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- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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- Drake, TM, et al.
(author)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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In: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Journal article (peer-reviewed)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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- Shepherd, L., et al.
(author)
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Infection-related and -unrelated malignancies, HIV and the aging population
- 2016
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In: HIV Medicine. - : Wiley. - 1464-2662 .- 1468-1293. ; 17:8, s. 590-600
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Journal article (peer-reviewed)abstract
- Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60%); IURMs: 255 (40%)]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95% confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95% CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95% CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29% over a 5-year period from 3.1 (95% CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44% from 4.1 (95% CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.
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- Roelfsema, P. R., et al.
(author)
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In-orbit performance of Herschel-HIFI
- 2012
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 537
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Journal article (peer-reviewed)abstract
- Aims: In this paper the calibration and in-orbit performance of the Heterodyne Instrument for the Far-Infrared (HIFI) is described.Methods: The calibration of HIFI is based on a combination of ground and in-flight tests. Dedicated ground tests to determine those instrument parameters that can only be measured accurately using controlled laboratory stimuli were carried out in the instrument level test (ILT) campaign. Special in-flight tests during the commissioning phase (CoP) and performance verification (PV) allowed the determination of the remaining instrument parameters. The various instrument observing modes, as specified in astronomical observation templates (AOTs), were validated in parallel during PV by observing selected celestial sources.Results: The initial calibration and in-orbit performance of HIFI has been established. A first estimate of the calibration budget is given. The overall in-flight instrument performance agrees with the original specification. Issues remain at only a few frequencies. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.
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| 12. |
- Lis, D. C., et al.
(author)
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Herschel/HIFI discovery of interstellar chloronium (H2Cl+)
- 2010
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521:1
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Journal article (peer-reviewed)abstract
- We report the first detection of chloronium, H_2Cl^+, in the interstellar medium, using the HIFI instrument aboard the Herschel Space Observatory. The 2_12-1_01 lines of ortho-H\_2^35Cl^+ and ortho-H\_2^37Cl^+ are detected in absorption towards NGC 6334I, and the 1_11-0_00 transition of para-H\_2^35Cl^+ is detected in absorption towards NGC 6334I and Sgr B2(S). The H_2Cl^+ column densities are compared to those of the chemically-related species HCl. The derived HCl/H_2Cl^+ column density ratios, ~1-10, are within the range predicted by models of diffuse and dense photon dominated regions (PDRs). However, the observed H_2Cl^+ column densities, in excess of 10^13 cm^-2, are significantly higher than the model predictions. Our observations demonstrate the outstanding spectroscopic capabilities of HIFI for detecting new interstellar molecules and providing key constraints for astrochemical models.
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| 13. |
- Nisini, B., et al.
(author)
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Water cooling of shocks in protostellar outflows. Herschel-PACS map of L1157
- 2010
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L120-
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Journal article (peer-reviewed)abstract
- Context. The far-IR/sub-mm spectral mapping facility provided by the Herschel-PACS and HIFI instruments has made it possible to obtain, for the first time, images of H2O emission with a spatial resolution comparable to ground based mm/sub-mm observations. Aims: In the framework of the Water In Star-forming regions with Herschel (WISH) key program, maps in water lines of several outflows from young stars are being obtained, to study the water production in shocks and its role in the outflow cooling. This paper reports the first results of this program, presenting a PACS map of the o-H2O 179 μm transition obtained toward the young outflow L1157. Methods: The 179 μm map is compared with those of other important shock tracers, and with previous single-pointing ISO, SWAS, and Odin water observations of the same source that allow us to constrain the H2O abundance and total cooling. Results: Strong H2O peaks are localized on both shocked emission knots and the central source position. The H2O 179 μm emission is spatially correlated with emission from H2 rotational lines, excited in shocks leading to a significant enhancement of the water abundance. Water emission peaks along the outflow also correlate with peaks of other shock-produced molecular species, such as SiO and NH3. A strong H2O peak is also observed at the location of the proto-star, where none of the other molecules have significant emission. The absolute 179 μm intensity and its intensity ratio to the H2O 557 GHz line previously observed with Odin/SWAS indicate that the water emission originates in warm compact clumps, spatially unresolved by PACS, having a H2O abundance of the order of 10-4. This testifies that the clumps have been heated for a time long enough to allow the conversion of almost all the available gas-phase oxygen into water. The total H2O cooling is ~10-1 L_ȯ, about 40% of the cooling due to H2 and 23% of the total energy released in shocks along the L1157 outflow. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important partecipation from NASA.
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- Shipman, R., et al.
(author)
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Data processing pipeline for Herschel HIFI
- 2017
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 608, s. A49-
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Journal article (peer-reviewed)abstract
- Context. The HIFI instrument on the Herschel Space Observatory performed over 9100 astronomical observations, almost 900 of which were calibration observations in the course of the nearly four-year Herschel mission. The data from each observation had to be converted from raw telemetry into calibrated products and were included in the Herschel Science Archive. Aims. The HIFI pipeline was designed to provide robust conversion from raw telemetry into calibrated data throughout all phases of the HIFI missions. Pre-launch laboratory testing was supported as were routine mission operations. Methods. A modular software design allowed components to be easily added, removed, amended and / or extended as the understanding of the HIFI data developed during and after mission operations. Results. The HIFI pipeline processed data from all HIFI observing modes within the Herschel automated processing environment as well as within an interactive environment. The same software can be used by the general astronomical community to reprocess any standard HIFI observation. The pipeline also recorded the consistency of processing results and provided automated quality reports. Many pipeline modules were in use since the HIFI pre-launch instrument level testing. Conclusions. Processing in steps facilitated data analysis to discover and address instrument artefacts and uncertainties. The availability of the same pipeline components from pre-launch throughout the mission made for well-understood, tested, and stable processing. A smooth transition from one phase to the next significantly enhanced processing reliability and robustness.
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| 21. |
- Dimopoulos, M A, et al.
(author)
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Expert panel consensus statement on the optimal use of pomalidomide in relapsed and refractory multiple myeloma.
- 2014
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In: Leukemia. - : Springer Science and Business Media LLC. - 1476-5551 .- 0887-6924. ; 28:8, s. 1573-1585
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Research review (peer-reviewed)abstract
- In this report, a panel of European myeloma experts discuss the role of pomalidomide in the treatment of relapsed and refractory multiple myeloma (RRMM). Based on the available evidence, the combination of pomalidomide and low-dose dexamethasone is a well-tolerated and effective treatment option for patients with RRMM who have exhausted treatment with lenalidomide and bortezomib. The optimal starting dose of pomalidomide is 4 mg given on days 1-21 of each 28-day cycle, while dexamethasone is administered at a dose of 40 mg weekly (reduced to 20 mg for patients aged >75 years). The treatment should continue until evidence of disease progression or unacceptable toxicity. Dose-modification schemes have been established for patients who develop neutropenia, thrombocytopenia and other grade 3-4 adverse events during pomalidomide therapy. Guidance on the prevention and management of infections and venous thromboembolism are provided, based on the available clinical evidence and the experience of panel members. The use of pomalidomide in special populations, such as patients with advanced age, renal impairment or unfavourable cytogenetic features, is also discussed.Leukemia accepted article preview online, 5 February 2014; doi:10.1038/leu.2014.60.
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| 37. |
- Dimopoulos, Meletios A., et al.
(author)
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Safety and efficacy of pomalidomide plus low-dose dexamethasone in STRATUS (MM-010) : A phase 3b study in refractory multiple myeloma
- 2016
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In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 128:4, s. 497-503
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Journal article (peer-reviewed)abstract
- Patients with relapsed and/or refractory multiple myeloma (RRMM) have poor prognosis. The STRATUS study assessed safety and efficacy of pomalidomide plus low-dose dexamethasone in the largest cohort to date of patients with RRMM. Patients who failed treatment with bortezomib and lenalidomide and had adequate prior alkylator therapy were eligible. Pomalidomide 4 mg was given on days 1-21 of 28-day cycles with low-dose dexamethasone 40 mg (20 mg for patients aged >75 years) on days 1, 8, 15, and 22 until progressive disease or unacceptable toxicity. Safety was the primary end point; secondary end points included overall response rate (ORR), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Among 682 patients enrolled, median age was 66 years, and median time since diagnosis was 5.3 years. Median number of prior regimens was 5. Most patients were refractory to both lenalidomide and bortezomib (80.2%). Median follow-up was 16.8 months; median duration of treatment was 4.9 months. Most frequent grade 3/4 treatment-emergent adverse events were hematologic (neutropenia [49.7%], anemia [33.0%], and thrombocytopenia [24.1%]). Most common grade 3/4 nonhematologic toxicities were pneumonia (10.9%) and fatigue (5.9%). Grade 3/4 venous thromboembolism and peripheral neuropathy were rare (1.6% each). The ORR was 32.6%, and the median DOR was 7.4 months. Median PFS and OS were 4.6 months and 11.9 months, respectively. We present the largest trial to date evaluating pomalidomide plus low-dose dexamethasone in patients with RRMM, further confirming that this regimen offers clinically meaningful benefit and is generally well tolerated. www.Clinicaltrials.gov identifier NCT01712789.
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- Teyssier, D., et al.
(author)
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Herschel/HIFI In-flight commissioning and performance
- 2010
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In: 21st International Symposium on Space Terahertz Technology 2010, ISSTT 2010; Oxford; United Kingdom; 23 March 2010 through 25 March 2010. - 9781617823626 ; , s. 23-28
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Conference paper (peer-reviewed)abstract
- The Herschel Space Observatory was successfully launched on the 14th of May, 2009, lifting into space the Heterodyne Instrument for the Far-Infrared (HIFI). After the standard early orbit operations on the Space-craft, the instrument was switched on for the first time on the 24th of May, kicking off an instrument Commissioning period of more than a month and a half. We present here the outcome of this Commissioning campaign, including the measured in-flight performance of the instrument. Among the challenges encountered during this period was the need to optimize the stability of the signal provided by the Local Oscillator (LO) chains in some of the frequency bands, in particular that covering the singly Ionized Carbon (C+) line at the upper edge of the HIFI range, and one of the backbones of the science program of the instrument. The same concept also allowed significant improvements in the upper end of the 3b LO chain. Another noticeable achievement was the very good co-alignment measured between the mixer beams in the respective H and V polarizations offered by HIFI, allowing for more than a simple build-in redundancy, as the observing efficiency will really benefits from the combination of the two mixers.
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