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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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| 4. |
- Guiriec, S., et al.
(författare)
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TOWARD A BETTER UNDERSTANDING OF THE GRB PHENOMENON : A NEW MODEL FOR GRB PROMPT EMISSION AND ITS EFFECTS ON THE NEW L-i(NT)-E-peak,i(rest,NT) RELATION
- 2015
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 807:2
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Tidskriftsartikel (refereegranskat)abstract
- Gamma-ray burst (GRB) prompt emission spectra in the keV-MeV energy range are usually considered to be adequately fitted with the empirical Band function. Recent observations with the Fermi Gamma-ray Space Telescope (Fermi) revealed deviations from the Band function, sometimes in the form of an additional blackbody (BB) component, while on other occasions in the form of an additional power law (PL) component extending to high energies. In this article we investigate the possibility that the three components may be present simultaneously in the prompt emission spectra of two very bright GRBs (080916C and 090926A) observed with Fermi, and how the three components may affect the overall shape of the spectra. While the two GRBs are very different when fitted to a single Band function, they look like "twins" in the three-component scenario. Through fine-time spectroscopy down to the 100 ms timescale, we follow the evolution of the various components. We succeed in reducing the number of free parameters in the three-component model, which results in a new semi-empirical model-but with physical motivations-to be competitive with the Band function in terms of number of degrees of freedom. From this analysis using multiple components, the Band function is globally the most intense component, although the additional PL can overpower the others in sharp time structures. The Band function and the BB component are the most intense at early times and globally fade across the burst duration. The additional PL is the most intense component at late time and may be correlated with the extended high-energy emission observed thousands of seconds after the burst with Fermi/Large Area Telescope. Unexpectedly, this analysis also shows that the additional PL may be present from the very beginning of the burst, where it may even overpower the other components at low energy. We investigate the effect of the three components on the new time-resolved luminosity-hardness relation in both the observer and rest frames and show that a strong correlation exists between the flux of the non-thermal Band function and its E-peak only when the three components are fitted simultaneously to the data (i.e., F-i(NT)-E-peak,i(NT) relation). In addition, this result points toward a universal relation between those two quantities when transposed to the central engine rest frame for all GRBs (i.e., L-i(NT)-E-peak,i(rest,NT) relation). We discuss a possible theoretical interpretation of the three spectral components within this new empirical model. We suggest that (i) the BB component may be interpreted as the photosphere emission of a magnetized relativistic outflow, (ii) the Band component has synchrotron radiation in an optically thin region above the photosphere, either from internal shocks or magnetic field dissipation, and (iii) the extra PL component extending to high energies likely has an inverse Compton origin of some sort, even though its extension to a much lower energy remains a mystery.
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| 5. |
- Guiriec, S., et al.
(författare)
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Evidence for a photospheric component in the prompt emission of the short grb 120323a and its effects on the grb hardness-luminosity relation
- 2013
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 770:1, s. 32-
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Tidskriftsartikel (refereegranskat)abstract
- The short GRB 120323A had the highest flux ever detected with the Gamma-Ray Burst Monitor on board the Fermi Gamma-Ray Space Telescope. Here we study its remarkable spectral properties and their evolution using two spectral models: (1) a single emission component scenario, where the spectrum is modeled by the empirical Band function (a broken power law), and (2) a two-component scenario, where thermal (a Planck-like function) emission is observed simultaneously with a non-thermal component (a Band function). We find that the latter model fits the integrated burst spectrum significantly better than the former, and that their respective spectral parameters are dramatically different: when fit with a Band function only, the E peak of the event is unusually soft for a short gamma-ray burst (GRB; 70 keV compared to an average of 300 keV), while adding a thermal component leads to more typical short GRB values (E peak 300 keV). Our time-resolved spectral analysis produces similar results. We argue here that the two-component model is the preferred interpretation for GRB 120323A based on (1) the values and evolution of the Band function parameters of the two component scenario, which are more typical for a short GRB, and (2) the appearance in the data of a significant hardness-intensity correlation, commonly found in GRBs, when we employee two-component model fits; the correlation is non-existent in the Band-only fits. GRB 110721A, a long burst with an intense photospheric emission, exhibits the exact same behavior. We conclude that GRB 120323A has a strong photospheric emission contribution, observed for the first time in a short GRB. Magnetic dissipation models are difficult to reconcile with these results, which instead favor photospheric thermal emission and fast cooling synchrotron radiation from internal shocks. Finally, we derive a possibly universal hardness-luminosity relation in the source frame using a larger set of GRBs (), which could be used as a possible redshift estimator for cosmology.
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