Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

Abstract-A broad range of embedded networked sensor (ENS) systems for critical environmental monitoring applications now require complex, high peak power dissipating sensor devices, as well as on-demand high performance computing and high bandwidth communication. Embedded computing demands for these new platforms include support for computationally intensive image and signal processing as well as optimization and statistical computing. To meet these new requirements while maintaining critical support for low energy operation, a new multiprocessor node hardware and software architecture, Low Power Energy Aware Processing (LEAP), has been developed. This architecture integrates fine-grained energy dissipation monitoring and sophisticated power control scheduling for all subsystems including sensor subsystems. The LEAP architecture enables complex energy-aware algorithm design by providing a simple interface to control numerous platform and sensor power modes and report detailed energy usage information. This paper also describes experimental results of a new distributed node testbed based on LEAP demonstrating that by exploiting high energy efficiency components and enabling proper on-demand scheduling, the LEAP architecture meets both sensing performance and energy dissipation objectives for a broad class of applications. This testbed including the network of distributed LEAP nodes and a system producing physical, mobile events provides a development environment for LEAP-hosted algorithms. New design principles, detailed implementation, and in-network programming and remote debugging capabilities of this platform are also described. While this is the first report of the LEAP system, it has been deployed for nearly one year with 50 users developing energy aware systems.Keywords-embedded wireless networked sensor, energy-aware multprocessor platform, sensor platform hardware and software architecture

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Intragastric balloons have been used as an invasive non-surgical treatment for obesity for over 30 years. Within the last 37 years, we have found only 27 cases reported in the literature of intestinal obstruction caused by a migrated intragastric balloon. We report the laparoscopic management of such a case and make observations from similar case presentations published in the literature. A 26-year-old woman had an intragastric balloon placed endoscopically for weight control 13 months previously. She presented to the emergency department with a four-day history of intermittent abdominal cramps and vomiting. Contrast enhanced computed tomography confirmed the presence of the intragastric balloon within the small bowel. At laparoscopic retrieval, the deflated intragastric balloon was found impacted in the terminal ileum approximately 15 cm from the ileocaecal valve. The balloon was retrieved by enterotomy and primary closure of the ileum without event. The risk of balloon deflation and subsequent migration increases over time but several published cases demonstrate that this complication can occur within six months of insertion. The initial approach to the treatment of migrated intragastric balloons causing small bowel obstruction should be determined by the location of impaction, severity of obstruction and the available skill set of the attending radiologist, endoscopist and/or surgeon. Balloons causing obstruction in the duodenum are likely amenable to endoscopic retrieval whereas impaction within the jejunum or ileum could be managed by percutaneous needle aspiration (in selected cases), endoscopy (double-balloon enteroscopy), laparoscopy or open surgery.

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