IMPORTANCE Systematic differences between patients included in randomized clinical trials (RCTs) and the general patient population may influence the generalizability of RCT findings. Comprehensive national registries of patients with end-stage kidney disease who are undergoing dialysis provide a unique opportunity to compare trial and real-world patient cohorts. OBJECTIVE To determine if participants in large, multicenter dialysis trials were similar to the general population undergoing dialysis in terms of age, comorbidities, and mortality rate.
Abstract-We present a nonlinear, dynamic controller for a 6DOF quadrotor operating in an estimated, spatially varying, turbulent wind field. The quadrotor dynamics include the aerodynamic effects of drag, rotor blade flapping, and induced thrust due to translational velocity and external wind fields. To control the quadrotor we use a dynamic input/output feedback linearization controller that estimates a parametric model of the wind field using a recursive Bayesian filter. Each rotor experiences a possibly different wind field, which introduces moments that are accounted for in the controller and allows flight in wind fields that vary over the length of the vehicle. We add noise to the wind field in the form of Dryden turbulence to simulate the algorithm in two applications: autonomous ship landing and quadrotor proximity flight.
Background As healthcare is responsible for 7% of Australia's carbon emissions, it was recognised that a policy implemented at St George Hospital, Sydney, to reduce non‐urgent pathology testing to 2 days per week and, on other days only if essential, would also result in a reduction in carbon emissions. The aim of the study was to measure the impact of this intervention on pathology collections and associated carbon emissions and pathology costs. Aims To measure the impact of an intervention to reduce unnecessary testing on pathology collections and associated carbon emissions and pathology costs. Methods The difference in the number of pathology collections, carbon dioxide equivalents (CO2e) for five common blood tests and pathology cost per admission were compared between a 6‐month reference period and 6‐month intervention period. CO2e were estimated from published pathology CO2e impacts. Cost was derived from pathology billing records. Outcomes were modelled using multivariable negative binomial, generalised linear and logistic regression. Results In total, 24 585 pathology collections in 5695 patients were identified. In adjusted analysis, the rate of collections was lower during the intervention period (rate ratio 0.90; 95% confidence interval (CI), 0.86–0.95; P < 0.001). This resulted in a reduction of 53 g CO2e (95% CI, 24–83 g; P < 0.001) and $22 (95% CI, $9–$34; P = 0.001) in pathology fees per admission. The intervention was estimated to have saved 132 kg CO2e (95% CI, 59–205 kg) and $53 573 (95% CI, 22 076–85 096). Conclusions Reduction in unnecessary hospital pathology collections was associated with both carbon emission and cost savings. Pathology stewardship warrants further study as a potentially scalable, cost‐effective and incentivising pathway to lowering healthcare associated greenhouse gas emissions.
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