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- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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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.
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| 2. |
- Shakoor, Awais, et al.
(författare)
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A global meta-analysis of greenhouse gases emission and crop yield under no-tillage as compared to conventional tillage
- 2020
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 1879-1026 .- 0048-9697.
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Tidskriftsartikel (refereegranskat)abstract
- No-tillage (NT) practice is extensively adopted with aims to improve soil physical conditions, carbon (C) sequestration and to alleviate greenhouse gases (GHGs) emissions without compromising crop yield. However, the influences of NT on GHGs emissions and crop yields remains inconsistent. A global meta-analysis was performed by using fifty peer-reviewed publications to assess the effectiveness of soil physicochemical properties, nitrogen (N) fertilization, type and duration of crop, water management and climatic zones on GHGs emissions and crop yields under NT compared to conventional tillage (CT) practices. The outcome reveals that compared to CT, NT increased CO2, N2O, and CH4 emissions by 7.1, 12.0, and 20.8%, respectively. In contrast, NT caused up to 7.6% decline in global warming potential as compared to CT. However, absence of difference in crop yield was observed both under NT and CT practices. Increasing N fertilization rates under NT improved crop yield and GHGs emission up to 23 and 58%, respectively, compared to CT. Further, NT practices caused an increase of 16.1% CO2 and 14.7% N2O emission in the rainfed areas and up to 54.0% CH4 emission under irrigated areas as compared to CT practices. This meta-analysis study provides a scientific basis for evaluating the effects of NT on GHGs emissions and crop yields, and also provides basic information to mitigate the GHGs emissions that are associated with NT practice.
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