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- 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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- James, SL, et al.
(author)
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Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017
- 2020
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In: Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention. - : BMJ. - 1475-5785. ; 26:SUPP_1Supp 1, s. 96-114
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Journal article (peer-reviewed)abstract
- Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.MethodsWe reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).FindingsIn 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).InterpretationInjuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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- Kinyoki, DK, et al.
(author)
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Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
- 2020
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In: Nature medicine. - : Springer Science and Business Media LLC. - 1546-170X .- 1078-8956. ; 26:5, s. 750-759
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Journal article (peer-reviewed)abstract
- A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
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7. |
- Mohamadi, Sedigheh, et al.
(author)
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Zoning map for drought prediction using integrated machine learning models with a nomadic people optimization algorithm
- 2020
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In: Natural Hazards. - Germany : Springer. - 0921-030X .- 1573-0840. ; 104:1, s. 537-579
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Journal article (peer-reviewed)abstract
- The modelling of drought is of utmost importance for the efficient management of water resources. This article used the adaptive neuro-fuzzy interface system (ANFIS), multilayer perceptron (MLP), radial basis function neural network (RBFNN), and support vector machine (SVM) models to forecast meteorological droughts in Iran. The spatial–temporal pattern of droughts in Iran was also found using recorded observation data from 1980 to 2014. A nomadic people algorithm (NPA) was utilized to train the ANFIS, MLP, RBFNN, and SVM models. Additionally, the NPA was benchmarked against the bat algorithm, salp swarm algorithm, and krill algorithm (KA). The hybrid ANFIS, MLP, RBFNN, and SVM models were used to forecast the 3-month standardized precipitation index. New evolutionary algorithms were utilized to improve the convergence speed of the soft computing models and their accuracy. First, random stations, namely, in Azarbayjan (northwest Iran), Khouzestan (southwest Iran), Khorasan (northeast Iran), and Sistan and Balouchestan (southeast Iran) were selected for the testing of the models. According to the results obtained from the Azarbayjan station, the Nash–Sutcliffe efficiency (NSE) was 0.93, 0.86, 0.85, and 0.83 for the ANFIS–NPA, MLP–NPA, RBFNN–NPA, and SVM–NPA models, respectively. For Sistan and Baloucehstan, the results indicated the superiority of the ANFIS–NPA model, followed by the MLP–NPA model, compared to the RBFNN–NPA and SVM–NPA models, and suggested that the hybrid models performed better than the standalone MLP, RBFNN, ANFIS, and SVM models. The second aim of the study was to capture the relationship between large-scale climate signals and drought indices by using a wavelet coherence analysis. The general results indicated that the NPA and wavelet coherence analysis are useful tools for modelling drought indices.
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- Ahmed, Saad, et al.
(author)
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Demystifying Energy Consumption Dynamics in Transiently Powered Computers
- 2020
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In: ACM Transactions on Embedded Computing Systems. - : Association for Computing Machinery. - 1539-9087 .- 1558-3465. ; 19:6
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Journal article (peer-reviewed)abstract
- Transiently powered computers (TPCs) form the foundation of the battery-less Internet of Things, using energy harvesting and small capacitors to power their operation. This kind of power supply is characterized by extreme variations in supply voltage, as capacitors charge when harvesting energy and discharge when computing. We experimentally find that these variations cause marked fluctuations in clock speed and power consumption. Such a deceptively minor observation is overlooked in existing literature. Systems are thus designed and parameterized in overly conservative ways, missing on a number of optimizations.We rather demonstrate that it is possible to accurately model and concretely capitalize on these fluctuations. We derive an energy model as a function of supply voltage and prove its use in two settings. First, we develop EPIC, a compile-time energy analysis tool. We use it to substitute for the constant power assumption in existing analysis techniques, giving programmers accurate information on worst-case energy consumption of programs. When using EPIC with existing TPC system support, run-time energy efficiency drastically improves, eventually leading up to a 350% speedup in the time to complete a fixed workload. Further, when using EPIC with existing debugging tools, it avoids unnecessary program changes that hurt energy efficiency. Next, we extend the MSPsim emulator and explore its use in parameterizing a different TPC system support. The improvements in energy efficiency yield up to more than 1000% time speedup to complete a fixed workload.
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- Ahmed, Saad, et al.
(author)
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Fast and Energy-Efficient State Checkpointing for Intermittent Computing
- 2020
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In: ACM Transactions on Embedded Computing Systems. - : Association for Computing Machinery. - 1539-9087 .- 1558-3465. ; 19:6
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Journal article (peer-reviewed)abstract
- Intermittently powered embedded devices ensure forward progress of programs through state checkpointing in non-volatile memory. Checkpointing is, however, expensive in energy and adds to the execution times. To minimize this overhead, we present DICE, a system that renders differential checkpointing profitable on these devices. DICE is unique because it is a software-only technique and efficient because it only operates in volatile main memory to evaluate the differential. DICE may be integrated with reactive (Hibernus) or proactive (MementOS, HarvOS) checkpointing systems, and arbitrary code can be enabled with DICE using automatic code-instrumentation requiring no additional programmer effort. By reducing the cost of checkpoints, DICE cuts the peak energy demand of these devices, allowing operation with energy buffers that are one-eighth of the size originally required, thus leading to benefits such as smaller device footprints and faster recharging to operational voltage level. The impact on final performance is striking: with DICE, Hibernus requires one order of magnitude fewer checkpoints and one order of magnitude shorter time to complete a workload in real-world settings.
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10. |
- Ahmed, Saad, et al.
(author)
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Intermittent Computing with Dynamic Voltage and Frequency Scaling
- 2020
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In: EWSN '20. ; , s. 97-107
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Conference paper (peer-reviewed)abstract
- We present D2VFS, a run-time technique to intelligently regulate supply voltage and accordingly reconfigure clock frequency of intermittently-computing devices. These devices rely on energy harvesting to power their operation and on small capacitors as energy buffer. Statically setting their clock frequency fails to achieve energy efficiency, as the setting remains oblivious of fluctuations in capacitor voltage and of their impact on a microcontroller operating range. In contrast, D2VFS captures these dynamics and places the microcontroller in the most efficient configuration by regulating the microcontroller supply voltage and changing its clock frequency. Our evaluation shows that D2VFS markedly increases energy efficiency; for example, ultimately enabling a 30-300% reduction of workload completion times.
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