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| 12. |
- 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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| 14. |
- Loza, M. J., et al.
(författare)
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Validated and longitudinally stable asthma phenotypes based on cluster analysis of the ADEPT study
- 2016
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Ingår i: Respiratory Research. - : Springer Nature. - 1465-9921 .- 1465-993X. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Asthma is a disease of varying severity and differing disease mechanisms. To date, studies aimed at stratifying asthma into clinically useful phenotypes have produced a number of phenotypes that have yet to be assessed for stability and to be validated in independent cohorts. The aim of this study was to define and validate, for the first time ever, clinically driven asthma phenotypes using two independent, severe asthma cohorts: ADEPT and U-BIOPRED. Methods: Fuzzy partition-around-medoid clustering was performed on pre-specified data from the ADEPT participants (n = 156) and independently on data from a subset of U-BIOPRED asthma participants (n = 82) for whom the same variables were available. Models for cluster classification probabilities were derived and applied to the 12-month longitudinal ADEPT data and to a larger subset of the U-BIOPRED asthma dataset (n = 397). High and low type-2 inflammation phenotypes were defined as high or low Th2 activity, indicated by endobronchial biopsies gene expression changes downstream of IL-4 or IL-13. Results: Four phenotypes were identified in the ADEPT (training) cohort, with distinct clinical and biomarker profiles. Phenotype 1 was "mild, good lung function, early onset", with a low-inflammatory, predominantly Type-2, phenotype. Phenotype 2 had a "moderate, hyper-responsive, eosinophilic" phenotype, with moderate asthma control, mild airflow obstruction and predominant Type-2 inflammation. Phenotype 3 had a "mixed severity, predominantly fixed obstructive, non-eosinophilic and neutrophilic" phenotype, with moderate asthma control and low Type-2 inflammation. Phenotype 4 had a "severe uncontrolled, severe reversible obstruction, mixed granulocytic" phenotype, with moderate Type-2 inflammation. These phenotypes had good longitudinal stability in the ADEPT cohort. They were reproduced and demonstrated high classification probability in two subsets of the U-BIOPRED asthma cohort. Conclusions: Focusing on the biology of the four clinical independently-validated easy-to-assess ADEPT asthma phenotypes will help understanding the unmet need and will aid in developing tailored therapies. Trial registration:NCT01274507(ADEPT), registered October 28, 2010 and NCT01982162(U-BIOPRED), registered October 30, 2013.
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| 18. |
- Adlarson, Patrik, et al.
(författare)
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Search for eta-mesic He-4 in the dd -> (3)Hen pi(0) and dd -> (3)Hep pi(-) reactions with the WASA-at-COSY facility
- 2017
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Ingår i: Nuclear Physics A. - : ELSEVIER SCIENCE BV. - 0375-9474 .- 1873-1554. ; 959, s. 102-115
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Tidskriftsartikel (refereegranskat)abstract
- The search for He-4-eta bound states was performed with the WASA-at-COSY facility via the measurement of the excitation function for the dd -> (3)Hen pi(0) and dd -> (3)Hep pi(-) processes. The deuteron beam momentum was varied continuously between 2.127 GeV/c and 2.422 GeV/c, corresponding to the excess energy for the dd -> He-4 eta reaction ranging from Q = 70 MeV to Q = 30 MeV. The luminosity was determined based on the dd -> (3)Hen reaction and the quasi-free proton proton scattering via dd -> ppn(spectator)n(spectator) reactions. The excitation functions, determined independently for the measured reactions, do not reveal a structure which could be interpreted as a narrow mesic nucleus. Therefore, the upper limits of the total cross sections for the bound state production and decay in dd -> (4He-eta)(bound) -> (3)Hen pi(0) and dd -> (He-4-eta)(bound) -> (3)Hep pi(-) processes were determined taking into account the isospin relation between the both of the considered channels. The results of the analysis depend on the assumptions of the N* (1535) momentum distribution in the anticipated mesic-He-4. Assuming, as in the previous works, that this is identical with the distribution of nucleons bound with 20 MeV in He-4, we determined that (for the mesic bound state width in the range from 5 MeV to 50 MeV) the upper limits at 90% confidence level are about 3 nb and about 6 nb for n pi(0) and p pi(-) channels, respectively. However, based on the recent theoretical findings of the N*(1535) momentum distribution in the N*-He-3 nucleus bound by 3.6 MeV, we find that the WASA-at-COSY detector acceptance decreases and hence the corresponding upper limits are 5 nb and 10 nb for n pi(0) and p pi(-) channels respectively. (C) 2017 Elsevier B.V. All rights reserved.
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| 19. |
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| 20. |
- Adlarson, Patrik, et al.
(författare)
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Backward single-pion production in the pd -> He-3 pi(0)reaction with WASA-at-COSY
- 2018
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Ingår i: European Physical Journal A. - : SPRINGER. - 1434-6001 .- 1434-601X. ; 54:9
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Tidskriftsartikel (refereegranskat)abstract
- New data on the production of single neutral pions in the pd -> He-3 pi(0) reaction are presented. For fifteen proton beam momenta between p(p) = 1.60GeV/c and p(p) = 1.74 GeV/c, differential cross sections are determined over a large fraction of the backward hemisphere. Since the only previous systematic measurements of single-pion production at these energies were made in collinear kinematics, the present work constitutes a significant extension of the current knowledge on this reaction. Even this far above the production threshold, significant changes are found in the behaviour of the angular distributions over small intervals in beam momentum.
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