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- 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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- 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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- Baharin, S. A. S., et al.
(författare)
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Wavelet Analysis of the Onset of VHF and Microwave Radiation Emitted by Lightning
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 297-300
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Konferensbidrag (refereegranskat)abstract
- Lightning flash is an electrical discharge in air (dielectric breakdown) which emits electromagnetic (FM) fields across very wide spectra from a few Hertz up to visible wavelength. Electrical breakdown process is an important event that initiates lightning. For electrical breakdown process to occur, it must fulfill two conditions which are at least has one free electron and the electric field region is more than 3 MV/m. This process starts with electron avalanche in millimeter scale then grows into streamer in centimeter scale. Lastly, from streamer it will grow into leader in meter scale. It has already established that streamer emits intensely at Very High Frequency (VHF) band as it's already proven both theoretically and experimentally. A study by Cooray, theoretically proved that emission of electron avalanche peaks at microwave band. Air-gap parallel plate antenna which could operate at 1 GHz with remote sensing is designed and simulated to measure the microwave radiation emitted by lightning. Both temporal and wavelet analyses are used to compare the onset of microwave radiation and VHF radiation in both time and frequency domains to determine electron avalanche appears at which electromagnetic band.
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- Ong, J. Y., et al.
(författare)
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Performance Analysis of Stacked Capacitive Antenna for Lightning Remote Sensing
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 305-308
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Konferensbidrag (refereegranskat)abstract
- Antennas are the important elements in the lightning detection system. To improve performance of the lightning detection system, it is so necessary to improve the efficiency of the antennas. There are two types of antennas used in the system which are capacitive antenna for electric field sensing and loop antenna for magnetic field sensing Pi. Both of these antennas arc big in size and causing inconvenient during set up. Thus, small and portable antennas are designed. It is so important to remain or improve the sensitivity of the antennas even though it is small in size. Stacking method is used in capacitive antenna by increase copper plate layer in between the parallel plate antenna. After prototype the multi stacked capacitive antenna, performance analysis is carried out. Performances of the antennas are compared using CST simulation and hardware set up. Multi-stacked capacitive antenna is compared with the single plate antenna and found that the performance of the antenna increases as the stacked number increases.
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- Sabri, M. H. M., et al.
(författare)
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Initial electric field changes of lightning flashes in tropical thunderstorms and their relationship to the lightning initiation mechanism
- 2019
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Ingår i: Atmospheric research. - : ELSEVIER SCIENCE INC. - 0169-8095 .- 1873-2895. ; 226, s. 138-151
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, the key finding is that all the examined first classic Initial Breakdown (IB) pulses in tropical flashes within the reversal distance were found to be initiated by a clearly detectable Initial E-field Change or IEC (45 -CG, 32 normal IC, and 3 IC initiated by +NBE). The durations of IECs for both -CG and IC flashes in tropical storms were longer than in Florida storms. On the other hand, for the magnitudes of the E-change, the values were smaller compared to Florida storms with averages of 0.30 V/m compared to 1.65 V/m for -CG flashes, and -0.81 V/m compared to -6.30 V/m for IC flashes. The IEC process of lightning flashes in tropical regions took longer to increase the local electric field in order to produce the first IB pulse because of the smaller magnitude of E-change. On the other hand, in Florida storms, the IEC process took a shorter time to increase the local electric field to produce the first IB pulse because of the larger magnitude of E-change. We found that very high frequency (VHF) pulses for tropical thunderstorms started sometime prior to the onset of the IECs. They started between 12.69 and 251.60 mu s before the initiation of the IEC for two normal IC flashes. The first two VHF pulses were detected alone without narrow IB pulses (fast antenna and slow antenna records) or any pulses from the B-field and dE/dt records. Furthermore, the VHF pulses for three IC flashes initiated by + NBEs were also detected before the onset of the IEC. The IEC started immediately after the detection of the + NBE. It is clear that the IEC is initiated by VHF pulses. It can be suggested that lightning is initiated by Fast Positive Breakdowns or FPBs (which emit strong VHF pulses and large + NBEs) and is followed by several negative breakdowns (weak VHF pulses and/or weak NBE-type pulses) before the IEC started. For the case of normal IC flashes, several weaker VHF pulses (mean values of 41.97 mV and 46.4 mV compared to the amplitudes of the VHF pulses of + NBEs of around 800 mV) were detected before the onset of the IEC. As FPBs can occur with a wide range of VHF strengths and E-change amplitudes, it can be suggested these weak VHF pulses accompanied by narrow IB pulses or weak NBE-type pulses detected before the onset of IEC are actually FPBs followed by negative breakdowns or several attempted FPBs.
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| 10. |
- Sabri, M. H. M., et al.
(författare)
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VHF Emissions Prior to the Onset of Initial Electric Field Changes of Intracloud Flashes
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 301-304
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Konferensbidrag (refereegranskat)abstract
- We present the observation of VHF impulses electric (E) field emissions found in two normal intracloud (IC) flashes accompanied by initial electric field changes (LECs) in a tropical thunderstorm. The data was collected on November 23rd, 2017 (within reversal distance) to our lightning sensor in Malacca, Malaysia. The durations from the onset of IECs to the first initial breakdown (IB) pulse are range between 0.68 and 0.69 ms and the magnitudes of IECs are range between 0.18 and 0.50 V/m. Besides that, before the onset of LECs there is small pulses was detected for IC flash (Nov_67) same with the VHF impulse for both IC flash. It was detected earlier before the onset of IEC by 12.69 and 251.60 mu s for the VHF impulse.
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