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- Glasbey, JC, et al.
(author)
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- 2021
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swepub:Mat__t
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- Kanai, M, et al.
(author)
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- 2023
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swepub:Mat__t
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| 5. |
- Drake, TM, et al.
(author)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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In: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Journal article (peer-reviewed)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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- Hu, Weida, et al.
(author)
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CLASSY VII Lyα Profiles : The Structure and Kinematics of Neutral Gas and Implications for LyC Escape in Reionization-era Analogs
- 2023
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In: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 956:1
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Journal article (peer-reviewed)abstract
- Lyα line profiles are a powerful probe of interstellar medium (ISM) structure, outflow speed, and Lyman-continuum escape fraction. In this paper, we present the Lyα line profiles of the Cosmic Origins Spectrograph (COS) Legacy Archive Spectroscopic SurveY, a sample rich in spectroscopic analogs of reionization-era galaxies. A large fraction of the spectra show a complex profile, consisting of a double-peaked Lyα emission profile in the bottom of a damped, Lyα absorption trough. Such profiles reveal an inhomogeneous ISM. We successfully fit the damped Lyα absorption and the Lyα emission profiles separately, but with complementary covering factors, a surprising result because this approach requires no Lyα exchange between high-NH i and low-NH i paths. The combined distribution of column densities is qualitatively similar to the bimodal distributions observed in numerical simulations. We find an inverse relation between Lyα peak separation and the [O iii]/[O ii] flux ratio, confirming that the covering fraction of Lyman-continuum-thin sightlines increases as the Lyα peak separation decreases. We combine measurements of Lyα peak separation and Lyα red peak asymmetry in a diagnostic diagram, which identifies six Lyman-continuum leakers in the COS Legacy Archive Spectrocopy SurveY (CLASSY) sample. We find a strong correlation between the Lyα trough velocity and the outflow velocity measured from interstellar absorption lines. We argue that greater vignetting of the blueshifted Lyα peak, relative to the redshifted peak, is the source of the well-known discrepancy between shell-model parameters and directly measured outflow properties. The CLASSY sample illustrates how scattering of Lyα photons outside the spectroscopic aperture reshapes Lyα profiles because the distances to these compact starbursts span a large range.
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