43 research outputs found

    Toward greener supply chains: is there a role for the new ISO 50001 approach to energy and carbon management?

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    © 2016, The Author(s). Considering the increased interest of stakeholders in climate change and a low-carbon economy, this article has investigated and identified several contributions of the ISO 50001 in support of the adoption of green supply chain management (GSCM). In this context, energy efficiency and reduced CO 2 emissions are critical. Therefore, the proposal for and the requirements of ISO 50001 can generate useful insights on how to structure green and low-carbon supply chains, hence helping to address the challenges posed by climate change

    Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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    Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

    On Pre&scaron;i&#263;&ndash;&#262;iri&#263;-Type &alpha;-&psi; Contractions with an Application

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    In this paper, we extend the idea of &alpha;-&psi; contraction mapping to the product spaces by introducing Pre&scaron;i&#263;&ndash;&#262;iri&#263;-type &alpha;-&psi; contractions and utilize them to prove some coincidence and common fixed-point theorems in the context of ordered metric spaces using &alpha;-admissibility of the mapping. Our newly established results generalize a number of well-known fixed-point theorems from the literature. Moreover, we give some examples that attest to the credibility of our results. Further, we give an application to the nonlinear integral equations, which can be employed to study the existence and uniqueness of solutions to the integral equations

    On Prešić–Ćirić-Type <i>α</i>-<i>ψ</i> Contractions with an Application

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    In this paper, we extend the idea of α-ψ contraction mapping to the product spaces by introducing Prešić–Ćirić-type α-ψ contractions and utilize them to prove some coincidence and common fixed-point theorems in the context of ordered metric spaces using α-admissibility of the mapping. Our newly established results generalize a number of well-known fixed-point theorems from the literature. Moreover, we give some examples that attest to the credibility of our results. Further, we give an application to the nonlinear integral equations, which can be employed to study the existence and uniqueness of solutions to the integral equations
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