In this paper, an energy optimisation approach for residential scenario has been investigated with an aim to maximise the utilisation of solar generation to meet the electricity demand of the household appliances. Given that users without energy storage do not have an option to consume the solar generation at a later period, it is important to develop a solution that schedules the deferrable appliances during high solar generation periods. The proposed solution utilises this approach to optimise the operating time of the deferrable appliances in a household, while considering other influential parameters such as weather, solar generation and demand forecasts. The developed approach is implemented for a number of participating users in Geelong, Australia during 2020-2022. The evaluation results demonstrate up to 38.8% savings in energy consumption and up to 48% savings in peak demand over the evaluation period. It can also be observed that the appliances are scheduled during mid-morning to early-afternoon for most of the participants.
Abstract Background: Melioidosis is a serious infection caused by soil-dwelling Gram-negative bacillus Burkholderia pseudomallei . It is most commonly reported in Northern Australia, Southeast and Southern Asia, China, and Taiwan. Methods: A case report and short review of the literature are presented. Presentation, diagnosis including genomic sequencing, and acute and long-term management are discussed. Results: A 58-year-old female presented with chronic rhinosinusitis secondary to melioidosis. This is the third reported incidence of sinusitis secondary to melioidosis, which occurred in an otherwise well female with no risk factors and no apparent cause of exposure. Treatment involved an acute phase in which meropenem was administered parenterally for two weeks, followed by a prolonged oral course of trimethoprim-sulfamethoxazole for three months, as per recommended guidelines. Conclusion: In patients presenting with refractory chronic rhinosinusitis, ENT surgeons should consider the presence of unusual causative pathogens such as B pseudomallei , particularly in those with recent travel history to Northern Queensland and/or Southeast Asia.
Abstract Background Venous thromboembolism ( VTE ) represents a major public health problem in A ustralia and worldwide, contributing to hundreds of thousands of deaths each year. Aim To assess adherence to recommended guidelines in a range of clinical settings. Methods Retrospective, observational study of 955 medical ( M ), surgical ( S ) and orthopaedic ( O ) patient charts of all M , S and O patients admitted during M arch 2011. Patients on warfarin were excluded from the analysis. Appropriate or inappropriate prophylaxis was assessed according to high, medium and low risk stratification. Patient risk stratification for VTE , suitability of prophylaxis given, adverse events and length of stay were recorded. Results Nine hundred and thirteen eligible patients were assessed, 54% male, mean age 57 ± 21 years. Regarding the 372 M patients, 235 (63%) were on appropriate prophylaxis, compared with 84% (273/326) S and 78% (168/215) O patients ( M to S , P < 0.0001; M to O , P = 0.0002; S to O , P = 0.113). High risk prevalence was 56% in M , 9% in S and 12% in O patients ( P < 0.0001). Nine confirmed or possible VTE events occurred (seven M , with five of these on inappropriate prophylaxis). All three bleeding events (one fatal) were in M patients, two of whom had appropriate prophylaxis. Average length of stay was 4.1 ± 5.0, 2.1 ± 3.3 and 2.1 ± 3.8 days ( P < 0.001) for M , S and O patients respectively. Conclusion Better adherence to prophylaxis guidelines is required, especially in M patients where the prevalence of high‐risk VTE is greater.
Abstract Background Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. Methods This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. Results 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33–4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76–2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42–0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14–0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11–0.44) and SSI (OR 0.21 95% CI 0.09–0.45). Conclusion A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. Trial registration: NCT02179112.