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- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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- Ademuyiwa, Adesoji O., et al.
(author)
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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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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)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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- Abdelshafy, Alaaeldin M., et al.
(author)
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Optimized energy management strategy for grid connected double storage (pumped storage-battery) system powered by renewable energy resources
- 2020
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In: Energy. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0360-5442 .- 1873-6785. ; 192
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Journal article (peer-reviewed)abstract
- This paper presents a grid-connected double storage system (DSS) consisting of pumped-storage hydropower (PSH) and battery. The system is supplied by photovoltaics and wind turbines. In the proposed hybrid system, batteries absorb excess renewable energy that cannot be stored in PSH and they cover loads that cannot be supplied from the water turbine. To improve the system performance, a novel energy management strategy for the DSS is proposed. The strategy is based on an optimized factor that governs the charging process of the DSS. The problem of the optimal system design is solved by a non-dominated sorting genetic algorithm (NSGA-II). The multi-objective function considers simultaneously the minimal investment cost and minimal CO2 emissions. A comparative study of photovoltaic/wind/pumped-storage hydropower and photovoltaic/wind/double storage system is performed to show the effectiveness of the proposed strategy in terms of system economic and environmental performance. The considered location of the PSH station is on Attaqa Mountain at Suez (Egypt). The results indicate the effectiveness of the proposed energy management strategy for the storage system from economic and environmental perspectives. Coupling the battery with the PSH reduces the electricity cost by 22.2% and results in minimal energy exchange with the national grid (5% of the annual demand). A sensitivity analysis shows the largest variation of the electricity cost with changing the capital cost of the solar and wind generators. Also, it is observed that when the load increases, the optimal size of the system components increases, but it isn't proportional with the demand increase as could be expected. (C) 2019 Elsevier Ltd. All rights reserved.
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- Ruck, A, et al.
(author)
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Paravalvular Aortic Regurgitation Severity Assessed by Quantitative Aortography: ACURATE neo2 versus ACURATE neo Transcatheter Aortic Valve Implantation
- 2021
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In: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 10:20
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Journal article (peer-reviewed)abstract
- The new-generation ACURATE neo2 system was commercially released in September 2020. In this study, we sought to compare the aortic regurgitation (AR) severity of the ACURATE neo2 versus the ACURATE neo transcatheter heart valve, using quantitative videodensitometric angiography (qAR). This is a retrospective, Corelab analysis of final post-transcatheter aortic valve implantation (TAVI) aortograms of patients treated with the ACURATE neo2 and ACURATE neo systems. The ACURATE neo2 cohort comprised consecutive patients treated between September 2020 and January 2021 at two centers. The ACURATE neo cohort included consecutive patients treated before September 2020. Our primary objective was to compare AR severity on qAR following TAVI with ACURATE neo2 and ACURATE neo. Out of 401 aortograms, 228 (56.9%) were analyzable, with 120 in the ACURATE neo2 cohort, and 108 in the ACURATE neo cohort. The mean AR fraction was 4.4 ± 4.8% in the neo2 cohort, and 9.9 ± 8.2% in the neo cohort (p < 0.001). Furthermore, moderate or severe AR (qAR > 17%) was detected in 2 aortograms (1.7%) in the neo2 cohort and 15 aortograms (13.9%) in the neo cohort (p < 0.001). Quantitative aortography shows a lower rate of moderate or severe paravalvular AR in what is the first European experience of the new-generation, self-expanding ACURATE neo2 when compared to the first-generation ACURATE neo. Moreover, aortographic data need to be correlated and compared to Core Laboratory-adjudicated 30-day echocardiographic data.
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