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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. |
- Dehnavi, Gholamali Z., et al.
(författare)
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Fractionation of the main components of barley spent grains from a microbrewery
- 2011
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Ingår i: Cellulose Chemistry and Technology. - 0576-9787. ; 45:5-6, s. 339-345
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Tidskriftsartikel (refereegranskat)abstract
- The chemical composition of barley spent grains generated in a microbrewery and their fractionation by acid hydrolysis and delignification were investigated. The material contained high amount of carbohydrates (60%), while its lignin content was lower than that reported for other sorts of barley spent grains. Different dilute-acid hydrolysis methods were evaluated for separating the main components of the spent grains, without affecting the sugars generated by starch hydrolysis. The utilization of a two-step dilute-acid hydrolysis approach allowed to hydrolyse starch in a first step, at 100 ºC, and hemicelluloses in a second step, at 121 ºC. Acetosolv and alkaline delignification were used for solubilising the lignin fraction. A higher lignin solubilisation (95% of the lignin contained in the raw material) was achieved after alkaline delignification, whereas only 34% of the initial lignin was removed by direct acetosolv. When the acetosolv treatment was combined with acid hydrolysis, lignin solubilisation increased to 74%. Lignin was precipitated from the liquors at recovery rates from 40 to 93%, as depending on the hydrolysis/delignification method used.
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