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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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- 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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- Acharyya, A., et al.
(författare)
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Monte Carlo studies for the optimisation of the Cherenkov Telescope Array layout
- 2019
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Ingår i: Astroparticle physics. - : Elsevier. - 0927-6505 .- 1873-2852. ; 111, s. 35-53
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Tidskriftsartikel (refereegranskat)abstract
- The Cherenkov Telescope Array (CTA) is the major next-generation observatory for ground-based veryhigh-energy gamma-ray astronomy. It will improve the sensitivity of current ground-based instruments by a factor of five to twenty, depending on the energy, greatly improving both their angular and energy resolutions over four decades in energy (from 20 GeV to 300 TeV). This achievement will be possible by using tens of imaging Cherenkov telescopes of three successive sizes. They will be arranged into two arrays, one per hemisphere, located on the La Palma island (Spain) and in Paranal (Chile). We present here the optimised and final telescope arrays for both CTA sites, as well as their foreseen performance, resulting from the analysis of three different large-scale Monte Carlo productions.
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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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- Patil, S., et al.
(författare)
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ARPES view on surface and bulk hybridization phenomena in the antiferromagnetic Kondo lattice CeRh2Si2
- 2016
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The hybridization between localized 4f electrons and itinerant electrons in rare-earth-based materials gives rise to their exotic properties like valence fluctuations, Kondo behaviour, heavy-fermions, or unconventional superconductivity. Here we present an angle-resolved photoemission spectroscopy (ARPES) study of the Kondo lattice antiferromagnet CeRh2Si2, where the surface and bulk Ce-4f spectral responses were clearly resolved. The pronounced 4f0 peak seen for the Ce terminated surface gets strongly suppressed in the bulk Ce-4f spectra taken from a Si-terminated crystal due to much larger f-d hybridization. Most interestingly, the bulk Ce-4f spectra reveal a fine structure near the Fermi edge reflecting the crystal electric field splitting of the bulk magnetic 4f15/2 state. This structure presents a clear dispersion upon crossing valence states, providing direct evidence of f-d hybridization. Our findings give precise insight into f-d hybridization penomena and highlight their importance in the antiferromagnetic phases of Kondo lattices.
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- Campmier, Mark Joseph, et al.
(författare)
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Seasonally optimized calibrations improve low-cost sensor performance: long-term field evaluation of PurpleAir sensors in urban and rural India
- 2023
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Ingår i: Atmospheric Measurement Techniques. - 1867-1381 .- 1867-8548. ; 16:19, s. 4357-4374
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Tidskriftsartikel (refereegranskat)abstract
- Lower-cost air pollution sensors can fill critical air quality data gaps in India, which experiences very high fine particulate matter (PM2.5) air pollution but has sparse regulatory air monitoring. Challenges for low-cost PM2.5 sensors in India include high-aerosol mass concentrations and pronounced regional and seasonal gradients in aerosol composition. Here, we report on a detailed long-time performance evaluation of a popular sensor, the Purple Air PA-II, at multiple sites in India. We established three distinct sites in India across land use categories and population density extremes (in urban Delhi and rural Hamirpur in north India and urban Bengaluru in south India), where we collocated the PA-II model with reference beta attenuation monitors. We evaluated the performance of uncalibrated sensor data, and then developed, optimized, and evaluated calibration models using a comprehensive feature selection process with a view to reproducibility in the Indian context. We assessed the seasonal and spatial transferability of sensor calibration schemes, which is especially important in India because of the paucity of reference instrumentation. Without calibration, the PA-II was moderately correlated with the reference signal (R2Combining double low line 0.55-0.74) but was inaccurate (NRMSE ≥ 40 %). Relative to uncalibrated data, parsimonious annual calibration models improved the PurpleAir (PA) model performance at all sites (cross-validated NRMSE 20 %-30 %; R2Combining double low line 0.82-0.95), and greatly reduced seasonal and diurnal biases. Because aerosol properties and meteorology vary regionally, the form of these long-term models differed among our sites, suggesting that local calibrations are desirable when possible. Using a moving-window calibration, we found that using seasonally specific information improves performance relative to a static annual calibration model, while a short-term calibration model generally does not transfer reliably to other seasons. Overall, we find that the PA-II model can provide reliable PM2.5 data with better than ±25 % precision and accuracy when paired with a rigorous calibration scheme that accounts for seasonality and local aerosol composition.
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- Gupta, Alok C., et al.
(författare)
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Multiband optical variability of the blazar OJ 287 during its outbursts in 2015-2016
- 2017
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 465:4, s. 4423-4433
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Tidskriftsartikel (refereegranskat)abstract
- We present recent optical photometric observations of the blazar OJ 287 taken during 2015 September-2016 May. Our intense observations of the blazar started in 2015 November and continued until 2016 May and included detection of the large optical outburst in 2015 December that was predicted using the binary black hole model for OJ 287. For our observing campaign, we used a total of nine ground-based optical telescopes of which one is in Japan, one is in India, three are in Bulgaria, one is in Serbia, one is in Georgia, and two are in the USA. These observations were carried out in 102 nights with a total of similar to 1000 image frames in BVRI bands, though the majority were in the R band. We detected a second comparably strong flare in 2016 March. In addition, we investigated multiband flux variations, colour variations, and spectral changes in the blazar on diverse time-scales as they are useful in understanding the emission mechanisms. We briefly discuss the possible physical mechanisms most likely responsible for the observed flux, colour, and spectral variability.
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- Walton, KD, et al.
(författare)
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Hedgehog-responsive mesenchymal clusters direct patterning and emergence of intestinal villi
- 2012
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 109:39, s. 15817-15822
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Tidskriftsartikel (refereegranskat)abstract
- In the adult intestine, an organized array of finger-like projections, called villi, provide an enormous epithelial surface area for absorptive function. Villi first emerge at embryonic day (E) 14.5 from a previously flat luminal surface. Here, we analyze the cell biology of villus formation and examine the role of paracrine epithelial Hedgehog (Hh) signals in this process. We find that, before villus emergence, tight clusters of Hh-responsive mesenchymal cells form just beneath the epithelium. Cluster formation is dynamic; clusters first form dorsally and anteriorly and spread circumferentially and posteriorly. Statistical analysis of cluster distribution reveals a patterned array; with time, new clusters form in spaces between existing clusters, promoting approximately four rounds of villus emergence by E18.5. Cells within mesenchymal clusters express Patched1 and Gli1, as well as Pdgfrα, a receptor previously shown to participate in villus development. BrdU-labeling experiments show that clusters form by migration and aggregation of Hh-responsive cells. Inhibition of Hh signaling prevents cluster formation and villus development, but does not prevent emergence of villi in areas where clusters have already formed. Conversely, increasing Hh signaling increases the size of villus clusters and results in exceptionally wide villi. We conclude that Hh signals dictate the initial aspects of the formation of each villus by controlling mesenchymal cluster aggregation and regulating cluster size.
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- Walton, KD, et al.
(författare)
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Villification in the mouse: Bmp signals control intestinal villus patterning
- 2016
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Ingår i: Development (Cambridge, England). - : The Company of Biologists. - 1477-9129 .- 0950-1991. ; 143:3, s. 427-436
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Tidskriftsartikel (refereegranskat)abstract
- In the intestine, finger-like villi provide abundant surface area for nutrient absorption. During murine villus development, epithelial Hedgehog signals promote aggregation of sub-epithelial mesenchymal clusters that drive villus emergence. Clusters arise first dorsally and proximally and spread over the entire intestine within 24-hours, but the mechanism driving this pattern in the murine intestine is unknown. In the chick, the driver of cluster pattern is tensile force from developing smooth muscle, which generates deep longitudinal epithelial folds that locally concentrate the Hh signal, promoting localized expression of cluster genes. In contrast, we show that in the mouse, muscle-induced epithelial folding does not occur and artificial deformation of the epithelium does not determine the pattern of clusters or villi. In intestinal explants, modulation of Bmp signaling alters the spatial distribution of clusters and changes the pattern of emerging villi. Increasing Bmp signaling abolishes cluster formation while inhibiting Bmp signaling leads to merged clusters. These dynamic changes in cluster pattern are faithfully simulated by a mathematical model of a Turing field in which an inhibitor of Bmp signaling acts as the Turing activator. In vivo, genetic interruption of Bmp signal reception in either epithelium or mesenchyme reveals that Bmp signaling in Hh-responsive mesenchymal cells controls cluster pattern. Thus, unlike the chick, the murine villus patterning system is independent of muscle-induced epithelial deformation. Rather, a complex cocktail of Bmps and Bmp signal modulators secreted from mesenchymal clusters determines the pattern of villi in a manner that mimics the spread of a self-organizing Turing field.
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- Xu, Su-Yang, et al.
(författare)
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Lifshitz transition and Van Hove singularity in a three-dimensional topological Dirac semimetal
- 2015
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 92:7
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Tidskriftsartikel (refereegranskat)abstract
- A three-dimensional (3D) Dirac semimetal is a novel state of quantum matter which has recently attracted much attention as an apparent 3D version of graphene. In this paper, we report results on the electronic structure of the 3D Dirac semimetal Na3Bi at a surface that reveals its nontrivial ground state. Our studies reveal that the two 3D Dirac cones go through a topological change in the constant energy contour as a function of the binding energy, featuring a Lifshitz point, which is missing in a strict 3D analog of graphene. Our results identify an example of a band saddle-point singularity in 3D Dirac materials. This is in contrast to its two-dimensional analogs such as graphene and the Dirac surface states of a topological insulator. The observation of multiple Dirac nodes in Na3Bi connecting via a Lifshitz point along its crystalline rotational axis away from the Kramers point serves as a decisive signature for the symmetry-protected nature of the Dirac semimetal's topological bulk ground state.
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