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- Ikuta, K. S., et al.
(författare)
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Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019
- 2022
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Ingår i: Lancet. - : Elsevier BV. - 0140-6736. ; 400:10369, s. 2221-2248
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Tidskriftsartikel (refereegranskat)abstract
- Background Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2.5th and 97.5th percentiles across 1000 posterior draws for each quantity of interest. Findings From an estimated 13.7 million (95% UI 10.9-17.1) infection-related deaths in 2019, there were 7.7 million deaths (5.7-10.2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13.6% (10.2-18.1) of all global deaths and 56.2% (52.1-60.1) of all sepsis-related deaths in 2019. Five leading pathogens-Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa-were responsible for 54.9% (52.9-56.9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185-285) per 100 000 population, and lowest in the high-income super-region, with 52.2 deaths (37.4-71.5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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- Baron, U, et al.
(författare)
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Epigenetic immune cell counting in human blood samples for immunodiagnostics
- 2018
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Ingår i: Science translational medicine. - : American Association for the Advancement of Science (AAAS). - 1946-6242 .- 1946-6234. ; 10:452
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Tidskriftsartikel (refereegranskat)abstract
- Epigenetic immune cell counting provides a potentially more robust platform to diagnose immune defects in adults and newborns.
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- Bin Asad, S M Sayeed, 1985-
(författare)
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Laser Based Flow Measurements to Evaluate Hydraulic Conditions for Migrating Fish and Benthic Fauna
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hydropower is one of the main sources for Sweden’s energy, which is clean and renewable. It is a clean energy source because no fuels are burned which does not pollute the air and it is a renewable energy source as it only uses natural water cycle for generating energy. However, hydropower has some consequences in nature, such as creating dams in rivers and changing water flow directions, which alters the natural behaviour of the river. These problems are mostly studied from a biological point of view but more detailed studies are required from a fundamental fluid mechanics point of view. For instance, fish migrates when an ecological imbalance is created and one of the reasons for this imbalance is having dams for hydropower that alter the natural flow of the river. This flow alteration of the river flow has other environmental effects such as flow alteration changes benthic (bottom) structure of the riverbed or stream that affects the fish and invertebrates. Fishes, as well as invertebrates, are adapted for different flows and habitats but flow alteration affects their life cycles. Therefore, flow measurements when the flow is altered due to the hydropower are one of the important issues concerning environmental problems. These flow measurements in the lab scale can increase the understanding of what happens in a river when the flow is altered.Flow characteristic measurements can provide quantitative information on the velocity distribution in the altered flow. Recent studies suggest that turbulence created due to flow alteration has a major effect on fish migration, for example, attracting fishes to enter fishway. This is why obtaining flow information from well-defined turbulent flows, such as flow past cylindrical objects is one of the prime objectives of work. However, flow alteration due to the dam for hydropower production has a significant environmental effect on the river ecosystem. Lotic species often adapt to prevailing flow conditions; and as a crude example, two species of caddis larvae: Hydropsyche instabilis and Plectrocnemia conspersa respectively are found to thrive on fast and slow-moving water flows. For some instances, changes in river velocity may merely mean the relocation of one species whilst the flourishing of another. Therefore, flow measurement in stones embedded riverbed in lab scale is another important objective of this work.Particle Image Velocimetry (PIV) and Laser Doppler Velocimetry (LDV) have become the most popular and promising techniques for these types of non-contact flow measurements. PIV techniques are used to visualize and measure the flow characteristic in a selected area while LDV techniques are suited for point-based measurement. The works included in this thesis are reviewing PIV techniques previously used in fish movement related studies, LDV measurements both at upstream (bow wake) and downstream wake of vertical cylindrical obstructions, Computational Fluid Dynamics (CFD) simulations to supplement wake information and PIV measurements over the horizontal semicircular cylinders to explore wall shear stress. Apart from this, flow visualization was also included in this work. The results from all these works can be useful to evaluate hydraulic conditions for migrating fish and benthic fauna.
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- Kranenbarg, Jelle, 1996-, et al.
(författare)
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Modeling an axial turbine: a parametric study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Numerical simulations of axial hydraulic turbines away from the best efficiency point are challenging. Especially previous studies show difficulties predicting the tangential velocity at part-load operating conditions where the swirl is high. Moreover, there is a lack of knowledge about the ability of eddy viscosity turbulence models to predict the runner inter-blades flow. Therefore, a parametric study is performed to address these points. Specifically, the effects of the blade clearance, blade angle, flow rate, and different turbulence models are studied on these issues. Results are analyzed by comparing the predicted axial and tangential velocity profiles and torque to experimentally obtained values. In addition, the physical phenomena responsible for head losses are studied in detail. Results show that the model can predict the flow relatively well at optimal flow conditions with low swirl but has problems at part load; the tangential velocity between the runner blades is underestimated by ~20%. The undervalued head losses are the root cause. They result in an overestimation of the axial velocity and an overestimation of the torque which is connected to the runner extracting too much swirl from the flow, hence the low tangential velocity. Furthermore, the blade clearance is found to be important as high-velocity jets that originate from the clearances affect the flow field, especially close to the hub. The torque prediction is also affected. Therefore, the clearance should be carefully measured during an experimental campaign, especially at the leading and trailing edge. A small modeling error of 0.5° in the blade angle and a change of 3% in the flow rate significantly affect the tangential velocity and torque prediction. The studied parameters must be considered carefully when building a numerical model. However, part of the deviation can also be explained by the insensitivity of eddy viscosity models to anisotropy, swirling flow with streamline curvature and runner mesh density.
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