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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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| 2. |
- Abdalla, E., et al.
(författare)
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Cosmology intertwined : A review of the particle physics, astrophysics, and cosmology associated with the cosmological tensions and anomalies
- 2022
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Ingår i: Journal of High Energy Astrophysics. - : Elsevier BV. - 2214-4048 .- 2214-4056. ; 34, s. 49-211
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Tidskriftsartikel (refereegranskat)abstract
- The standard Λ Cold Dark Matter (ΛCDM) cosmological model provides a good description of a wide range of astrophysical and cosmological data. However, there are a few big open questions that make the standard model look like an approximation to a more realistic scenario yet to be found. In this paper, we list a few important goals that need to be addressed in the next decade, taking into account the current discordances between the different cosmological probes, such as the disagreement in the value of the Hubble constant H0, the σ8–S8 tension, and other less statistically significant anomalies. While these discordances can still be in part the result of systematic errors, their persistence after several years of accurate analysis strongly hints at cracks in the standard cosmological scenario and the necessity for new physics or generalisations beyond the standard model. In this paper, we focus on the 5.0σ tension between the Planck CMB estimate of the Hubble constant H0 and the SH0ES collaboration measurements. After showing the H0 evaluations made from different teams using different methods and geometric calibrations, we list a few interesting new physics models that could alleviate this tension and discuss how the next decade's experiments will be crucial. Moreover, we focus on the tension of the Planck CMB data with weak lensing measurements and redshift surveys, about the value of the matter energy density Ωm, and the amplitude or rate of the growth of structure (σ8,fσ8). We list a few interesting models proposed for alleviating this tension, and we discuss the importance of trying to fit a full array of data with a single model and not just one parameter at a time. Additionally, we present a wide range of other less discussed anomalies at a statistical significance level lower than the H0–S8 tensions which may also constitute hints towards new physics, and we discuss possible generic theoretical approaches that can collectively explain the non-standard nature of these signals. Finally, we give an overview of upgraded experiments and next-generation space missions and facilities on Earth that will be of crucial importance to address all these open questions.
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| 5. |
- Barnes, DR, et al.
(författare)
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Breast and Prostate Cancer Risks for Male BRCA1 and BRCA2 Pathogenic Variant Carriers Using Polygenic Risk Scores
- 2022
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 114:1, s. 109-122
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundRecent population-based female breast cancer and prostate cancer polygenic risk scores (PRS) have been developed. We assessed the associations of these PRS with breast and prostate cancer risks for male BRCA1 and BRCA2 pathogenic variant carriers.Methods483 BRCA1 and 1318 BRCA2 European ancestry male carriers were available from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). A 147-single nucleotide polymorphism (SNP) prostate cancer PRS (PRSPC) and a 313-SNP breast cancer PRS were evaluated. There were 3 versions of the breast cancer PRS, optimized to predict overall (PRSBC), estrogen receptor (ER)–negative (PRSER-), or ER-positive (PRSER+) breast cancer risk.ResultsPRSER+ yielded the strongest association with breast cancer risk. The odds ratios (ORs) per PRSER+ standard deviation estimates were 1.40 (95% confidence interval [CI] =1.07 to 1.83) for BRCA1 and 1.33 (95% CI = 1.16 to 1.52) for BRCA2 carriers. PRSPC was associated with prostate cancer risk for BRCA1 (OR = 1.73, 95% CI = 1.28 to 2.33) and BRCA2 (OR = 1.60, 95% CI = 1.34 to 1.91) carriers. The estimated breast cancer odds ratios were larger after adjusting for female relative breast cancer family history. By age 85 years, for BRCA2 carriers, the breast cancer risk varied from 7.7% to 18.4% and prostate cancer risk from 34.1% to 87.6% between the 5th and 95th percentiles of the PRS distributions.ConclusionsPopulation-based prostate and female breast cancer PRS are associated with a wide range of absolute breast and prostate cancer risks for male BRCA1 and BRCA2 carriers. These findings warrant further investigation aimed at providing personalized cancer risks for male carriers and informing clinical management.
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| 11. |
- Forssén, Clayton, et al.
(författare)
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Circular comparison of conventional pressure standards using a transportable optical refractometer : preparation and transportation
- 2022
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Ingår i: 6th TC16 Conference on Pressure and Vacuum Measurement 2022, Together with the 24th TC3 Conference on the Measurement of Force, Mass and Torque, the 14th TC5 Conference on the Measurement of Hardness, and the 5th TC22 Conference on Vibration Measurement. - Budapest : International Measurement Confederation (IMEKO). - 9781713870227
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Konferensbidrag (refereegranskat)abstract
- Using a transportable Fabry-Pérot cavity refractometer, a circular comparison of existing primary standards at several national metrology institutes is currently underway. This paper provides information about the refractometer, the preparation for the comparison, and the transportation procedure.
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| 12. |
- Renuke, Avinash, et al.
(författare)
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High-Efficient Bladeless Expander Concept
- 2023
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Ingår i: E3S Web of Conferences. - : EDP Sciences.
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Konferensbidrag (refereegranskat)abstract
- Tesla bladeless expanders are promising in energy harvesting and small-scale power generation applications due to their lower cost and simplicity in design. Although such expanders exhibit very high rotor efficiency (analytical total to static efficiency ~ 90%), it shows poor performance when coupled with a stator (experimental total to static efficiency ~30%) due to losses present in the stator and stator-rotor interaction. This paper presents the design and experiment of a novel, high-efficient Tesla bladeless expander concept. The concept arises from the loss phenomena in the stator-rotor interaction in conventional bladeless expanders, which are among the main causes of the low performance. This concept is believed to bring the bladeless expanders to the same performances as the traditional ones with vanes, compared to which however the bladeless machines boast greater simplicity, robustness, and the absence of performance decay as the size decreases, competing even in the contexts for traditional turbomachinery. The high-efficient bladeless expander prototype with water as a working fluid is designed and developed, representing the similitude case for a liquid butane heat pump. The available isentropic power across the throttling process in the butane case is 3.3 kW @10000 rpm. The turbine consists of 24 nozzles and 150 disks separated by 0.1 mm spacers. The turbine shaft is connected to the high-speed electric generator. The performance test on the expander is carried out at rotational speeds ranging from 3000 rpm to 6200 rpm and with differential pressure across the expander up to 14 bar. Experimental ventilation loss is characterised and its effect on the performance of the expander is discussed. The preliminary results of the expander under investigation showed satisfactory production of power with an acceptable efficiency range. It is also shown that the present concept is promising and able to address the major i.e., stator-rotor interaction which is the major source of loss in the traditional bladeless expander.
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| 13. |
- Renuke, Avinash, et al.
(författare)
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Performance Investigation Of Stator-Less And Blade-Less Radial Expander
- 2023
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Ingår i: Proc. ASME Turbo Expo. - : American Society of Mechanical Engineers (ASME). - 9780791887035
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Konferensbidrag (refereegranskat)abstract
- Interests in small-scale turbomachinery are gaining momentum, particularly around waste heat recovery using Organic Rankine Cycle (ORC), energy harvesting, pico-hydro, refrigeration and heat pumps and small-scale power generation. These applications demand to have economical, simple construction, and reasonably efficient machines. The performance of bladed turbomachine at a small scale is poor mainly due to viscous losses and relatively large clearances. In some cases, like ORC, it requires a lubrication system, making it complex and costly. Bladeless or Tesla turbomachinery is seen as one of the solutions for these applications due to its simple construction and cost-effectiveness. However, the experimental efficiency of the bladeless turbines/compressors is found in the low region, < 40%. In this article, the performance of a bladeless turbine is investigated using a vaneless volute configuration, making the turbine stator-less (vaneless volute) and bladeless (vaneless rotor). This study presents numerical and experimental performance investigation with a volute as a stator of the bladeless rotor. 3D Numerical results show very promising performance of the turbine with total to static efficiencies calculated above 65%. In the second part of the article, turbine prototype components, assembly and test set-up are discussed. Experimental maximum efficiency of 41.5±0.88% at 3.5 kg/s@5000 rpm and power of 915 W is obtained. This is the highest recorded efficiency for the Tesla turbine in peer-reviewed research. The overall turbine performance from 3D numerical simulation with ventilation and mechanical losses is compared with experimental results. This work demonstrates that the proposed stator-less/volute configuration provides an efficient way for bladeless or Tesla turbines, particularly for low-head applications.
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| 14. |
- Rubin, T., et al.
(författare)
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'Quantum-based realizations of the pascal' status and progress of the empir-project: quantumpascal
- 2022
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Ingår i: 6th TC16 Conference on Pressure and Vacuum Measurement 2022, Together with the 24th TC3 Conference on the Measurement of Force, Mass and Torque, the 14th TC5 Conference on the Measurement of Hardness, and the 5th TC22 Conference on Vibration Measurement. - : International Measurement Confederation (IMEKO). - 9781713870227
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Konferensbidrag (refereegranskat)abstract
- The QuantumPascal (QP) project combines the capabilities of 12 European institutions to enable traceable pressure measurements utilizing quantum-based methods that evaluate the number density instead of force per area to target the wide pressure range between 1 Pa and 3 MPa. This article summarizes the goals and results since the project start in June 2019.
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| 15. |
- Silvestri, M, et al.
(författare)
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Detection of Genomically Aberrant Cells within Circulating Tumor Microemboli (CTMs) Isolated from Early-Stage Breast Cancer Patients
- 2021
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Circulating tumor microemboli (CTMs) are clusters of cancer cells detached from solid tumors, whose study can reveal mechanisms underlying metastatization. As they frequently comprise unknown fractions of leukocytes, the analysis of copy number alterations (CNAs) is challenging. To address this, we titrated known numbers of leukocytes into cancer cells (MDA-MB-453 and MDA-MB-36, displaying high and low DNA content, respectively) generating tumor fractions from 0–100%. After low-pass sequencing, ichorCNA was identified as the best algorithm to build a linear mixed regression model for tumor fraction (TF) prediction. We then isolated 53 CTMs from blood samples of six early-stage breast cancer patients and predicted the TF of all clusters. We found that all clusters harbor cancer cells between 8 and 48%. Furthermore, by comparing the identified CNAs of CTMs with their matched primary tumors, we noted that only 31–71% of aberrations were shared. Surprisingly, CTM-private alterations were abundant (30–63%), whereas primary tumor-private alterations were rare (4–12%). This either indicates that CTMs are disseminated from further progressed regions of the primary tumor or stem from cancer cells already colonizing distant sites. In both cases, CTM-private mutations may inform us about specific metastasis-associated functions of involved genes that should be explored in follow-up and mechanistic studies.
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| 16. |
- Yang, Xin, et al.
(författare)
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Cancer risks associated with germline PALB2 pathogenic variants : An international study of 524 families
- 2020
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Ingår i: Journal of Clinical Oncology. - 0732-183X. ; 38:7, s. 674-685
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE To estimate age-specific relative and absolute cancer risks of breast cancer and to estimate risks of ovarian, pancreatic, male breast, prostate, and colorectal cancers associated with germline PALB2 pathogenic variants (PVs) because these risks have not been extensively characterized. METHODS We analyzed data from 524 families with PALB2 PVs from 21 countries. Complex segregation analysis was used to estimate relative risks (RRs; relative to country-specific population incidences) and absolute risks of cancers. The models allowed for residual familial aggregation of breast and ovarian cancer and were adjusted for the family-specific ascertainment schemes. RESULTS We found associations between PALB2 PVs and risk of female breast cancer (RR, 7.18; 95% CI, 5.82 to 8.85; P = 6.5 × 10-76), ovarian cancer (RR, 2.91; 95% CI, 1.40 to 6.04; P = 4.1 × 10-3), pancreatic cancer (RR, 2.37; 95% CI, 1.24 to 4.50; P = 8.7 × 10-3), and male breast cancer (RR, 7.34; 95% CI, 1.28 to 42.18; P = 2.6 3 1022). There was no evidence for increased risks of prostate or colorectal cancer. The breast cancer RRs declined with age (P for trend = 2.0 × 10-3). After adjusting for family ascertainment, breast cancer risk estimates on the basis of multiple case families were similar to the estimates from families ascertained through population-based studies (P for difference = .41). On the basis of the combined data, the estimated risks to age 80 years were 53% (95% CI, 44% to 63%) for female breast cancer, 5% (95% CI, 2% to 10%) for ovarian cancer, 2%-3% (95% CI females, 1% to 4%; 95% CI males, 2% to 5%) for pancreatic cancer, and 1% (95% CI, 0.2% to 5%) for male breast cancer. CONCLUSION These results confirm PALB2 as a major breast cancer susceptibility gene and establish substantial associations between germline PALB2 PVs and ovarian, pancreatic, and male breast cancers. These findings will facilitate incorporation of PALB2 into risk prediction models and optimize the clinical cancer risk management of PALB2 PV carriers.
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