| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
-
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
-
Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
-
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.
|
|
| 2. |
|
|
| 3. |
- Thomas, HS, et al.
(författare)
-
- 2019
-
swepub:Mat__t
|
|
| 4. |
- Drake, TM, et al.
(författare)
-
Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
-
Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
-
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.
|
|
| 5. |
- Alves, Catarina S., et al.
(författare)
-
Considerations for Optimizing the Photometric Classification of Supernovae from the Rubin Observatory
- 2022
-
Ingår i: Astrophysical Journal Supplement Series. - : American Astronomical Society. - 0067-0049 .- 1538-4365. ; 258:2
-
Tidskriftsartikel (refereegranskat)abstract
- The Vera C. Rubin Observatory will increase the number of observed supernovae (SNe) by an order of magnitude; however, it is impossible to spectroscopically confirm the class for all SNe discovered. Thus, photometric classification is crucial, but its accuracy depends on the not-yet-finalized observing strategy of Rubin Observatory's Legacy Survey of Space and Time (LSST). We quantitatively analyze the impact of the LSST observing strategy on SNe classification using simulated multiband light curves from the Photometric LSST Astronomical Time-Series Classification Challenge (PLAsTiCC). First, we augment the simulated training set to be representative of the photometric redshift distribution per SNe class, the cadence of observations, and the flux uncertainty distribution of the test set. Then we build a classifier using the photometric transient classification library snmachine, based on wavelet features obtained from Gaussian process fits, yielding a similar performance to the winning PLAsTiCC entry. We study the classification performance for SNe with different properties within a single simulated observing strategy. We find that season length is important, with light curves of 150 days yielding the highest performance. Cadence also has an important impact on SNe classification; events with median inter-night gap <3.5 days yield higher classification performance. Interestingly, we find that large gaps (>10 days) in light-curve observations do not impact performance if sufficient observations are available on either side, due to the effectiveness of the Gaussian process interpolation. This analysis is the first exploration of the impact of observing strategy on photometric SN classification with LSST.
|
|
| 6. |
|
|
| 7. |
- Lochner, Michelle, et al.
(författare)
-
Optimizing the LSST Observing Strategy for Dark Energy Science : DESC Recommendations for the Wide-Fast-Deep Survey
- 2018
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Cosmology is one of the four science pillars of LSST, which promises to be transformative for our understanding of dark energy and dark matter. The LSST Dark Energy Science Collaboration (DESC) has been tasked with deriving constraints on cosmological parameters from LSST data. Each of the cosmological probes for LSST is heavily impacted by the choice of observing strategy. This white paper is written by the LSST DESC Observing Strategy Task Force (OSTF), which represents the entire collaboration, and aims to make recommendations on observing strategy that will benefit all cosmological analyses with LSST. It is accompanied by the DESC DDF (Deep Drilling Fields) white paper (Scolnic et al.). We use a variety of metrics to understand the effects of the observing strategy on measurements of weak lensing, large-scale structure, clusters, photometric redshifts, supernovae, strong lensing and kilonovae. In order to reduce systematic uncertainties, we conclude that the current baseline observing strategy needs to be significantly modified to result in the best possible cosmological constraints. We provide some key recommendations: moving the WFD (Wide-Fast-Deep) footprint to avoid regions of high extinction, taking visit pairs in different filters, changing the 2x15s snaps to a single exposure to improve efficiency, focusing on strategies that reduce long gaps (>15 days) between observations, and prioritizing spatial uniformity at several intervals during the 10-year survey.
|
|
