| 1. |
- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- 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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| 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. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 6. |
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| 7. |
- Al-Ali, Fatima, et al.
(författare)
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Attitudes Towards Artificial Intelligence Among Dermatologists Working in Saudi Arabia.
- 2023
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Ingår i: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Artificial intelligence (AI) and its applications are among the most discussed modern technologies today. Despite the rapidly expanding use of AI in medicine, and specifically in dermatology, only a few studies have studied the attitude of physicians toward AI.To recognize the attitudes towards AI among dermatologists in the Kingdom of Saudi Arabia.A cross-sectional survey was done among dermatologists in Saudi Arabia. Questionnaires were distributed through several online channels.Overall, 103 dermatologists filled out the survey. The majority saw very strong or strong potential for AI in the automated detection of skin diseases based on dermatological clinical images (50.9%), dermoscopic images (66.6%) and within dermatopathology (66.6%). In regard to results of attitudes towards AI, 56.6% and 52. 8% agreed that AI will revolutionize medicine and dermatology, respectively. However, many of the respondents disagreed that AI will replace physicians (41.5%) and human dermatologists (39.6%) in the future. Age did not impact the overall attitude of dermatologists.Dermatologists in Saudi Arabia showed an optimistic attitude towards AI in dermatology and medicine. However, dermatologists believe that AI will not replace humans in the future.
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| 8. |
- Al Sam, Ali, et al.
(författare)
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Evaluation of sub grid scale and local wall models in Large-eddy simulations of separated flow
- 2015
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Ingår i: 2nd Symposium on OpenFOAM® in Wind Energy. - : EDP Sciences. ; 5
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Konferensbidrag (refereegranskat)abstract
- The performance of the Sub Grid Scale models is studied by simulating a separated flow over a wavy channel. The first and second order statistical moments of the resolved velocities obtained by using Large-Eddy simulations at different mesh resolutions are compared with Direct Numerical Simulations data. The effectiveness of modeling the wall stresses by using local log-law is then tested on a relatively coarse grid. The results exhibit a good agreement between highly-resolved Large Eddy Simulations and Direct Numerical Simulations data regardless the Sub Grid Scale models. However, the agreement is less satisfactory with relatively coarse grid without using any wall models and the differences between Sub Grid Scale models are distinguishable. Using local wall model returned the basic flow topology and reduced significantly the differences between the coarse meshed Large-Eddy Simulations and Direct Numerical Simulations data. The results show that the ability of local wall model to predict the separation zone depends strongly on its implementation way.
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| 12. |
- Al Sam, Ali, et al.
(författare)
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The effect of moving waves on neutral marine atmospheric boundary layer
- 2014
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Ingår i: First Symposium on OpenFOAM® in Wind Energy. - : EDP Sciences. ; 2:01003
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Konferensbidrag (refereegranskat)abstract
- Large eddy simulations are performed to study the effects of wind-wave direction misalignment of the neutral marine atmospheric boundary layer over a wavy wall. The results show that the wind-wave misalignment has a significant effect on the velocity profiles and the pressure fluctuation over the wave surface. These effects are not confined to the near wave surface region but extend over the whole atmospheric surface layer.
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| 13. |
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| 14. |
- Al Sam, Ali, et al.
(författare)
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The Influence of Sea Waves on Offshore Wind Turbine Aerodynamics
- 2015
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Ingår i: Journal of Energy Resources Technology. - : ASME International. - 1528-8994 .- 0195-0738. ; 137:5
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Tidskriftsartikel (refereegranskat)abstract
- The impacts of swells on the atmospheric boundary layer (ABL) flows and by this on the standalone offshore wind turbine (WT) performance are investigated by using large eddy simulations (LES) and actuator-line techniques. At high swell to wind speed ratio, the swell-induced stress reduces the total wind stress resulting in higher wind velocity, less wind shear, and lower turbulence intensity level. These effects increase by increasing swell to wind speed ratio (C/U) and/or swell steepness. Moreover, for the same hub-height wind speed (U-hub), the presence of swells increases the turbine power extraction rate by about 3% and 8.4% for C/U-hub = 1.53 and 2.17, respectively.
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| 15. |
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| 16. |
- Al Sam, Ali
(författare)
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Wind-wave interaction effects on offshore wind energy
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is devoted to the investigation of the impacts of fast moving ocean surface waves on the aerodynamics of offshore wind turbines. The impacts of non-locally generated waves (swell) on the Marine Atmospheric BoundaryLayer (MABL) and thereby on offshore wind turbine aerodynamics are studied numerically by using Large Eddy Simulations and the Actuator Line Method.The MABL is often interacting with ocean surface waves causing mass, heat and momentum exchange between the air and the underlying waves’ surface. Due to this coupling between the MABL and the surface waves, the MABL differs from boundary layer over land. The effects of ocean waves on the MABL are believed to be small and usually taken into account as a roughness height when offshore wind farms are designed. This roughness height is commonlytreated either as a constant or as a function of the friction velocity without regard to its dependency on the sea state (i.e. the waves’ height, slope and velocity). However, recent field observations and numerical simulations have shown that the impact of the waves, in particularly swell, on the MABL might be stronger than previously assumed. Wave statistics show that the earth’s oceans are strongly dominated by swell waves almost all the time. Hence, abetter understanding of swell effects on the MABL would provide a valuable information that can lead to improve: the offshore wind turbine design, the layout of offshore wind farms and the accuracy of wind farm power extractionrate estimations.The results presented in this thesis show that the swell impacts on the MABL are significant. By comparing the MABL over moving waves to that over flat surface (calm sea), the effects of swell are isolated from the effects of atmospheric turbulence. The wave-induced stress reduces the total wind stress resulting in higher wind velocity, less wind shear and lower turbulence intensity level. These effects increase by increasing the wave age and/or wave steepness. These modifications in the MABL in the presence of fast moving swells propagating in the direction of the local wind invalidate the use of the Monin–Obukhov Similarity Theory widely used in wind energy applications and indicate that the extrapolation of a wind speed measured at a certain height to another height assuming a logarithmic wind speed profile is questionable in the presence of swell. Moreover, the results show that fast moving waves have pronounced effects on wind turbine aerodynamics. Longer wind turbine wake regions and weaker velocity deficits downstream a stand-alone wind turbine with higher power extraction rates are obtained in the presence of swell. More remarkably, higher overall power extraction rates are obtained from a 2 by 2 wind farm in the presence of swell for the same hub-height wind velocity.
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| 17. |
- Escaned, Javier, et al.
(författare)
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Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes
- 2018
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Ingår i: JACC. - : Elsevier. - 1936-8798 .- 1876-7605. ; 11:15, s. 1437-1449
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to assess physiological significance. In deferred patients presenting with ACS, the event rate was significantly increased compared with SAP at 1 year. (C) 2018 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.
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