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- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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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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| 6. |
- 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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- Mirza, Jawad, et al.
(författare)
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Modeling and analysis of single-mode widely tunable all-fiber Ho-doped CW master oscillator power amplifier system
- 2024
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Ingår i: Physica Scripta. - : Institute of Physics Publishing (IOPP). - 0031-8949 .- 1402-4896. ; 99:8
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Tidskriftsartikel (refereegranskat)abstract
- We report the design of an all-fiber single-mode polarization maintaining widely tunable Ho-doped master oscillator power amplifier (MOPA) system operating in the wavelength range of 2005-2135 nm based on a pre-amplifier and two power amplification stages. The single clad Ho-doped active fibers in the ring cavity based master oscillator, pre-amplifier, and power amplifiers are pumped using 1950 nm semiconductor laser diode pump sources. The amplification of the MOPA system is investigated over the entire spectral range of 2005-2135 nm. The highest output power achieved by the continuous wave (CW) Ho-doped MOPA system is 43 W at a wavelength of 2028.6 nm using pump power of 20 W with power conversion efficiency (PCE) of 90% for second power amplifier while the total pump power of Ho-doped MOPA system is 45 W. Optical bandpass filters (OBPFs) are employed between different stages of MOPA system to enable amplification over the wider spectral range of 2005-2135 nm by suppressing the amplified spontaneous emission (ASE). Not using OBPFs results in amplification that is limited to the spectral range of 2045-2130 nm. Therefore, a penalty of 45 nm can be avoided at the expense of using the OBPFs between different stages of MOPA system. This flexible MOPA system can be used in multiple applications, especially for space-borne high power transmitters operating in atmospheric transmission windows.
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| 9. |
- Mirza, Jawad, et al.
(författare)
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Pair induced quenching in high concentration Holmium-doped fiber amplifiers
- 2024
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Ingår i: Physica Scripta. - : Institute of Physics Publishing (IOPP). - 0031-8949 .- 1402-4896. ; 99:5
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Tidskriftsartikel (refereegranskat)abstract
- The spectrum required for future optical communication systems is being extended towards the C-, L- and U-bands, resulting in a significant interest in the spectral region around 2 μm wavelength. Since Holmium doped fiber amplifiers (HDFAs) provide amplification in this spectral region, they have become a focus of researchers working on doped fiber amplifiers. A major factor resulting in the performance degradation of HDFAs is the inhomogeneous energy transfer within Ho3+ ion-pairs in high-concentration Holmium-doped fibers (HDFs), an effect generally known as pair-induced quenching (PIQ). In this paper, we study the luminal and temporal dynamics of pulses of different repetition rates at 2.05 μm in high-concentration HDFs considering the effects of ion-pairs. Input pulses having repetition rates of 25 GHz and 500 kHz are generated using wavelength tunable actively mode-locked Holmium-doped fiber laser (AML-HDFL) based on a single ring cavity and bidirectional pumping. The characteristics of the pulses propagating through high-concentration HDF are analyzed based on different metrics such as average power, peak power, pulse energy, full-width at half maximum (FWHM), and time delay without and with ion-pairs for values of fraction of ion-pairs k = 0 and k = 10%, respectively. The results obtained at optimized length of HDF show that ion-pairs significantly degrade the average power, peak power, and energy of the output pulses for both of the repetition rates. For both k = 0 and k = 10%, the FWHM and shape of the output pulses remain same in the presence of the ion-pairs while, time delay of 4 ps and 19 ns is observed in the output pulses at repetition rates of 25 GHz and 500 kHz, respectively. The effects of increasing the pump and signal power on the average power and energy of the output pulses for k = 0 and k = 10% are also discussed for both repetition rates. This analysis provides important guidelines for designers of 2 μm fiber lasers and amplifiers based on high-concentration HDFs.
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- Mirza, Jawad, et al.
(författare)
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Underwater temperature and pressure monitoring for deep-sea SCUBA divers using optical techniques
- 2024
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Ingår i: Frontiers in Physics. - : Frontiers Media S.A.. - 2296-424X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- The safety of SCUBA divers remains at high risk in deep-sea owing to multiple factors such as dangerous surrounding, rely upon technical equipment necessary for life support, decreased underwater navigation, and communication infrastructure. Gradual decrease and increase in water temperature and pressure corresponding to depth are among the most common problems that cause most of the fatalities in deep-sea diving. Therefore, different gadgets for accurate measurement of vital parameters, reliable navigation, and seamless communication are of prime importance. In this paper, we propose an all-optical technique for local and remote monitoring of underwater temperature and pressure for deep-sea SCUBA divers based on fiber Bragg grating (FBG) sensors and underwater optical communication-single mode fiber (UWOC-SMF) integrated transmission system. The proposed technique is implemented using two FBG temperature and pressure sensors fixed over diver's suit and UWOC-SMF integrated transmission system for simultaneous local and remote monitoring of underwater temperature and pressure. Remote monitoring of underwater temperature and pressure is achieved at ship station through a remotely operated underwater vehicle (ROV) and UWOC-SMF integrated transmission system by means of shifts in the original Bragg wavelengths of sensors due to temperature and pressure variations. The performance of the sensors is analyzed for pressure and temperature in the range of 0 to 6.4 MPa ( approximate to 0 to 655 m H 2 O ) and 40 to -2 degrees C, respectively corresponding to different depths. The results show that the proposed technique can work well in the deep ocean over a range of pressures and temperatures of 0-7 MPa and 40 to -2 degrees C while achieving a temperature sensitivity of 4.3 p.m./degrees C and a pressure sensitivity of 30.5 p.m./MPa. Clear spectra of reflected signals from FBG sensors at ship station are achieved after signal transmission over UWOC-SMF hybrid link.
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