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- Gardumi, Francesco, et al.
(författare)
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Carrying out a multi-model integrated assessment of European energy transition pathways : Challenges and benefits
- 2022
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Ingår i: Energy. - : Elsevier BV. - 0360-5442 .- 1873-6785. ; 258, s. 124329-124329
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Tidskriftsartikel (refereegranskat)abstract
- With the publication of the European Green Deal, the European Union has committed to reaching carbon neutrality by 2050. The envisaged reductions of direct greenhouse gases emissions are seen as technically feasible, but if a wrong path is pursued, significant unintended impacts across borders, sectors, societies and ecosystems may follow. Without the insights gained from an impact assessment framework reaching beyond the techno-economic perspective, the pursuit of direct emission reductions may lead to counterproductive outcomes in the long run. We discuss the opportunities and challenges related to the creation and use of an integrated assessment framework built to inform the European Commission on the path to decarbonisation. The framework is peculiar in that it goes beyond existing ones in its scope, depth and cross-scale coverage, by use of numerous specialised models and case studies. We find challenges of consistency that can be overcome by linking modelling tools iteratively in some cases, harmonising modelling assumptions in others, comparing model outputs in others. We find the highest added value of the framework in additional insights it provides on the technical feasibility of decarbonisation pathways, on vulnerability aspects and on unintended environmental and health impacts on national and sub-national scale.
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| 2. |
- Fusai, Giuseppe Kito, et al.
(författare)
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Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries
- 2023
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Ingår i: British Journal of Surgery. - : OXFORD UNIV PRESS. - 0007-1323 .- 1365-2168.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761).
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