two patients for an adverse event.
Patients treated with LET with viral load<1000 IU/ml had good virologic outcomes. Outcomes were mixed when LET was initiated at higher viral loads. Further studies on combination therapy or alternative LET dosing are needed.
Patients treated with LET with viral load less then 1000 IU/ml had good virologic outcomes. Outcomes were mixed when LET was initiated at higher viral loads. Further studies on combination therapy or alternative LET dosing are needed.
Vascular trauma is a complex and evolving area. Unlike internationally, the epidemiology of vascular trauma is not well documented in Australia; the most recent study was published in 2013. Gold Coast University Hospital (GCUH) is a level 1 trauma centre in Queensland, Australia. The aim of this study was to describe the epidemiology and outcomes of vascular trauma at a level 1 trauma centre, and compare these with the Australian and international literature.
All individuals who presented to GCUH between January 2014 and December 2019 with vascular injury were retrieved from the GCUH prospective trauma database. A descriptive analysis was undertaken on this cohort.
The incidence of vascular trauma as a percentage of total trauma remained stable over the study period. mTOR inhibitor The study included 5454 trauma admissions to GCUH, of which 213 sustained vascular injuries. Males were more likely to be injured and blunt trauma was more common than penetrating. Blunt trauma was associated with increased injury complexity. The mortality rate was 8.5% and 10 patients required amputation.
The proportion of vascular injuries as a percentage of total trauma in Australia is higher than in previous studies. Vascular trauma causes significant injuries and has a higher mortality rate than general trauma.
The proportion of vascular injuries as a percentage of total trauma in Australia is higher than in previous studies. Vascular trauma causes significant injuries and has a higher mortality rate than general trauma.The dynamics of xenon gas, loaded in a series of 1-alkyl-3-methylimidazolium based ionic liquids, probes the formation of increasingly blurred polar/apolar nanodomains as a function of the anion type and the cation chain length. Exploiting 129 Xe NMR spectroscopy techniques, like Pulse Gradient Spin Echo (PGSE) and inversion recovery (IR), the diffusion motion and relaxation times are determined for 1-alkyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide [Cn C1 im][TFSI]. A correlation between the ILs nano-structure and both xenon diffusivity and relaxation times, as well as chemical shifts, is outlined. Interestingly, comparison with previous results of the same properties in the homologous imidazolium chlorides and hexafluorophospate shows an opposite trend with the alkyl chain length. Classical molecular dynamics (MD) simulations are used to calculate the xenon and cation and anion diffusion coefficients in the same systems, including imidazolium cations with longer chains (n=4, 6, 8 … 20). An almost quantitative agreement with the experiments validates the MD simulations and, at the same time, provides the necessary structural and dynamic microscopic insights on the nano-segregation and diffusion of xenon in bistriflimide, chloride and hexafluorphosphate salts allowing to observe and rationalize the shaping effect of the cation in the nanostructure.This study compares the physicochemical properties of six electrolytes comprising of three salts LiFTFSI, NaFTFSI and KFTFSI in two solvent mixtures, the binary (3EC/7EMC) and the ternary (EC/PC/3DMC). The transport properties (conductivity, viscosity) as a function of temperature and concentration were modeled using the extended Jones-Dole-Kaminsky equation, the Arrhenius model, and the Eyring theory of transition state for activated complexes. Results are discussed in terms of ionicity, solvation shell, and cross-interactions between electrolyte components. The application of the six formulated electrolytes in symmetrical activated carbon (AC)//AC supercapacitors (SCs) was characterized by cyclic voltammetry (CV), galvanostatic cycling with potential limitation (GCPL), electrochemical impedance spectroscopy (EIS) and accelerated aging. Results revealed that the geometrical flexibility of the FTFSI anion allows it to access and diffuse easily in AC whereas its counter ions (Li+ , Na+ or K+ ) can remain trapped in porosity.
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