| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- 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.
|
|
| 5. |
- Sandu, Irina, et al.
(författare)
-
Impacts of orography on large-scale atmospheric circulation
- 2019
-
Ingår i: npj Climate and Atmospheric Science. - : Springer Science and Business Media LLC. - 2397-3722. ; 2
-
Tidskriftsartikel (refereegranskat)abstract
- Some of the largest and most persistent circulation errors in global numerical weather prediction and climate models are attributable to the inadequate representation of the impacts of orography on the atmospheric flow. Existing parametrization approaches attempting to account for unresolved orographic processes, such as turbulent form drag, low-level flow blocking or mountain waves, have been successful to some extent. They capture the basic impacts of the unresolved orography on atmospheric circulation in a qualitatively correct way and have led to significant progress in both numerical weather prediction and climate modelling. These approaches, however, have apparent limitations and inadequacies due to poor observational evidence, insufficient fundamental knowledge and an ambiguous separation between resolved and unresolved orographic scales and between different orographic processes. Numerical weather prediction and climate modelling has advanced to a stage where these inadequacies have become critical and hamper progress by limiting predictive skill on a wide range of spatial and temporal scales. More physically based approaches are needed to quantify the relative importance of apparently disparate orographic processes and to account for their combined effects in a rational and accurate way in numerical models. We argue that, thanks to recent advances, significant progress can be made by combining theoretical approaches with observations, inverse modelling techniques and high-resolution and idealized numerical simulations.
|
|
