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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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- Lu, Xiaohu, et al.
(författare)
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Evaluation of test sections with Polymer Modified Bitumens
- 2014
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Ingår i: Asphalt Pavements. - 9781138027121 ; , s. 287-296
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Konferensbidrag (refereegranskat)abstract
- It has been recognized that Polymer Modified Bitumens (PMB) have more potential for use in asphalt paving and can clearly demonstrate the value of their initial higher cost. To further assess sustainable benefits on heavy trafficked roads, test sections using various PMBs were built on highway E6 in Sweden during 2003-2006. The main objective of this paper is to study the aging and rheological properties of the binders used. A large number of cores were drilled and characterized with respect to stiffness, fatigue and permanent deformation. The binders (original, lab aged and recovered) were investigated extensively with rheological and chemical methods. It was found that PMBs, particularly SBS modified, demonstrate better rheological properties as compared to unmodified bitumens, even after several years in the field. These include higher strain recovery and lower non-recoverable compliance at high temperatures, and lower stiffness at low temperatures. For the SBS modified binders, good aging resistance was observed. The high resistance to aging for the SBS modified binders was also evident in the stiffness measurement made on asphalt field cores. Although significant differences have not yet been seen between the test sections (all the sections are in good condition after six years of traffic), the observed improvements for the modified binders are expected to be confirmed by a longer follow-up of the test road.
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| 5. |
- Said, Safwat F, 1951-
(författare)
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Alternativa beläggningar – högpresterande : kunskapsöversikt
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det finns kunskaper och erfarenheter av att högpresterande beläggningar, med till exempel polymermodifierat/gummimodifierat bitumen med flera, kan leda till ökade livslängder hos vägar. En ökad livslängd kan innebära en besparing i naturresurser och kostnader. Högprestandabeläggningar skulle därför kunna vara ett sätt för beställare att uppnå de miljömål regering och riksdag har satt upp. Målsättningen med detta projekt var att påvisa nyttan med högprestandabeläggningar ur samhällsekonomiska och miljömässiga synvinklar. Projektet som helhet omfattar dels kunskapsinhämtning inom området, förslag på alternativa konstruktioner och högprestanda-beläggningar, implementering och demonstration samt användning av tillförlitliga nedbrytningsmodeller och funktionsmetoder för dimensionering och tillståndsutveckling av vägar. Generella modeller och metoder skapar gynnsammare förutsättningar för att utvärdera och implementera nyutvecklade produkter. Slutsatserna från denna begränsade kunskapsöversikt är att det finns högpresterande asfaltbeläggningar och teknik som både kan leda till längre livslängd hos vägar och som tar mindre naturresurser i anspråk. Koncepten kan också innebära lägre kostnader och mindre klimatpåverkan.
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