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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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| 3. |
- Kumar, Rohan, et al.
(författare)
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Transforming the transportation sector : Mitigating greenhouse gas emissions through electric vehicles (EVs) and exploring sustainable pathways
- 2024
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Ingår i: AIP Advances. - : American Institute of Physics (AIP). - 2158-3226. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- Transportation-related emissions in Pakistan have been rapidly increasing in recent years. This study aims to determine how important it is to electrify road transportation in Pakistan to reduce greenhouse gas (GHG) emissions from the transportation sector. Motivated by the need to tackle the growing environmental issues related to conventional fuel-powered automobiles, this research explores the application of electrification techniques in the context of Pakistan’s transportation system. During the 2019 fiscal year, the transportation industry in Pakistan consumed 23 × 106 tonnes of energy from the burning of fossil fuels and produced 52.9 × 106 metric tons of CO2, which made up 31% of the country’s total carbon emissions. In this research, different scenarios, such as business as usual, low carbon, strengthen low carbon, and Pakistan National Electric Vehicle Policy 2040, are evaluated for the transportation sector of the country. Using the LEAP model, this study projects the effects of electrification on Pakistan road transportation over 30 years. When estimating how electrification will affect road transportation in Pakistan over the next 30 years, several factors were taken into account, including policy frameworks, changing consumer behavior, technology advancements, and infrastructure improvements. The analysis covered the emission levels, adoption hurdles, and possible advantages of transitioning to electric vehicles (EVs). The outcomes illustrate that adopting EVs can produce substantial drops in fuel consumption and environmental emissions, providing a sustainable solution to mitigate global warming. This work is directly associated with various Sustainable Development Goals, including SDG3 (good health and well-being), SDG7 (affordable and clean energy), and SDG13 (climate action). The results of this study highlight the considerable potential for GHG reduction associated with the widespread adoption of EVs, offering crucial insights to stakeholders and policymakers.
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| 4. |
- Zhang, Huai, et al.
(författare)
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A global survey on the use of the international classification of diseases codes for metabolic dysfunction-associated fatty liver disease.
- 2024
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Ingår i: Hepatology international. - 1936-0541.
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Tidskriftsartikel (refereegranskat)abstract
- With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.A total of 890 international experts in various fields from 61 countries responded to the survey. We also achieved full coverage of provincial-level administrative regions in China. 77.1% of respondents agreed that MAFLD should be represented in ICD-11 by updating NAFLD, with no significant regional differences (77.3% in Asia and 76.6% in non-Asia, p=0.819). Over 80% of respondents agreed or somewhat agreed with the need to assign specific codes for progressive stages of MAFLD (i.e. steatohepatitis) (92.2%), MAFLD combined with comorbidities (84.1%), or MAFLD subtypes (i.e., lean, overweight/obese, and diabetic) (86.1%).This global survey by a collaborative panel of clinical, coding, health management and policy experts, indicates agreement that MAFLD should be coded in ICD-11. The data serves as a foundation for corresponding adjustments in the ICD-11 revision.
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