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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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| 4. |
- Vlemmings, Wouter, 1974, et al.
(författare)
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Magnetically aligned dust and SiO maser polarisation in the envelope of the red supergiant VY Canis Majoris
- 2017
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 603, s. A92-
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Tidskriftsartikel (refereegranskat)abstract
- Aims. Polarisation observations of circumstellar dust and molecular (thermal and maser) lines provide unique information about dust properties and magnetic fields in circumstellar envelopes of evolved stars. Methods. We use Atacama Large Millimeter/submillimeter Array (ALMA) Band 5 science verification observations of the red supergiant VY CMa to study the polarisation of SiO thermal /maser lines and dust continuum at similar to 1.7 mm wavelength. We analyse both linear and circular polarisation and derive the magnetic field strength and structure, assuming the polarisation of the lines originates from the Zeeman effect, and that of the dust originates from aligned dust grains. We also discuss other effects that could give rise to the observed polarisation. Results. We detect, for the first time, significant polarisation (similar to 3%) of the circumstellar dust emission at millimeter wavelengths. The polarisation is uniform with an electric vector position angle of similar to 8 degrees. Varying levels of linear polarisation are detected for the J = 4-3 (SiO)-Si-28 nu = 0; 1; 2; and (SiO)-Si-29 nu = 0; 1 lines, with the strongest polarisation fraction of similar to 30% found for the (SiO)-Si-29 nu = 1 maser. The linear polarisation vectors rotate with velocity, consistent with earlier observations. We also find significant (up to similar to 1%) circular polarisation in several lines, consistent with previous measurements. We conclude that the detection is robust against calibration and regular instrumental errors, although we cannot yet fully rule out non-standard instrumental effects. Conclusions. Emission from magnetically aligned grains is the most likely origin of the observed continuum polarisation. This implies that the dust is embedded in a magnetic field >13 mG. The maser line polarisation traces the magnetic field structure. The magnetic field in the gas and dust is consistent with an approximately toroidal field configuration, but only higher angular resolution observations will be able to reveal more detailed field structure. If the circular polarisation is due to Zeeman splitting, it indicates a magnetic field strength of similar to 1-3 Gauss, consistent with previous maser observations.
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| 5. |
- Decin, L., et al.
(författare)
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Study of the aluminium content in AGB winds using ALMA Indications for the presence of gas-phase (Al2O3)n clusters
- 2017
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 608, s. A55-
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Tidskriftsartikel (refereegranskat)abstract
- Context. The condensation of inorganic dust grains in the winds of evolved stars is poorly understood. As of today, it is not yet known which molecular clusters form the first dust grains in oxygen-rich (C/O 34) can be the potential agents of the broad 11 mu m feature in the SED and in the interferometric data and we propose potential formation mechanisms for these large clusters.
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| 6. |
- Khouri, Theo, 1985, et al.
(författare)
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Imaging the dust and the gas around Mira using ALMA and SPHERE/ZIMPOL
- 2018
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Ingår i: Proceedings of the International Astronomical Union. - 1743-9213 .- 1743-9221. ; 14:S343, s. 31-35
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Konferensbidrag (refereegranskat)abstract
- The mass-loss mechanism of asymptotic giant branch stars has long been thought to rely on two processes: Stellar pulsations and dust formation. The details of the mass-loss mechanism have remained elusive, however, because of the overall complexity of the dust formation process in the very dynamical pulsation-enhanced atmosphere. Recently, our understanding of AGB stars and the associated mass loss has evolved significantly, thanks both to new instruments which allow sensitive and high-angular-resolution observations and the development of models for the convective AGB envelopes and the dust formation process. ALMA and SPHERE/ZIMPOL on the VLT have been very important instruments in driving this advance in the last few years by providing high-angular resolution images in the sub-mm and visible wavelengths, respectively. I will present observations obtained using these instruments at the same epoch (2.5 weeks apart) of the AGB star Mira that resolve even the stellar disk. The ALMA data reveals the distribution and dynamics of the gas around the star, while the polarised light imaged using SPHERE shows the distribution of the dust grains expected to drive the outflows. Moreover, the observations show a central source surrounded by asymmetric distributions of gas and dust, with complementary structures seen in the two components. We model the observed CO v = 1, J = 3-2 line to determine the density, temperature and velocity of gas close to the star. This model is then used to estimate the abundance of AlO. Our results show that only a very small fraction of aluminium (‰20.1%) is locked in AlO molecules. We also calculate models to fit the observed polarised light based on the gas densities we find. The low level of visible-light polarisation detected using ZIMPOL implies that, at the time of the observations, aluminium atoms are either not efficiently depleted into dust or the aluminium-oxide grains are relatively small (‰20.02μm).
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| 7. |
- Melloni, Chiara, et al.
(författare)
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Efficacy and Safety of Apixaban Versus Warfarin in Patients with Atrial Fibrillation and a History of Cancer : Insights from the ARISTOTLE Trial.
- 2017
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Ingår i: American Journal of Medicine. - : Elsevier BV. - 0002-9343 .- 1555-7162. ; 130:12, s. 1440-1448.e1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer is associated with a prothrombotic state and increases the risk of thrombotic events in patients with atrial fibrillation. We described the clinical characteristics and outcomes and assessed the safety and efficacy of apixaban versus warfarin in patients with atrial fibrillation and cancer in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial.METHODS: The association between cancer and clinical outcomes was assessed using Cox regression models. At baseline, 1236 patients (6.8%) had a history of cancer; 12.7% had active cancer, and 87.3% had remote cancer.RESULTS: There were no significant associations between history of cancer and stroke/systemic embolism, major bleeding, or death. The effect of apixaban versus warfarin for the prevention of stroke/systemic embolism was consistent among patients with a history of cancer (event/100 patient-years = 1.4 vs 1.2; hazard ratio [HR], 1.09; 95% confidence interval [CI], 0.53-2.26) and no cancer (1.3 vs 1.6; HR, 0.77; 95% CI, 0.64-0.93) (P interaction = .37). The safety and efficacy of apixaban versus warfarin were preserved among patients with and without active cancer. Apixaban was associated with a greater benefit for the composite of stroke/systemic embolism, myocardial infarction, and death in active cancer (HR, 0.30; 95% CI, 0.11-0.83) versus without cancer (HR, 0.86; 95% CI, 0.78-0.95), but not in remote cancer (HR, 1.46; 95% CI, 1.01-2.10) (interaction P = .0028).CONCLUSIONS: Cancer was not associated with a higher risk of stroke. The superior efficacy and safety of apixaban versus warfarin were consistent in patients with and without cancer. Our positive findings regarding apixaban use in patients with atrial fibrillation and cancer are exploratory and promising, but warrant further evaluation.
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| 9. |
- O Gorman, Eamon, 1984, et al.
(författare)
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ALMA Observations of Anisotropic Dust Mass Loss around VY CMa
- 2015
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Ingår i: 4th ALMA Science Conference on Revolution in Astronomy with ALMA: The Third Year, Tokyo, Japan, 8-11 December. - 9781583818831 ; 499, s. 335-336
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Konferensbidrag (refereegranskat)abstract
- We present high resolution ALMA Science Verification data of the continuum emission around the highly evolved oxygen-rich red supergiant VY CMa. These data enable us to study the dust in its inner circumstellar environment at a spatial resolution of 129 mas at 321 GHz and 59 mas at 658 GHz, thus allowing us to trace dust on spatial scales down to 11 R-star (71 AU). Two prominent dust components are detected and resolved. We find that at least 17% of the dust mass around VY CMa is located in clumps ejected within a more quiescent roughly spherical stellar wind, with a quiescent dust mass loss rate of 5 x 10(-6) M-circle dot yr(-1). The anisotropic morphology of the dust indicates a continuous, directed mass loss over a few decades, suggesting that this mass loss cannot be driven by large convection cells alone.
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| 10. |
- O Gorman, Eamon, 1984, et al.
(författare)
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ALMA observations of anisotropic dust mass loss in the inner circumstellar environment of the red supergiant VY Canis Majoris
- 2015
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 573, s. Article no. L1-
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Tidskriftsartikel (refereegranskat)abstract
- The processes leading to dust formation and the subsequent role it plays in driving mass loss in cool evolved stars is an area of intense study. Here we present high resolution ALMA Science Verification data of the continuum emission around the highly evolved oxygen-rich red supergiant VY CMa. These data enable us to study the dust in its inner circumstellar environment at a spatial resolution of 129 mas at 321 GHz and 59 mas at 658 GHz, thus allowing us to trace dust on spatial scales down to 11 R-star (71 AU). Two prominent dust components are detected and resolved. The brightest dust component. C, is located 334 mas (61 R-star) southeast of the star and has a dust mass of at least 2.5 x 10(-4) M-circle dot. It has a dust emissivity spectral index of beta = -0.1 at its peak, implying that it is optically thick at these frequencies with a cool core of T-d less than or similar to 100 K. Interestingly, not a single molecule in the ALMA data has emission close to the peak of this massive dust clump. The other main dust component. VY, is located at the position of the star and contains a total dust mass of 4.0 x 10(-)5 M-circle dot. It also contains a weaker dust feature extending over 60 R-star to the north with the total component having a typical dust emissivity spectral index of beta = 0.7. We find that at least 17% of the dust mass around VY CMa is located in clumps ejected within a more quiescent roughly spherical stellar wind, with a quiescent dust mass loss rate of 5 x 10(-6) M-circle dot yr(-1). The anisotropic morphology of the dust indicates a continuous, directed mass loss over a few decades, suggesting that this mass loss cannot be driven by large convection cells alone.
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