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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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- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
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Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
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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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- Prentice, S. J., et al.
(författare)
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SN 2016coi/ASASSN-16fp : an example of residual helium in a type Ic supernova?
- 2018
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 478:3, s. 4162-4192
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Tidskriftsartikel (refereegranskat)abstract
- The optical observations of Ic-4 supernova (SN) 2016coi/ASASSN-16fp, from similar to 2 to similar to 450 d after explosion, are presented along with analysis of its physical properties. The SN shows the broad lines associated with SNe Ic-3/4 but with a key difference. The early spectra display a strong absorption feature at similar to 5400 angstrom which is not seen in other SNe Ic-3/4 at this epoch. This feature has been attributed to He I in the literature. Spectral modelling of the SN in the early photospheric phase suggests the presence of residual He in a C/O dominated shell. However, the behaviour of the He I lines is unusual when compared with He-rich SNe, showing relatively low velocities and weakening rather than strengthening over time. The SN is found to rise to peak similar to 16 d after core-collapse reaching a bolometric luminosity of L-p similar to 3 x 10(42) erg s(-1). Spectral models, including the nebular epoch, show that the SN ejected 2.5-4M(circle dot) of material, with similar to 1.5M(circle dot) below 5000 km s(-1), and with a kinetic energy of (4.5-7) x 10(51) erg. The explosion synthesized similar to 0.14M(circle dot) of Ni-56. There are significant uncertainties in E(B - V)(host) and the distance, however, which will affect L-p and M-Ni. SN 2016coi exploded in a host similar to the Large Magellanic Cloud (LMC) and away from star-forming regions. The properties of the SN and the host-galaxy suggest that the progenitor had M-ZAMS of 23-28M(circle dot) and was stripped almost entirely down to its C/O core at explosion.
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18. |
- Sakamoto, T., et al.
(författare)
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IDENTIFYING THE LOCATION IN THE HOST GALAXY OF THE SHORT GRB 111117A WITH THE CHANDRA SUBARCSECOND POSITION
- 2013
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 766:1, s. 41-
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Tidskriftsartikel (refereegranskat)abstract
- We present our successful Chandra program designed to identify, with subarcsecond accuracy, the X-ray afterglow of the short GRB 111117A, which was discovered by Swift and Fermi. Thanks to our rapid target of opportunity request, Chandra clearly detected the X-ray afterglow, though no optical afterglow was found in deep optical observations. The host galaxy was clearly detected in the optical and near-infrared band, with the best photometric redshift of z = 1.31(-0.23)(+0.46) (90% confidence), making it one of the highest known short gamma-ray burst ( GRB) redshifts. Furthermore, we see an offset of 1.0 +/- 0.2 arcsec, which corresponds to 8.4 +/- 1.7 kpc, between the host and the afterglow position. We discuss the importance of using Chandra for obtaining subarcsecond X-ray localizations of short GRB afterglows to study GRB environments.
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19. |
- Ridker, P. M., et al.
(författare)
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Antiinflammatory therapy with canakinumab for atherosclerotic disease
- 2017
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Ingår i: New England Journal of Medicine. - 0028-4793. ; 377:12, s. 1119-1131
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). CONCLUSIONS: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. Copyright © 2017 Massachusetts Medical Society.
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20. |
- Traylor, Matthew, et al.
(författare)
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Genetic basis of lacunar stroke : a pooled analysis of individual patient data and genome-wide association studies
- 2021
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Ingår i: The Lancet Neurology. - 1474-4422. ; 20:5, s. 351-361
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Tidskriftsartikel (refereegranskat)abstract
- Background: The genetic basis of lacunar stroke is poorly understood, with a single locus on 16q24 identified to date. We sought to identify novel associations and provide mechanistic insights into the disease. Methods: We did a pooled analysis of data from newly recruited patients with an MRI-confirmed diagnosis of lacunar stroke and existing genome-wide association studies (GWAS). Patients were recruited from hospitals in the UK as part of the UK DNA Lacunar Stroke studies 1 and 2 and from collaborators within the International Stroke Genetics Consortium. Cases and controls were stratified by ancestry and two meta-analyses were done: a European ancestry analysis, and a transethnic analysis that included all ancestry groups. We also did a multi-trait analysis of GWAS, in a joint analysis with a study of cerebral white matter hyperintensities (an aetiologically related radiological trait), to find additional genetic associations. We did a transcriptome-wide association study (TWAS) to detect genes for which expression is associated with lacunar stroke; identified significantly enriched pathways using multi-marker analysis of genomic annotation; and evaluated cardiovascular risk factors causally associated with the disease using mendelian randomisation. Findings: Our meta-analysis comprised studies from Europe, the USA, and Australia, including 7338 cases and 254 798 controls, of which 2987 cases (matched with 29 540 controls) were confirmed using MRI. Five loci (ICA1L-WDR12-CARF-NBEAL1, ULK4, SPI1-SLC39A13-PSMC3-RAPSN, ZCCHC14, ZBTB14-EPB41L3) were found to be associated with lacunar stroke in the European or transethnic meta-analyses. A further seven loci (SLC25A44-PMF1-BGLAP, LOX-ZNF474-LOC100505841, FOXF2-FOXQ1, VTA1-GPR126, SH3PXD2A, HTRA1-ARMS2, COL4A2) were found to be associated in the multi-trait analysis with cerebral white matter hyperintensities (n=42 310). Two of the identified loci contain genes (COL4A2 and HTRA1) that are involved in monogenic lacunar stroke. The TWAS identified associations between the expression of six genes (SCL25A44, ULK4, CARF, FAM117B, ICA1L, NBEAL1) and lacunar stroke. Pathway analyses implicated disruption of the extracellular matrix, phosphatidylinositol 5 phosphate binding, and roundabout binding (false discovery rate <0·05). Mendelian randomisation analyses identified positive associations of elevated blood pressure, history of smoking, and type 2 diabetes with lacunar stroke. Interpretation: Lacunar stroke has a substantial heritable component, with 12 loci now identified that could represent future treatment targets. These loci provide insights into lacunar stroke pathogenesis, highlighting disruption of the vascular extracellular matrix (COL4A2, LOX, SH3PXD2A, GPR126, HTRA1), pericyte differentiation (FOXF2, GPR126), TGF-β signalling (HTRA1), and myelination (ULK4, GPR126) in disease risk. Funding: British Heart Foundation.
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21. |
- Brown, P.G., et al.
(författare)
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The Hamburg meteorite fall : Fireball trajectory, orbit, and dynamics
- 2019
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Ingår i: Meteoritics and Planetary Science. - : John Wiley & Sons. - 1086-9379 .- 1945-5100. ; 54:9, s. 2027-2045
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Tidskriftsartikel (refereegranskat)abstract
- The Hamburg (H4) meteorite fell on 17 January 2018 at 01:08 UT approximately 10 km north of Ann Arbor, Michigan. More than two dozen fragments totaling under 1 kg were recovered, primarily from frozen lake surfaces. The fireball initial velocity was 15.83 ± 0.05 km s−1, based on four independent records showing the fireball above 50 km altitude. The radiant had a zenith angle of 66.14 ± 0.29° and an azimuth of 121.56 ± 1.2°. The resulting low inclination (<1°) Apollo‐type orbit has a large aphelion distance and Tisserand value relative to Jupiter (Tj) of ~3. Two major flares dominate the energy deposition profile, centered at 24.1 and 21.7 km altitude, respectively, under dynamic pressures of 5–7 MPa. The Geostationary Lightning Mapper on the Geostationary Operational Environmental Satellite‐16 also detected the two main flares and their relative timing and peak flux agree with the video‐derived brightness profile. Our preferred total energy for the Hamburg fireball is 2–7 T TNT (8.4–28 × 109 J), which corresponds to a likely initial mass in the range of 60–225 kg or diameter between 0.3 and 0.5 m. Based on the model of Granvik et al. (2018), the meteorite originated in an escape route from the mid to outer asteroid belt. Hamburg is the 14th known H chondrite with an instrumentally derived preatmospheric orbit, half of which have small (<5°) inclinations making connection with (6) Hebe problematic. A definitive parent body consistent with all 14 known H chondrite orbits remains elusive.
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- Jacobs, Jeffrey P., et al.
(författare)
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Combining Congenital Heart Surgical and Interventional Cardiology Outcome Data in a Single Database : The Development of a Patient-Centered Collaboration of the European Congenital Heart Surgeons Association (ECHSA) and the Association for European Paediatric and Congenital Cardiology (AEPC)
- 2023
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Ingår i: World Journal for Pediatric and Congenital Heart Surgery. - 2150-1351. ; 14:4, s. 464-473
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Tidskriftsartikel (refereegranskat)abstract
- The European Congenital Heart Surgeons Association (ECHSA) Congenital Database (CD) is the second largest clinical pediatric and congenital cardiac surgical database in the world and the largest in Europe, where various smaller national or regional databases exist. Despite the dramatic increase in interventional cardiology procedures over recent years, only scattered national or regional databases of such procedures exist in Europe. Most importantly, no congenital cardiac database exists in the world that seamlessly combines both surgical and interventional cardiology data on an international level; therefore, the outcomes of surgical and interventional procedures performed on the same or similar patients cannot easily be tracked, assessed, and analyzed. In order to fill this important gap in our capability to gather and analyze information on our common patients, ECHSA and The Association for European Paediatric and Congenital Cardiology (AEPC) have embarked on a collaborative effort to expand the ECHSA-CD with a new module designed to capture data about interventional cardiology procedures. The purpose of this manuscript is to describe the concept, the structure, and the function of the new AEPC Interventional Cardiology Part of the ECHSA-CD, as well as the potentially valuable synergies provided by the shared interventional and surgical analyses of outcomes of patients. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow centers to have access to robust surgical and transcatheter outcome data from their own center, as well as robust national and international aggregate outcome data for benchmarking. Each contributing center or department will have access to their own data, as well as aggregate data from the AEPC Interventional Cardiology Part of the ECHSA-CD. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow cardiology centers to have access to aggregate cardiology data, just as surgical centers already have access to aggregate surgical data. Comparison of surgical and catheter interventional outcomes could potentially strengthen decision processes. A study of the wealth of information collected in the database could potentially also contribute toward improved early and late survival, as well as enhanced quality of life of patients with pediatric and/or congenital heart disease treated with surgery and interventional cardiac catheterization across Europe and the world.
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24. |
- Jacobs, Jeffrey P., et al.
(författare)
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Combining Congenital Heart Surgical and Interventional Cardiology Outcome Data in a Single Database : The Development of a Patient-Centered Collaboration of the European Congenital Heart Surgeons Association (ECHSA) and the Association for European Paediatric and Congenital Cardiology (AEPC)
- 2023
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Ingår i: Cardiology in the Young. - 1047-9511. ; 33:7, s. 1043-1059
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Tidskriftsartikel (refereegranskat)abstract
- The European Congenital Heart Surgeons Association (ECHSA) Congenital Database (CD) is the second largest clinical pediatric and congenital cardiac surgical database in the world and the largest in Europe, where various smaller national or regional databases exist. Despite the dramatic increase in interventional cardiology procedures over recent years, only scattered national or regional databases of such procedures exist in Europe. Most importantly, no congenital cardiac database exists in the world that seamlessly combines both surgical and interventional cardiology data on an international level; therefore, the outcomes of surgical and interventional procedures performed on the same or similar patients cannot easily be tracked, assessed, and analyzed. In order to fill this important gap in our capability to gather and analyze information on our common patients, ECHSA and The Association for European Paediatric and Congenital Cardiology (AEPC) have embarked on a collaborative effort to expand the ECHSA-CD with a new module designed to capture data about interventional cardiology procedures. The purpose of this manuscript is to describe the concept, the structure, and the function of the new AEPC Interventional Cardiology Part of the ECHSA-CD, as well as the potentially valuable synergies provided by the shared interventional and surgical analyses of outcomes of patients. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow centers to have access to robust surgical and transcatheter outcome data from their own center, as well as robust national and international aggregate outcome data for benchmarking. Each contributing center or department will have access to their own data, as well as aggregate data from the AEPC Interventional Cardiology Part of the ECHSA-CD. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow cardiology centers to have access to aggregate cardiology data, just as surgical centers already have access to aggregate surgical data. Comparison of surgical and catheter interventional outcomes could potentially strengthen decision processes. A study of the wealth of information collected in the database could potentially also contribute toward improved early and late survival, as well as enhanced quality of life of patients with pediatric and/or congenital heart disease treated with surgery and interventional cardiac catheterization across Europe and the world.
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25. |
- Lin, Chung-Ying, et al.
(författare)
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Psychometric evaluation of the Persian Internet Disorder Scale among adolescents.
- 2018
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Ingår i: Journal of Behavioral Addictions. - : Akademiai Kiado. - 2062-5871 .- 2063-5303. ; 7:3, s. 665-675
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Given the growing epidemiological research interest concerning Internet addiction, brief instruments with a robust theoretical basis are warranted. The Internet Disorder Scale (IDS-15) is one such instrument that can be used to quickly assess the Internet addiction in an individual. However, only two language versions of the IDS-15 have been developed. This study translated the IDS-15 into Persian and examined its psychometric properties using comprehensive psychometric testing.METHODS: After ensuring the linguistic validity of the Persian IDS-15, 1,272 adolescents (mean age = 15.53 years; 728 males) completed the IDS-15, Depression Anxiety Stress Scale (DASS), Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and the Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis (CFA), Rasch models, regression analysis, and latent profile analysis (LPA) were carried out to test the psychometric properties of the Persian IDS-15.RESULTS: Both CFA and Rasch supported the construct validity of the Persian IDS-15. Multigroup analysis in CFA and differential item functioning in Rasch indicated that male and female adolescents interpreted the IDS-15 items similarly. Regression analysis showed that the IDS-15 correlated with IGDS9-SF and BSMAS (ΔR2 = .12 and .36, respectively) is stronger than the DASS (ΔR2 = .03-.05). LPA based on IDS-15 suggests three subgroups for the sample. Significant differences in depression, anxiety, IGDS9-SF, and BSMAS were found among the three LPA subgroups.CONCLUSION: The Persian IDS-15 has robust psychometric properties as evidenced by both classical test theory and Rasch analysis.
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26. |
- Roettenbacher, Rachael M., et al.
(författare)
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The Connection between Starspots and Flares on Main-sequence Kepler Stars
- 2018
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 868:1
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Tidskriftsartikel (refereegranskat)abstract
- Starspots and flares are indicators of stellar magnetic activity and can both be studied in greater detail by utilizing the long-term, space-based archive of the Kepler satellite. Here, we aim to investigate a subset of the Kepler archive to reveal a connection between the starspots and the stellar flares, in order to provide insight into the overall stellar magnetic field. We use the flare-finding algorithm FLATW'RM in conjunction with a new suite of algorithms that aim to locate the local minima caused by starspot groups. We compare the phase difference between the time of maximum flux of a flare and the time of minimum stellar flux due to a starspot group. The strongest flares do not appear to be correlated to the largest starspot group present, but are also not uniformly distributed in phase with respect to the starspot group. The weaker flares, however, do show an increased occurrence close to the starspot groups.
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27. |
- Streatfield, P Kim, et al.
(författare)
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Pregnancy-related mortality in Africa and Asia : evidence from INDEPTH Health and Demographic Surveillance System sites
- 2014
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Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Women continue to die in unacceptably large numbers around the world as a result of pregnancy, particularly in sub-Saharan Africa and Asia. Part of the problem is a lack of accurate, population-based information characterising the issues and informing solutions. Population surveillance sites, such as those operated within the INDEPTH Network, have the potential to contribute to bridging the information gaps.OBJECTIVE: To describe patterns of pregnancy-related mortality at INDEPTH Network Health and Demographic Surveillance System sites in sub-Saharan Africa and southeast Asia in terms of maternal mortality ratio (MMR) and cause-specific mortality rates.DESIGN: Data on individual deaths among women of reproductive age (WRA) (15-49) resident in INDEPTH sites were collated into a standardised database using the INDEPTH 2013 population standard, the WHO 2012 verbal autopsy (VA) standard, and the InterVA model for assigning cause of death.RESULTS: These analyses are based on reports from 14 INDEPTH sites, covering 14,198 deaths among WRA over 2,595,605 person-years observed. MMRs varied between 128 and 461 per 100,000 live births, while maternal mortality rates ranged from 0.11 to 0.74 per 1,000 person-years. Detailed rates per cause are tabulated, including analyses of direct maternal, indirect maternal, and incidental pregnancy-related deaths across the 14 sites.CONCLUSIONS: As expected, these findings confirmed unacceptably high continuing levels of maternal mortality. However, they also demonstrate the effectiveness of INDEPTH sites and of the VA methods applied to arrive at measurements of maternal mortality that are essential for planning effective solutions and monitoring programmatic impacts.
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28. |
- Tehrani, Kamaleddin H. M. E., et al.
(författare)
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Novel Cephalosporin Conjugates Display Potent and Selective Inhibition of Imipenemase-Type Metallo-beta-Lactamases
- 2021
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Ingår i: Journal of Medicinal Chemistry. - : American Chemical Society (ACS). - 0022-2623 .- 1520-4804. ; 64:13, s. 9141-9151
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Tidskriftsartikel (refereegranskat)abstract
- In an attempt to exploit the hydrolytic mechanism by which beta-lactamases degrade cephalosporins, we designed and synthesized a series of novel cephalosporin prodrugs aimed at delivering thiol-based inhibitors of metallo-beta-lactamases (MBLs) in a spatiotemporally controlled fashion. While enzymatic hydrolysis of the beta-lactam ring was observed, it was not accompanied by inhibitor release. Nonetheless, the cephalosporin prodrugs, especially thiomandelic acid conjugate (8), demonstrated potent inhibition of IMP-type MBLs. In addition, conjugate 8 was also found to greatly reduce the minimum inhibitory concentration of meropenem against IMP-producing bacteria. The results of kinetic experiments indicate that these prodrugs inhibit IMP-type MBLs by acting as slowly turned-over substrates. Structure-activity relationship studies revealed that both phenyl and carboxyl moieties of 8 are crucial for its potency. Furthermore, modeling studies indicate that productive interactions of the thiomandelic acid moiety of 8 with Trp28 within the IMP active site may contribute to its potency and selectivity.
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29. |
- Vida, Krisztián, et al.
(författare)
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Finding flares in Kepler data using machine-learning tools
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 616
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Tidskriftsartikel (refereegranskat)abstract
- Context. Archives of long photometric surveys, such as the Kepler database, are a great basis for studying flares. However, identifying the flares is a complex task; it is easily done in the case of single-target observations by visual inspection, but is nearly impossible for several year-long time series for several thousand targets. Although automated methods for this task exist, several problems are difficult (or impossible) to overcome with traditional fitting and analysis approaches.Aims. We introduce a code for identifying and analyzing flares based on machine-learning methods, which are intrinsically adept at handling such data sets.Methods. We used the RANSAC (RANdom SAmple Consensus) algorithm to model light curves, as it yields robust fits even in the case of several outliers, such as flares. The light curves were divided into search windows, approximately on the order of the stellar rotation period. This search window was shifted over the data set, and a voting system was used to keep false positives to a minimum: only those flare candidate points were kept that were identified as a flare in several windows.Results. The code was tested on short-cadence K2 observations of TRAPPIST-1 and on long-cadence Kepler data of KIC 1722506. The detected flare events and flare energies are consistent with earlier results from manual inspections.
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30. |
- von Sarnowski, Bettina, et al.
(författare)
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Lifestyle Risk Factors for Ischemic Stroke and Transient Ischemic Attack in Young Adults in the Stroke in Young Fabry Patients Study
- 2013
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 44:1, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose-Although many stroke patients are young or middle-aged, risk factor profiles in these age groups are poorly understood. Methods-The Stroke in Young Fabry Patients (sifap1) study prospectively recruited a large multinational European cohort of patients with cerebrovascular events aged 18 to 55 years to establish their prevalence of Fabry disease. In a secondary analysis of patients with ischemic stroke or transient ischemic attack, we studied age-and sex-specific prevalences of various risk factors. Results-Among 4467 patients (median age, 47 years; interquartile range, 40-51), the most frequent well-documented and modifiable risk factors were smoking (55.5%), physical inactivity (48.2%), arterial hypertension (46.6%), dyslipidemia (34.9%), and obesity (22.3%). Modifiable less well-documented or potentially modifiable risk factors like high-risk alcohol consumption (33.0%) and short sleep duration (20.6%) were more frequent in men, and migraine (26.5%) was more frequent in women. Women were more often physically inactive, most pronouncedly at ages <35 years (18-24: 38.2%; 25-34: 51.7%), and had high proportions of abdominal obesity at age 25 years or older (74%). Physical inactivity, arterial hypertension, dyslipidemia, obesity, and diabetes mellitus increased with age. Conclusions-In this large European cohort of young patients with acute ischemic cerebrovascular events, modifiable risk factors were highly prevalent, particularly in men and older patients. These data emphasize the need for vigorous primary and secondary prevention measures already in young populations targeting modifiable lifestyle vascular risk factors. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00414583. (Stroke. 2013; 44: 119-125.)
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31. |
- Zhong, Yong, 1987-, et al.
(författare)
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Highly Conductive, Photolithographically Patternable Ionogels for Flexible and Stretchable Electrochemical Devices
- 2018
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Ingår i: ACS Applied Materials and Interfaces. - : AMER CHEMICAL SOC. - 1944-8244 .- 1944-8252. ; 10:25, s. 21601-21611
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Tidskriftsartikel (refereegranskat)abstract
- An ionic conducting membrane is an essential part in various electrochemical devices including ionic actuators. To miniaturize these devices, micropatterns of ionic conducting membrane are desired. Here, we present a novel type of ionogel that can be patterned using standard photolithography and soft imprinting lithography. The ionogel is prepared in situ by UV-initiated free-radical polymerization of thiol acrylate precursors in the presence of ionic liquid 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide. The resultant ionogel is very flexible with a low Youngs modulus (as low as 0.23 MPa) and shows a very high ionic conductivity (up to 2.4 X 10(-3) S/cm with 75 wt % ionic liquid incorporated) and has a reactive surface due to the excess thiol groups. Micropatterns of ionogel are obtained by using the thiol acrylate ionogel solution as an ionic conducting photoresist with standard photolithography. Water, a solvent immiscible with ionic liquid, is used as the photoresist developer to avoid complete removal of ionic liquid from thin micropatterns of the ionogel. By taking advantage of the reactive surface of ionogels and the photopatternability, ionogels with complex three-dimensional microstructure are developed. The surface of the ionogels can also be easily patterned using UV-assisted soft imprinting lithography. This new type of ionogels may open up for building high-performance flexible electrochemical microdevices.
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