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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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- Breedvelt, Josefien J. F., et al.
(författare)
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An individual participant data meta-analysis of psychological interventions for preventing depression relapse
- 2024
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Ingår i: Nature Mental Health. - 2731-6076. ; 2:2, s. 154-163
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Tidskriftsartikel (refereegranskat)abstract
- Major depressive disorder is a leading cause of disability worldwide; identifying effective strategies to prevent depression relapse is crucial. This individual participant data meta-analysis addresses whether and for whom psychological interventions can be recommended for relapse prevention of major depressive disorder. One- and two-stage individual patient data meta-analyses were conducted on 14 randomized controlled trials (N = 1,720). The relapse risk over 12 months was substantially lower for those who received a psychological intervention versus treatment as usual, antidepressant medication, or evaluation-only control (hazard ratio, 0.60; 95% confidence interval, 0.48–0.74). The number of previous depression episodes moderated the treatment effect, with psychological interventions demonstrating greater efficacy for patients with three or more previous episodes. Our results suggest that adding psychological interventions to current treatment to prevent depression relapse is recommended. For patients at lower risk of relapse, less-intensive approaches may be indicated.
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- Charpentier Ljungqvist, Fredrik, 1982-, et al.
(författare)
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Regional Patterns of Late Medieval and Early Modern European Building Activity Revealed by Felling Dates
- 2022
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Ingår i: Frontiers in Ecology and Evolution. - : Frontiers Media SA. - 2296-701X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Although variations in building activity are a useful indicator of societal well-being and demographic development, historical datasets for larger regions and longer periods are still rare. Here, we present 54,045 annually precise dendrochronological felling dates from historical construction timber from across most of Europe between 1250 and 1699 CE to infer variations in building activity. We use geostatistical techniques to compare spatiotemporal dynamics in past European building activity against independent demographic, economic, social and climatic data. We show that the felling dates capture major geographical patterns of demographic trends, especially in regions with dense data coverage. A particularly strong negative association is found between grain prices and the number of felling dates. In addition, a significant positive association is found between the number of felling dates and mining activity. These strong associations, with well-known macro-economic indicators from pre-industrial Europe, corroborate the use of felling dates as an independent source for exploring large-scale fluctuations of societal well-being and demographic development. Three prominent examples are the building boom in the Hanseatic League region of northeastern Germany during the 13th century, the onset of the Late Medieval Crisis in much of Europec. 1300, and the cessation of building activity in large parts of central Europe during armed conflicts such as the Thirty Years’ War (1618–1648 CE). Despite new insights gained from our European-wide felling date inventory, further studies are needed to investigate changes in construction activity of high versus low status buildings, and of urban versus rural buildings, and to compare those results with a variety of historical documentary sources and natural proxy archives.
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- Horváth, E., et al.
(författare)
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Investigation of mandelic acid bonding on Pirkle type chromatographic stationary phases by Raman spectroscopy
- 2000
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Ingår i: Journal of Chromatography A. - 0021-9673 .- 1873-3778. ; 893:1, s. 37-46
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Tidskriftsartikel (refereegranskat)abstract
- The bonding of mandelic acid enantiomers has been studied on benzene-leucine, dinitrobenzene-leucine and dinitrobenzene-phenylalanine type chiral stationary phases connected to zeolite A supports. The π-donor, π-acceptor and H-bonding interactions responsible for diastereomer pair formations can be studied under quasi in situ chromatographic conditions by Fourier transform Raman and surface enhanced Raman spectroscopic techniques. Structural differences between diastereomer pairs result in observable spectral differences at a phase load of approx. 50%. It was shown that the decreasing π-acceptor character of the phase is associated with its increasing capability of H-bond formation. Correlating spectral data to chromatographic results it can be concluded that, in addition to H-bonding as well as to π-donor-π-acceptor interactions, steric hindrances due to bulky moieties of either the stationary phase or the analyte molecules are of importance in successful separations.
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- Trompoukis, C., et al.
(författare)
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Photonic nanostructures for advanced light trapping in thin crystalline silicon solar cells
- 2015
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Ingår i: Physica Status Solidi (A) Applications and Materials Science. - : Wiley. - 1862-6319 .- 1862-6300. ; 212:1, s. 140-155
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Tidskriftsartikel (refereegranskat)abstract
- We report on the fabrication, integration, and simulation, both optical and optoelectrical, of two-dimensional photonic nanostructures for advanced light trapping in thin crystalline silicon (c-Si) solar cells. The photonic nanostructures are fabricated by the combination of various lithography (nanoimprint, laser interference, and hole mask colloidal) and etching (dry plasma and wet chemical) techniques. The nanopatterning possibilities thus range from periodic to random corrugations and from inverted nanopyramids to high aspect ratio profiles. Optically, the nanopatterning results in better performance than the standard pyramid texturing, showing a more robust behavior with respect to light incidence angle. Electrically, wet etching results in higher minority carrier lifetimes compared to dry etching. From the integration of the photonic nanostructures into a micron-thin c-Si solar cell certain factors limiting the efficiencies are identified. More precisely: (a) the parasitic absorption is limiting the short circuit current, (b) the conformality of thin-film coatings on the nanopatterned surface is limiting the fill factor, and (c) the material damage from dry etching is limiting the open circuit voltage. From optical simulations, the optimal pattern parameters are identified. From optoelectrical simulations, cell design considerations are discussed, suggesting to position the junction on the opposite side of the nanopattern.
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- Charpentier Ljungqvist, Fredrik, et al.
(författare)
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Linking European building activity with plague history
- 2018
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Ingår i: Journal of Archaeological Science. - : Elsevier BV. - 0305-4403 .- 1095-9238. ; 98, s. 81-92
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Tidskriftsartikel (refereegranskat)abstract
- Variations in building activity reflect demographic, economic and social change during history. Tens of thousands of wooden constructions in Europe have been dendrochronologically dated in recent decades. We use the annually precise evidence from a unique dataset of 49 640 tree felling dates of historical constructions to reconstruct temporal changes in building activity between 1250 and 1699 CE across a large part of western and central Europe largely corresponding to the former Holy Roman Empire of the German Nation. Comparison with annual records of 9772 plague outbreaks shows that construction activity was significantly negatively correlated to the number of plague outbreaks, with the greatest decrease in construction following the larger outbreaks by three to four years after the start of the epidemics. Preceding the Black Death (1346-1353 CE) by five decades and the Great Famine (1315-1322 CE) by two decades, a significant decline in construction activity at c. 1300 CE is indicative of a societal crisis, associated with population stagnation or decline. Another dramatic decline in building activity coincides with the Thirty Years' War (1618-1648 CE) and confirms the devastating nature of this conflict. While construction activity was significantly lower during periods of high grain prices, no statistically robust relationship between the number of felling dates and past temperature or hydroclimate variations is found. This study demonstrates the value of dendrochronological felling dates as an indicator for times of crisis and prosperity during periods when documentary evidence is limited.
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- Courtney, Aisling E, et al.
(författare)
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Living Donor Kidney Transplantation in Older Individuals: An Ethical Legal and Psychological Aspects of Transplantation (ELPAT) View.
- 2023
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Ingår i: Transplant international : official journal of the European Society for Organ Transplantation. - 1432-2277. ; 36
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Tidskriftsartikel (refereegranskat)abstract
- Living donor transplantation is the optimal treatment for suitable patients with end-stage kidney disease. There are particular advantages for older individuals in terms of elective surgery, timely transplantation, and early graft function. Yet, despite the superiority of living donor transplantation especially for this cohort, older patients are significantly less likely to access this treatment modality than younger age groups. However, given the changing population demographic in recent decades, there are increasing numbers of older but otherwise healthy individuals with kidney disease who could benefit from living donor transplantation. The complex reasons for this inequity of access are explored, including conscious and unconscious age-related bias by healthcare professionals, concerns relating to older living donors, ethical anxieties related to younger adults donating to aging patients, unwillingness of potential older recipients to consider living donation, and the relevant legislation. There is a legal and moral duty to consider the inequity of access to living donor transplantation, recognising both the potential disparity between chronological and physiological age in older patients, and benefits of this treatment for individuals as well as society.
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- Dor, Frank J M F, et al.
(författare)
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New classification of ELPAT for living organ donation.
- 2011
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Ingår i: Transplantation. - 1534-6080. ; 91:9, s. 935-8
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Tidskriftsartikel (refereegranskat)abstract
- In the literature, varying terminology for living organ donation can be found. However, there seems to be a need for a new classification to avoid confusion. Therefore, we assessed existing terminology in the light of current living organ donation practices and suggest a more straightforward classification. We propose to concentrate on the degree of specificity with which donors identify intended recipients and to subsequently verify whether the donation to these recipients occurs directly or indirectly. According to this approach, one could distinguish between "specified" and "unspecified" donation. Within specified donation, a distinction can be made between "direct" and "indirect" donation.
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- Javaheri, Anahita, et al.
(författare)
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Helicobacter pylori adhesin HopQ engages in a virulence-enhancing interaction with human CEACAMs
- 2017
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Ingår i: Nature Microbiology. - : NATURE PUBLISHING GROUP. - 2058-5276. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Helicobacter pylori specifically colonizes the human gastric epithelium and is the major causative agent for ulcer disease and gastric cancer development. Here, we identify members of the carcinoembryonic antigen-related cell adhesion molecule (CEACAM) family as receptors of H. pylori and show that HopQ is the surface-exposed adhesin that specifically binds human CEACAM1, CEACAM3, CEACAM5 and CEACAM6. HopQ-CEACAM binding is glycan-independent and targeted to the N-domain. H. pylori binding induces CEACAM1-mediated signalling, and the HopQ-CEACAM1 interaction enables translocation of the virulence factor CagA into host cells and enhances the release of pro-inflammatory mediators such as interleukin-8. Based on the crystal structure of HopQ, we found that a beta-hairpin insertion (HopQ-ID) in HopQ's extracellular 3+4 helix bundle domain is important for CEACAM binding. A peptide derived from this domain competitively inhibits HopQ-mediated activation of the Cag virulence pathway, as genetic or antibody-mediated abrogation of the HopQ function shows. Together, our data suggest the HopQ-CEACAM1 interaction to be a potentially promising novel therapeutic target to combat H. pylori-associated diseases.
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