Revisión del estado actual de las formulaciones y aplicaciones de astaxantina producida por Haematococcus pluvialis

Astaxanthin is a carotenoid pigment widely recognized for its antioxidant properties and its great health benefits. Although there are several microorganisms that have the ability to synthesize this carotenoid, the microalgae Haematococcus pluvialis has proven to be the most promising source since it performs the synthesis under stress conditions due to nutrient deficiency and different light intensities, among others. Because astaxanthin is a molecule with great chemical instability, low bioavailability and hydrophobicity, there are different formulation methods that improve its stability and, therefore, its use as a colorant and bioactive compound in food, nutraceutical, cosmetic, aquaculture or pharmacist products. Due to the various uses of the carotenoid, the objective of this research is to know the existing applications and formulations of astaxanthin as methods to improve its stability, bioavailability and application, and to identify the materials used and the technologies applied in the formulation processes. Emulsions, liposomes, encapsulates and microencapsulates represent the current formulations, which use calcium alginate, sunflower oil, soybean oil, maltodextrin and gum Arabic as different materials –these present different percentages of encapsulation efficiency between 40-98.8%– to protect the wall, and prevent oxidation of the carotenoid (Burgos-Díaz et al., 2020, Oh et al., 2020), and technologies such as emulsification, lyophilization, nanoliposomes, spray drying, among others, are used.La astaxantina es un pigmento carotenoide ampliamente reconocido por sus propiedades antioxidantes y por sus grandes beneficios sobre la salud. Aunque existen varios microorganismos que tienen la capacidad de sintetizar este carotenoide, la microalga Haematococcus pluvialis ha demostrado ser la fuente más promisoria al realizarlo bajo condiciones de estrés por deficiencia de nutrientes, diferentes intensidades de luz, entre otros. Dado que la astaxantina es una molécula con gran inestabilidad química, baja biodisponibilidad e hidrofobicidad, existen diferentes métodos de formulación, que mejoran su estabilidad y por ende su uso como colorante y compuesto bioactivo en productos alimenticios, nutracéuticos, cosméticos, acuícolas o farmacéuticos. Debido a las diferentes aplicaciones y utilidades del carotenoide, se propone como objetivo conocer las aplicaciones y formulaciones existentes de astaxantina como métodos para mejorar su estabilidad, biodisponibilidad y aplicación, e identificar los materiales utilizados y las tecnologías aplicadas en los procesos de formulación. Las emulsiones, liposomas, encapsulados y microencapsulados, representan las formulaciones actuales, las cuales utilizan como diferentes materiales para proteger la pared, y evitar la oxidación del carotenoide, alginato de calcio, aceite de girasol, aceite de soja, maltodextrina y goma arábiga, estos presentan diferentes porcentajes de eficiencia de encapsulación entre 40-98.8% (Burgos-Díaz et al., 2020, Oh et al., 2020), y se emplean tecnologías como emulsificación, liofilización, nanoliposomas, spray drying, entre otras

ESTERILIZACIÓN DE TEJIDOS CELULARES

Since the 1950s, they have been described skin storage procedures, thanks to advances in health sciences worldwide, in currently several methods have been described for obtaining sterile cell tissues suitable to be implanted in a human being and to guarantee both its operation and its harmlessness. Some of The methods described are ionizing radiation, ethylene oxide, the use of antibiotics an antifungals and the Immersion in 70% alcohol and acetone. Of these, the one better meets the objective are ionizing radiation mainl gamma radiation (there is already a plant in the country). In Costa Rica, to this day we have a Bank of Eyes, a Tissue Bank and the first Bank of Bone Tissues of Central America.Desde la década de los años 50 se han descrito procedimientos de almacenamiento de piel, gracias a los avances en ciencias de la salud a nivel mundial, en la actualidad se han descrito varios métodos empleados para la obtención de tejidos celulares estériles aptos para ser implantados en un ser humano y que garanticen tanto su funcionamiento como su inocuidad. Algunos de los métodos descritos son las radiaciones ionizantes, el óxido de etileno, el uso de antibióticos y antimicóticos y la inmersión en alcohol al 70% y acetona. De éstos, el que mejor cumple el objetivo son las radiaciones ionizantes principalmente la radiación gamma (ya hay una planta en el país). En Costa Rica, al día de hoy se tiene un Banco de Ojos, un Banco de Tejidos y el primer Banco de Tejidos Óseos de Centroamérica.&nbsp

De los métodos y las maneras, número 8

Por octava ocasión el Posgrado en Diseño de la división de Ciencias y Artes para el Diseño, en colaboración con el comité organizador de “De los métodos y las maneras”, logró reunir investigaciones de especialistas en el ámbito del diseño y la investigación, así como de alumnos de tres de las cinco líneas de investigación del posgrado de diseño. Este libro es muestra de una constante al presentar temas en torno a las metodologías para hacer investigación en Diseño, además de ser una herramienta teórico - práctica, para apoyar tanto a docentes como estudiantes de los posgrados en diseño.Coordinación del Posgrado de Ciencias y Artes para el DiseñoGustavo Iván Garmendia Ramírez, coordinador; Sandra Rodríguez Mondragón, compilación y diseño editorial; Martín Lucas Flores Carapia, Diseño de la portad

Achieving sustainable development in rural areas in Colombia: Future scenarios for biodiversity conservation under land use change

Agricultural expansion is a complex land use change phenomenon with deep environmental and socio-economic consequences, especially across tropical countries where most of this expansion is occurring. Here we use scenario and network analysis combined with sustainability assessment to understand the drivers of landscape change and their effects on sustainable development in Colombia’s rural areas, using the Central Magdalena region as a case study, and ultimately informing strategies to reconcile agricultural expansion with biodiversity conservation and rural development. Using this approach we investigated three environmental and agricultural policy scenarios: the Business as Usual scenario, enforcing a stronger regulatory framework, and adopting incentives. Our analysis show that the Business as Usual scenario is not supported by stakeholders and negatively affects most sustainability objectives with the predominant agricultural sectors in the region (cattle ranching and oil palm) not improving social inequality, and threatening biodiversity, natural resources, and food security. Both alternative scenarios improve overall sustainability, including biodiversity. Therefore to reconcile agricultural expansion, biodiversity and sustainable development, it is important to adopt a stronger regulatory and enforcement framework at different administrative levels, as well as incentive schemes focusing on small holders. Our study also shows that history cannot be ignored when thinking about the future and sustainability especially in areas with legacies of strong inequalities caused by armed conflict. Finally, we suggest that combining scenario analysis, network analysis, and sustainability assessment is a useful methodology for studying land use changes holistically, exploring complex systems at different scales, and informing locally-relevant strategies and recommendations, ultimately enabling science to be proactive

The Caldera. No. 23

La pandemia, sin lugar a dudas, nos ha cambiado la vida a todos; un viernes nos fuimos para nuestros hogares, en el marco de una educación presencial; al lunes siguiente, después de dos días, estábamos iniciando el camino hacia una educación remota, una educación virtual, que se ha convertido en una gran alternativa para seguir contribuyendo con la formación de nuestros niños y jóvenes caldistas y al mejoramiento de nuestra calidad de vida que halla, en la educación, nuevamente la respuesta; han sido meses de cambios drásticos, inimaginables pero, cambios positivos que nos han permitido crecer como individuos, como familia, como escuela y como sociedad.Especial pandemia. Una generación Resiliente por promoción DINASTIA…06 VII Concurso Intercolegiado departamental de Oratoria. Ulibro 2020…51 Deporte en el Caldas…64 Expresiones Caldistas…71 Celebremos la palabra…93 Nuestros Maestros…102 Galería de Imágenes…107The pandemic, without a doubt, has changed the lives of all of us; One Friday we went to our homes, as part of a face-to-face education; The following Monday, after two days, we were starting the path towards a remote education, a virtual education, which has become a great alternative to continue contributing to the training of our children and young Caldistas and to the improvement of our quality of life. that finds, in education, the answer again; They have been months of drastic changes, unimaginable but positive changes that have allowed us to grow as individuals, as a family, as a school and as a society

The Caldera. No. 24

El poder extraordinario que tiene la literatura, en la vida de un ser humano, es incalculable; no sólo es abrir un libro y pasar los ojos por las páginas; ¡No! Es dejarse atrapar, dejarse llevar por mundos y contextos distintos, diversos, pletóricos de vivencias humanas que nos hacen únicos e irrepetibles. Cada vez que abrimos un libro y nos damos el permiso de leerlo, nos volvemos mejores seres humanos, porque comprendemos más al otro, o por lo menos, tratamos de reconocer cómo vivían, cómo pensaban, cómo actuaban, en otras épocas, incluyendo la nuestra. Con la lectura, podemos entender por qué los seres humanos son como son, potenciamos la empatía y fortalecemos la conciencia moral, entre algunas ventajas que tiene este proceso que nos acompaña a lo largo de toda la vida. Este año, en la mejor Feria del Libro del Oriente Colombiano, ULIBRO 2021, que se realiza del 30 de agosto, al 4 de septiembre, estamos invitados a participar en conversatorios, talleres, encuentros con autores, entre otras actividades propuestas, de manera presencial y virtual, para seguir fortaleciendo nuestro proyecto de vida; también, estamos invitados a dejarnos contagiar de la lectura, de la escritura, de la oralidad, a partir de “Las historias asombrosas”, que se van a tomar los diferentes espacios propuestos.1. Experiencias Internacionales…5 2. Homenaje al Dr. Alfonso Gómez Gómez; Por Samir Rodríguez Sarmiento…12 3. Nuestro Preescolar; Por Pilar Rocío Silva, Clara María Hassen y Laura Melissa Ayala…16 4. Maestros Caldistas; Por Gisela Afanador Díaz y Elena Mireya Brijaldo…20 5. Reloj Solar…24 6. La Cuna de Excélsior. VIII Concurso de Lectura en Voz Alta…29 7. VIII Concurso Intercolegiado Departamental de Oratoria...35 8. Homenaje a Augusto Monterroso; Por comunidad caldista...49 9. Expresiones Caldistas…52 10. Galería de Imágenes…86 11. Nuestros Maestros…92The extraordinary power that literature has, in the life of a human being, is incalculable; It is not just opening a book and running your eyes through the pages; No! It is to let yourself be trapped, to let yourself be carried away by different, diverse worlds and contexts, full of human experiences that make us unique and unrepeatable. Every time we open a book and give ourselves permission to read it, we become better human beings, because we understand others more, or at least, we try to recognize how they lived, how they thought, how they acted, in other times, including ours. . With reading, we can understand why human beings are the way they are, we enhance empathy and strengthen moral conscience, among some advantages that this process has that accompanies us throughout our lives. This year, in the best Book Fair of the Colombian East, ULIBRO 2021, which takes place from August 30 to September 4, we are invited to participate in talks, workshops, meetings with authors, among other proposed activities, in person and virtual, to continue strengthening our life project; Also, we are invited to let ourselves be infected with reading, writing, orality, starting from "The amazing stories", which are going to take the different spaces proposed

Taking the pulse of Earth's tropical forests using networks of highly distributed plots

Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests.Additional co-authors: Susan Laurance, William Laurance, Francoise Yoko Ishida, Andrew Marshall, Catherine Waite, Hannsjoerg Woell, Jean-Francois Bastin, Marijn Bauters, Hans Beeckman, Pfascal Boeckx, Jan Bogaert, Charles De Canniere, Thales de Haulleville, Jean-Louis Doucet, Olivier Hardy, Wannes Hubau, Elizabeth Kearsley, Hans Verbeeck, Jason Vleminckx, Steven W. Brewer, Alfredo Alarcón, Alejandro Araujo-Murakami, Eric Arets, Luzmila Arroyo, Ezequiel Chavez, Todd Fredericksen, René Guillén Villaroel, Gloria Gutierrez Sibauty, Timothy Killeen, Juan Carlos Licona, John Lleigue, Casimiro Mendoza, Samaria Murakami, Alexander Parada Gutierrez, Guido Pardo, Marielos Peña-Claros, Lourens Poorter, Marisol Toledo, Jeanneth Villalobos Cayo, Laura Jessica Viscarra, Vincent Vos, Jorge Ahumada, Everton Almeida, Jarcilene Almeida, Edmar Almeida de Oliveira, Wesley Alves da Cruz, Atila Alves de Oliveira, Fabrício Alvim Carvalho, Flávio Amorim Obermuller, Ana Andrade, Fernanda Antunes Carvalho, Simone Aparecida Vieira, Ana Carla Aquino, Luiz Aragão, Ana Claudia Araújo, Marco Antonio Assis, Jose Ataliba Mantelli Aboin Gomes, Fabrício Baccaro, Plínio Barbosa de Camargo, Paulo Barni, Jorcely Barroso, Luis Carlos Bernacci, Kauane Bordin, Marcelo Brilhante de Medeiros, Igor Broggio, José Luís Camargo, Domingos Cardoso, Maria Antonia Carniello, Andre Luis Casarin Rochelle, Carolina Castilho, Antonio Alberto Jorge Farias Castro, Wendeson Castro, Sabina Cerruto Ribeiro, Flávia Costa, Rodrigo Costa de Oliveira, Italo Coutinho, John Cunha, Lola da Costa, Lucia da Costa Ferreira, Richarlly da Costa Silva, Marta da Graça Zacarias Simbine, Vitor de Andrade Kamimura, Haroldo Cavalcante de Lima, Lia de Oliveira Melo, Luciano de Queiroz, José Romualdo de Sousa Lima, Mário do Espírito Santo, Tomas Domingues, Nayane Cristina dos Santos Prestes, Steffan Eduardo Silva Carneiro, Fernando Elias, Gabriel Eliseu, Thaise Emilio, Camila Laís Farrapo, Letícia Fernandes, Gustavo Ferreira, Joice Ferreira, Leandro Ferreira, Socorro Ferreira, Marcelo Fragomeni Simon, Maria Aparecida Freitas, Queila S. García, Angelo Gilberto Manzatto, Paulo Graça, Frederico Guilherme, Eduardo Hase, Niro Higuchi, Mariana Iguatemy, Reinaldo Imbrozio Barbosa, Margarita Jaramillo, Carlos Joly, Joice Klipel, Iêda Leão do Amaral, Carolina Levis, Antonio S. Lima, Maurício Lima Dan, Aline Lopes, Herison Madeiros, William E. Magnusson, Rubens Manoel dos Santos, Beatriz Marimon, Ben Hur Marimon Junior, Roberta Marotti Martelletti Grillo, Luiz Martinelli, Simone Matias Reis, Salomão Medeiros, Milton Meira-Junior, Thiago Metzker, Paulo Morandi, Natanael Moreira do Nascimento, Magna Moura, Sandra Cristina Müller, Laszlo Nagy, Henrique Nascimento, Marcelo Nascimento, Adriano Nogueira Lima, Raimunda Oliveira de Araújo, Jhonathan Oliveira Silva, Marcelo Pansonato, Gabriel Pavan Sabino, Karla Maria Pedra de Abreu, Pablo José Francisco Pena Rodrigues, Maria Piedade, Domingos Rodrigues, José Roberto Rodrigues Pinto, Carlos Quesada, Eliana Ramos, Rafael Ramos, Priscyla Rodrigues, Thaiane Rodrigues de Sousa, Rafael Salomão, Flávia Santana, Marcos Scaranello, Rodrigo Scarton Bergamin, Juliana Schietti, Jochen Schöngart, Gustavo Schwartz, Natalino Silva, Marcos Silveira, Cristiana Simão Seixas, Marta Simbine, Ana Claudia Souza, Priscila Souza, Rodolfo Souza, Tereza Sposito, Edson Stefani Junior, Julio Daniel do Vale, Ima Célia Guimarães Vieira, Dora Villela, Marcos Vital, Haron Xaud, Katia Zanini, Charles Eugene Zartman, Nur Khalish Hafizhah Ideris, Faizah binti Hj Metali, Kamariah Abu Salim, Muhd Shahruney Saparudin, Rafizah Mat Serudin, Rahayu Sukmaria Sukri, Serge Begne, George Chuyong, Marie Noel Djuikouo, Christelle Gonmadje, Murielle Simo-Droissart, Bonaventure Sonké, Hermann Taedoumg, Lise Zemagho, Sean Thomas, Fidèle Baya, Gustavo Saiz, Javier Silva Espejo, Dexiang Chen, Alan Hamilton, Yide Li, Tushou Luo, Shukui Niu, Han Xu, Zhang Zhou, Esteban Álvarez-Dávila, Juan Carlos Andrés Escobar, Henry Arellano-Peña, Jaime Cabezas Duarte, Jhon Calderón, Lina Maria Corrales Bravo, Borish Cuadrado, Hermes Cuadros, Alvaro Duque, Luisa Fernanda Duque, Sandra Milena Espinosa, Rebeca Franke-Ante, Hernando García, Alejandro Gómez, Roy González-M., Álvaro Idárraga-Piedrahíta, Eliana Jimenez, Rubén Jurado, Wilmar López Oviedo, René López-Camacho, Omar Aurelio Melo Cruz, Irina Mendoza Polo, Edwin Paky, Karen Pérez, Angel Pijachi, Camila Pizano, Adriana Prieto, Laura Ramos, Zorayda Restrepo Correa, James Richardson, Elkin Rodríguez, Gina M. Rodriguez M., Agustín Rudas, Pablo Stevenson, Markéta Chudomelová, Martin Dancak, Radim Hédl, Stanislav Lhota, Martin Svatek, Jacques Mukinzi, Corneille Ewango, Terese Hart, Emmanuel Kasongo Yakusu, Janvier Lisingo, Jean-Remy Makana, Faustin Mbayu, Benjamin Toirambe, John Tshibamba Mukendi, Lars Kvist, Gustav Nebel, Selene Báez, Carlos Céron, Daniel M. Griffith, Juan Ernesto Guevara Andino, David Neill, Walter Palacios, Maria Cristina Peñuela-Mora, Gonzalo Rivas-Torres, Gorky Villa, Sheleme Demissie, Tadesse Gole, Techane Gonfa, Kalle Ruokolainen, Michel Baisie, Fabrice Bénédet, Wemo Betian, Vincent Bezard, Damien Bonal, Jerôme Chave, Vincent Droissart, Sylvie Gourlet-Fleury, Annette Hladik, Nicolas Labrière, Pétrus Naisso, Maxime Réjou-Méchain, Plinio Sist, Lilian Blanc, Benoit Burban, Géraldine Derroire, Aurélie Dourdain, Clement Stahl, Natacha Nssi Bengone, Eric Chezeaux, Fidèle Evouna Ondo, Vincent Medjibe, Vianet Mihindou, Lee White, Heike Culmsee, Cristabel Durán Rangel, Viviana Horna, Florian Wittmann, Stephen Adu-Bredu, Kofi Affum-Baffoe, Ernest Foli, Michael Balinga, Anand Roopsind, James Singh, Raquel Thomas, Roderick Zagt, Indu K. Murthy, Kuswata Kartawinata, Edi Mirmanto, Hari Priyadi, Ismayadi Samsoedin, Terry Sunderland, Ishak Yassir, Francesco Rovero, Barbara Vinceti, Bruno Hérault, Shin-Ichiro Aiba, Kanehiro Kitayama, Armandu Daniels, Darlington Tuagben, John T. Woods, Muhammad Fitriadi, Alexander Karolus, Kho Lip Khoon, Noreen Majalap, Colin Maycock, Reuben Nilus, Sylvester Tan, Almeida Sitoe, Indiana Coronado G., Lucas Ojo, Rafael de Assis, Axel Dalberg Poulsen, Douglas Sheil, Karen Arévalo Pezo, Hans Buttgenbach Verde, Victor Chama Moscoso, Jimmy Cesar Cordova Oroche, Fernando Cornejo Valverde, Massiel Corrales Medina, Nallaret Davila Cardozo, Jano de Rutte Corzo, Jhon del Aguila Pasquel, Gerardo Flores Llampazo, Luis Freitas, Darcy Galiano Cabrera, Roosevelt García Villacorta, Karina Garcia Cabrera, Diego García Soria, Leticia Gatica Saboya, Julio Miguel Grandez Rios, Gabriel Hidalgo Pizango, Eurídice Honorio Coronado, Isau Huamantupa-Chuquimaco, Walter Huaraca Huasco, Yuri Tomas Huillca Aedo, Jose Luis Marcelo Peña, Abel Monteagudo Mendoza, Vanesa Moreano Rodriguez, Percy Núñez Vargas, Sonia Cesarina Palacios Ramos, Nadir Pallqui Camacho, Antonio Peña Cruz, Freddy Ramirez Arevalo, José Reyna Huaymacari, Carlos Reynel Rodriguez, Marcos Antonio Ríos Paredes, Lily Rodriguez Bayona, Rocio del Pilar Rojas Gonzales, Maria Elena Rojas Peña, Norma Salinas Revilla, Yahn Carlos Soto Shareva, Raul Tupayachi Trujillo, Luis Valenzuela Gamarra, Rodolfo Vasquez Martinez, Jim Vega Arenas, Christian Amani, Suspense Averti Ifo, Yannick Bocko, Patrick Boundja, Romeo Ekoungoulou, Mireille Hockemba, Donatien Nzala, Alusine Fofanah, David Taylor, Guillermo Bañares-de Dios, Luis Cayuela, Íñigo Granzow-de la Cerda, Manuel Macía, Juliana Stropp, Maureen Playfair, Verginia Wortel, Toby Gardner, Robert Muscarella, Hari Priyadi, Ervan Rutishauser, Kuo-Jung Chao, Pantaleo Munishi, Olaf Bánki, Frans Bongers, Rene Boot, Gabriella Fredriksson, Jan Reitsma, Hans ter Steege, Tinde van Andel, Peter van de Meer, Peter van der Hout, Mark van Nieuwstadt, Bert van Ulft, Elmar Veenendaal, Ronald Vernimmen, Pieter Zuidema, Joeri Zwerts, Perpetra Akite, Robert Bitariho, Colin Chapman, Eilu Gerald, Miguel Leal, Patrick Mucunguzi, Miguel Alexiades, Timothy R. Baker, Karina Banda, Lindsay Banin, Jos Barlow, Amy Bennett, Erika Berenguer, Nicholas Berry, Neil M. Bird, George A. Blackburn, Francis Brearley, Roel Brienen, David Burslem, Lidiany Carvalho, Percival Cho, Fernanda Coelho, Murray Collins, David Coomes, Aida Cuni-Sanchez, Greta Dargie, Kyle Dexter, Mat Disney, Freddie Draper, Muying Duan, Adriane Esquivel-Muelbert, Robert Ewers, Belen Fadrique, Sophie Fauset, Ted R. Feldpausch, Filipe França, David Galbraith, Martin Gilpin, Emanuel Gloor, John Grace, Keith Hamer, David Harris, Tommaso Jucker, Michelle Kalamandeen, Bente Klitgaard, Aurora Levesley, Simon L. Lewis, Jeremy Lindsell, Gabriela Lopez-Gonzalez, Jon Lovett, Yadvinder Malhi, Toby Marthews, Emma McIntosh, Karina Melgaço, William Milliken, Edward Mitchard, Peter Moonlight, Sam Moore, Alexandra Morel, Julie Peacock, Kelvin Peh, Colin Pendry, R. Toby Pennington, Luciana de Oliveira Pereira, Carlos Peres, Oliver L. Phillips, Georgia Pickavance, Thomas Pugh, Lan Qie, Terhi Riutta, Katherine Roucoux, Casey Ryan, Tiina Sarkinen, Camila Silva Valeria, Dominick Spracklen, Suzanne Stas, Martin Sullivan, Michael Swaine, Joey Talbot, James Taplin, Geertje van der Heijden, Laura Vedovato, Simon Willcock, Mathew Williams, Luciana Alves, Patricia Alvarez Loayza, Gabriel Arellano, Cheryl Asa, Peter Ashton, Gregory Asner, Terry Brncic, Foster Brown, Robyn Burnham, Connie Clark, James Comiskey, Gabriel Damasco, Stuart Davies, Tony Di Fiore, Terry Erwin, William Farfan-Rios, Jefferson Hall, David Kenfack, Thomas Lovejoy, Roberta Martin, Olga Martha Montiel, John Pipoly, Nigel Pitman, John Poulsen, Richard Primack, Miles Silman, Marc Steininger, Varun Swamy, John Terborgh, Duncan Thomas, Peter Umunay, Maria Uriarte, Emilio Vilanova Torre, Ophelia Wang, Kenneth Young, Gerardo A. Aymard C., Lionel Hernández, Rafael Herrera Fernández, Hirma Ramírez-Angulo, Pedro Salcedo, Elio Sanoja, Julio Serrano, Armando Torres-Lezama, Tinh Cong Le, Trai Trong Le, Hieu Dang Tra

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

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

Facilitation of ejaculation induced by 8-OH-DPAT does not produce conditioned place preference in male rats

The serotonin 1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) produces a drastic facilitation of ejaculation characterized by a significant reduction in the number of pre-ejaculatory intromissions and a shortening of ejaculation latency. In the present study, the authors evaluated whether this facilitation of ejaculation can induce a reward state assessed by conditioned place preference. Males treated with 0.1 or 1.0 mg/kg of 8-OH-DPAT showed a clear facilitation of ejaculation but did not develop conditioned place preference. These results clearly indicate that the pharmacological facilitation of ejaculation and the reduction of the number of intromissions does not necessarily make sex rewarding.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigaciones Psicológicas (IIP