9 research outputs found

    Non-stop industries were the main source of air pollution during the 2020 coronavirus lockdown in the North China Plain

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    International audienceDespite large decreases of emissions of air pollution during the coronavirus disease 2019 (COVID-19) lockdown in 2020, an unexpected regional severe haze has still occurred over the North China Plain. To clarify the origin of this pollution, we studied air concentrations of fine particulate matter (PM 2.5), NO2 , O3 , PM 10 , SO2 , and CO in Beijing, Hengshui and Baoding during the lockdown period from January 24 to 29, 2020. Variations of PM 2.5 composition in inorganic ions, elemental carbon and organic matter were also investigated. The HYSPLIT model was used to calculate backward trajectories and concentration weighted trajectories. Results of the cluster trajectory analysis and model simulations show that the severe haze was caused mainly by the emissions of northeastern non-stopping industries located in Inner Mongolia, Liaoning, Hebei, and Tianjin. In Beijing, Hengshui and Baoding, the mixing layer heights were about 30% lower and the maximum relative humidity was 83% higher than the annual averages, and the average wind speeds were lower than 1.5 ms−1. The concentrations of NO3− , SO4 2− , NH4+ , organics and K+ were the main components of PM 2.5 in Beijing and Hengshui, while organics, K+ , NO3− , SO4 2− , and NH4+ were the main components of PM 2.5 in Baoding. Contrary to previous reports suggesting a southerly transport of air pollution, we found that northeast transport caused the haze formation

    Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

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    This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

    Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group

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    Funded by Nestle Health Sciences through an unrestricted research grant, by a National Institute for Health Research Professorship held by R.P., and sponsored by Queen Mary University of London

    Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

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    Nestle Health Sciences

    Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery.

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    Background: The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods: We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results: A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a three-fold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failure-to-rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions: Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries

    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study

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    Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study

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    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational stud

    In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study

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    AIMS: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level. METHODS: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals. RESULTS: 2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]). CONCLUSIONS: Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk
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