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Sökning: WFRF:(Gosling S. N.)

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  • Ademuyiwa, Adesoji O., et al. (författare)
  • Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
  • 2016
  • Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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  • Stepniewska, Kasia, et al. (författare)
  • Efficacy of single dose primaquine with artemisinin combination therapy on P. falciparum gametocytes and transmission : A WWARN individual patient meta-analysis.
  • 2020
  • Ingår i: Journal of Infectious Diseases. - 0022-1899 .- 1537-6613.
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Since the World Health Organization recommended single low-dose (0.25mg/kg) primaquine (PQ) in combination with artemisinin-based combination therapies (ACTs) in areas of low transmission or artemisinin-resistant P. falciparum, several single-site studies have been conducted to assess its efficacy.METHODS: An individual patient meta-analysis to assess the gametocytocidal and transmission-blocking efficacy of PQ used in combination with different ACTs was conducted. Random effects logistic regression was used to quantify PQ effect on (i) gametocyte carriage in the first two weeks post-treatment; (ii) the probability of infecting at least one mosquito or of a mosquito becoming infected.RESULTS: In 2,574 participants from fourteen studies, PQ reduced PCR-determined gametocyte carriage on days 7 and 14, most apparently in patients presenting with gametocytaemia on day 0 (Odds Ratio (OR)=0.22; 95%CI 0.17-0.28 and OR=0.12; 95%CI 0.08-0.16, respectively). The rate of decline in gametocyte carriage was faster when PQ was combined with artemether-lumefantrine (AL) compared to dihydroartemisinin-piperaquine (DP) (p=0.010 for day 7). Addition of 0.25mg/kg PQ was associated with near complete prevention of transmission to mosquitoes.CONCLUSION: Primaquine's transmission-blocking effects are achieved with 0.25 mg/kg PQ. Gametocyte persistence and infectivity are lower when PQ is combined with AL compared to DP.
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  • Vanderkelen, I., et al. (författare)
  • Global Heat Uptake by Inland Waters
  • 2020
  • Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 47:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Heat uptake is a key variable for understanding the Earth system response to greenhouse gas forcing. Despite the importance of this heat budget, heat uptake by inland waters has so far not been quantified. Here we use a unique combination of global‐scale lake models, global hydrological models and Earth system models to quantify global heat uptake by natural lakes, reservoirs, and rivers. The total net heat uptake by inland waters amounts to 2.6 ± 3.2 ×1020 J over the period 1900–2020, corresponding to 3.6% of the energy stored on land. The overall uptake is dominated by natural lakes (111.7%), followed by reservoir warming (2.3%). Rivers contribute negatively (‐14%) due to a decreasing water volume. The thermal energy of water stored in artificial reservoirs exceeds inland water heat uptake by a factor ∼10.4. This first quantification underlines that the heat uptake by inland waters is relatively small, but non‐negligible.
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  • McMichael, C. N. H., et al. (författare)
  • 30,000 years of landscape and vegetation dynamics in a mid-elevation Andean valley
  • 2021
  • Ingår i: Quaternary Science Reviews. - 0277-3791 .- 1873-457X. ; 258
  • Tidskriftsartikel (refereegranskat)abstract
    • The mid-elevation settings of the Andes are important biodiversity hotspots, yet little is known of their long-term ecology or environmental change. Here, we assess 30,000 years of landscape and vegetation dynamics on an alluvial terrace located in a mid-elevation valley of the Ecuadorian Andes (Campo Libre). We used loss-on-ignition and particle size analysis to reconstruct past river dynamics, charcoal analysis to reconstruct past fire regimes, and phytolith analysis to reconstruct vegetation change through time. Our results show that Campo Libre was a part of the active floodplain system of the Quijos River until 18,000 cal yr BP. The biggest vegetation change in vegetation at Campo Libre occurred ca. 13,000 cal yr BP, when the site warmed and dried, transforming the swampy alluvial terrace into a palm forest. As Ho-locene precipitation increased, the site transformed back into a swamp around 7500 cal yr BP, and it remained that way until maize agriculture began around 4600 cal yr BP. Local and regional fires were absent from the system until regional fires were detected ca. 3300 cal yr BP. By ca. 2700 cal yr BP, maize cultivation became frequent and regular. Climate, tectonic activity, and the human history have shaped the modern vegetation around Campo Libre, although during different periods of the Holocene. Our results demonstrate the ability of phytoliths to reconstruct vegetation change through time, and show that the mid-elevation Andean valley systems were highly dynamic over the last 30,000 years.
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