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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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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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- Aldehani, Mohammed, et al.
(författare)
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Kinetics and reactive stripping modelling of hydrogen isotopic exchange of deuterated waters
- 2016
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Ingår i: Chemical Engineering and Processing. - : Elsevier BV. - 0255-2701 .- 1873-3204. ; 108, s. 58-73
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Tidskriftsartikel (refereegranskat)abstract
- This work presents results of experimental kinetics and modelling of the isotopic exchange between hydrogen and water in a reactive stripping column for water dedeuteriation. The missing physical properties of deuterium and tritium isotopologues in hydrogen gas and water forms were predicted and validated using existing literature data. The kinetic model relevant to a styrene-divinyl-benzene copolymer-supported platinum catalyst was used for modelling, by Aspen plus modular package, impact of design parameters including temperature, total pressure, gas to liquid flowrate ratio, pressure drop and flow mixing, on the separation of deuterium and further the separation of tritium. The modelling by the rate-based non-equilibrium, including design correlations of model of mass and heat transfers, chemical kinetic constants, mass transfer coefficients and overall exchange rate constants, allowed access to separation trends in a good agreement with published data. The synergy between the rates of chemical isotopic exchange and gas/liquid mass transfer, and by inference the performance of reactive stripping, was particularly sensitive to high temperatures, low hydrogen flow rates, pressure drops and internals properties. Extension to tritium confirmed a slightly slower mass transport compared with deuterium leading to potentially under-estimated design features for detritiation processing when deuterium is used instead.
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- Alzahrani, Faris, et al.
(författare)
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Gas Flow Visualization in Low Aspect Ratio Packed Beds by Three-Dimensional Modeling and Near-Infrared Tomography
- 2015
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Ingår i: Industrial & Engineering Chemistry Research. - : American Chemical Society (ACS). - 0888-5885 .- 1520-5045. ; 54:51, s. 12714-12729
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Tidskriftsartikel (refereegranskat)abstract
- Nonuniform local flow inside randomly porous media of gas solid packed beds of low aspect ratios ranging from 1.5 to 5 was investigated by three-dimensional modeling and near-infrared tomography. These beds are known to demonstrate heterogeneous mixing and uneven distributions of mass and heat. The effects of the confining wall on flow dynamics were found nonlinear, particularly for aspect ratios lower than 3. High velocities were mainly observed in regions near the wall of aspect ratio value of 1.5 and those of values higher than 3, owing to high local porosities in these zones. Mass dispersion characterized both by experimental near-infrared imaging and by particle tracking showed discrepancies with literature models, particularly for aspect ratios lower than 3. Uncertainties were more significant with the radial dispersion due to bed size limits. Beyond this value, the wall affected more the axial dispersion, confirming the nonlinear impact of the wall on global hydrodynamics.
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- Fisher, Oliver M., et al.
(författare)
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Hyperthermic intraperitoneal chemotherapy in colorectal cancer
- 2024
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Ingår i: BJS Open. - : Oxford University Press. - 2474-9842. ; 8:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients.Patients and Methods: Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received-oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed.Results: Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period.Conclusions: Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported.
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- Khan, Mohd. Tasleem, et al.
(författare)
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Two Distributed Arithmetic Based High Throughput Architectures of Non-Pipelined LMS Adaptive Filters
- 2022
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Ingår i: IEEE Access. - : Institute of Electrical and Electronics Engineers (IEEE). - 2169-3536. ; 10, s. 76693-76706
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Tidskriftsartikel (refereegranskat)abstract
- Distributed arithmetic (DA) is an efficient look-up table (LUT) based approach. The throughput of DA based implementation is limited by the LUT size. This paper presents two high-throughput architectures (Type I and II) of non-pipelined DA based least-mean-square (LMS) adaptive filters (ADFs) using twos complement (TC) and offset-binary coding (OBC) respectively. We formulate the LMS algorithm using the steepest descent approach with possible extension to its power-normalized LMS version and followed by its convergence properties. The coefficient update equation of LMS algorithm is then transformed via TC DA and OBC DA to design and develop non-pipelined architectures of ADFs. The proposed structures employ the LUT pre-decomposition technique to increase the throughput performance. It enables the same mapping scheme for concurrent update of the decomposed LUTs. An efficient fixed-point quantization model for the evaluation of proposed structures from a realistic point-of-view is also presented. It is found that Type II structure provides higher throughput than Type I structure at the expense of slow convergence rate with almost the same steady-state mean square error. Unlike existing non-pipelined LMS ADFs, the proposed structures offer very high throughput performance, especially with large order DA base units. Furthermore, they are capable of performing less number of additions in every filter cycle. Based on the simulation results, it is found that 256th order filter with 8th order DA base unit using Type I structure provides 9 :41 x higher throughput while Type II structure provides 16 :68 x higher throughput as compared to the best existing design. Synthesis results show that 32nd order filter with 8th order DA base unit using Type I structure achieves 38 :76% less minimum sampling period (MSP), occupies 28 :62% more area, consumes 67 :18% more power, utilizes 49 :06% more slice LUTs and 3 :31% more flip-flops (FFs), whereas Type II structure achieves 51 :25% less MSP, occupies 21 :42% more area, consumes 47 :84% more power, utilizes 29 :10% more slice LUTs and 1 :47% fewer FFs as compared to the best existing design.
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