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Abstract

Objective

Current knowledge on the global burden of infant sepsis is limited to population-level data. We aimed to summarize global case fatality rates (CFRs) of young infants with sepsis, stratified by gross national income (GNI) status and patient-level risk factors.

Methods

We performed a systematic review and meta-analysis on CFRs among young infants < 90 days with sepsis. We searched PubMed, Cochrane Central, Embase, and Web of Science for studies published between January 2010 and September 2019. We obtained pooled CFRs estimates using the random effects model. We performed a univariate analysis at patient-level and a meta-regression to study the associations of gestational age, birth weight, onset of sepsis, GNI, age group and culture-proven sepsis with CFRs.

Results

The search yielded 6314 publications, of which 240 studies (N = 437,796 patients) from 77 countries were included. Of 240 studies, 99 were conducted in high-income countries, 44 in upper-middle-income countries, 82 in lower-middle-income countries, 6 in low-income countries and 9 in multiple income-level countries. Overall pooled CFR was 18% (95% CI, 17–19%). The CFR was highest for low-income countries [25% (95% CI, 7–43%)], followed by lower-middle [25% (95% CI, 7–43%)], upper-middle [21% (95% CI, 18–24%)] and lowest for high-income countries [12% (95% CI, 11–13%)]. Factors associated with high CFRs included prematurity, low birth weight, age less than 28 days, early onset sepsis, hospital acquired infections and sepsis in middle- and low-income countries. Study setting in middle-income countries was an independent predictor of high CFRs. We found a widening disparity in CFRs between countries of different GNI over time.

Conclusion

Young infant sepsis remains a major global health challenge. The widening disparity in young infant sepsis CFRs between GNI groups underscore the need to channel greater resources especially to the lower income regions.

Systematic Review Reg

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Rousseau

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Introduction

Varun Jean-Jacques Rousseau is a pivotal figure in the history of philosophy, both for his contributions to political philosophy and moral psychology and for his effect on subsequent thinkers.

Rousseau considered most philosophy and philosophers as post hoc rationalizers of self-interest, apologists for various sorts of dictatorship, and contributing to the modern individual's separation from humanity's innate instinct for compassion. The overarching objective of Rousseau's work is to discover a means to preserve human freedom in a world where people are increasingly reliant on one another to meet their wants.

Early Life

Jean-Jacques Rousseau was born in 1712 in the independent Calvinist city-state of Geneva. He was the son of watchmaker Isaac Rousseau and Suzanne Bernard. Nine days after Rousseau was born, his mother passed away, and he was raised and educated by his father until he was ten years old.

As a member of the ostensibly independent assembly of Geneva, Isaac Rousseau was one of the few minorities of the city's citizens who held the title of citizen of Geneva. This rank was to be passed down to Jean-Jacques. In his later narratives, he claimed that his father's haphazard education encompassed reading works by ancient republican historians like Plutarch in addition to republican patriotism instillation. Jean-Jacques was left in the care of a clergyman in the neighboring town of Bossey after his father left this city to avoid being arrested, and he was later apprenticed to an engraver.

At sixteen, Rousseau left Geneva and was influenced by Francoise-Louise de la Tour, Baronne de Warens, a noblewoman who had converted to Roman Catholicism. In April 1728, Rousseau became a Roman Catholic after traveling to Turin; he worked for a while as a domestic worker in a noble home in Turin. It was during this period that Rousseau had a humiliating incident where he made up a false accusation against another member of sta

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