Hadronization properties in e+e- annihilation at S=0 60GeV centre of mass energy

The hadronic events from the experimental data , as well as the PYTHIA Monte-carlo data at the 60 GeV centre of mass energies are studied.We present the general properties of multihadron final states produced by e+e- .Globalshape, inclusive charged-particle, and particle-flow distributions are presented. Our measurements are comparedwith QCD + fragmentation models that use either leading-logarithmic parton-shower evolution or QCD matrixelements at the parton level, and either string or cluster fragmentation for hadronization. Possible explanations forourcompariaon are presented in this paper

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Assessment of Fluctuation Patterns Similarity in Temperature and Vapor Pressure Using Discrete Wavelet Transform

Period and trend are two main effective and important factors in hydro-climatological time series and because of this importance, different methods have been introduced and applied to study of them, until now. Most of these methods are statistical basis and they are classified in the non-parametric tests. Wavelet transform is a mathematical based powerful method which has been widely used in signal processing and time series analysis in recent years. In this research, trend and main periodic patterns similarity in temperature and vapor pressure has been studied in Babolsar, Tehran and Shahroud synoptic stations during 55 years period (from 1956 to 2010), using wavelet method and the sequential Mann-Kendall trend test. The results show that long term fluctuation patterns in temperature and vapor pressure have more correlations in the arid and semi-arid climates, as well as short term oscillation patterns in temperature and vapor pressure in the humid climates, and these dominant periods increase with the aridity of region

Calibration and Validation Parameter of Hydrologic Model HEC-HMS using Particle Swarm Optimization Algorithms – Single Objective

Introduction: Planning and management of water resource and river basins needs use of conceptual hydrologic models which play a significant role in predicting basins response to different climatic and meteorological processes. Evaluating watershed response through mathematical hydrologic models requires finding a set of parameter values of the model which provides thebest fit between observed and estimated hydrographs in a procedure called calibration. Asmanual calibration is tedious, time consuming and requires personal experience, automaticcalibration methods make application of more significant CRR models which are based onusing a systematic search procedure to find good parameter sets in terms of at least oneobjective function. Materials and Methods: Conceptual hydrologic models play a significant role inpredicting a basin’s response to different climatic and meteorological processes within natural systems. However, these models require a number of estimated parameters. Model calibration is the procedure of adjusting the parametervalues until the model predictions match the observed data. Manual calibration of high-fidelity hydrologic (simulation) models is tedious, time consuming and sometimesimpractical, especially when the number of parameters islarge. Moreover, the high degrees of nonlinearity involved in different hydrologic processes and non-uniqueness ofinverse-type calibration problems make it difficult to find asingle set of parameter values. In this research, the conceptual HEC-HMS model is integrated with the Particle Swarm Optimization (PSO) algorithm.The HEC-HMS model was developed as areplacement for HEC-1, which has long been considered as astandard model for hydrologic simulation. Most of thehydrologic models employed in HEC-HMS are event-basedmodels simulating a single storm requiring the specificationof all conditions at the beginning of the simulation. The soil moistureaccounting model in the HEC-HMS is the onlycontinuous model that simulates both wet and dry weatherbehavior.Programming of HEC –HMS has been done by MATLAB and techniques such as elite mutation and creating confusion have been used in order to strengthen the algorithm and improve the results. The event-based HEC-HMS model simulatesthe precipitation-runoff process for each set of parameter values generated by PSO. Turbulentand elitism with mutation are also employed to deal with PSO premature convergence. The integrated PSO-HMS model is tested on the Kardeh dam basin located in the Khorasan Razavi province. Results and Discussion: Input parameters of hydrologic models are seldomknown with certainty. Therefore, they are not capable ofdescribing the exact hydrologic processes. Input data andstructural uncertainties related to scale and approximationsin system processes are different sources of uncertainty thatmake it difficult to model exact hydrologic phenomena.In automatic calibration, the parameter values dependon the objective function of the search or optimization algorithm.In characterizing a runoff hydrograph, threecharacteristics of time-to-peak, peak of discharge and totalrunoff volume are of the most importance. It is thereforeimportant that we simulate and observe hydrographs matchas much as possible in terms of those characteristics. Calibration was carried out in single objective cases. Model calibration in single-objective approach with regard to the objective function in the event of NASH and RMSE were conducted separately.The results indicated that the capability of the model was calibrated to an acceptable level of events. Continuing calibration results were evaluated by four different criteria.Finally, to validate the model parameters with those obtained from the calibration, tests perfomed indicated poor results. Although, based on the calibration and verification of individual events one event remains, suggesting set is a possible parameter. Conclusion: All events were evaluated by validations and the results show that the performance model is not desirable. The results emphasized the impossibility of obtaining unique parameters for a basin. This method of solution, because of non-single solutions of calibration, could be helpful as an inverse problem that could limit the number of candidates. The above analysis revealed the existence of differentparameter sets that can altogether simulate verificationevents quite well, which shows the non-uniqueness featureof the calibration problem under study. However, the methodologyhas benefited from that feature by finding newparameter intervals that should be fine-tuned further inorder to decrease input and model prediction uncertainties.The proposed methodology performed well in the automatedcalibration of an event-based hydrologic model;however, the authors are aware of a drawback of the presentedanalysis – this undertakingwas not a completely fair validationprocedure. It is because validation events represent possiblefuture scenarios and thus are not available at the time ofmodel calibration. Hence, an event being selected as a validationevent should not be used to receive any morefeedback for adjusting parameter values and ranges.However,this remark was not fully taken into consideration, mostlybecause of being seriously short of enough observed eventsin this calibration study. Therefore, the proposed methodology,although sound and useful, should be validated inother case studies with more observed flood events