Respuesta de la papa criolla (Solanum tuberosum) cultivar Colombia a la fertilización orgánico mineral

The ‘Criolla’ potato (Solanum tuberosum) phureja group cultivated in the inter-Andean valleys of the high tropics, is commonly fertilized only with mineral nutrients in conventional production, without the use of soil test and use of organic fertilizers. The purpose of this study was to determine the potential of organic chicken manure as a source of nutrients to increase yield and quality in ‘Criolla’ potatoes compared to conventional fertilization. Treatments evaluated were organic chicken manure, mineral nutrition based on soil tests, organic manure mixed with mineral nutrition, and conventional nutrition based on farmers’ typical nutrition plans. In plant response conventional and mineral treatments mixed with organic matter were the best in leaf area and dry weight of shoot and tuber. Treatment with mineral nutrition mixed with organic manure (2 and 6 t) obtained the largest length of the main stems. The best yield response was obtained with conventional nutrition, while the major size was obtained with mineral and mineral combined with organic treatments. According to the results, the best response was obtained with the application of mineral nutrition in the combination of 6 t ha-1 organic manure.La papa criolla (Solanum tuberosum) grupo phureja es cultivada en los valles interandinos del trópico alto, comúnmente fertilizada con nutrientes minerales en la producción convencional, sin hacer uso de análisis de suelos y nutrición con fertilizantes orgánicos. El objetivo de este estudio fue determinar el potencial de la materia orgánica de gallinaza, como fuente de nutrientes, para incrementar el rendimiento y la calidad en la papa criolla, comparándola con la nutrición convencional. Los tratamientos evaluados fueron gallinaza, nutrición mineral, basado en análisis de suelos; nutrición mineral, combinada con materia orgánica y un tratamiento soportado en la fertilización convencional, con base en los planes nutricionales, típicos de los agricultores. En las respuestas de la planta, los tratamientos convencionales y minerales mezclados con nutrición mineral obtuvieron los valores más altos en área foliar y peso seco de la parte aérea y el tubérculo. En longitud de tallo, la mejor respuesta se obtuvo con los tratamientos minerales mezclados con materia orgánica (2 y 6 toneladas). La mejor respuesta en rendimiento fue obtenida en la nutrición mineral convencional, mientras que las papas con mayor calibre, se lograron con los tratamientos mineral y mineral mezclado con orgánico. De acuerdo con los resultados, la mejor respuesta en cultivo se puede obtener con la nutrición mineral, en combinación con 6 toneladas de materia orgánica

Robotic colorectal surgery in Latin America: a systematic review on surgical outcomes

Background and objectivesRobotic approach in colorectal surgery is rapidly gaining interest, particularly in the context of rectal cancer resection. Despite economic barriers, substantial proliferation of robotic colorectal procedures has been observed throughout Latin America. However, there is a lack of data regarding intraoperative and early postoperative outcomes, as well as oncological and long-term results. This systematic review aims to provide an overview of the surgical outcomes of robotic-assisted colorectal approaches across Latin America.Material and methodsA systematic literature search of electronic databases, including PubMed, LILACS, Scopus, Cochrane Library and Scielo, was performed and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The main target of the literature search was studies that reported outcomes of colorectal robotic surgery in Latin America.ResultsA total of 9,694 published articles were identified from the initial search. Nine thousand six hundred thirty-six publications were excluded after title and abstract review and removal of duplicates. Fifty-eight articles were thoroughly reviewed, and 11 studies met the inclusion criteria. The critical appraisal of study quality (biases risk assessment) was performed according to the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. In general, the overall study quality was poor. Of the 11 studies included in the analysis, ten addressed intraoperative and early postoperative outcomes, seven addressed oncological/pathological outcomes, and just one addressed long-term outcomes. Ten studies evaluated intraoperative and early postoperative outcomes, encompassing a total of 425 patients, the majority of whom were diagnosed with colorectal cancer. Morbidity rates exhibited a range between 0% and 45.9%, while mortality ranged from 0% to 2.5%.ConclusionFew studies have been published addressing intraoperative, postoperative, pathological, and oncological outcomes of robotic colorectal surgery in this region. Undoubtedly, there are unique challenges not encountered by developed countries, including economic obstacles in establishing structured training programmes and high-quality centres for the development of robotic surgery. Further studies are needed to assess the real extent of robotic surgery in the region and its results.Systematic Review Registrationhttps://www.crd.york.ac.uk/, PROSPERO (CRD42023494112)

A narrative on diversity, equity, and inclusion in surgery: insights from the European Society of Coloproctology and identification of points for action

Diversity; Equity; InterviewDiversidad; Equidad; EntrevistaDiversitat; Equitat; EntrevistaThe focus of the 2022 European Society of Coloproctology (ESCP) annual campaign was diversity, equity, and inclusion (DEI) in surgery. The ESCP “Operation Equal Access” campaign sought to interview key-opinion leaders and trainees, to raise awareness on inequalities, inform the community of the status of the topic, and to identify future areas for improvement. The ESCP Social Media Working Group interviewed experts who have made significant contributions to DEI in colorectal surgery and were acknowledged opinion leaders in the field. The interviews focused on their career, professional life, experiences, and opportunities during their training, and their views on DEI in colorectal surgery. DEI principles, education, and values need further promotion to reduce and address bias within the profession and overall improve the experience of minority community including health professionals and patients. International Societies are working to facilitate training opportunities and overcome DEI, and networking have contributed to that. Collaborations between societies will be pivotal to contribute to offering research and leadership opportunities equally. Access to advanced workshops including cadaveric training and simulation can be consistently promoted and provided globally via societies through telemonitoring. Involving patients in research should be encouraged, as it brings the perspective of a living experience.Open access funding provided by Università degli Studi della Campania Luigi Vanvitelli within the CRUI-CARE Agreement

Efficient Industrial Solution for Robotic Task Sequencing Problem With Mutual Collision Avoidance & Cycle Time Optimization

© 2022 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other worksIn the automotive industry, several robots are required to simultaneously carry out welding sequences on the same vehicle. Coordinating and assigning welding points between robots is a manual and difficult phase that needs to be optimized using automatic tools. The cycle time of the cell strongly depends on different robotic factors such as the task allocation among the robots, the configuration solutions and obstacle avoidance. Moreover, a key aspect, often neglected in the state of the art, is to define a strategy to solve the robotic task sequencing with an effective robot-robot collision avoidance integration. In this paper, we present an efficient iterative algorithm that generates a high-quality solution for Multi-Robotic Task Sequencing Problem. This latter manages not only the mentioned robotic factors but also aspects related to accessibility constraints and mutual collision avoidance. In addition, a home-developed planner ( RoboTSPlanner ) handling 6 axis has been validated in a real case scenario. In order to ensure the completeness of the proposed methodology, we perform an optimization in the task, configuration and coordination space in a synergistic way. Comparing to the existing approaches, both simulation and real experiments reveal positive results in terms of cycle time and show the ability of this method to be interfaced with both industrial simulation software and ROS-I tools.Peer ReviewedPostprint (published version

Descripción de dos casos de babesiosis cerebral en terneros de hasta 15 días de edad

La babesiosis es una enfermedad causada por Babesia bovis y Babesia bigemina, integrante del complejo conocido como “Tristeza bovina” y relevante en el Noroeste argentino (NOA). La presentación clínica de esta enfermedad es infrecuente en bovinos jóvenes, a los que se considera parcialmente resistentes a la babesiosis. Este trabajo describe dos casos de babesiosis cerebral en terneros de dos rodeos de cría diferentes, que a la necropsia mostraron ictericia, esplenomegalia y severa congestión cerebral y hemoglobinuria. Estructuras intraeritrocitarias compatibles morfológicamente con B. bovis fueron identificadas en extendidos de sistema nervioso central y sangre periférica teñidos con Giemsa y se confirmó luego la infección por medio de técnicas moleculares. La evaluación del estatus epidemiológico en los rodeos de origen determinó diferentes contextos: uno de los casos fue aislado en un rodeo con estabilidad enzoótica para babesiosis, donde la enfermedad clínica era escasa a pesar de altas tasas de transmisión de B. bovis; el segundo caso ocurrió en un rodeo en situación de brote con niveles significativos de mortandad. La ocurrencia de babesiosis (B. bovis) no había sido descripta todavía en terneros de la Argentina, sumándose ahora al diagnóstico diferencial para esta categoría de bovinos en zonas donde la enfermedad es enzoótica.Bovine babesiosisis a disease caused by Babesia bovisand Babesia bigemina, as part of the tick fever complex and relevant in the Northwest of Argentina. Clinical occurrence of this illness is uncommon in young cattle, considered resistant to babesiosis. This work described two cases of cerebral babesiosis in calves of different beef herds. Jaundice, splenomegaly, severe cerebral congestion and hemoglobinuria was observed at necropsy. Babesia bovis-like structures were identified in cerebral and blood smears Giemsa stainedand confirmed by molecular techniques. Different situations were recognized following the evaluation of the epidemiological status of both herds: the first one was a single case in a herd with enzootic stability for babesiosis, with scarce clinical cases despite high rates of B. bovistransmission; the other case was in a context of outbreak with high level of mortality within a herd susceptible to babesiosis. Clinical babesiosis was not previously described in calves from Argentina. Babesiosis must be taken into account for the differential diagnosis in calves from endemic areas of the disease.Instituto de Investigación Animal del Chaco SemiáridoFil: Olmos, Leandro Hipólito. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal Chaco Semiarido; Argentina. Universidad Católica de Salta. Facultad de Ciencias Veterinarias; ArgentinaFil: Micheloud, Juan Francisco. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal Chaco Semiarido; Argentina. Universidad Católica de Salta. Facultad de Ciencias Veterinarias; ArgentinaFil: Morel, Nicolas. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Bertoni, Emiliano Agustí­n. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; ArgentinaFil: Avellaneda-Cáceres, Agustín. Universidad Católica de Salta. Facultad de Ciencias Veterinarias; ArgentinaFil: Primo, María Evangelina. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Rafaela; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Thompson, Carolina Soledad. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Torioni, Susana Marta. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Aguirre, Daniel Hector. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Animal del Chaco Semiárido; Argentin

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P <0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

Background: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings: In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. InterpBackground The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings: In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. Interpretation: The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.retation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries