Environmental awareness with ICT: App “Ubica un primate”

Las constantes amenazas y conflictos que afectan a los primates en ambientes urbanos ponen a sus poblaciones en declive. Esto se agrava por la falta de conocimiento de los habitantes sobre la fauna y la flora con la que coexisten. Con el objetivo de aumentar el conocimiento y sensibilizar a la población de Villavicencio sobre la importancia y distribución de primates en ecosistemas urbanos se desarrolló una aplicación móvil (app) gratuita. Inicialmente, se realizaron entrevistas semiestructuradas (n = 140) con residentes de cada zona (n = 28) de la ciudad de Villavicencio en la que se observaron primates, con el fin de generar un mapa de la distribución de primates diurnos. También se hizo la identificación de las especies presentes, siendo: Saimiri sciureus cassiquiarensis, Plecturocebus ornatus, Alouatta seniculus y Sapajus apella. Con los datos de distribución, conflictos y amenazas, se construyó una aplicación móvil en el sistema Android, donde tales datos están georreferenciados, con el fin de sensibilizar a la comunidad sobre las especies de primates presentes en la ciudad. La socialización de la app fue dirigida a las entidades gubernamentales y ONGs de la ciudad, obteniendo una evaluación positiva por el público. Trabajar con comunidades en proyectos de sensibilización ambiental que utilizan herramientas como las TICs tiene el potencial de transformar la dinámica sociocultural local, promoviendo una mayor preocupación con la biodiversidad y siendo una herramienta bien recibida por diferentes grupos de la población.Constant threats and conflicts that affect primates in urban environments put their populations in decline. The situation is aggravated by the lack of knowledge of the community about the fauna and flora that they coexist with. Aiming to increase the knowledge and awareness of the people from Villavicencio on the importance and distribution of primates in urban ecosystems, a free mobile application (app) was developed. Initially, 140 semi-structured interviews were conducted with residents of each area of Villavicencio where primates were observed (n=28). As a result, a distribution map of diurnal primates was created. Identification of the present species was also made. The following species were found: Saimiri sciureus cassiquiarensis, Plecturocebus ornatus, Alouatta seniculus, and Sapajus apella. With distribution, conflicts and threats data, a mobile application was built in the Android system, georeferencing the information available, so the community could be sensitized about the primate species in the city. Socialization of the application was addressed to governmental entities and NGOs of the city, obtaining a positive evaluation by the public. Working with communities on environmental awareness projects that use tools such as ICTs has the potential to transform local socio-cultural dynamics, to promote greater concern about biodiversity, and it is a well-received tool by different groups of people

Sensibilización ambiental con TIC: App “Ubica un primate”

Abstract Constant threats and conflicts that affect primates in urban environments put their populations in decline. The situation is aggravated by the lack of knowledge of the community about the fauna and flora that they coexist with. Aiming to increase the knowledge and awareness of the people from Villavicencio on the importance and distribution of primates in urban ecosystems, a free mobile application (app) was developed. Initially, 140 semi-structured interviews were conducted with residents of each area of Villavicencio where primates were observed (n=28). As a result, a distribution map of diurnal primates was created. Identification of the present species was also made. The following species were found: Saimiri sciureus cassiquiarensis, Plecturocebus ornatus, Alouatta seniculus, and Sapajus apella. With distribution, conflicts and threats data, a mobile application was built in the Android system, georeferencing the information available, so the community could be sensitized about the primate species in the city. Socialization of the application was addressed to governmental entities and NGOs of the city, obtaining a positive evaluation by the public. Working with communities on environmental awareness projects that use tools such as ICTs has the potential to transform local socio-cultural dynamics, to promote greater concern about biodiversity, and it is a well-received tool by different groups of people.Resumo As constantes ameaças e conflitos que afetam os primatas em ambientes urbanos colocam suas populações em declínio. Isso é agravado ainda pela falta de conhecimento dos habitantes sobre a fauna e a flora com a qual coexistem. Com o objetivo de aumentar o conhecimento e sensibilizar a população de Villavicencio sobre a importância e distribuição de primatas em ecossistemas urbanos foi desenvolvido um aplicativo móvel (app) gratuito. Inicialmente, foram realizadas entrevistas semi-estruturadas (n=140) com residentes de cada zona (n=28) da cidade de Villavicencio nas quais se observaram primatas a fim de gerar um mapa da distribuição de primatas diurnos. Também foi feita a identificação das espécies presentes, sendo: Saimiri sciureus cassiquiarensis, Plecturocebus ornatus, Alouatta seniculus e Sapajus apella. Com os dados de distribuição, conflitos e ameaças, foi construído um aplicativo móvel no sistema Android, onde tais dados estão georeferenciados, a fim de sensibilizar a comunidade sobre as espécies de primatas presentes na cidade. A socialização do app foi direcionada para as entidades governamentais e ONGs da cidade, obtendo uma avaliação positiva pelo público. Trabalhar com comunidades em projetos de sensibilização ambiental que utilizam ferramentas como as TICs tem o potencial de transformar a dinâmica sociocultural local, promovendo uma maior preocupação com a biodiversidade, sendo uma ferramenta bem recebida por diferentes grupos da população.Resumen Las constantes amenazas y conflictos que afectan a los primates en ambientes urbanos ponen a sus poblaciones en declive. Esto se agrava por la falta de conocimiento de los habitantes sobre la fauna y la flora con la que coexisten. Con el objetivo de aumentar el conocimiento y sensibilizar a la población de Villavicencio sobre la importancia y distribución de primates en ecosistemas urbanos se desarrolló una aplicación móvil (app) gratuita. Inicialmente, se realizaron entrevistas semiestructuradas (n = 140) con residentes de cada zona (n = 28) de la ciudad de Villavicencio en la que se observaron primates, con el fin de generar un mapa de la distribución de primates diurnos. También se hizo la identificación de las especies presentes, siendo: Saimiri sciureus cassiquiarensis, Plecturocebus ornatus, Alouatta seniculus y Sapajus apella. Con los datos de distribución, conflictos y amenazas, se construyó una aplicación móvil en el sistema Android, donde tales datos están georreferenciados, con el fin de sensibilizar a la comunidad sobre las especies de primates presentes en la ciudad. La socialización de la app fue dirigida a las entidades gubernamentales y ONGs de la ciudad, obteniendo una evaluación positiva por el público. Trabajar con comunidades en proyectos de sensibilización ambiental que utilizan herramientas como las TICs tiene el potencial de transformar la dinámica sociocultural local, promoviendo una mayor preocupación con la biodiversidad y siendo una herramienta bien recibida por diferentes grupos de la población

Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit.

This is the peer reviewed version of the following article: group, T. E. S. o. C. c. (2018). "Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit." Colorectal Disease 20(S6): 47-57., which has been published in final form at https://doi.org/10.1111/codi.1437. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsINTRODUCTION: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. METHODS: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). RESULTS: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83-2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43-11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. CONCLUSIONS: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications

An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)

IntroductionTransanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally.MethodsA pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak.ResultsOf 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02-2.48, P=0.04) and robotic TaTME (OR 3.05, 1.10-7.34, P=0.02) were associated with a higher risk of anastomotic leak than non-transanal laparoscopic TME. However this association was lost in the mixed-effects model controlling for patient and disease factors (OR 1.23, 0.77-1.97, P=0.39 and OR 2.11, 0.79-5.62, P=0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55-4.77, P<0.001) and male gender (OR 2.29, 1.52-3.44, P<0.001) remained strongly associated. The overall positive circumferential margin resection rate was 4.0%, which varied between operative approaches: laparoscopic 3.2%, transanal 3.8%, open 4.7%, robotic 1%.ConclusionThis contemporaneous international snapshot shows that uptake of the TaTME approach is widespread and is associated with surgically and pathologically acceptable results

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit.

This is the peer reviewed version of the following article: The and E. S. o. C. c. groups (2018). "The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit." Colorectal Disease 20(S6): 69-89., which has been published in final form at https://doi.org/10.1111/codi.14371. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. RESULTS: Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001). CONCLUSIONS: Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection

Evaluating the incidence of pathological complete response in current international rectal cancer practice: the barriers to widespread safe deferral of surgery

This is the peer reviewed version of the following article: , which has been published in final form at https://doi.org/10.1111/codi.14361. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland Introduction: The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging. Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any regression from baseline staging following chemoradiotherapy. The primary endpoint was the pCR rate. The secondary endpoint was agreement between post-treatment MRI restaging (yMRI) and final pathological staging. Results: Of 2572 patients undergoing rectal cancer surgery in 277 participating centres across 44 countries, 673 (26.2%) underwent chemoradiotherapy and surgery. The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. Comparison of AJCC stage determined by post-treatment yMRI with final pathology showed understaging in 13% (55/429) and overstaging in 34% (148/429). Agreement between yMRI and final pathology for T-stage, N-stage, or AJCC status were each graded as ‘fair’ only (n = 429, Kappa 0.25, 0.26 and 0.35 respectively). Conclusion: The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. The limited strength of agreement between basic conventional post-chemoradiotherapy imaging assessment techniques and pathology suggest alternative markers of response should be considered, in the context of controlled clinical trials