MSD (Australia)

Abstract The shear capacity of hollow core bolts is still unclear due to the lack of experimental data. Therefore, to address this limitation, in this paper, the shear strength of three different types of hollow core bolts, including “X”, “S”, and “E” grade bolts, were studied experimentally using the double shear testing method under competent rock conditions. The outcomes of this research revealed that the shear force depended on the bolt type. The “X” grade hollow bolt tolerated larger shear displacement and shear force. In addition, it was found that the shear load capacity of hollow core bolts is not necessarily around 70% of their ultimate tensile strength under general engineering principles and Von Mises relations. Another finding was that the shear load–displacement plots showed five distinct stages in the shear process: self-adjusting, high stiffness, non-linear, low stiffness, and failure. The shear profiles indicated that the average shear stiffness was reduced as the inner diameter of the bolt increased. The results also showed that the “X” and “S” grade bolts are more brittle due to their higher tensile strength and lower elongation capacity. Moreover, strong concrete with internal confinement significantly improved the host medium integrity, simulating, more closely, competent rock conditions. The study offered insights into the shear performance of hollow core bolts and suggested further research of different types of hollow core bolts for comparison. Future studies can examine the bolt’s behaviour in weaker rock and explore the effects of various levels of pre-tensioning on the bolt shear strength and stiffness.

ObjectivesThis study aimed to assess preferences of patients and doctors regarding treatment attributes for early-stage triple-negative breast cancer (eTNBC) in the Asia–Pacific region.DesignA discrete choice experiment (DCE) by cross-sectional survey was conducted with patients and doctors. Key attributes relevant to eTNBC treatment decision-making were verified through a consultative process with clinical experts. The levels and description of seven attributes were refined through cognitive interviews. A D-efficient fractional-factorial design was employed to create 15 choice sets with seven key attributes.SettingAn online web-based DCE with the 15 choice sets was developed and made available to participants in Australia, Japan, Korea, the Philippines and Taiwan.ParticipantsThe final dataset comprised 115 patients who self-reported a diagnosis of eTNBC and 86 medical oncologists, breast and general surgeons with at least five years of experience managing eTNBC patients.Primary outcomesPatients’ and doctors’ preferences on seven attributes: pathological complete response (pCR), disease-free/event-free survival (DFS/EFS), chance of undergoing breast-conserving surgery after receiving anticancer treatment, febrile neutropenia, peripheral sensory neuropathy (PSN), diarrhoea and irreversible endocrine-related side effects requiring lifelong medication. Data were analysed using a mixed logit model to determine preference weights for attribute levels, which were then used to compute the relative importance score (RIS) for each attribute.ResultsThe median age of patients was 44.0 (IQR 38.0–56.5) years. Most patients (68%) were married, and 77% had children. Additionally, 40% were employed full-time, and 70% held a college degree. Nearly half (46%) were diagnosed before the age of 40. Among the doctors, 58% were medical oncologists and the remaining breast or general surgeons. pCR, DFS/EFS and PSN were the three most important attributes in both doctor and patient groups. pCR had the highest weighted preference among patients and doctors (RIS, 28.5 and 32.9, respectively). In general, patients assigned more weight to safety attributes compared with doctors, while doctors assigned more weight to efficacy attributes than patients did. Surgeons assigned more weight to irreversible endocrine-related side effects than medical oncologists (RIS, 14.4 vs 5.4). Differences in preferences within the regions were noted.ConclusionsWhile our study revealed a concordance between patients’ and doctors’ ranking of the seven assessed treatment attributes, patients generally assigned greater emphasis on safety-related attributes in comparison to doctors.

ABSTRACT Aims To investigate the association between gastrointestinal parasites (GIP) and animal behaviour in dairy calves under New Zealand pastoral conditions, using animal-mounted, accelerometer-based sensors. Methods Thirty-six, 5–6-month-old, Friesian-Jersey, heifer calves fitted with animal activity sensors to track behaviour were randomly allocated to one of two treatment groups. Half the animals were challenged with an oral dose of 20,000 larvae of Ostertagia ostertagi and Cooperia oncophera once a week for 3 weeks and half were unchallenged. Five weeks after the last dose, seven infected and nine uninfected animals were treated with an oral anthelmintic (AHC) and data collected for a further week. Accelerometer data were classified into minutes per day eating, ruminating, in moderate–high activity or in low activity. Live weight and faecal egg counts (FEC) were recorded weekly over the study period. All animals co-grazed a newly sown pasture not previously grazed by ruminants and were moved every week to fresh grazing. Treatment status was blinded to those managing the animals which were otherwise treated identically. Results Complete behavioural records were available from 30/36 calves, (13 challenged and 17 unchallenged). Before treatment with AHC, FEC increased in infected and un-treated calves over the study, while uninfected animals maintained a near zero FEC. There was no difference in live weight gain between the two groups over the study period. Bayesian, multinomial regression predicted differences in animal behaviour between infected and uninfected animals that were not treated with AHC over the 7 weeks following initial infection. Parasitised calves not treated with AHC were less active and spent up to 6 (95% highest density interval (HDI) = 1–11) minutes/day less in low level activity and up to 15 (95% HDI = 7–20) minutes/day less in moderate to high level activity. They ruminated up to 9 (95% HDI = 2–15) minutes/day more and ate up to 10 (95% HDI = 2–19) minutes/day more than control calves that were not treated with AHC. The effect of AHC on time spent in each behaviour differed between infected and uninfected calves and increased the coefficient of dispersion of the behavioural data. Conclusions and clinical relevance Small differences in animal behaviour can be measured in calves with GIP. However, to use this to target treatment, further validation studies are required to confirm the accuracy of behavioural classification and understand the complex drivers of animal behaviour in a dynamic and variable pasture-parasite–host environment.

As mortality due to cardiovascular disease increases throughout the world, accurate data on risk factors such as hyperlipidemia are required. This is lacking in the Asia-Pacific region. The observational Dyslipidemia International Study (DYSIS) II was established to quantify the extent of hyperlipidemia in adults with acute and stable coronary heart disease globally. Patients with stable coronary heart disease or hospitalised with an acute coronary syndrome were enrolled across nine Asia-Pacific countries from July 2013 to October 2014. Lipid-lowering therapy and low-density lipoprotein cholesterol target attainment (<70 mg/dL) were assessed. The acute coronary syndrome cohort was followed up 4 months post-discharge. Of the 4592 patients enrolled, 2794 had stable coronary heart disease and 1798 were admitted with an acute coronary syndrome. In the coronary heart disease cohort, the mean low-density lipoprotein cholesterol level was 86.9 mg/dL, with 91.7% using lipid-lowering therapy and 31% achieving low-density lipoprotein cholesterol of less than 70 mg/dL. In the acute coronary syndrome cohort at admission, the corresponding values were 103.2 mg/dL, 63.4% and 23.0%, respectively. Target attainment was significantly higher in lipid-lowering therapy-treated than non-treated patients in each cohort (32.6% vs. 12.9% and 31.1% vs. 9.0%, respectively). Mean atorvastatin-equivalent dosages were low (20 ± 15 and 22 ± 18 mg/day, respectively), with little use of non-statin adjuvants (13.0% and 6.8%, respectively). Low-density lipoprotein cholesterol target attainment had improved by follow-up for the acute coronary syndrome patients, but remained low (41.7%). Many patients in Asia at very high risk of recurrent cardiovascular events had a low-density lipoprotein cholesterol level above the recommended target. Although lipid-lowering therapy was common, it was not used to its full potential.

This paper reports prescribing patterns for prophylaxis of chemotherapy-induced nausea and vomiting (CINV) after highly or moderately emetogenic chemotherapy (HEC or MEC) for cancer in six Asia Pacific countries. In a prospective noninterventional study, 31 sites in Australia, China, India, Singapore, South Korea, and Taiwan recorded details of CINV prophylaxis for the acute phase (first 24 h) and delayed phase (days 2-5) after single-day HEC or MEC for adult patients. Additional information on CINV prophylactic medications was collected from 6-day patient diaries. Primary antiemetic therapies were defined as corticosteroids, the 5-hydroxytryptamine-3 receptor antagonists (5HT3-RAs), and neurokinin-1 receptor antagonists (NK1-RAs). Evaluable patients in cycle 1 numbered 648 (318 [49%] HEC and 330 [51%] MEC) of mean (SD) age of 56 (12) years, including 58% women. For the acute phase after HEC, overall (and country range), 96% (91-100%) of patients received a 5HT3-RA, 87% (70-100%) a corticosteroid, and 43% (0-91%) an NK1-RA. CINV prophylaxis for the HEC delayed phase was more variable: including 22% (7-65%) 5HT3-RA, 52% (12-93%) corticosteroid, and 46% (0-88%) NK1-RA. For the MEC acute phase, 97% (87-100%) of patients received 5HT3-RA and 86% (73-97%) a corticosteroid. For the MEC delayed phase, 201 patients (61%) received a primary antiemetic, including 5HT3-RA (41%), corticosteroid (37%), and/or NK1-RA (4%). The 5HT3-RAs were prescribed consistently in all countries, while prescribing of other antiemetic therapies was variable, and corticosteroids were under-prescribed for CINV prophylaxis, particularly in the delayed phase.

This study explored changes in quality of life (QOL) and psychosocial variables in a large cohort of people with multiple sclerosis (MS). A total of 1287 Australians with MS were administered self-report questionnaires at baseline and 24 months later to examine the impact of disease severity and duration, perceived stress, self-efficacy, depression, and social support on QOL and self-care. Over the 2-year survey period, MS remained stable for 70% of respondents. Disease severity correlated with social support at baseline but not at 24 months, when the only significant correlation with disease severity was that of the World Health Organization Quality of Life-100 instrument (WHOQOL-100) domain of Level of Independence. Although QOL improved across the WHOQOL-100 domains Physical, Psychological, Level of Independence, Social Relationships, and Environment, decreases were found in the WHOQOL-100 facet overall QOL and well-being as well as self-efficacy over the same time period. Hierarchical multiple regression was used to assess the utility of four control measures. MS disease severity and MS disease duration were entered at Step 1, explaining 16.1% of the variance in QOL. After entry of perceived stress, self-efficacy, social support, and the Depression, Anxiety and Stress Scale-21 (DASS-21) at Step 2, the total variance explained by the model as a whole was 55.8% (F6,1028 = 216.495, P < .001). Thus, even in the presence of stable disease and improvement in some WHOQOL-100 domains, overall QOL and self-efficacy had decreased at 2 years after the collection of baseline data. Loss of self-efficacy, increased stress, and depression are key factors in reduced QOL in people with MS.

This chapter contains sections titled: Introduction The Road Transport Management System (RTMS) PBS as a concession of the Road Transport Management System Support of the Department of Transport Objectives Demonstration Projects Design Criteria PBS Assessments and Results Operation and driver feedback References