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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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| 2. |
- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 3. |
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| 4. |
- 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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| 5. |
- Mamdouh, Moustafa, et al.
(författare)
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Authentication and Identity Management of IoHT Devices : Achievements, Challenges, and Future Directions
- 2021
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Ingår i: Computers & security (Print). - : Elsevier. - 0167-4048 .- 1872-6208. ; 111
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Forskningsöversikt (refereegranskat)abstract
- The Internet of Things (IoT) paradigm serves as an enabler technology in several domains. Healthcare is one of the domains in which the IoT plays a vital role in increasing quality of life. On the one hand, the Internet of Healthcare Things (IoHT) creates smart environments and increases the efficiency and intelligence of the provided services. On the other hand, unfortunately, it suffers from security vulnerabilities inside and outside. There are various techniques used to identify, access, and securely manage IoT devices. Additionally, sensors, monitoring, key confidentiality management, integrity, and sensitive data accessibility are required. This study focuses on the IoT perception layer and offers a comprehensive review of the IoHT or the Internet of Medical Things (IoMT). The paper covers the current trends and open challenges in IoHT device authentication mechanisms, such as the physically unclonable function (PUF) and blockchain-based techniques. In addition, IoT simulators and verification tools are included. Finally, a future vision regarding the evolution of IoHT device authentication in terms of the utilization of different technologies, such as artificial intelligence, cloud computing, and 5G, is provided at end of this review.
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| 6. |
- Mamdouh, Moustafa, et al.
(författare)
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Outlook on Security and Privacy in IoHT : Key Challenges and Future Vision
- 2020
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Ingår i: Proceedings of the International Conference on Artificial Intelligence and Computer Vision (AICV2020). - Cham : Springer. - 9783030442880 - 9783030442897 ; , s. 721-730
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The Internet of Things (IoT) security and privacy have received considerable research attention due to the IoT applicability in various domains. IoT systems have several applications, such as smart homes, smart cities, e-Health, industry, agriculture, and environmental monitoring. One of the most important applications is the Internet of Healthcare Things (IoHT) because it helps humans and patients obtain rapid diagnoses, remote monitoring, and home rehabilitation. IoHT security can be classified into four categories: applications, architecture, communication, and data security. This paper presents a short, but focused, review on IoHT security and privacy. It also explores recent security algorithms and protocols that are used to secure personal patient data, clinicians, and healthcare information. The future vision of IoHT challenges and countermeasures is given at the end of this study. Blockchain healthcare technology provides secure digital payment and privileged data access.
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