Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

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

Utopia or Failed Opportunity? A Critical Analysis of the Peace Agreement

Este libro nació en una conversación entre los editores unas semanas antes del 2 de octubre del 2016, día en que el Acuerdo de Paz de la Habana fue sometido a plebiscito. Como muchos colombianos, nos enfrascamos en una discusión sobre diversos aspectos de lo pactado por el gobierno colombiano y las Fuerzas Armadas Revolucionarias de Colombia —FARC—. Esta inquietud de dos personas se transformó en un diálogo de veintitrés. Así, esta obra es una contribución de la Facultad de Jurisprudencia de la Universidad del Rosario al debate del fin del conflicto armado y la construcción de paz en Colombia. En él, participan profesores de esta y otras universidades colombianas con el fin de presentar una reflexión académica desde los estudios socio-jurídicos de los alcances, limitaciones y oportunidades de aprendizaje del proceso de paz y acuerdo logrado en 2016 con las FARC. En este contexto, este libro responde a la necesidad de promover una discusión informada sobre el papel del derecho y de los abogados en la estructuración e implementación de iniciativas de paz. Luego de tantos años en que los académicos han estudiado en el país la interacción conflicto armado y derecho, es esencial dar paso a una reflexión profunda que concatene esta disciplina con los escenarios de paz.This book is the outcome of a conversation between its editors several weeks before October 2, 2016, the date on which the Colombian people were to vote whether to approve the Havana Peace Agreement. Like many Colombians, we discussed different aspects and challenges of the agreement between the Colombian Government and the Revolutionary Armed Forces of Colombia –farc–. This conversation between two people soon became a dialogue among twenty-three authors. This volume is a contribution of Universidad del Rosario’s Law School to the ongoing debate around the end of the armed conflict and peacebuilding in Colombia. Professors from Universidad del Rosario and other Colombian universities shared their articles to offer insights from the socio-legal perspective to the debate on the Peace Agreement’s advantages and disadvantages, and lessons learned in this process. In this context, this work aims at promoting an informed discussion on the role of the law and lawyers in designing and implementing peace initiatives. After many years in which scholars have devoted their research to understand the interplay between the internal armed conflict and the law, it is time to begin an in-depth analysis of the interaction between the law and post-conflict scenarios

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort studyResearch in context

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017

New landscape of science, technology and innovation

La Ingeniería Química Colombiana está inmersa en nuevos panoramas de Ciencia, Tecnología e Innovación que traen consigo grandes retos para la industria, la academia y el Estado. Las investigaciones multidisciplinarias en energía, materiales, ingeniería de procesos y bioprocesos han llevado a estrategias de emprendimiento e innovación que prometen ser base de desarrollo en el país. En los siguientes capítulos se presentan los resultados más relevantes de las investigaciones realizadas por 19 instituciones colombianas en cooperación con 7 universidades internacionales, así como las contribuciones científicas de numerosas empresas colombianas. Este libro compila 236 resúmenes de investigaciones clasificadas en las siguientes líneas temáticas:1. Bioprocesos - 2. Economía circular - 3. Educación en Ingeniería Química - 4. Emprendimiento e innovación en Ingeniería Química - 5. Energías alternativas - 6. Oil & Gas - 7. Procesos y ciencia - 8. Tecnología en Ingeniería Química y simulación - 9. Tópicos ambientales - 10. MaterialesColombian Chemical Engineering is immersed in new scenarios of Science, Technology and Innovation that bring great challenges for industry, academia and the State. Multidisciplinary research in energy, materials, process engineering and bioprocesses have led to entrepreneurship and innovation strategies that promise to be the basis for development in the country. The following chapters present the most relevant results of the research carried out by 19 Colombian institutions in cooperation with 7 international universities, as well as the scientific contributions of numerous Colombian companies. This book compiles 236 research summaries classified in the following thematic lines: 1. Bioprocesses - 2. Circular economy - 3. Education in Chemical Engineering - 4. Entrepreneurship and innovation in Chemical Engineering - 5. Alternative energies - 6. Oil & Gas - 7. Processes and science - 8. Technology in Chemical Engineering and simulation - 9 Environmental topics - 10. MaterialsUniversidad EA

Empowering Latina scientists

Purdue Univ, Dept Life Sci, W Lafayette, IN 47906 USASmithsonian Trop Res Inst, Apartado 0843-03092, Balboa, Ancon, PanamaUniv Jyvaskyla, Ctr Excellence Biol Interact, Dept Biol & Environm Sci, Jyvaskyla, FinlandUniv Nacl Colombia, Inst Ciencias Nat, Bogota, ColombiaUniv Nacl Autonoma Mexico, Dept Ciencias Biol, Mexico City, DF, MexicoUniv Puerto Rico, San Juan, PR USACorp Gest Ambiental Biodiversa, Santiago De Cali, ColombiaPurdue Univ, Dept Biol Sci, W Lafayette, IN 47907 USASmithsonian Trop Res Inst, Balboa, Ancon, PanamaUniv Jyvaskyla, Jyvaskyla, FinlandUniv Puerto Rico, X Vittatus Project, San Juan, PR 00936 USAUniv Puerto Rico, San Juan, PR 00936 USACorp Gest Ambiental Biodiversa, Bogota, ColombiaCorp Colombiana Invest Agropecua Agrosavia, Bogota, ColombiaCUNY, Biol Program, New York, NY 10021 USAUniv Colorado, Boulder, CO 80309 USAUniv Rosario, Fac Ciencias Nat & Matemat, Programa Biol, Cra 24 63C-69, Bogota 111221, ColombiaUniv La Laguna, Grp Invest Etol & Ecol Comportamiento, Tenerife, SpainUCL, Phys, London WC1E 6BT, EnglandPontificia Univ Javeriana, Fac Rural & Environm Studies, Dept Ecol & Terr, Bogota, ColombiaUSFQ, Colegio Ciencias Biol & Ambientales, Inst Biosfera, Lab Biol Evolut, Quito, EcuadorCornell Univ, Dept Neurobiol & Behav, Ithaca, NY 14853 USAUniv Sao Paulo, Inst Biociencias, Dept Fisiol, Lab Comportamiento & Fisiol Evolut, Sao Paulo, BrazilUniv Udine, Dept Agr Food Environm & Animal Sci, Udine, ItalyVirginia Polytech Univ, Dept Biol Sci, Blacksburg, VA 24061 USAOregon State Univ, Dept Fisheries & Wildlife, Corvallis, OR 97331 USAUniv Los Andes, Dept Biol Sci, Bogota, ColombiaUniv Calif Berkeley, Miller Inst Basic Res Sci, Berkeley, CA USAUniv Chicago, Dept Ecol & Evolut, Chicago, IL 60637 USAUniv New South Wales, Sch BEES, PANGEA Res Ctr, Sydney, NSW 2052, AustraliaPontificia Univ Catolica Ecuador, Escuela Biol, Museo Zool, Quito, EcuadorUniv Calif Davis, Davis, CA 95616 USAUniv Tecnol Indoamer, Ctr Invest Biodiversidad & Cambio Climat, BioCamp, Quito, EcuadorUniv Hong Kong, Sch Biol Sci, Pok Fu Lam Rd, Hong Kong, Peoples R ChinaPontificia Univ Javeriana, Dept Biol, Bogota, ColombiaUniv Connecticut, Dept Ecol & Evolutionary Biol, Storrs, CT USAUniv Illinois, Dept Biol Sci, Chicago, IL 60680 USAUniv Massachusetts, Mol & Cellular Biol Program, Amherst, MA 01003 USAGettysburg Coll, Dept Biol, Gettysburg, PA 17325 USAUniv Barcelona, Barcelona, SpainLeibniz Inst Evolut & Biodiversitaetsforsch, Museum Nat Kunde, Berlin, GermanyConsejo Nacl Invest Cient & Tecn, San Miguel De Tucuman, ArgentinaCUNY, Dept Biol, New York, NY 10021 USAUniv Michigan, Dept Ecol & Evolut Biol, Ann Arbor, MI 48109 USAInst Alexander Humboldt, Bogota, ColombiaUniv Los Andes, Bogota, ColombiaUniv Autonoma Chihuahua, Acad Catedras Conacyt, Chihuahua, MexicoUniv Maryland, Dept Biol, College Pk, MD 20742 USAUniv Estado Rio de Janeiro, UFRJ, Rio De Janeiro, BrazilChalmers Univ Technol, Depat Phys, Gothenburg, SwedenUniv Los Andes, Lab Neurociencia & Comportamiento, Bogota, ColombiaSmithsonian Inst, Nat Museum Nat Hist, Washington, DC 20560 USAInst Invest Recursos Biol Alexander von Humboldt, Bogota, ColombiaMuseo Nacl Hist Nat, Montevideo, UruguayUniv Fed Alagoas, Maceio, BrazilGettysburg Coll, Dept Biol, Gothenburg, SwedenIVIC, Caracas, VenezuelaUniv Distrital Francisco Jose de Caldas, Bogota, ColombiaUniv Costa Rica, Golfito, Costa RicaUniv Diego Portales, Psychol, Santiago, ChileSwansea Univ, Biosci Dept, Marie Curie COFUND, Swansea, W Glam, WalesIndiana Univ, Dept Comp Sci, Bloomington, IN 47405 USAIndiana Univ, Dept Biol, Bloomington, IN USABoston Univ, Biol, Boston, MA 02215 USAEMCALI EICE ESP, Dept Prod Agua Potable, Cali, ColombiaWildlife Conservat Soci, Cali, ColombiaUniv Sao Paulo, Inst Biociencias, Dept Zool, Sao Paulo, BrazilUniv Norte, Dept Quim & Biol, Barranquilla, ColombiaSan Diego State Univ, Dept Quim & Biol, Riverside, CA USAUniv Calif Riverside, Riverside, CA 92521 USAUniv Puerto Rico, Biol, Rio Piedras, PR USAFlorida Int Univ, Dept Biol Sci, Miami, FL 33199 USAUniv Fed Rio De Janeiro, Museu Nacl, Dept Vertebrados, Rio De Janeiro, BrazilSan Francisco State Univ, Dept Biol, San Francisco, CA 94132 USAUniv Calif Santa Cruz, Dept Ecol & Evolut, Santa Cruz, CA USAUniv Calif Los Angeles, Dept Ecol & Evolut Biol, Los Angeles, CA USAUniv Reg Blumenau, Dept Anim Biol, Blumenau, Santa Catarina, BrazilUniv Fed Mato Grosso do Sul, Dept Zool, Campo Grande, BrazilUniv Fuerzas Armadas ESPE, Dept Life Sci & Agr, Sangolqui, EcuadorCorp Biodiversa, Cali, ColombiaUSFQ, Inst Biosfera, Colegio Ciencias & Ingn, Quito, EcuadorUniv Melbourne, Sch BioSci, Melbourne, Vic, AustraliaUniv Calif Los Angeles, Dept Integrat Biol & Physiol, Los Angeles, CA USAUniv Fed Santa Maria, Dept Ecol & Evolucao, Santa Maria, RS, BrazilUniv Fed ABC, Ctr Ciencias Nat & Humanas, Sao Bernardo Do Campo, BrazilUniv Nacl Autonoma Mexico, Ctr Ciencias Atmosfera, Mexico City, DF, MexicoColorado State Univ, Dept Biol, Ft Collins, CO 80523 USAUniv Estado Rio De Janeiro, Dept Ecol, Rio De Janeiro, BrazilConsejo Nacl Invest Cient & Tecn, Buenos Aires, DF, ArgentinaConsejo Nacl Invest Cient & Tecn, Museo Argentino Ciencias Nat Bernardino Rivadavia, Buenos Aires, DF, ArgentinaUniv Fed Mato Grosso do Sul, Dept Ecol & Conservacao, Campo Grande, BrazilUniv Gothenburg, Gothenburg, SwedenGothenburg Global Biodivers Ctr, Gothenburg, SwedenUniv Los Andes, Dept Ciencias Biol, Bogota, ColombiaUniv Fed Goias, Inst Ciencias Biol, Goiania, Go, BrazilCUNY, New York, NY 10021 USAUniv Calif Irvine, Dept Ecol & Evolut Biol, Irvine, CA 92717 USAUniv Puerto Rico Rio Piedras, Dept Biol, San Juan, PR 00931 USAUniv Sao Paulo, Dept Zool, Sao Paulo, SP, BrazilUniv Estadual Minas Gerais, Passos, BrazilUniv Estadual Paulista, UNESP, Sao Jose Do Rio Preto, SP, BrazilMuseu Paraense Emilio Goeldi, Belem, Para, BrazilUniv Estad Rio De Janeiro, Rio De Janeiro, BrazilOrg Trop Studies, Montes De Oca, Costa RicaUniv Guayaquil, Escuela Biol, Guayaquil, EcuadorUniv Estadual Sudoeste Bahia, Jequie, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilMax Planck Inst Ornithol, Constance, GermanyInvest Conservac Neotropi, Bogota, ColombiaAustralian Natl Univ, Div Ecol & Evolut, Canberra, ACT, AustraliaUniv Sao Paulo, Sao Paulo, BrazilUniv Estadual Paulista Julio Mesquita, Araraquara, BrazilUniv Kansas, Biodivers Inst, Lawrence, KS 66045 USAUniv Estado Mato Grosso, Caceres, BrazilUniv Chicago, Dept Ecol & Evolut, 940 E 57Th St, Chicago, IL 60637 USAUniv Estadual Paulista, Lab Ecol & Evolucao, Sao Paulo, SP, BrazilUniv Estadual Paulista, Sao Paulo, BrazilUniv Brasilia, Brasilia, DF, BrazilUniv Estadual Campinas, Sao Paulo, BrazilAsociac Calidris, Cali, ColombiaInst Invest Recursos Biol Alexander von Humboldt, Villa De Leyva, ColombiaCORPAVET, Bogota, ColombiaUniv Nacl Jujuy, Fac Ciencias Agr, Ctr Estudios Terr Ambientales & Sociales, San Salvador De Jujuy, ArgentinaMacquarie Univ, Dept Biol Sci, Sydney, AustraliaUniv Los Andes, Dept Ciencias Biol, Biol, Bogota, ColombiaUniv Nacl Colombia, Dept Biol, Bogota, ColombiaUniv Nacl Colombia, Dept Matemat, Bogota, ColombiaPontificia Univ Catolica Minas Gerais, Dept Ciencias Biol & Saude, Belo Horizonte, MG, BrazilUniv Antioquia, Fac Ciencias Exactas & Nat, Inst Biol, Medellin, ColombiaZRC SAZU, Biol Inst Jovan Hadiz, Ljubljana, SloveniaUniv Fed Rio Grande do Sul, Programa Pos Grad Biol Anim, Porto Alegre, RS, BrazilUniv Nacl Cordoba, CONICET, Buenos Aires, DF, ArgentinaCornell Lab of Ornithol, Ithaca, NY USAInvest Conservac Neotrop, Bogota, ColombiaUniv Nacl Costa Rica, Escuela Ciencias Biol, Heredia, Costa RicaUniv Los Andes, Dept Ingn Biomed, Bogota, ColombiaUniv Costa Rica, Inst Clodomiro Picado, San Jose, Costa RicaUniv Costa Rica, Escuela Biol, San Jose, Costa RicaNIH, Bldg 10, Bethesda, MD 20892 USAUniv Nacl Colombia, Lab Ecol Paisaje & Modelacion Ecosistemas, ECOLMOD, Bogota, ColombiaUniv Nacl Colombia, Bogota, ColombiaSalisbury Univ, Salisbury, MD USAUniv Calif Irvine, Irvine, CA USAUniv Queensland, Sch Biol Sci, St Lucia, Qld, AustraliaStanford Univ, Stanford, CA 94305 USAUniv Buenos Aires, Buenos Aires, DF, ArgentinaVet Univ Hannover, Hannover, GermanyUniv La Plata, La Plata, Buenos Aires, ArgentinaUniv Nacl Cordoba, Misiones, ArgentinaConsejo Nacl Invest Cient & Tecn, Misiones, ArgentinaSouthern Illinois Univ, Carbondale, IL 62901 USAUniv Las Amer, Quito, EcuadorUniv Arizona, Tucson, AZ USAUniv Vienna, Vienna, AustriaJames Cook Univ, Cairns, AustraliaGoethe Univ Frankfurt, Frankfurt, GermanyConsejo Nacl Invest Cient & Tecn, UNJu, Inst Ecorreg Andinas, San Salvador De Jujuy, ArgentinaUniv Lincoln, Sch Life Sci, Lincoln LN6 7TS, EnglandWCS Chile, Santiago, ChileUniv Lincoln, Lincoln, EnglandSUNY Buffalo, Biol Sci, Buffalo, NY USAUniv Sao Paulo, LEFE, Sao Paulo, BrazilUniv Amsterdam, Inst Biodivers & Ecosyst Dynam, Amsterdam, NetherlandsUniv Vet Med Vienna, Vienna, AustriaUniv Puerto Rico, Dept Environm Sci, Rio Piedras, PR USAWashington Univ, Dept Biol, Campus Box 1137, St Louis, MO 63130 USAMarquette Univ, Milwaukee, WI 53233 USASmithsonian Trop Rese Inst, Panama City, PanamaUniv Oviedo, Zool Unit, Oviedo, SpainUniv Oviedo, Res Unit, UMIB, Oviedo, SpainUniv Minnesota, Dept Ecol Evolut & Behav, Minneapolis, MN 55455 USASalisbury Univ, Dept Biol Sci, Salisbury, MD USAUniv Magdalena, Grp Invest Biodiversidad & Ecol Aplicada, Santa Marta, ColombiaUniv Tecn Particular Loja, Dept Ciencias Biol, Loja, EcuadorInst Invest Biol Clemente Estable, Dept Ecol & Biol Evolut, Montevideo, UruguayUniv Autonoma Nayarit, Programa Acad Biol, Tepic, MexicoUNT, CONICET, Inst Ecol Reg, San Miguel De Tucuman, ArgentinaWestern Sydney Univ, Hawkesbury Inst Environm, Sydney, NSW, AustraliaFlorida Int Univ, Coll Arts Sci & Educ, Grad Studies, Miami, FL 33199 USAUniv Calif Berkeley, Dept Integrat Biol, Berkeley, CA 94720 USAUniv Cambridge, Dept Zool, Downing St, Cambridge CB2 3EJ, EnglandTrier Univ, Dept Biogeog, Trier, GermanyUniv Amsterdam, IBED, Amsterdam, NetherlandsCtr Ecol Fonct & Evolut, Montpellier, FranceInst Curicaca, Rio Grande Do Sul, BrazilUniv Fed Rio Grande do Sul, Dept Ecol, Porto Alegre, RS, BrazilCUNY, Dept Biol, Newark, NY USAInst Alexander von Humboldt, Villa De Leyva 257, ColombiaMNHN, Inst Systemat, Evolut, Biodiversite, Paris, FranceUniv Los Andes, Chem Dept, Lab Adv Analyt Techn Nat Prod, Bogota, ColombiaUniv Rosario, Bogota, ColombiaFlorey Inst Neurosci & Mental Hlth, Parkville, Vic, AustraliaUniv Antioquia, Medellin, ColombiaUniv Magallanes, Punta Arenas, ChileUniv Fed Rio Grande do Sul, Ecol Dept, Porto Alegre, RS, BrazilUniv Estadual Paulista, Campus Rio Claro, Rio Claro, SP, BrazilHarvard Univ, Organism & Evolutionary Biol, Cambridge, MA 02138 USAUniv Distrital Francisco Jose Caldas, Bogota, ColombiaUniv Icesi, Dept Biol, Cali, ColombiaUniv Wien, Dept Integrat Zool, Vienna, AustriaConsejo Nacl Invest Cient & Tecn, Fdn Miguel Lillo, Unidad Ejecutora Lillo, San Miguel De Tucuman, Tucuman, ArgentinaUniv EAFIT, Medellin, ColombiaUniv Estadual Paulista, UNESP, Sao Jose Do Rio Preto, SP, BrazilUniv Estadual Paulista Julio Mesquita, Araraquara, BrazilUniv Estadual Paulista, Lab Ecol & Evolucao, Sao Paulo, SP, BrazilUniv Estadual Paulista, Sao Paulo, BrazilUniv Estadual Paulista, Campus Rio Claro, Rio Claro, SP, Brazi

Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries

Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countrie