| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
-
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
-
Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
|
|
| 2. |
- Kumar, Sunil, et al.
(författare)
-
Multifunctional ammonium fuel cell using compost as a novel electro-catalyst
- 2018
-
Ingår i: Journal of Power Sources. - : Elsevier BV. - 0378-7753 .- 1873-2755. ; 402, s. 221-228
-
Tidskriftsartikel (refereegranskat)abstract
- Due to acute ammonium toxicity, it is always desirable to find a cheaper and abundant electro-catalyst other than platinum, iridium oxide, boron diamond etc with a high selectivity and negligible de-activation for its oxidation. Also ammonium is not known for electricity generation except biological nitrification process. So this paper elucidates the studies of compost as a novel electro-catalyst in a ammonium fuel cell configuration. These studies are done by varying type of electrodes & compost as well as ammonium concentration. Bi-polar cyclic voltammetry, electrochemical impedance spectroscopy, temperature dependence, cyclic stability and chronoamperometry techniques are used to study compost. Cow dung based compost is found to show the best electro-catalytic activity. IV measurements are conducted to study power generation in tune with the electro-catalytic activity. Finally, polarization and sustainability measurements are done on a comparatively larger fuel cell to check the size scalability. The results shows that the maximum power density is 108 mW/m(2) and this multifunctional device can be fueled after every 12 h for continuous operation and with negligible de-activation of electro-catalyst. These studies opens a window for doing further advanced research in compost triggered electro-catalysis to make multifunctional fuel cell devices for solving environmental and energy issues together.
|
|
| 3. |
|
|
| 4. |
-
- 2017
-
Ingår i: Physical Review D. - 2470-0010 .- 2470-0029. ; 96:2
-
Tidskriftsartikel (refereegranskat)
|
|
| 5. |
- Bakare, Fatimat O., et al.
(författare)
-
Thermomechanical properties of bio-based composites made from a lactic acid thermoset resin and flax and flax/basalt fibre reinforcements
- 2016
-
Ingår i: Composites. Part A, Applied science and manufacturing. - : Elsevier. - 1359-835X .- 1878-5840. ; 83, s. 176-184
-
Tidskriftsartikel (refereegranskat)abstract
- Low viscosity thermoset bio-based resin was synthesised from lactic acid, allyl alcohol and pentaerythritol. The resin was impregnated into cellulosic fibre reinforcement from flax and basalt and then compression moulded at elevated temperature to produce thermoset composites. The mechanical properties of composites were characterised by flexural, tensile and Charpy impact testing whereas the thermal properties were analysed by dynamic mechanical thermal analysis (DMTA) and thermogravimetric analysis (TGA). The results showed a decrease in mechanical properties with increase in fibre load after 40 wt.% for the neat flax composite due to insufficient fibre wetting and an increase in mechanical properties with increase fibre load up to 60 wt.% for the flax/basalt composite. The results of the ageing test showed that the mechanical properties of the composites deteriorate with ageing; however, the flax/basalt composite had better mechanical properties after ageing than the flax composite before ageing.
|
|
| 6. |
- Colombini, Manuela, et al.
(författare)
-
Agenda setting and framing of gender-based violence in Nepal : how it became a health issue.
- 2016
-
Ingår i: Health Policy and Planning. - : Oxford University Press (OUP). - 0268-1080 .- 1460-2237. ; 31:4, s. 493-503
-
Tidskriftsartikel (refereegranskat)abstract
- Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model.
|
|
| 7. |
- Coughlin, Michael W., et al.
(författare)
-
GROWTH on S190425z : Searching Thousands of Square Degrees to Identify an Optical or Infrared Counterpart to a Binary Neutron Star Merger with the Zwicky Transient Facility and Palomar Gattini-IR
- 2019
-
Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8205 .- 2041-8213. ; 885:1
-
Tidskriftsartikel (refereegranskat)abstract
- The third observing run by LVC has brought the discovery of many compact binary coalescences. Following the detection of the first binary neutron star merger in this run (LIGO/Virgo S190425z), we performed a dedicated follow-up campaign with the Zwicky Transient Facility (ZTF) and Palomar Gattini-IR telescopes. The initial skymap of this single-detector gravitational wave (GW) trigger spanned most of the sky observable from Palomar Observatory. Covering 8000 deg(2) of the initial skymap over the next two nights, corresponding to 46% integrated probability, ZTF system achieved a depth of 21 m(AB) in g- and r-bands. Palomar Gattini-IR covered 2200 square degrees in J-band to a depth of 15.5 mag, including 32% integrated probability based on the initial skymap. The revised skymap issued the following day reduced these numbers to 21% for the ZTF and 19% for Palomar Gattini-IR. We narrowed 338,646 ZTF transient ?alerts? over the first two nights of observations to 15 candidate counterparts. Two candidates, ZTF19aarykkb and ZTF19aarzaod, were particularly compelling given that their location, distance, and age were consistent with the GW event, and their early optical light curves were photometrically consistent with that of kilonovae. These two candidates were spectroscopically classified as young core-collapse supernovae. The remaining candidates were ruled out as supernovae. Palomar Gattini-IR did not identify any viable candidates with multiple detections only after merger time. We demonstrate that even with single-detector GW events localized to thousands of square degrees, systematic kilonova discovery is feasible.
|
|
| 8. |
- Dahal, Pranab, et al.
(författare)
-
'We are looked down upon and rejected socially' : a qualitative study on the experiences of trafficking survivors in Nepal
- 2015
-
Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 8, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The successful reintegration of sexual trafficking survivors into Nepalese society is challenging. This paper aims to explore the trafficking process, abuses faced during sexual slavery, and the challenges faced by women and girl survivors for successful reintegration. Method: This exploratory study used qualitative methods to identify that poverty, illiteracy, lack of opportunities, and varied social stigma initiate the victimization process, and continuity of this vicious circle increases the risk for (re) entrapment. Result: The reasons for sexual trafficking have also become the reasons for restricting survivors from opportunities for growth and mainstreaming. Conclusion: Non-existent support systems, detachment from familial ties, being outcast by society, and an uncertain livelihood make reintegration difficult for survivors.
|
|
| 9. |
- Jain, Anupriya, et al.
(författare)
-
Studies of hypro-mellose (HPMC) functionalized ZnS:Mn fluorescent quantum dots
- 2017
-
Ingår i: Journal of materials science. Materials in electronics. - : Springer Science and Business Media LLC. - 0957-4522 .- 1573-482X. ; 28:2, s. 1931-1937
-
Tidskriftsartikel (refereegranskat)abstract
- Fluorescent ZnS:Mn quantum dots coated with hypro-mellose (HPMC) were synthesized by using simple and facile chemical precipitation technique in which HPMC acts as a novel organic surfactant to passivate the surface, to tune the optical properties and also to functionalize the surface of quantum dot for a futuristic controlled drug release applications. Morphological and optical characterizations were done to see the effect of HPMC coating on ZnS: Mn quantum dots. Structural and morphological studies was done by using XRD and TEM respectively. XRD studies confirms the pure zinc blende phase for all the samples. TEM studies shows that HPMC is efficiently doing the surface passivation in doped quantum dots. Optical studies were done by using UV-visible, FTIR and time resolved photoluminescence. UV-visible studies shows that quantum confinement effect is more prominent and also tunable in case of HPMC coated manganese doped ZnS quantum dots. FTIR studies confirms the functionalization of HPMC on the surface of doped ZnS quantum dots. Laser induced time resolved photoluminescence studies were also done to see the effect of HPMC on the photoluminescence intensity of doped quantum dots. Time resolved studies clearly shows the much desired luminescence stability of the HPMC coated quantum dots. It is observed that both the structural and optical characteristics have strong dependence on capping concentration. As HPMC is a very important viscoelastic polymer and organic surfactant used in various types of drug formulations, these studies opens a new way in the area of efficient drug delivery, controlled drug release and targeting.
|
|
| 10. |
- KC, Ashish, 1982-, et al.
(författare)
-
Effect of a scaled-up neonatal resuscitation quality improvement package on intrapartum-related mortality in Nepal : A stepped-wedge cluster randomized controlled trial
- 2019
-
Ingår i: PLoS Medicine. - : PUBLIC LIBRARY SCIENCE. - 1549-1277 .- 1549-1676. ; 16:9
-
Tidskriftsartikel (refereegranskat)abstract
- Background Improving quality of intrapartum care will reduce intrapartum stillbirth and neonatal mortality, especially in resource-poor settings. Basic neonatal resuscitation can reduce intrapartum stillbirth and early neonatal mortality, if delivered in a high-quality health system, but there is a dearth of evidence on how to scale up such evidence-based interventions. We evaluated the scaling up of a quality improvement (QI) package for neonatal resuscitation on intrapartum-related mortality (intrapartum stillbirth and first day mortality) at hospitals in Nepal. Methods and findings We conducted a stepped-wedge cluster randomized controlled trial in 12 hospitals over a period of 18 months from April 14, 2017, to October 17, 2018. The hospitals were assigned to one of four wedges through random allocation. The QI package was implemented in a stepped-wedge manner with a delay of three months for each step. The QI package included improving hospital leadership on intrapartum care, building health workers' competency on neonatal resuscitation, and continuous facilitated QI processes in clinical units. An independent data collection system was set up at each hospital to gather data on mortality through patient case note review and demographic characteristics of women using semi-structured exit interviews. The generalized linear mixed model (GLMM) and multivariate logistic regression were used for analyses. During this study period, a total of 89,014 women-infant pairs were enrolled. The mean age of the mother in the study period was 24.0 +/- 4.3 years, with 54.9% from disadvantaged ethnic groups and 4.0% of them illiterate. Of the total birth cohort, 54.4% were boys, 16.7% had gestational age less than 37 weeks, and 17.1% had birth weight less than 2,500 grams. The incidence of intrapartum-related mortality was 11.0 per 1,000 births during the control period and 8.0 per 1,000 births during the intervention period (adjusted odds ratio [aOR], 0.79; 95% CI, 0.69-0.92; p = 0.002; intra-cluster correlation coefficient [ICC], 0.0286). The incidence of early neonatal mortality was 12.7 per 1,000 live births during the control period and 10.1 per 1,000 live births during the intervention period (aOR, 0.89; 95% CI, 0.78-1.02; p = 0.09; ICC, 0.1538). The use of bag-and-mask ventilation for babies with low Apgar score (<7 at 1 minute) increased from 3.2% in the control period to 4.0% in the intervention period (aOR, 1.52; 95% CI, 1.32-1.77, p = 0.003). There were two major limitations to the study; although a large sample of women-infant pairs were enrolled in the study, the clustering reduced the power of the study. Secondly, the study was not sufficiently powered to detect reduction in early neonatal mortality with the number of clusters provided. Conclusion These results suggest scaled-up implementation of a QI package for neonatal resuscitation can reduce intrapartum-related mortality and improve clinical care. The QI intervention package is likely to be effective in similar settings. More implementation research is required to assess the sustainability of QI interventions and quality of care.
|
|
