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. |
- Feigin, Valery L., et al.
(författare)
-
Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
-
Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
-
Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
|
|
3. |
- Hoseini-Athar, Mohammad Mehdi, et al.
(författare)
-
Microstructure and superplasticity of Mg-2Gd-xZn alloys processed by equal channel angular pressing
- 2021
-
Ingår i: Materials Science & Engineering. - : Elsevier. - 0921-5093 .- 1873-4936. ; 808
-
Tidskriftsartikel (refereegranskat)abstract
- Microstructure, mechanical properties and superplastic behavior of Mg-2Gd-xZn (x = 0, 1, 2 and 3 wt%) alloys were investigated after extrusion and equal channel angular pressing (ECAP). After only 2 passes of ECAP, a homogenous fine-grained microstructure with a grain size of 2.33 mu m and a high fraction of high-angle grain boundaries of 84% were formed in the Mg-2Gd-3Zn (GZ23) alloy, while 4 ECAP passes were necessary to create such a structure in the other alloys. This was attributed to the higher solute drag effect in the other alloys, retarding dynamic recrystallization (DRX). Although DRX occurred more easily in the GZ23 alloy, the final DRX grain size was slightly coarser compared to the other alloys. Shear punch testing (SPT) showed that grain refinement during ECAP leads to a slight increase in the shear yield strength of all studied materials after 2 ECAP passes, which was mostly balanced by texture softening caused by the shear texture component and grain growth after 4 ECAP passes. Contrary to the other alloys, the GZ23 alloy exhibited superplastic behavior after a lower number of ECAP passes. In addition, the superplastic temperature for GZ23 was 648 K, which was lower than the 673 K observed for the other alloys. The m-values of similar to 0.45-0.5 and activation energies of 98-114 kJ/mol suggested grain boundary sliding (GBS) controlled by grain boundary diffusion as the dominant deformation mechanism in the superplastic regime. This was confirmed by microstructural observations.
|
|
4. |
- Hoseini-Athar, Mohammad Mehdi, et al.
(författare)
-
Tailoring the texture of an extruded Mg sheet through constrained groove pressing for achieving low mechanical anisotropy and high yield strength
- 2020
-
Ingår i: Scripta Materialia. - : Elsevier BV. - 1359-6462 .- 1872-8456. ; 186, s. 253-258
-
Tidskriftsartikel (refereegranskat)abstract
- Constrained groove pressing (CGP) was utilized to modify the texture and mechanical properties of extruded Mg-2Gd-3Zn sheet with typical TD (transverse direction)-split texture and pronounced mechanical anisotropy. The texture evolution sequence during CGP was studied and it was observed that a new (1211) component with basal poles rotated 15-30 toward the extrusion direction (ED) is introduced during CGP, as a result of simultaneous activation of basal and prismatic slip and shear deformation. Finally, a non-basal ED-TD double split texture was obtained after the CGP process, resulting in significantly reduced mechanical anisotropy.
|
|
5. |
|
|
6. |
- Hoseini-Athar, Mohammad Mehdi, et al.
(författare)
-
Towards implementation of alloy-specific thermo-fluid modelling for laser powder-bed fusion of Mg alloys
- 2024
-
Ingår i: JOURNAL OF MAGNESIUM AND ALLOYS. - : Elsevier BV. - 2213-9567. ; 12:6, s. 2327-2344
-
Tidskriftsartikel (refereegranskat)abstract
- Multi-physics thermo-fluid modeling has been extensively used as an approach to understand melt pool dynamics and defect formation as well as optimizing the process-related parameters of laser powder-bed fusion (L-PBF). However, its capabilities for being implemented as a reliable tool for material design, where minor changes in material-related parameters must be accurately captured, is still in question. In the present research, first, a thermo-fluid computational fluid dynamics (CFD) model is developed and validated against experimental data. Considering the predicted material properties of the pure Mg and commercial ZK60 and WE43 Mg alloys, parametric studies are done attempting to elucidate how the difference in some of the material properties, i.e., saturated vapor pressure, viscosity, and solidification range, can influence the melt pool dynamics. It is found that a higher saturated vapor pressure, associated with the ZK60 alloy, leads to a deeper unstable keyhole, increasing the keyhole-induced porosity and evaporation mass loss. Higher viscosity and wider solidification range can increase the non-uniformity of temperature and velocity distribution on the keyhole walls, resulting in increased keyhole instability and formation of defects. Finally, the WE43 alloy showed the best behavior in terms of defect formation and evaporation mass loss, providing theoretical support to the extensive use of this alloy in L-PBF. In summary, this study suggests an approach to investigate the effect of materials-related parameters on L-PBF melting and solidification, which can be extremely helpful for future design of new alloys suitable for L-PBF.
|
|
7. |
- Sayari, F., et al.
(författare)
-
Comparison of the effect of ECAP and SSE on microstructure, texture, and mechanical properties of magnesium
- 2022
-
Ingår i: Journal of Alloys and Compounds. - : Elsevier BV. - 0925-8388 .- 1873-4669. ; 908
-
Tidskriftsartikel (refereegranskat)abstract
- Microstructure, crystallographic texture, and mechanical properties of pure Mg, as a model hcp metal, were compared after processing by the two severe plastic deformation (SPD) techniques of equal channel angular pressing (ECAP) and simple shear extrusion (SSE). Both processes were performed on extruded bars at 250 degrees C for up to four passes, where the minimum grain sizes of 13.7 and 9.8 mu m were achieved in the ECAP and SSE processes, respectively. The fraction of dynamically recrystallized (DRX) grains, high angle grain boundaries (HAGBs), and the evolution of dislocation density with equivalent strain experienced the same trend in both processes with higher values after ECAP. The textural evolutions were completely different during ECAP and SSE despite their similar deformation modes. A conventional shear texture was developed after ECAP, while after SSE basal planes were aligned parallel to the processing direction. In the ECAP-processed material, texture softening and lower dislocation density counterbalanced the strengthening effect of grain refinement, resulting in a decrease in shear yield stress (SYS) and ultimate shear strength (USS), while in SSE the shear strength increased constantly with increasing number of passes. It can be deduced from the experimental results that SSE was more effective in achieving a fine-grained homogenous microstructure with high shear strengths as compared to ECAP.
|
|