Background: Postoperative pulmonary complications (PPCs) are a common concern in patients undergoing thoracic or abdominal surgery, contributing to increased morbidity, extended hospital stays, and elevated healthcare costs. Early initiation of chest physiotherapy (CPT) has been proposed as a strategy to reduce the incidence of PPCs by enhancing respiratory function through various techniques, such as deep breathing exercises, incentive spirometry, and airway clearance. Materials and Methods: This systematic review was conducted following PRISMA guidelines. A comprehensive search was performed across multiple databases, including PubMed, Cochrane Library, Embase, and Scopus, to identify studies assessing the effectiveness of early CPT in reducing PPCs. Studies were screened and selected based on predetermined inclusion criteria focusing on adults undergoing thoracic or abdominal surgery who received CPT within the first 24–48 hours postoperatively. Data extraction and quality assessments were conducted using standardized tools to evaluate study bias and reliability. Results: The review included 12 studies, comprising randomized controlled trials and observational studies. Most studies demonstrated that early CPT significantly reduces the incidence of PPCs, such as atelectasis and pneumonia, and improves lung function. However, the degree of effectiveness varied based on the CPT techniques and timing. Some studies highlighted reductions in hospital stay and ICU admissions, underscoring CPT's potential for improving overall surgical outcomes. Conclusion: Chest physiotherapy after induction of surgery seems to be an efficient method for the prevention of postoperative pulmonary complications in patients who underwent thoracic and abdominal surgery. The results provide evidence for integrating CPT into the postoperative care pathways but the differences in CPT application imply that individualized strategies should be used depending on the patient characteristics and types of surgery. More work needs to be done to support such gains and fine-tune CPT procedure.
Abstract Improving irrigation efficiency (IE) is conventionally perceived as a water‐conserving practice in the agriculture sector. The common understanding is that increased on‐farm IE leads to an increase in water availability at the basin. However, in the recent past, many instances have been reported where increasing on‐farm IE failed to increase water availability at the basin scale. This phenomenon is commonly known as the ‘Irrigation Efficiency Paradox (IEP)’. In this paper, we present a dynamic systems model of the IEP. Our model combines a simple mass‐balance description of the water flows with the rent‐seeking behavior of consumers. Through the socio‐hydrological model, we arrive at a parametric characterization of the IEP, which is given by three attributes: the maximum short‐term benefit enjoyed after improvement in IE, the time duration after which the paradox occurs, and the escalation of the paradox once it occurs. We find that the paradox in basins with lower evaporation and higher recharge is more pronounced, the policy implications of which are in contrast to the common narrative that seeks to reduce evaporation and increase recharge. We also use our findings along with global data sets to identify regions that are most susceptible to the IEP. We argue that much caution must be practiced while introducing efficient irrigation technologies in the identified regions so as to avoid paradoxical effects to as much extent as possible. We also discuss the seemingly counter‐intuitive role of evaporation and recharge properties of the basin and how it ties in with contemporary policy narratives.
Abstract. The energy-water-land nexus represents a critical leverage future policies must draw upon to reduce trade-offs between sustainable development objectives. Yet, existing long-term planning tools do not provide the scope or level of integration across the nexus to unravel important development constraints. Moreover, existing tools and data are not always made openly available or are implemented across disparate modeling platforms that can be difficult to link directly with modern scientific computing tools and databases. In this paper, we present the Nexus Solutions Tool (NEST): a new open modeling platform that integrates multi-scale energy-water-land resource optimization with distributed hydrological modeling. The new approach provides insights into the vulnerability of water, energy and land resources to future socioeconomic and climatic change and how multi-sectoral policies, technological solutions and investments can improve the resilience and sustainability of transformation pathways while avoiding counterproductive interactions among sectors. NEST can be applied at different spatial and temporal resolutions, and is designed specifically to tap into the growing body of open access geospatial data available through national inventories and the earth system modeling community. A case study analysis of the Indus River Basin in South Asia demonstrates the capability of the model to capture important interlinkages across system transformation pathways towards the United Nations' Sustainable Development Goals, including the intersections between local and regional transboundary policies and incremental investment costs from rapidly increasing regional consumption projected over the coming decades.
Earth and Space Science Open Archive This work has been accepted for publication in Water Resources Research. Version of RecordESSOAr is a venue for early communication or feedback before peer review. Data may be preliminary. Learn more about preprints. preprintOpen AccessYou are viewing the latest version by default [v1]A Dynamic Socio-hydrological Model of The Irrigation Efficiency ParadoxAuthorsAnsirIlyasiDSee all authors Ansir IlyasiDCorresponding Author• Submitting AuthorLahore University of Management SciencesiDhttps://orcid.org/0000-0002-9612-9006view email addressThe email was not providedcopy email address