53 research outputs found
Preliminary investigation of systematics of some Tasmanian Galaxiidae
The investigation has revealed no Tasmanian
galaxiid identical with any New Zealand form.
The fish known hitherto as Galaxias attenuatus in
Tasmania is shown to be at least subspecifically
different from the form bearing this name in New
Zealand. The two forms are referred to the species
maculatus Jenyns on the grounds of page precedence,
and are regarded as different subspecies.
No fish agreeing with G. auratus,Johnson and G.
weedoni Johnston have been found but G. affinis
Regan appears to be a valid species represented by
variants in different waters
A new species of mudfish, Neochanna (Teleostei: Galaxidae), from northern New Zealand
A new species of mudfish, Neochanna, is described from Northland. Neochanna heleios n.sp. is known from only three ephemeral wetland sites on the Kerikeri volcanic plateau and is abundant only at the type locality. The new species has a head resembling that of the brown mudfish, Neochanna apoda, and a caudal region resembling that of the black mudfish, Neochanna diversus. It can be distinguished from all Neochanna species in having a reduced number of principal caudal fin rays (13 or less). Morphometric and meristic comparisons with N. apoda and N. diversus are provided
A systematic review of supervisory relationships in general practitioner training:a qualitative synthesis
Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial.
BACKGROUND: Studies evaluating titration of antihypertensive medication using self-monitoring give contradictory findings and the precise place of telemonitoring over self-monitoring alone is unclear. The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in primary care, compared with usual care. METHODS: This study was a parallel randomised controlled trial done in 142 general practices in the UK, and included hypertensive patients older than 35 years, with blood pressure higher than 140/90 mm Hg, who were willing to self-monitor their blood pressure. Patients were randomly assigned (1:1:1) to self-monitoring blood pressure (self-montoring group), to self-monitoring blood pressure with telemonitoring (telemonitoring group), or to usual care (clinic blood pressure; usual care group). Randomisation was by a secure web-based system. Neither participants nor investigators were masked to group assignment. The primary outcome was clinic measured systolic blood pressure at 12 months from randomisation. Primary analysis was of available cases. The trial is registered with ISRCTN, number ISRCTN 83571366. FINDINGS: 1182 participants were randomly assigned to the self-monitoring group (n=395), the telemonitoring group (n=393), or the usual care group (n=394), of whom 1003 (85%) were included in the primary analysis. After 12 months, systolic blood pressure was lower in both intervention groups compared with usual care (self-monitoring, 137·0 [SD 16·7] mm Hg and telemonitoring, 136·0 [16·1] mm Hg vs usual care, 140·4 [16·5]; adjusted mean differences vs usual care: self-monitoring alone, -3·5 mm Hg [95% CI -5·8 to -1·2]; telemonitoring, -4·7 mm Hg [-7·0 to -2·4]). No difference between the self-monitoring and telemonitoring groups was recorded (adjusted mean difference -1·2 mm Hg [95% CI -3·5 to 1·2]). Results were similar in sensitivity analyses including multiple imputation. Adverse events were similar between all three groups. INTERPRETATION: Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings. With most general practitioners and many patients using self-monitoring, it could become the cornerstone of hypertension management in primary care. FUNDING: National Institute for Health Research via Programme Grant for Applied Health Research (RP-PG-1209-10051), Professorship to RJM (NIHR-RP-R2-12-015), Oxford Collaboration for Leadership in Applied Health Research and Care, and Omron Healthcare UK
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High-dimensional regression with potential prior information on variable importance
Abstract: There are a variety of settings where vague prior information may be available on the importance of predictors in high-dimensional regression settings. Examples include the ordering on the variables offered by their empirical variances (which is typically discarded through standardisation), the lag of predictors when fitting autoregressive models in time series settings, or the level of missingness of the variables. Whilst such orderings may not match the true importance of variables, we argue that there is little to be lost, and potentially much to be gained, by using them. We propose a simple scheme involving fitting a sequence of models indicated by the ordering. We show that the computational cost for fitting all models when ridge regression is used is no more than for a single fit of ridge regression, and describe a strategy for Lasso regression that makes use of previous fits to greatly speed up fitting the entire sequence of models. We propose to select a final estimator by cross-validation and provide a general result on the quality of the best performing estimator on a test set selected from among a number M of competing estimators in a high-dimensional linear regression setting. Our result requires no sparsity assumptions and shows that only a logM price is incurred compared to the unknown best estimator. We demonstrate the effectiveness of our approach when applied to missing or corrupted data, and in time series settings. An R package is available on github
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