| 1. |
- Anderson, Geoffrey A., et al.
(författare)
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Development of a Novel Global Surgery Course for Medical Schools
- 2019
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Ingår i: Journal of Surgical Education. - : Elsevier BV. - 1931-7204. ; 76:2, s. 469-479
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We endeavored to create a comprehensive course in global surgery involving multinational exchange. Design: The course involved 2 weeks of didactics, 2 weeks of clinical rotations in a low-resource setting and 1 week for a capstone project. We evaluated our success through knowledge tests, surveys of the students, and surveys of our Zimbabwean hosts. Setting: The didactic portions were held in Sweden, and the clinical portion was primarily in Harare with hospitals affiliated with the University of Zimbabwe. Participants: Final year medical students from Lund University in Sweden, Harvard Medical School in the USA and the University of Zimbabwe all participated in didactics in Sweden. The Swedish and American students then traveled to Zimbabwe for clinical work. The Zimbabwean students remained in Sweden for a clinical experience. Results: The course has been taught for 3 consecutive years and is an established part of the curriculum at Lund University, with regular participation from Harvard Medical School and the University of Zimbabwe. Participants report significant improvements in their physical exam skills and their appreciation of the needs of underserved populations, as well as confidence with global surgical concepts. Our Zimbabwean hosts thought the visitors integrated well into the clinical teams, added value to their own students’ experience and believe that the exchange should continue despite the burden associated with hosting visiting students. Conclusions: Here we detail the development of a course in global surgery for medical students that integrates didactic as well as clinical experiences in a low-resource setting. The course includes a true multilateral exchange with students from Sweden, the United States and Zimbabwe participating regularly. We hope that this course might serve as a model for other medical schools looking to establish courses in this burgeoning field.
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| 2. |
- Chen, Yu-Hsiang, et al.
(författare)
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Enhanced thermal stability and fracture toughness of TiAlN coatings by Cr, Nb and V-alloying
- 2018
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Ingår i: Surface & Coatings Technology. - : Elsevier. - 0257-8972 .- 1879-3347. ; 342, s. 85-93
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Tidskriftsartikel (refereegranskat)abstract
- The effect of metal alloying on mechanical properties including hardness and fracture toughness were investigated in three alloys, Ti 0.33Al0.50(Me) 0.17N (Me = Cr, Nb and V), and compared to Ti0.50Al0.50N, in the as-deposited state and after annealing. All studied alloys display similar as-deposited hardness while the hardness evolution during annealing is found to be connected to phase transformations, related to the alloy’s thermal stability. The most pronounced hardening was observed in Ti0.50Al0.50N, while all the coatings with additional metal elements sustain their hardness better and they are harder than Ti0.50Al0.50N after annealing at 1100 °C. Fracture toughness properties were extracted from scratch tests. In all tested conditions, as-deposited and annealed at 900 and 1100 °C, Ti0.33Al0.50Nb0.17N show the least surface and sub-surface damage when scratched despite the differences in decomposition behavior and h-AlN formation. Theoretically estimated ductility of phases existing in the coatings correlates well with their crack resistance. In summary, Ti0.33Al0.50Nb0.17N is the toughest alloy in both as-deposited and post-annealed states.
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| 3. |
- Chen, Yu-Hsiang, et al.
(författare)
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Thermal and mechanical stability of wurtzite-ZrA1N/cubic-TiN and wurtzite-ZrA1N/cubic-ZrN multilayers
- 2017
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Ingår i: Surface & Coatings Technology. - : ELSEVIER SCIENCE SA. - 0257-8972 .- 1879-3347. ; 324, s. 328-337
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Tidskriftsartikel (refereegranskat)abstract
- The phase stability and mechanical properties of wurtzite (w)-Zr(0.25)A1(0.75)N/cubic (c)-TiN and w-Zr(0.25)A1(0.75)N/c-ZrN multilayers grown by arc evaporation are studied. Coherent interfaces with an orientation relation of c-TiN (111)[1-10]IIw-ZrAlN (0001)[11-20] form between ZrA1N and TiN sublayers during growth of the w-ZrAIN/c-TiN multilayer. During annealing at 1100 degrees C a c-Ti(Zr)N phase forms at interfaces between ZrA1N and TiN, which reduces the lattice mismatch so that the coherency and the compressive strain are partially retained, resulting in an increased hardness (32 GPa) after annealing. For the w-ZrAIN/c-ZrN multilayer, there is no coherency between sublayers leading to strain relaxation during annealing causing the hardness to drop. The retained coherency between layers and the compressive strain in the w-ZrAIN/c-TiN multilayer results in superior fracture toughness compared to the w-ZrAIN/c-ZrN multilayer as revealed by cross-sectional investigations of damage events under scratch and indentation tests. (C) 2017 Elsevier B.V. All rights reserved.
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| 4. |
- Juran, Sabrina, et al.
(författare)
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The Development and Inclusion of Questions on Surgery in the 2018 Zambia Demographic and Health Survey
- 2021
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Ingår i: Global Health Science and Practice. - 2169-575X. ; 9:4, s. 905-914
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Tidskriftsartikel (refereegranskat)abstract
- Background: While primary data on the unmet need for surgery in low- and middle-income countries is lacking, household surveys could provide an entry point to collect such data. We describe the first development and inclusion of questions on surgery in a nationally representative Demographic and Health Survey (DHS) in Zambia. Method: Questions regarding surgical conditions were developed through an iterative consultative process and integrated into the rollout of the DHS survey in Zambia in 2018 and administered to a nationwide sample survey of eligible women aged 15-49 years and men aged 15-59 years. Results: In total, 7 questions covering 4 themes of service delivery, diagnosed burden of surgical disease, access to care, and quality of care were added. The questions were administered across 12,831 households (13,683 women aged 15-49 years and 12,132 men aged 15-59 years). Results showed that approximately 5% of women and 2% of men had undergone an operation in the past 5 years. Among women, cesarean delivery was the most common surgery; circumcision was the most common procedure among men. In the past 5 years, an estimated 0.61% of the population had been told by a health care worker that they might need surgery, and of this group, 35% had undergone the relevant procedure. Conclusion: For the first time, questions on surgery have been included in a nationwide DHS. We have shown that it is feasible to integrate these questions into a large-scale survey to provide insight into surgical needs at a national level. Based on the DHS design and implementation mechanisms, a country interested in including a set of questions like the one included in Zambia, could replicate this data collection in other settings, which provides an opportunity for systematic collection of comparable surgical data, a vital role in surgical health care system strengthening.
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| 5. |
- Morawska, Lidia, et al.
(författare)
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The state of science on severe air pollution episodes : Quantitative and qualitative analysis
- 2021
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Ingår i: Environment International. - : Elsevier BV. - 1873-6750 .- 0160-4120. ; 156, s. 106732-106732
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Tidskriftsartikel (refereegranskat)abstract
- Severe episodic air pollution blankets entire cities and regions and have a profound impact on humans and their activities. We compiled daily fine particle (PM2.5) data from 100 cities in five continents, investigated the trends of number, frequency, and duration of pollution episodes, and compared these with the baseline trend in air pollution. We showed that the factors contributing to these events are complex; however, long-term measures to abate emissions from all anthropogenic sources at all times is also the most efficient way to reduce the occurrence of severe air pollution events. In the short term, accurate forecasting systems of such events based on the meteorological conditions favouring their occurrence, together with effective emergency mitigation of anthropogenic sources, may lessen their magnitude and/or duration. However, there is no clear way of preventing events caused by natural sources affected by climate change, such as wildfires and desert dust outbreaks.
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