| 1. |
- 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. |
- Sid Ahmed, Mazen, 1970-, et al.
(författare)
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Association of blaVIM-2, blaPDC-35, blaOXA-10, blaOXA-488 and blaVEB-9 β-Lactamase Genes with Resistance to Ceftazidime-Avibactam and Ceftolozane-Tazobactam in Multidrug-Resistant Pseudomonas aeruginosa
- 2022
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Ingår i: Antibiotics. - : MDPI. - 2079-6382. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Ceftazidime-avibactam and ceftolozane-tazobactam are approved for the treatment of complicated Gram-negative bacterial infections including multidrug-resistant (MDR) Pseudomonas aeruginosa. Resistance to both agents has been reported, but the underlying mechanisms have not been fully explored. This study aimed to correlate β-lactamases with phenotypic resistance to ceftazidime-avibactam and/or ceftolozane-tazobactam in MDR-P. aeruginosa from Qatar. A total of 525 MDR-P. aeruginosa isolates were collected from clinical specimens between 2014 and 2017. Identification and antimicrobial susceptibility were performed by the BD PhoenixTM system and gradient MIC test strips. Of the 75 sequenced MDR isolates, 35 (47%) were considered as having difficult-to-treat resistance, and 42 were resistant to ceftazidime-avibactam (37, 49.3%), and/or ceftolozane-tazobactam (40, 53.3%). They belonged to 12 sequence types, with ST235 being predominant (38%). Most isolates (97.6%) carried one or more β-lactamase genes, with blaOXA-488 (19%) and blaVEB-9 (45.2%) being predominant. A strong association was detected between class B β-lactamase genes and both ceftazidime-avibactam and ceftolozane-tazobactam resistance, while class A genes were associated with ceftolozane-tazobactam resistance. Co-resistance to ceftazidime-avibactam and ceftolozane-tazobactam correlated with the presence of blaVEB-9, blaPDC-35, blaVIM-2, blaOXA-10 and blaOXA-488. MDR-P. aeruginosa isolates resistant to both combination drugs were associated with class B β-lactamases (blaVIM-2) and class D β-lactamases (blaOXA-10), while ceftolozane-tazobactam resistance was associated with class A (blaVEB-9), class C (blaVPDC-35), and class D β-lactamases (blaOXA-488).
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| 3. |
- Abdul Salam, Parveena Shamim, et al.
(författare)
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Disease contagion models coupled to crowd motion and mesh-free simulation
- 2021
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Ingår i: Mathematical Models and Methods in Applied Sciences. - : World Scientific. - 0218-2025. ; 31:6, s. 1277-1295
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Tidskriftsartikel (refereegranskat)abstract
- Modeling and simulation of disease spreading in pedestrian crowds have recently become a topic of increasing relevance. In this paper, we consider the influence of the crowd motion in a complex dynamical environment on the course of infection of the pedestrians. To model the pedestrian dynamics, we consider a kinetic equation for multi-group pedestrian flow based on a social force model coupled with an Eikonal equation. This model is coupled with a non-local SEIS contagion model for disease spread, where besides the description of local contacts, the influence of contact times has also been modeled. Hydrodynamic approximations of the coupled system are derived. Finally, simulations of the hydrodynamic model are carried out using a mesh-free particle method. Different numerical test cases are investigated, including uni- and bi-directional flow in a passage with and without obstacles.
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| 4. |
- Ali, Nurshad, et al.
(författare)
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Association between arsenic exposure and plasma cholinesterase activity : a population based study in Bangladesh
- 2010
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Ingår i: Environmental Health. - : BioMed Central (BMC). - 1476-069X. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Arsenic is a potent pollutant that has caused an environmental catastrophe in certain parts of the world including Bangladesh where millions of people are presently at risk due to drinking water contaminated by arsenic. Chronic arsenic exposure has been scientifically shown as a cause for liver damage, cancers, neurological disorders and several other ailments. The relationship between plasma cholinesterase (PChE) activity and arsenic exposure has not yet been clearly documented. However, decreased PChE activity has been found in patients suffering liver dysfunction, heart attack, cancer metastasis and neurotoxicity. Therefore, in this study, we evaluated the PChE activity in individuals exposed to arsenic via drinking water in Bangladesh.Methods: A total of 141 Bangladeshi residents living in arsenic endemic areas with the mean arsenic exposure of 14.10 ± 3.27 years were selected as study subjects and split into tertile groups based on three water arsenic concentrations: low (< 129 μg/L), medium (130-264 μg/L) and high (> 265 μg/L). Study subjects were further sub-divided into two groups (≤50 μg/L and > 50 μg/L) based on the recommended upper limit of water arsenic concentration (50 μg/L) in Bangladesh. Blood samples were collected from the study subjects by venipuncture and arsenic concentrations in drinking water, hair and nail samples were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). PChE activity was assayed by spectrophotometer.Results: Arsenic concentrations in hair and nails were positively correlated with the arsenic levels in drinking water. Significant decreases in PChE activity were observed with increasing concentrations of arsenic in water, hair and nails. The average levels of PChE activity in low, medium and high arsenic exposure groups were also significantly different between each group. Lower levels of PChE activity were also observed in the > 50 μg/L group compared to the ≤50 μg/L group. Moreover, PChE activity was significantly decreased in the skin (+) symptoms group compared to those without (-).Conclusions: We found a significant inverse relationship between arsenic exposure and PChE activity in a human population in Bangladesh. This research demonstrates a novel exposure-response relationship between arsenic and PChE activity which may explain one of the biological mechanisms through which arsenic exerts its neuro-and hepatotoxicity in humans.
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| 5. |
- Bheel, Naraindas, et al.
(författare)
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A comprehensive study on the impact of human hair fiber and millet husk ash on concrete properties: response surface modeling and optimization
- 2024
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Ingår i: Scientific Reports. - : Nature Research. - 2045-2322. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Revolutionizing construction, the concrete blend seamlessly integrates human hair (HH) fibers and millet husk ash (MHA) as a sustainable alternative. By repurposing human hair for enhanced tensile strength and utilizing millet husk ash to replace sand, these materials not only reduce waste but also create a durable, eco-friendly solution. This groundbreaking methodology not only adheres to established structural criteria but also advances the concepts of the circular economy, representing a significant advancement towards environmentally sustainable and resilient building practices. The main purpose of the research is to investigate the fresh and mechanical characteristics of concrete blended with 10–40% MHA as a sand substitute and 0.5–2% HH fibers by applying response surface methodology modeling and optimization. A comprehensive study involved preparing 225 concrete specimens using a mix ratio of 1:1.5:3 with a water-to-cement ratio of 0.52, followed by a 28 day curing period. It was found that a blend of 30% MHA and 1% HH fibers gave the best compressive and splitting tensile strengths at 28 days, which were 33.88 MPa and 3.47 MPa, respectively. Additionally, the incorporation of increased proportions of MHA and HH fibers led to reductions in both the dry density and workability of the concrete. In addition, utilizing analysis of variance (ANOVA), response prediction models were created and verified with a significance level of 95%. The models' R2 values ranged from 72 to 99%. The study validated multi-objective optimization, showing 1% HH fiber and 30% MHA in concrete enhances strength, reduces waste, and promotes environmental sustainability, making it recommended for construction.
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| 6. |
- Bhutto, Shahzeb, et al.
(författare)
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Effect of banana tree leaves ash as cementitious material on the durability of concrete against sulphate and acid attacks
- 2024
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Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- The construction industry's rapid growth poses challenges tied to raw material depletion and increased greenhouse gas emissions. To address this, alternative materials like agricultural residues are gaining prominence due to their potential to reduce carbon emissions and waste generation. In this context this research optimizes the use of banana leaves ash as a partial cement substitution, focusing on durability, and identifying the ideal cement-to-ash ratio for sustainable concrete. For this purpose, concrete mixes were prepared with BLA replacing cement partially in different proportions i.e. (0 %, 5 %, 10 %, 15 %, & 20 %) and were analyzed for their physical, mechanical and Durability (Acid and Sulphate resistance) properties. Compressive strength, acid resistance and sulphate resistance testing continued for 90 days with the intervals of 7, 28 and 90 days. The results revealed that up to 10 % incorporation of BLA improved compressive strength by 10 %, while higher BLA proportions (up to 20 %) displayed superior performance in durability tests as compared to the conventional mix. The results reveal the potentials of banana leave ash to refine the concrete matrix by formation of addition C–S–H gel which leads towards a better performance specially in terms of durability aspect. Hence, banana leaf ash (BLA) is an efficient concrete ingredient, particularly up to 10 % of the mix. Beyond this threshold, it's still suitable for applications where extreme strength isn't the primary concern, because there may be a slight reduction in compressive strength.
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| 7. |
- Canoy, Dexter, et al.
(författare)
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Antihypertensive drug effects on long-term blood pressure : an individual-level data meta-analysis of randomised clinical trials
- 2022
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Ingår i: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 108:16, s. 1281-1289
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Evidence from randomised trials of pharmacological treatments on long-term blood pressure (BP) reduction is limited. We investigated the antihypertensive drug effects on BP over time and across different participant characteristics.Methods: We conducted an individual patient-level data meta-analysis of 52 large-scale randomised clinical trials in the Blood Pressure Lowering Treatment Trialists' Collaboration using mixed models to examine treatment effects on BP over 4 years of mean follow-up.Results: There were 363 684 participants (42% women), with baseline mean age=65 years and mean systolic/diastolic BP=152/87 mm Hg, and among whom 19% were current smokers, 49% had cardiovascular disease, 28% had diabetes and 69% were taking antihypertensive treatment at baseline. Drugs were effective in lowering BP showing maximal effect after 12 months and gradually attenuating towards later years. Based on measures taken >= 12 months postrandomisation, mean systolic/diastolic BP difference (95% CI) between more and less intense BP-lowering treatment was -11.1 (-11.3 to -10.8)/-5.6 (-5.7 to -5.4) mm Hg; between active treatment and placebo was -5.1 (-5.3 to -5.0)/-2.3 (-2.4 to -2.2) mm Hg; and between active and control arms for drug comparison trials was -1.4 (-1.5 to -1.3)/-0.6 (-0.7 to -0.6) mm Hg. BP reductions were observed across different baseline BP values and ages, and by sex, history of cardiovascular disease and diabetes and prior antihypertensive treatment use.Conclusion: These findings suggest that BP-lowering pharmacotherapy is effective in lowering BP, up to 4 years on average, in people with different characteristics. Appropriate treatment strategies are needed to sustain substantive long-term BP reductions.
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| 8. |
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| 9. |
- El Ansari, Walid, et al.
(författare)
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Is achieving the guidelines of four forms of physical activity associated with less self-reported health complaints? : Cross-sectional study of undergraduates at the University of Turku, Finland
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:15, s. 1-19
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Tidskriftsartikel (refereegranskat)abstract
- Very little research has assessed the physical activity (PA) of university students in in Finland, and their associations with self-reported health complaints (HCs), whilst simultaneously accounting for a range of other potential confounders. Students at the University of Turku (1177) completed an online health and wellbeing questionnaire that assessed 22 physical and somatic HCs, and students’ achievement of the international guidelines of four forms of PA (moderate, vigorous, moderate-to-vigorous and muscle strengthening PA; MPA, VPA, MVPA, MSPA respectively). We also explored the associations between HCs and PA, controlling for sociodemographic and health confounders (age, sex, year of study, marital status, accommodation during semesters, health awareness). Factor analysis reduced the HCs into three factors (psychological, pains/aches, circulatory/breathing). Bivariate relationships (no controlling for confounders) between these 3 factors and four forms of PA guideline achievement showed significant effects of achieving the PA guidelines against various groups of HCs, where more strenuous PA was associated with significantly less HCs in a step-ladder pattern. Multiple regression analyses (controlling for confounders) showed that achievement of PA guidelines was significantly independently associated with self-reported HCs scores in most cases. Psychological HCs were negatively associated with achieving any type of PA; pains/aches were negatively associated with achieving two types of PA or with achieving MSPA guidelines; and circulatory/breathing HCs were negatively associated with achieving the VPA guidelines only. This is the first study in Finland to examine such relationships, and highlights the critical role of PA for the health of these young adults. Programs and policies to strengthen and improve the PA of university students would be beneficial, recognizing the benefits of instilling life-long PA habits among this group of young adults.
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| 10. |
- El Ansari, Walid, et al.
(författare)
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Is alcohol consumption associated with poor perceived academic performance? : Survey of undergraduates in Finland
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:4
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between academic performance and alcohol consumption among students remains inconsistent. We assessed this relationship, controlling for sociodemographic characteristics across seven faculties at the University of Turku (1177 undergraduates). An online questionnaire assessed: seven sociodemographic characteristics (age, gender, year/discipline of study, accommodation type, being in intimate relationship, parental education, and income sufficiency); two perceived academic performance (students’ subjective importance of achieving good grades and students’ appraisal of their academic performance compared to peers); and six alcohol consumption behaviors (length of time, amount consumed, frequency, heavy episodic drinking, problem drinking, and possible alcohol dependence). Simple logistic regression assessed relationships between sociodemographic and academic variables with alcohol consumption behaviors; multiple logistic regression assessed the same relationships after controlling for all other variables. Students reported long duration and large amount of drinking (46% and 50%), high frequency of drinking (41%), heavy episodic drinking (66%), problem drinking (29%), and possible alcohol dependence (9%). After controlling, gender was associated with all alcohol consumption behaviors, followed by religiosity (associated with four alcohol behaviors), living situation, marital status, age (each associated with two alcohol behaviors), and parental education and year of study (each associated with one alcohol behavior). Study discipline, income sufficiency, importance of achieving good grades, and academic performance compared to peers were not associated with any alcohol behaviors. Universities need to assess problem drinking and alcohol use disorders among students. Prevention strategies are required to reduce risk. Health promotion efforts could focus on beliefs and expectations about alcohol and target student groups at risk for more efficient and successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
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