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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. |
- Ahmed, Sultan, et al.
(författare)
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Arsenic Exposure Affects Plasma Insulin-Like Growth Factor 1 (IGF-1) in Children in Rural Bangladesh
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:11, s. e81530-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to inorganic arsenic (As) through drinking water during pregnancy is associated with lower birth size and child growth. The aim of the study was to assess the effects of As exposure on child growth parameters to evaluate causal associations. Methodology/Findings: Children born in a longitudinal mother-child cohort in rural Bangladesh were studied at 4.5 years (n=640) as well as at birth (n=134). Exposure to arsenic was assessed by concurrent and prenatal (maternal) urinary concentrations of arsenic metabolites (U-As). Associations with plasma concentrations of insulin-like growth factor 1 (IGF-1), calcium (Ca), vitamin D (Vit-D), bone-specific alkaline phosphatase (B-ALP), intact parathyroid hormone (iPTH), and phosphate (PO4) were evaluated by linear regression analysis, adjusted for socioeconomic factor, parity and child sex. Child U-As (per 10 mu g/L) was significantly inversely associated with concurrent plasma IGF-1 (beta=-0.27; 95% confidence interval: -0.50, -0.0042) at 4.5 years. The effect was more obvious in girls (beta=-0.29; -0.59, 0.021) than in boys, and particularly in girls with adequate height (beta=-0.491; -0.97, -0.02) or weight (beta=-0.47; 0.97, 0.01). Maternal U-As was inversely associated with child IGF-1 at birth (r=-0.254, P=0.003), but not at 4.5 years. There was a tendency of positive association between U-As and plasma PO4 in stunted boys (beta=0.27; 0.089, 0.46). When stratified by % monomethylarsonic acid (MMA, arsenic metabolite) (median split at 9.7%), a much stronger inverse association between U-As and IGF-1 in the girls (beta=-0.41; -0.77, -0.03) was obtained above the median split. Conclusion: The results suggest that As-related growth impairment in children is mediated, at least partly, through suppressed IGF-1 levels.
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| 3. |
- Javed, Muhammad Sufyan, et al.
(författare)
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Electrochemical studies of perovskite cathode material for direct natural gas fuel cell
- 2016
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Ingår i: International journal of hydrogen energy. - : Elsevier. - 0360-3199 .- 1879-3487. ; 41:4, s. 3072-3078
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Tidskriftsartikel (refereegranskat)abstract
- Natural gas is the most promising renewable energy source and its widespread availability ensured its importance for early applications in stationary fuel cells as a reliable and low cost fuel. Therefore it is very important to efficiently utilization of natural gas in low temperature fuel cells. Herein, we demonstrate the synthesis of perovskite material of Yttrium doped Sr0.92FexTi1-xO3-delta (x = 0.25, 030) (YSFT) by solid state reaction method and further investigated as a new cathode material for a low temperature solid oxide fuel cell fueled by natural gas. The YSFT is characterized by X-ray powder diffraction, Brunauer-Emmett-Teller and scanning electron microscopy. The perovskite structure is achieved at relatively low temperature (850 degrees C). The average crystalline size is found 28 nm and 36 nm for x = 0.25 and 0.30 respectively. TGA results showed the lattice oxygen loss of YSFT is about 0.206% in its original weight in the temperature range of 25-1000 degrees C. The maximum electronic conductivities of 2.3 Scm(-1) and 2.07 Scm(-1) are achieved for x = 025 and x = 0.30 at 550 degrees C in air atmosphere respectively. It is observed that the oxygen reduction is enhanced due to the perovskite crystal structure and oxygen vacancies play an important role in the redox reaction to improve the performance of fuel cell. The YSFT perovskite cathode material based fuel cell with natural gas have achieved the power density of 250 mWcm(-2) for x = 025 at 550 degrees C. The fuel cell device has demonstrated very stable results by running continuously for 5 h with domestic available natural gas.
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