14 research outputs found
Non tuberculous Mycobacterial Surgical Site Infections after Laparoscopic Surgery: A Case Series of 37 Patients
No full textNontuberculous mycobacterial surgical site infections (SSIs) have a distinct course of disease with diagnosis and treatment presenting challenges. Thirty-seven patients who underwent various procedures and then developed late SSI due to nontuberculous mycobacteria included in this case series. Samples were sent for diagnosis. Patients were started on a regime of levofloxacin with azithromycin. Multiple patients required repeat surgical intervention. The duration of treatment varied from 4 to 6 months. Complete resolution of symptoms occurred in all patients. Nontuberculous mycobacterial infections can be challenging to diagnose and treat. A high degree of clinical suspicion is warranted to limit morbidity
Graphitization induced structural transformation of candle soot carbon into carbon nano-onion as a functional anode for metal-ion batteries
No full textThis work reports for the first time the structural transformation of glassy spherical candle soot carbon into graphitic polyhedral carbon nano-onions (multilayer fullerenes) by simple graphitization of candle soot carbon at varying temperatures from 1500 to 2400 °C. This structural transformation of candle soot carbon is thoroughly investigated by high-resolution transmission electron microscopy, X-ray diffraction, and Raman spectroscopy, with the aid of first-principles calculation based on density functional theory to understand the effect on physiochemical properties. Further, this understanding of structural transformation enables a promising pathway to tune the electrochemical properties of graphitized candle soot carbon to develop it as a functional anode for metal-ion (Li-ion as well K-ion) battery applications. © 2022 The Author(s)
Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study
No full textBackground: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these. Method: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality. Results: 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4–2), (OR = 4.7, 95% CI 3.1–7.6)], female gender [(OR = 1.8, 95% CI 1.4–2.3), (OR = 1.9, 95% CI 1.3–2.9)], shock on admission [(OR = 2.1, 95% CI 1.7–2.7), (OR = 4.8, 95% CI 3.2–7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9–3.2), (OR = 3.9), 95% CI 2.7–5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1–1.6], but not mortality. Conclusions: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality. Graphical abstract: (Figure presented.
The virtues of small grain size: Potential pathways to a distinguishing feature of Asian wheats
No full textIncrease in grain/seed size recurrently features as a key element in the ‘domestication syndrome’ of plants (cf. Zohary and Hopf 2000; Fuller et al. 2014). In the context of its spread across Eurasia, however, the grain size of one of the world's major crop species underwent a substantial reduction. Between the fifth and second millennia BC, the grain length in a number of species of Triticum, collectively known as free-threshing wheat, decreased by around 30%. In order to understand and help account for this trend, we have obtained direct radiocarbon measurements from 51 charred wheat grains and measured the dimensions of several hundred grains from Asia to establish when and where that size diminution occurred. Our results indicate that the pace of a eastward/southward spread was interrupted around 1800 BC on the borders of the distinct culinary zone recognized by Fuller and Rowlands (2011), but regained pace around 200–300 years later in central-east China with a diminished grain size. We interpret this as evidence of a period of active crop selection to suit culinary needs, and consider whether it constitutes a distinct episode in the general character of genetic intervention in domesticated species
How well do India's social service programs serve the poor?
No full textReaching India's poor calls for greatly improved social service delivery systems, better targeting of the poor, more coordination between agencies, policies aimed at income generation, and more involvement of the poor and of nongovernmental organizations. The authors of this paper found that India's social services were used relatively little by the poor. The health and education of the poor has improved but not as much for the population as a whole. The reasons that all social service programs did so little to alleviate poverty are similar. Physical access to education and health services has improved but inequalities exist because of biases in locating facilities. The access of the poor to housing, social security, and social welfare services has been limited because these services were inadequate relative to needs and because services leak to the nonpoor. Social service policies are not comprehensive enough and the quality of services is low. Issues common to the social sector delivery systems are weak management, ineffective targeting, and inflexible service delivery systems that result in a mismatch between perceived needs and services delivered. The bureaucracy is inadequate to reach the poor. Existing capacity and resources are inadequate, particularly for education and health.Health Monitoring&Evaluation,Health Economics&Finance,Poverty Assessment,Safety Nets and Transfers,Rural Poverty Reduction
SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues
No full textVariability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types. © 2021 The Author(s
The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study.
No full textFranklin RC, Peden AE, Hamilton EB, et al. The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention. 2020:injuryprev-2019-043484.BACKGROUND: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.; METHODS: Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning.; RESULTS: Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531956 (uncertainty interval (UI): 484107 to 572854) to 295210 (284493 to 306187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45434 (40850 to 50 539) YLLs per 100000 across both sexes.; CONCLUSIONS: There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ
Global injury morbidity and mortality from 1990 to 2017: Results from the global burden of disease study 2017
No full textBackground 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. methods We 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). Findings In 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). Interpretation Injuries 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. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ
Global, regional, and national burden of chronic kidney disease, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017
No full textAbstract: Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and induded incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017,1.2 million (95% uncertainty interval [UI] 1.2 to 1.3) people died from CKD. The global all-age mortality rate from CKD increased 41.5% (95% UI 35.2 to 46.5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2.8%, -1.5 to 6.3). In 2017,697.5 million (95% UI 649.2 to 752.0) cases of all-stage CKD were recorded, for a global prevalence of 9.1% (8.5 to 9.8). The global all-age prevalence of CKD increased 29.3% (95% UI 26.4 to 32.6) since 1990, whereas the age-standardised prevalence remained stable (1.2%, -1.1 to 3.5). CKD resulted in 35.8 million (95% UI 33.7 to 38.0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1.4 million (95% UI 1.2 to 1.6) cardiovascular disease-related deaths and 25.3 million (22.2 to 28.9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd
