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Background:Potentially preventable hospitalisations (PPHs) are a common occurrence. Knowing the factors associated with PPHs may allow high-risk patients to be identified and healthcare resources to be better allocated, and these factors may differ between urban and rural locations. Aim: To determine factors associated with PPHs in an Australian rural population. Method: A retrospective review of admitted patients' demographic and clinical data was used to describe and model the factors associated with PPHs, using an age- and sex-matched control group of non-admitted patients. Setting:A multi-site rural general practice, Tasmania. Participants: Patients aged >18 years residing in the Huon-Bruny Island region of Tasmania, who were active patients at a rural general practice and were admitted to a public hospital for a PPH between 1/7/2016 and 30/6/2019. Main outcome measures: Overnight admission to hospital for a PPH. Results: Predictors with a significant odds-ratio (OR) in the final model were being single/unmarried (OR 2.43, 95%CI 1.38-4.28), higher Charlson Comorbidity Index score (OR 1.40, 95%CI 1.13-1.74) and the number of general practice visits in the preceding 12 months (OR 1.09, 95%CI 1.05-1.14). Conclusion(s): This study found that being single and having a higher comorbidity burden were the strongest independent risk factors for PPHs in a rural population. Demographic and socioeconomic factors appeared to be as, if not more, important than medical factors and warrant attention when considering the design of programs to reduce PPH risk in rural communities. This article is protected by copyright. All rights reserved.

Supplemental Table 1. Criteria for Unresectable Disease Supplemental Table 2. Modified RECIST Criteria for Head and Neck Cancer. Supplemental Table 3. Summary of Serum Analyte Levels. Supplemental Figure 1. Study Schematic Supplemental Figure 2. Time to locoregional failure for all eligible and treated patients (a) and by tumor HPV status (b). Log rank test comparing time to failure for HPV+ versus HPV- p value provided. Supplemental Figure 3. Representative tissue cores with high or low expression levels of XPF or ERCC1 as assessed by AQUA. Tumors were stained for cytokeratin (CK) to create a tumor mask and with DAPI to define the nuclear compartment. Supplemental Figure 4. Representative tumor IHC molecular correlates ERCC1, XPF and MET.

List of Supplemental Materials: Supplemental Table 1. Criteria for Unresectable Disease Supplemental Table 2. Modified RECIST Criteria for Head and Neck Cancer. Supplemental Table 3. Summary of Serum Analyte Levels. Supplemental Figure 1. Study Schematic Supplemental Figure 2. Time to locoregional failure for all eligible and treated patients (a) and by tumor HPV status (b). Log rank test comparing time to failure for HPV+ versus HPV- p value provided. Supplemental Figure 3. Representative tissue cores with high or low expression levels of XPF or ERCC1 as assessed by AQUA. Tumors were stained for cytokeratin (CK) to create a tumor mask and with DAPI to define the nuclear compartment. Supplemental Figure 4. Representative tumor IHC molecular correlates ERCC1, XPF and MET.

Purpose: Treatment with cisplatin or cetuximab combined with radiotherapy each yield superior survival in locally advanced squamous cell head and neck cancer (LA-SCCHN) compared with radiotherapy alone. Eastern Cooperative Oncology Group Trial E3303 evaluated the triple combination.Experimental Design: Patients with stage IV unresectable LA-SCCHN received a loading dose of cetuximab (400 mg/m2) followed by 250 mg/m2/week and cisplatin 75 mg/m2 q 3 weeks ×3 cycles concurrent with standard fractionated radiotherapy. In the absence of disease progression or unacceptable toxicity, patients continued maintenance cetuximab for 6 to 12 months. Primary endpoint was 2-year progression-free survival (PFS). Patient tumor and blood correlates, including tumor human papillomavirus (HPV) status, were evaluated for association with survival.Results: A total of 69 patients were enrolled; 60 proved eligible and received protocol treatment. Oropharyngeal primaries constituted the majority (66.7%), stage T4 48.3% and N2-3 91.7%. Median radiotherapy dose delivered was 70 Gy, 71.6% received all three cycles of cisplatin, and 74.6% received maintenance cetuximab. Median PFS was 19.4 months, 2-year PFS 47% [95% confidence interval (CI), 33%–61%]. Two-year overall survival (OS) was 66% (95% CI, 53%–77%); median OS was not reached. Response rate was 66.7%. Most common grade ≥3 toxicities included mucositis (55%), dysphagia (46%), and neutropenia (26%); one attributable grade 5 toxicity occurred. Only tumor HPV status was significantly associated with survival. HPV was evaluable in 29 tumors; 10 (all oropharyngeal) were HPV positive. HPV+ patients had significantly longer OS and PFS (P = 0.004 and P = 0.036, respectively).Conclusions: Concurrent cetuximab, cisplatin, and radiotherapy were well tolerated and yielded promising 2-year PFS and OS in LA-SCCHN with improved survival for patients with HPV+ tumors. Clin Cancer Res; 20(19); 5041–51. ©2014 AACR.

Potentially preventable hospitalisations (PPHs) are common in rural communities in Australia and around the world. Healthcare providers have a perspective on PPHs that may not be accessible by analysing routine patient data. This study explores the factors that healthcare providers believe cause PPHs and seeks to identify strategies for preventing them. Physicians, nurses, paramedics, and health administrators with experience in managing rural patients with PPHs were recruited from southern Tasmania, Australia. Semi-structured telephone interviews were conducted, and reflexive thematic analysis was used to analyse the data. Participants linked health literacy, limited access to primary care, and perceptions of primary care services with PPH risk. The belief that patients did not have a good understanding of where, when, and how to manage their health was perceived to be linked to patient-specific health literacy challenges. Access to primary healthcare was impacted by appointment availability, transport, and financial constraints. In contrast, it was felt that the prompt, comprehensive, and free healthcare delivered in hospitals appealed to patients and influenced their decision to bypass rural primary healthcare services. Strategies to reduce PPHs in rural Australian communities may include promoting health literacy, optimising the delivery of existing services, and improving social support structures.

Potentially preventable hospitalisations (PPHs) are common and increase the burden on already stretched healthcare services. Increasingly, psychosocial factors have been recognised as contributing to PPHs and these may be mitigated through greater attention to social capital. This systematic review investigates the factors associated with PPHs within rural populations. The review was designed, conducted, and reported according to PRISMA guidelines and registered with Prospero (ID: CRD42020152194). Four databases were systematically searched, and all potentially relevant papers were screened at the title/abstract level, followed by full-text review by at least two reviewers. Papers published between 2000–2022 were included. Quality assessment was conducted using Newcastle–Ottawa Scale and CASP Qualitative checklist. Of the thirteen papers included, eight were quantitative/descriptive and five were qualitative studies. All were from either Australia or the USA. Access to primary healthcare was frequently identified as a determinant of PPH. Socioeconomic, psychosocial, and geographical factors were commonly identified in the qualitative studies. This systematic review highlights the inherent attributes of rural populations that predispose them to PPHs. Equal importance should be given to supply/system factors that restrict access and patient-level factors that influence the ability and capacity of rural communities to receive appropriate primary healthcare.

Hydraulic fracturing operations in unconventional reservoirs are typically monitored using geophones located either at the surface or in the adjacent wellbores. A new approach to record hydraulic stimulations uses fiber-optic distributed acoustic sensing (DAS). A fiber-optic cable was installed in a treatment well in the Meramec formation to monitor the hydraulic fracture stimulation of an unconventional reservoir. A variety of physical effects, such as temperature, strain, and microseismicity are measured and correlated with the treatment program during hydraulic fracturing of the well containing the fiber and also an adjacent well. The analysis of this DAS data set demonstrates that current fiber-optic technology provides enough sensitivity to detect a considerable number of microseismic events and that these events can be integrated with temperature and strain measurements for comprehensive hydraulic fracture monitoring.

Hydraulic fracturing operations in unconventional reservoirs are monitored using distributed fiber-optic sensing through which physical effects such as temperature, strain, and microseismic activity can be measured. When combined with treatment curves and other reservoir information, these measurements give engineers more data to understand the effectiveness of a treatment program and make future reservoir management decisions. Distributed fiber-optic data are acquired within a borehole that is actively being fractured and is subsequently used as an observation well for treatments of a neighboring well. The large-aperture and finely sampled data acquisition provides a variety of measurements at different resolution scales as changes are induced in the reservoir. Distributed acoustic sensing microseismic events are observed with magnitudes above −2. The spatial distribution of events, up to 500 m from the observation well, allows us to estimate diffusivity and fracturing trends for nearby treatment wells. Microseismic events acquired using a standard three-component borehole tool provide insight into the type of events that can be observed only on one system or simultaneously on both systems. We correlate very low frequency (well below 1 Hz) strain-front behavior with the onset of microseismic events, as they are triggered by pore pressure and fracturing progress throughout the reservoir.

Background Adverse drug reactions are common in Australian general practice and can be a cause of, or contribute to, preventable hospital admissions. Developing practical tools to assist in identifying patients who are at high risk of serious adverse drug reactions is an important step in preventing these hospitalisations. Objective The aims of the study were to apply the Prediction of Hospitalisation due to Adverse Drug Reactions in Elderly Community-Dwelling Patients (PADR-EC) Score to assess the risk of medication-related hospitalisation among patients aged ≥ 65 years attending a rural general practice, and to investigate general practitioners’ acceptance of the PADR-EC Score. Setting The project was based in a multicentre rural general practice in southern Tasmania, Australia. Method We conducted a cross-sectional study wherein the PADR-EC score was administered to patients aged ≥ 65 years attending a general practice. A focus group of general practice doctors was conducted and thematic analysis of the transcript used to explore their views regarding the utility of the PADR-EC score. Main Outcome Measures Successful application of the PADR-EC Score and an evaluation of general practitioners' acceptance of the PADR-EC Score are the two outcome measures of the project. Results The PADR-EC score was applied by the practice pharmacist and reported to GPs for 428 patients aged ≥ 65 years, with 24.8% classified as high-risk. The focus group found the PADR-EC score helped raise awareness of the risk of adverse drug reactions in the general practice setting. Doctors demonstrated good understanding of the PADR-EC Score and there were no negative reactions to the delivery model used. No changes to prescribing were implemented directly as a result of the PADR-EC Score, but more caution was used when doctors provided their usual clinical care. Conclusion Doctors used the PADR-EC score to complement their decision making. The PADR-EC Score was used as a reminder to review existing medication lists, follow-up on pathology results that may impact drug treatment and assess patients for prevalent ADRs. Further research is needed to validate the PADR-EC score in this setting.

The newly introduced pathologic diagnosis of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) will result in less bilateral thyroid surgery as well as deescalation in T4 suppressive and radioactive iodine treatment. Although, NIFTP is a nonmalignant lesion that has nuclear features of some papillary malignancies, the challenge for the surgeon is to identify a lesion as possibly NIFTP before the pathologic diagnosis. NIFTP, due to its reduction of overall rates of malignancy, will result in the initial surgical pendulum swinging toward lobectomy instead of initial total thyroidectomy. This American Head and Neck Society endocrine section consensus statement is intended to inform preoperative evaluation to attempt to identify those patients whose final pathology report may ultimately harbor NIFTP and can be offered a conservative surgical plan to assist in cost‐effective, optimal management of patients with NIFTP.

Abstract Fiber Optic (FO) sensing technology is an exciting and novel technique offering many advantages over traditional wellbore surveillance methods1–3. Multiple FO cables can be installed that can be designed for sensitivity to a wide variety of signals such as temperature, pressure4–5, strain6–7, sound8, and the presence of specific chemical compounds. Permanently installed FO cables enable a cost effective surveillance policy where data acquisition surveys can be conducted without well interventions, in real-time, at any time, and continuous along the entire well bore. The avoidance of well intervention eliminates production deferment and operational risks of conventional surveys. Frequent, time-lapse FO based surveys can provide critical reservoir surveillance data for production and recovery optimization. One instance of fiber-optic surveillance is Distributed Sensing, which uses the entire fiber as a sensing element. Recently, very good progress has been made in Distributed Acoustic Sensing (DAS) for hydraulic fracturing monitoring9, production profiling for commingled oil and gas producers, injection profiling for water injectors10, gas lift monitoring and the acquisition of wellbore seismic data such as Vertical Seismic Profile (VSP) surveys11–12. These applications are also seen to benefit from integration with other methods such as Distributed Temperature Sensing (DTS) and Distributed Pressure Sensing (DPS). In terms of wellbore surveillance, the possibility to monitor flow along the entire wellbore from FO sensing provides useful insights in the complex flow behavior in a well which can be used to optimize well performance. There are also many improvements to be made in the enabling Distributed Sensing infrastructure such as the handling and evaluation of very large data volumes and seamless FO data transfer, the robustness & cost of the FO system installation, and the overall integration of FO surveillance into the full workflows. It will take some time before all these issues are addressed but it is clear that FO based applications will play a key role in future well and reservoir surveillance. In this paper some examples of using DAS for Production Allocation are discussed.

Traditionally, systemic chemotherapy has been the main form of treatment for recurrent squamous carcinoma of the head and neck. Unfortunately, response rates are seldom higher than 20-30%, with median survival times of 6-8 months. This paper explores the emerging role of reirradiation in the setting of recurrent squamous cell carcinoma of the head and neck; it reviews the existing literature focusing on radiation alone in this setting, and more recent literature integrating systemic radiosensitizing cytotoxics with reirradiation. Data from recent series using fluorinated pyrimidines and hydroxyurea, as well as platinating agents and taxanes, suggest occasional longterm survival benefits that exceed the historic norm. These approaches, largely confined to single institutions or small consortiums to date, are being evaluated prospectively in the cooperative group setting.