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Record W4408732647 · doi:10.1097/gox.0000000000006572

WALANT Decreases Costs of Surgery to Increase Access and Help Alleviate Poverty in East Africa

2025· article· en· W4408732647 on OpenAlexaff
Pankaj Jani, James Thuo Kariuki, Nilkanth V. Jani, Sameer M. Pandya, Ankit J. Dave, С. Амин, Baiya A. Rashid, Donald H. Lalonde

Bibliographic record

VenuePlastic & Reconstructive Surgery Global Open · 2025
Typearticle
Languageen
FieldMedicine
TopicGlobal Health and Surgery
Canadian institutionsSaint John Regional HospitalDalhousie University
Fundersnot available
KeywordsTourniquetMedicineSedationSurgeryLocal anesthesia

Abstract

fetched live from OpenAlex

Surgery is essential to help people regain health and get back to work. Many Africans cannot afford traditional surgery because the sedation and main operating room sterility components are much too expensive. This often results in crushing debt for African families. Lack of access to surgery leads to poverty and poverty leads to lack of access to surgery. Wide-awake local anesthesia no tourniquet surgery, minimal pain tumescent local anesthesia, and evidence-based sterility are 3 disruptive game-changing innovations that eliminate the expensive general anesthesia and/or main operating room sterility components for many operations. Eliminating the tourniquet removes its need for sedation. Minimal pain tumescent local anesthesia enables comfortable numbing of large areas of the body to perform sedation-free operations such as soft tissue facial reconstruction, long bone fracture fixation, breast surgery, hernia repair, extremity surgery, and skin grafting. Evidence-based sterility has proven that many operations can be performed with field sterility outside of the main operating room environment with no significant increase in infection rates. No sedation also means no need for the main operating room environment. Moving some surgery out of the main operating room increases access for other operations that need full sterility to be accomplished. Since January 2020, these 3 disruptive changes have been adopted in 75 hospitals in 8 East African countries. This article documents how these changes have decreased the costs of surgery for the patients and, therefore, increased access to surgery, which helps alleviate poverty.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.012
Threshold uncertainty score0.041

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0010.001
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0120.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.040
GPT teacher head0.323
Teacher spread0.283 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2025
Admission routes1
Has abstractyes

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