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With the development of the electric market, electric load forecasting has been increasingly pursued by many scholars. Because the electric load is affected by many factors, it is characterized by volatility and uncertainty, and it cannot be forecasted accurately only by a single model. In the research, a short‐term load forecasting integrated model is proposed to solve the problem of inaccurate forecasting of a single model. The key point of using the integrated model to forecast is to optimize the decomposed sequence to improve the accuracy of the forecast. empirical wavelet decomposition (EWT) is used to decompose the sequence into stationary sequences and avoid modal aliasing; the sparrow search algorithm (SSA) simulates the forecasting and anti‐forecasting behavior of the sparrow population, which is very similar to the electricity consumption behavior of various industries and has good optimization effect; generalized regression neural network (GRNN) is used for forecast and reconstruction; This is the EWT‐SSA‐GRNN model. This paper studies and analyzes the power load of a city in southern Australia. The results show that the integrated model reduces volatility through decomposition and optimization, and can improve forecast accuracy. [ABSTRACT FROM AUTHOR]

Background: The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real‐world Australian patients. Methods: CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5‐year time periods (A: 2005–2009, B: 2010–2014, C: 2015–2019). Stage III was further stratified as pre‐ and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time‐to‐recurrence (TTR), and overall survival (OS) was compared across the time periods. Results: Of 3977 identified patients, 1148 (stage II: 640, stage III: 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post‐IDEA, the proportion of patients receiving ≤3 months of oxaliplatin‐based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A: 89% vs. B: 88% vs. C: 90%, p =.53) and stage III (72% vs. 76% vs. 72%, p =.08). OS significantly improved for stage II (80%–85%, p =.04) and stage III (69%–77%, <.01) from period A to B. Conclusion: AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer‐related mortality. [ABSTRACT FROM AUTHOR]

Objective: A pilot study to: (1) describe the ability of emergency physicians to provide primary consults at an Australian, major metropolitan, adult emergency department (ED) during the COVID-19 pandemic when compared with historical performance; and (2) to identify the effect of system and process factors on productivity. Methods: A retrospective cross-sectional description of shifts worked between 1 and 29 February 2020, while physicians were carrying out their usual supervision, flow and problem-solving duties, as well as undertaking additional COVID-19 preparation, was documented. Effect of supervisory load, years of Australian registration and departmental flow factors were evaluated. Descriptive statistical methods were used and regression analyses were performed. Results: A total of 188 shifts were analysed. Productivity was 4.07 patients per 9.5-h shift (95% CI 3.56–4.58) or 0.43 patients per h, representing a 48.5% reduction from previously published data (P < 0.0001). Working in a shift outside of the resuscitation area or working a day shift was associated with a reduction in individual patient load. There was a 2.2% (95% CI: 1.1–3.4, P < 0.001) decrease in productivity with each year after obtaining Australian medical registration. There was a 10.6% (95% CI: 5.4–15.6, P < 0.001) decrease in productivity for each junior physician supervised. Bed access had no statistically significant effect on productivity. Conclusions: Emergency physicians undertake multiple duties. Their ability to manage their own patients varies depending on multiple ED operational factors, particularly their supervisory load. COVID-19 preparations reduced their ability to see their own patients by half. What is known about the topic?: An understanding of emergency physician productivity is essential in planning clinical operations. Medical productivity, however, is challenging to define, and is controversial to measure. Although baseline data exist, few studies examine the effect of patient flow and supervision requirements on the emergency physician's ability to perform primary consults. No studies describe these metrics during COVID-19. What does this paper add?: This pilot study provides a novel cross-sectional description of the effect of COVID-19 preparations on the ability of emergency physicians to provide direct patient care. It also examines the effect of selected system and process factors in a physician's ability to complete primary consults. What are the implications for practitioners?: When managing an emergency medical workforce, the contribution of emergency physicians to the number of patients requiring consults should take into account the high volume of alternative duties required. Increasing alternative duties can decrease primary provider tasks that can be completed. COVID-19 pandemic preparation has significantly reduced the ability of emergency physicians to manage their own patients. [ABSTRACT FROM AUTHOR]

The Devonian Sn-mineralized Heemskirk and barren Pieman Heads granites of western Tasmania (southeast Australia) contain abundant tourmaline-rich features, including orbicules, patches, cavities, and veins within their roof zones. The δ11B and δ18O compositions of tourmaline from these texturally different features range from − 21.7 to + 4.1‰ (average − 4.7 ± 4.0‰, n = 127), and from + 6.5 to + 14.9‰ (average + 10.7 ± 1.8‰, n = 38), respectively. These data suggest that the tourmaline-rich assemblages precipitated mostly from magmatic-hydrothermal fluids derived from their host plutons, mixed with minor external components sourced from metasedimentary, meta-ultramafic rocks, and/or meteoric water. The B-isotopic values increase sequentially from tourmaline patches to orbicules and/or cavities in both granites, probably caused by progressive volatile exsolution and systematic fluxing of aqueous boron-rich fluids from the S-type magmas during emplacement into the shallow crust. High degrees of fractional crystallization of the melt may have caused the exsolution of boron-rich hypersaline fluids from which the tourmaline orbicules and cavities formed. Bimodal δ11B populations (− 21.7 to − 12.7‰ and − 3.9 to + 4.0‰) imply that the granitic melts were mostly sourced from 10B-rich metapelitic rocks. The granites underwent fluid exsolution during the late magmatic stage that contributed to the widespread development of tourmaline-rich features and also to the formation of tin deposits associated with the Heemskirk Granite. [ABSTRACT FROM AUTHOR]

The article offers information on the statistical models for the forecasting of patient presentations in Australia's Emergency Department. It discusses that the statistical models as useful tools for planning service delivery, and various methods and models have been proposed. It mentions the applicability of the national public hospital time presentation curve to the clinical settings.

• The Kekesu Group was likely deposited during ca. 1010–969 Ma. • The CTB was probably located near Australia during assembly of Rodinia. • Microcontinents in the southwest CAOB possibly have different origins. There are multiple Precambrian microcontinents within the Central Asian Orogenic Belt (CAOB), and the paleogeographic locations of those in the southwest CAOB (e.g. Central Tianshan Block, Yili Block, Aktau-Mointy terrane, Erementau-Niyaz terrane and Kokchetav terrane) remain controversial. The Central Tianshan Block is one of the representative Precambrian microcontinents in the southwest CAOB. It can be divided into the western Central Tianshan Block and eastern Central Tianshan Block. To investigate their relationships and paleogeographic locations, we collected metasedimentary rocks from the Kekesu Group in western Central Tianshan Block. The results of zircon LA–ICP–MS U-Pb dating, combining with previously obtained magmatic ages, suggest that the Kekesu Group was deposited during the latest Mesoproterozoic to earliest Neoproterozoic (ca. 1010–969 Ma). Detrital zircon populations of Kekesu Group were dominated by 2.0–0.9 Ga grains with an age peak at 1474 Ma. The Archean to end-Paleoproterozoic zircon grains had variable ε Hf (t) values from +9.7 to −8.7, and most of the Mesoproterozoic zircons had positive ε Hf (t) values (+13.9 to +2.4). The Kekesu Group in western Central Tianshan Block has similar zircon age populations and ε Hf (t) values to those in eastern Central Tianshan Block. In combination with magmatism, these data suggest that western and eastern Central Tianshan Block had similar tectonic affinities and locations during the earliest Neoproterozoic. We compiled 4566 concordant detrital zircon U-Pb age data of Mesoproterozoic to early Neoproterozoic strata from microcontinents in the southwest CAOB and potential sources. The zircon age probability density plots, kernel density estimates and multidimensional scaling plot suggest that the Central Tianshan and Yili blocks had similar sources mainly derived from the Musgrave Province in central Australia in the latest Mesoproterozoic to early Neoproterozoic, and were possibly located near Australia during assembly of Rodinia. The sources for the Erementau-Niyaz and Kokchetav terranes were probably mainly within the northern Laurentia in the latest Mesoproterozoic to earliest Neoproterozoic. [ABSTRACT FROM AUTHOR]

Background: The treatment of locally advanced rectal cancer (LARC) is moving towards total neoadjuvant therapy and potential organ preservation. Of particular interest are predictors of pathological complete response (pCR) that can guide personalized treatment. There are currently no clinical biomarkers which can accurately predict neoadjuvant therapy (NAT) response but body composition (BC) measures present as an emerging contender. The primary aim of the study was to determine if artificial intelligence (AI) derived body composition variables can predict pCR in patients with LARC., Methods: LARC patients who underwent NAT followed by surgery from 2012 to 2023 were identified from the Australian Comprehensive Cancer Outcomes and Research Database registry (ACCORD). A validated in-house pre-trained 3D AI model was used to measure body composition via computed tomography images of the entire Lumbar-3 vertebral level to produce a volumetric measurement of visceral fat (VF), subcutaneous fat (SCF) and skeletal muscle (SM). Multivariate analysis between patient body composition and histological outcomes was performed., Results: Of 214 LARC patients treated with NAT, 22.4% of patients achieved pCR. SM volume (P = 0.015) and age (P = 0.03) were positively associated with pCR in both male and female patients. SCF volume was associated with decreased likelihood of pCR (P = 0.059)., Conclusion: This is the first study in the literature utilizing AI-measured 3D Body composition in LARC patients to assess their impact on pathological response. SM volume and age were positive predictors of pCR disease in both male and female patients following NAT for LARC. Future studies investigating the impact of body composition on clinical outcomes and patients on other neoadjuvant regimens such as TNT are potential avenues for further research., (© 2024 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)

Background: The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real-world Australian patients., Methods: CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5-year time periods (A: 2005-2009, B: 2010-2014, C: 2015-2019). Stage III was further stratified as pre- and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time-to-recurrence (TTR), and overall survival (OS) was compared across the time periods., Results: Of 3977 identified patients, 1148 (stage II: 640, stage III: 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post-IDEA, the proportion of patients receiving ≤3 months of oxaliplatin-based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A: 89% vs. B: 88% vs. C: 90%, p = .53) and stage III (72% vs. 76% vs. 72%, p = .08). OS significantly improved for stage II (80%-85%, p = .04) and stage III (69%-77%, <.01) from period A to B., Conclusion: AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer-related mortality., (© 2022 John Wiley & Sons Australia, Ltd.)

Background: International guidelines recommend combining a CDK4/6 inhibitor and endocrine therapy (ET) as first line treatment for hormone receptor (HR) positive, HER2 negative metastatic breast cancer (MBC). Results from MONALEESA-2 demonstrate superior progression free survival (PFS) and overall survival (OS) with ribociclib (CDK4/6 inhibitor) and ET compared to ET alone. Real world outcomes have yet to be reported., Materials and Methods: KARMA is a non-interventional registry of Australian patients receiving first-line treatment with ribociclib and aromatase inhibitor (AI), obtained via a Medicine Access Program (MAP) for HR+, HER2- MBC. Outcomes were compared with the ribociclib/letrozole cohort in MONALEESA-2., Results: Data from 160 patients at 17 sites was analysed. Median follow-up is 36.5 months. Compared to MONALEESA-2, patients were numerically younger (54.3 vs. 62 years), with higher rates of bone-only metastases (31% vs. 21%). A total of 63 of 160 (39%) patients remain on treatment. A total of 56% of patients had at least 1 dose reduction, with neutropenia (68%) and abnormal liver enzymes (17%) the most common reasons. A total of 17 of 160 (11%) discontinued treatment due to toxicity, with no treatment related deaths. Median PFS was not reached (95% CI 29.9- NR), with PFS at 12 months and 18 months being 76% and 67% respectively versus 25.3 months, 73% and 63% in MONALEESA-2., Conclusion: The ribociclib and AI combination was well tolerated in this real-world setting. The KARMA registry cohort achieved a superior PFS (>36.5 months) to MONALEESA-2, potentially due to more favourable baseline disease characteristics. Less frequent assessment scheduling in this non trial setting may also contribute., Competing Interests: Disclosure Vanessa Wong has received speaker honoraria from Amgen and Janssen, and her affiliated institution is the recipient of research grant funding from Pierre-Fabre, Amgen, Roche, MSD, AstraZeneca and Merck. Richard de Boer is on the Australian advisory board for Eli Lilly, Novartis and Pfizer, received speaker honoraria from Novartis and Eli Lilly, and research funding from Novartis and Pfizer. Katharine Cuff has received speaker honoraria from Novartis, is on the advisory board for Novartis, Pfizer and Ipsen, and is part of Amgen education support. Sheau Wen Lok's breast research team has received funding from Novartis, AstraZeneca, Roche and Amgen., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: RAS mutation testing now routinely informs the optimal management of metastatic colorectal cancer (mCRC), specifically the finding of a RAS mutation defines patients who will not benefit from treatment with an epidermal growth factor receptor inhibitor. Over time more RAS genes have been tested and more sensitive techniques used., Aims: To review routine care RAS testing and results over time., Methods: A retrospective analysis of the molecular data collected prospectively in the multi-site Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) registry from 2009 to 2018 was undertaken. Patients with RAS data were further analyzed. In parallel, the RAS mutation status of patients enrolled in the Test Tailor Treat (TTT) program was examined for 2011-2018., Results: Of 2908 patients in the TRACC registry, 1892 (65%) were tested, with 898 (47%) of tested patients found to be RAS mutant (RASmt). RAS data were available for 5935 TTT patients. Of the tested TRACC patients diagnosed in 2009 and 2010, 38% were RASmt. For each 2-year period from 2011/2012 through to 2017/2018, the prevalence of RASmt in TRACC and TTT was 42% and 40% (2011/2012), 52% and 40% (2013/2014), 47% and 49% (2015/2016), and 47% and 49% (2017/2018)., Conclusions: Based on both TRACC and TTT data, the proportion of patients reported to have a RAS mutation increased from 2009 to 2015 but has remained relatively stable in recent years. The increased proportion of RASmt patients observed over time is likely largely driven by the uptake of extended RAS testing., (© 2022 John Wiley & Sons Australia, Ltd.)

Background: Fecal occult blood test (FOBT)-based screening for colorectal cancer (CRC) reduces mortality, with earlier stage at diagnosis a prominent feature. Other characteristics of FOBT screen-detected cancers and any implications for clinical management have not been well explored., Methods: We examined a multisite clinical registry to compare the characteristics and outcomes of FOBT screen-detected CRC via the Australian National Bowel Cancer Screening Program (NBCSP), which is offered biennially to individuals aged 50-74 years, and age-matched non-screen-detected CRC in the same registry. All statistical tests were 2-sided. Odds ratios (ORs) were calculated using the Baptista-Pike method, and hazard ratios via the log-rank method., Results: Of 7153 registry patients diagnosed June 1, 2006, to June 30, 2020, 4142 (57.9%) were aged between 50 and 74 years. Excluding 406 patients with non-NBCSP screen-detected cancers and 35 patients with unknown method of detection, 473 (12.8%) were screen detected via the NBCSP, and 3228 (87.2%) were non-screen detected. Screen-detected patients were younger (mean age = 62.4 vs 64.2 years; P < .001) and more medically fit (OR for ASA score 1-2 = 1.91, 95% confidence interval [CI] = 1.51 to 2.41; P < .001). Pathologic characteristics within each stage favored the screen-detected patients. Stage III screen-detected colon cancers were more likely to receive adjuvant therapy (OR = 3.58, 95% CI = 1.52 to 8.36; P = .002). Screen-detected patients had superior relapse-free (hazard ratio = 0.41, 95% CI = 0.29 to 0.60; P < .001) and overall survival (hazard ratio = 0.22, 95% CI = 0.15 to 0.35; P < .001), which was maintained in matched stage comparisons and multivariable analysis., Conclusions: Beyond stage at diagnosis, multiple other factors associated with a favorable outcome are observed in FOBT screen-detected CRC. Given the substantial stage-by-stage differences in survival outcomes, if independently confirmed, individualized adjuvant therapy and surveillance strategies could be warranted for FOBT screen-detected cancers., (© The Author(s) 2022. Published by Oxford University Press.)

Aim: As therapeutic options for cancer evolve and become more complex, the concept of financial toxicity has emerged. The comprehensive score for financial toxicity (COST) and iMTA Productivity Cost questionnaires (iPCQ) represent two tools developed to measure the concept. The aim of this pilot study was to review the impact of financial toxicity in patients with cancer in an Australian public setting where there is a universal health care model., Methods: This pilot study utilized an exploratory, cross-sectional design in a single Australian large inner-city tertiary center. After providing written consent eligible patients, in an ambulatory setting, completed four self-reporting questionnaires, which were written in English (basic demographics, COST, iPCQ and the European Organization Research Treatment of Cancer Quality of Life Questionnaire-C30 [EORTC-QLQ-C30])., Results: Of 97 patients approached, 66 consented to participate. The median age was 63.5 years. Fifty-five percent were female. Fifty-three completed COST questionnaires. The median score for financial toxicity was 18 (range 1-42). Higher COST scores indicated greater financial concerns and were associated with poorer quality of life (P = .004). This was maintained after adjusting for confounders (age, gender, regional postcode.) Univariate analysis demonstrated younger age was associated with higher COST scores (P < .001), while gender (P = .243) and geographical location (P = .243) were not., Conclusions: In a cohort of patients receiving systemic cancer therapy in an Australian public setting, financial toxicity was associated with poorer quality of life. Despite a universal health-model, the COST questionnaire identified a substantial proportion of patients who experienced financial toxicity., (© 2020 John Wiley & Sons Australia, Ltd.)