Creación y visualización de mapas prospectivos de mercurio mediante técnicas de inteligencia artificial

Depto. de Mineralogía y PetrologíaFac. de Ciencias GeológicasTRUEpu

Las necesidades básicas insatisfechas a partir de los Censos 2011

El presente fascículo resume los principales resultados del procesamiento de los Censos 2011 con el objetivo de calcular la población con Necesidades Básicas Insatisfechas (NBI) en el UruguayPresentación -- Introducción -- Capítulo 1: Metodología de cálculo de las Necesidades Básicas Insatisfechas -- Capítulo 2: Resultados generales y distribución territorial y por edades de la población con Necesidades Básicas Insatisfechas -- Capítulo 3: La heterogeneidad del comportamiento reproductivo: fecundidad y Necesidades Básicas Insatisfechas -- Capítulo 4: Las Necesidades Básicas Insatisfechas y los migrantes internos, internacionales y uruguayos retornantes -- Capítulo 5: Situación de la población afrodescendiente -- Capítulo 6: Limitaciones en la población y Necesidades Básicas Insatisfechas -- Síntesis -- Referencias bibliográfica

Gaia Early Data Release 3: Summary of the contents and survey properties

Context. We present the early installment of the third Gaia data release, Gaia EDR3, consisting of astrometry and photometry for 1.8 billion sources brighter than magnitude 21, complemented with the list of radial velocities from Gaia DR2. Aims. A summary of the contents of Gaia EDR3 is presented, accompanied by a discussion on the differences with respect to Gaia DR2 and an overview of the main limitations which are present in the survey. Recommendations are made on the responsible use of Gaia EDR3 results. Methods. The raw data collected with the Gaia instruments during the first 34 months of the mission have been processed by the Gaia Data Processing and Analysis Consortium and turned into this early third data release, which represents a major advance with respect to Gaia DR2 in terms of astrometric and photometric precision, accuracy, and homogeneity. Results. Gaia EDR3 contains celestial positions and the apparent brightness in G for approximately 1.8 billion sources. For 1.5 billion of those sources, parallaxes, proper motions, and the (GBP − GRP) colour are also available. The passbands for G, GBP, and GRP are provided as part of the release. For ease of use, the 7 million radial velocities from Gaia DR2 are included in this release, after the removal of a small number of spurious values. New radial velocities will appear as part of Gaia DR3. Finally, Gaia EDR3 represents an updated materialisation of the celestial reference frame (CRF) in the optical, the Gaia-CRF3, which is based solely on extragalactic sources. The creation of the source list for Gaia EDR3 includes enhancements that make it more robust with respect to high proper motion stars, and the disturbing effects of spurious and partially resolved sources. The source list is largely the same as that for Gaia DR2, but it does feature new sources and there are some notable changes. The source list will not change for Gaia DR3. Conclusions. Gaia EDR3 represents a significant advance over Gaia DR2, with parallax precisions increased by 30 per cent, proper motion precisions increased by a factor of 2, and the systematic errors in the astrometry suppressed by 30-40% for the parallaxes and by a factor ~2.5 for the proper motions. The photometry also features increased precision, but above all much better homogeneity across colour, magnitude, and celestial position. A single passband for G, GBP, and GRP is valid over the entire magnitude and colour range, with no systematics above the 1% leve

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

ICAP-1 loss impairs CD8+ thymocyte development and leads to reduced marginal zone B cells in mice

ICAP-1 regulates β1-integrin activation and cell adhesion. Here, we used ICAP-1-null mice to study ICAP-1 potential involvement during immune cell development and function. Integrin α4β1-dependent adhesion was comparable between ICAP-1-null and control thymocytes, but lack of ICAP-1 caused a defective single-positive (SP) CD8+ cell generation, thus, unveiling an ICAP-1 involvement in SP thymocyte development. ICAP-1 bears a nuclear localization signal and we found it displayed a strong nuclear distribution in thymocytes. Interestingly, there was a direct correlation between the lack of ICAP-1 and reduced levels in SP CD8+ thymocytes of Runx3, a transcription factor required for CD8+ thymocyte generation. In the spleen, ICAP-1 was found evenly distributed between cytoplasm and nuclear fractions, and ICAP-1–/– spleen T and B cells displayed upregulation of α4β1-mediated adhesion, indicating that ICAP-1 negatively controls their attachment. Furthermore, CD3+- and CD19+-selected spleen cells from ICAP-1-null mice showed reduced proliferation in response to T- and B-cell stimuli, respectively. Finally, loss of ICAP-1 caused a remarkable decrease in marginal zone B- cell frequencies and a moderate increase in follicular B cells. Together, these data unravel an ICAP-1 involvement in the generation of SP CD8+ thymocytes and in the control of marginal zone B-cell numbers

The celestial reference frame (Gaia-CRF3)

Gaia Collaboration: Klioner, S. A. et al.[Context] Gaia-CRF3 is the celestial reference frame for positions and proper motions in the third release of data from the Gaia mission, Gaia DR3 (and for the early third release, Gaia EDR3, which contains identical astrometric results). The reference frame is defined by the positions and proper motions at epoch 2016.0 for a specific set of extragalactic sources in the (E)DR3 catalogue.[Aims] We describe the construction of Gaia-CRF3 and its properties in terms of the distributions in magnitude, colour, and astrometric quality.[Methods] Compact extragalactic sources in Gaia DR3 were identified by positional cross-matching with 17 external catalogues of quasi-stellar objects (QSO) and active galactic nuclei (AGN), followed by astrometric filtering designed to remove stellar contaminants. Selecting a clean sample was favoured over including a higher number of extragalactic sources. For the final sample, the random and systematic errors in the proper motions are analysed, as well as the radio-optical offsets in position for sources in the third realisation of the International Celestial Reference Frame (ICRF3).[Results] Gaia-CRF3 comprises about 1.6 million QSO-like sources, of which 1.2 million have five-parameter astrometric solutions in Gaia DR3 and 0.4 million have six-parameter solutions. The sources span the magnitude range G = 13–21 with a peak density at 20.6 mag, at which the typical positional uncertainty is about 1 mas. The proper motions show systematic errors on the level of 12 µas yr–1 on angular scales greater than 15 deg. For the 3142 optical counterparts of ICRF3 sources in the S/X frequency bands, the median offset from the radio positions is about 0.5 mas, but it exceeds 4 mas in either coordinate for 127 sources. We outline the future of Gaia-CRF in the next Gaia data releases. Appendices give further details on the external catalogues used, how to extract information about the Gaia-CRF3 sources, potential (Galactic) confusion sources, and the estimation of the spin and orientation of an astrometric solution.The Gaia mission and data processing have financially been supported by, in alphabetical order by country: the Algerian Centre de Recherche en Astronomie, Astrophysique et Géophysique of Bouzareah Observatory; the Austrian Fonds zur Förderung der wissenschaftlichen Forschung (FWF) Hertha Firnberg Programme through grants T359, P20046, and P23737; the BELgian federal Science Policy Office (BELSPO) through various PROgramme de Développement d’Expériences scientifiques (PRODEX) grants and the Polish Academy of Sciences - Fonds Wetenschappelijk Onderzoek through grant VS.091.16N, and the Fonds de la Recherche Scientifique (FNRS), and the Research Council of Katholieke Universiteit (KU) Leuven through grant C16/18/005 (Pushing AsteRoseismology to the next level with TESS, GaiA, and the Sloan DIgital Sky SurvEy – PARADISE); the Brazil-France exchange programmes Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) and Coordenação de Aperfeicoamento de Pessoal de Nível Superior (CAPES) – Comité Français d’Evaluation de la Coopération Universitaire et Scientifique avec le Brésil (COFECUB); the Chilean Agencia Nacional de Investigación y Desarrollo (ANID) through Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT) Regular Project 1210992 (L. Chemin); the National Natural Science Foundation of China (NSFC) through grants 11573054, 11703065, and 12173069, the China Scholarship Council through grant 201806040200, and the Natural Science Foundation of Shanghai through grant 21ZR1474100; the Tenure Track Pilot Programme of the Croatian Science Foundation and the École Polytechnique Fédérale de Lausanne and the project TTP-2018-07-1171 ‘Mining the Variable Sky’, with the funds of the Croatian-Swiss Research Programme; the Czech-Republic Ministry of Education, Youth, and Sports through grant LG 15010 and INTER-EXCELLENCE grant LTAUSA18093, and the Czech Space Office through ESA PECS contract 98058; the Danish Ministry of Science; the Estonian Ministry of Education and Research through grant IUT40-1; the European Commission’s Sixth Framework Programme through the European Leadership in Space Astrometry (ELSA) Marie Curie Research Training Network (MRTN-CT-2006-033481), through Marie Curie project PIOF-GA-2009-255267 (Space AsteroSeismology & RR Lyrae stars, SAS-RRL), and through a Marie Curie Transfer-of-Knowledge (ToK) fellowship (MTKD-CT-2004-014188); the European Commission’s Seventh Framework Programme through grant FP7-606740 (FP7-SPACE-2013-1) for the Gaia European Network for Improved data User Services (GENIUS) and through grant 264895 for the Gaia Research for European Astronomy Training (GREAT-ITN) network; the European Cooperation in Science and Technology (COST) through COST Action CA18104 ‘Revealing the Milky Way with Gaia (MW-Gaia)’; the European Research Council (ERC) through grants 320360, 647208, and 834148 and through the European Union’s Horizon 2020 research and innovation and excellent science programmes through Marie Sklodowska-Curie grant 745617 (Our Galaxy at full HD – Gal-HD) and 895174 (The build-up and fate of self-gravitating systems in the Universe) as well as grants 687378 (Small Bodies: Near and Far), 682115 (Using the Magellanic Clouds to Understand the Interaction of Galaxies), 695099 (A sub-percent distance scale from binaries and Cepheids – CepBin), 716155 (Structured ACCREtion Disks – SACCRED), 951549 (Sub-percent calibration of the extra-galactic distance scale in the era of big surveys – UniverScale), and 101004214 (Innovative Scientific Data Exploration and Exploitation Applications for Space Sciences – EXPLORE); the European Science Foundation (ESF), in the framework of the Gaia Research for European Astronomy Training Research Network Programme (GREAT-ESF); the European Space Agency (ESA) in the framework of the Gaia project, through the Plan for European Cooperating States (PECS) programme through contracts C98090 and 4000106398/12/NL/KML for Hungary, through contract 4000115263/15/NL/IB for Germany, and through PROgramme de Développement d’Expériences scientifiques (PRODEX) grant 4000127986 for Slovenia; the Academy of Finland through grants 299543, 307157, 325805, 328654, 336546, and 345115 and the Magnus Ehrnrooth Foundation; the French Centre National d’Études Spatiales (CNES), the Agence Nationale de la Recherche (ANR) through grant ANR-10-IDEX-0001-02 for the ‘Investissements d’avenir’ programme, through grant ANR-15-CE31-0007 for project ‘Modelling the Milky Way in the Gaia era’ (MOD4Gaia), through grant ANR-14-CE33-0014-01 for project ‘The Milky Way disc formation in the Gaia era’ (ARCHEOGAL), through grant ANR-15-CE31-0012-01 for project ‘Unlocking the potential of Cepheids as primary distance calibrators’ (UnlockCepheids), through grant ANR-19-CE31-0017 for project ‘Secular evolution of galxies’ (SEGAL), and through grant ANR-18-CE31-0006 for project ‘Galactic Dark Matter’ (GaDaMa), the Centre National de la Recherche Scientifique (CNRS) and its SNO Gaia of the Institut des Sciences de l’Univers (INSU), its Programmes Nationaux: Cosmologie et Galaxies (PNCG), Gravitation Références Astronomie Métrologie (PNGRAM), Planétologie (PNP), Physique et Chimie du Milieu Interstellaire (PCMI), and Physique Stellaire (PNPS), the ‘Action Fédératrice Gaia’ of the Observatoire de Paris, the Région de Franche-Comté, the Institut National Polytechnique (INP) and the Institut National de Physique nucléaire et de Physique des Particules (IN2P3) co-funded by CNES; the German Aerospace Agency (Deutsches Zentrum für Luft- und Raumfahrt e.V., DLR) through grants 50QG0501, 50QG0601, 50QG0602, 50QG0701, 50QG0901, 50QG1001, 50QG1101, 50QG1401, 50QG1402, 50QG1403, 50QG1404, 50QG1904, 50QG2101, 50QG2102, and 50QG2202, and the Centre for Information Services and High Performance Computing (ZIH) at the Technische Universität Dresden for generous allocations of computer time; the Hungarian Academy of Sciences through the Lendület Programme grants LP2014-17 and LP2018-7 and the Hungarian National Research, Development, and Innovation Office (NKFIH) through grant KKP-137523 (‘SeismoLab’); the Science Foundation Ireland (SFI) through a Royal Society - SFI University Research Fellowship (M. Fraser); the Israel Ministry of Science and Technology through grant 3-18143 and the Tel Aviv University Center for Artificial Intelligence and Data Science (TAD) through a grant; the Agenzia Spaziale Italiana (ASI) through contracts I/037/08/0, I/058/10/0, 2014-025-R.0, 2014-025-R.1.2015, and 2018-24-HH.0 to the Italian Istituto Nazionale di Astrofisica (INAF), contract 2014-049-R.0/1/2 to ΓNAF for the Space Science Data Centre (SSDC, formerly known as the ASI Science Data Center, ASDC), contracts I/008/10/0, 2013/030/I.0, 2013-030-I.0.1-2015, and 2016-17-I.0 to the Aerospace Logistics Technology Engineering Company (ALTEC S.p.A.), INAF, and the Italian Ministry of Education, University, and Research (Ministero dell’Istruzione, dell’Università e della Ricerca) through the Premiale project ‘Mining The Cosmos Big Data and Innovative Italian Technology for Frontier Astrophysics and Cosmology’ (MITiC); the Netherlands Organisation for Scientific Research (NWO) through grant NWO-M-614.061.414, through a VICI grant (A. Helmi), and through a Spinoza prize (A. Helmi), and the Netherlands Research School for Astronomy (NOVA); the Polish National Science Centre through HARMONIA grant 2018/30/M/ST9/00311 and DAINA grant 2017/27/L/ST9/03221 and the Ministry of Science and Higher Education (MNiSW) through grant DIR/WK/2018/12; the Portuguese Fundação para a Ciência e a Tecnologia (FCT) through national funds, grants SFRH/BD/128840/2017 and PTDC/FIS-AST/30389/2017, and work contract DL 57/2016/CP1364/CT0006, the Fundo Europeu de Desenvolvimento Regional (FEDER) through grant POCI-01-0145-FEDER-030389 and its Programa Operacional Competitividade e Internacionalização (COMPETE2020) through grants UIDB/04434/2020 and UIDP/04434/2020, and the Strategic Programme UIDB/00099/2020 for the Centro de Astrof sica e Gravitação (CENTRA); the Slovenian Research Agency through grant P1-0188; the Spanish Ministry of Economy (MINECO/FEDER, UE), the Spanish Ministry of Science and Innovation (MICIN), the Spanish Ministry of Education, Culture, and Sports, and the Spanish Government through grants BES-2016-078499, BES-2017-083126, BES-C-2017-0085, ESP2016-80079-C2-1-R, ESP2016-80079-C2-2-R, FPU16/03827, PDC2021-121059-C22, RTI2018-095076-B-C22, and TIN2015-65316-P (‘Computación de Altas Prestaciones VII’), the Juan de la Cierva Incorporación Programme (FJCI-2015-2671 and IJC2019-04862-I for F. Anders), the Severo Ochoa Centre of Excellence Programme (SEV2015-0493), and MICIN/AEI/10.13039/501100011033 (and the European Union through European Regional Development Fund ‘A way of making Europe’) through grant RTI2018-095076-B-C21, the Institute of Cosmos Sciences University of Barcelona (ICCUB, Unidad de Excelencia ‘Mar a de Maeztu’) through grant CEX2019-000918-M, the University of Barcelona’s official doctoral programme for the development of an R+D+i project through an Ajuts de Personal Investigador en Formació (APIF) grant, the Spanish Virtual Observatory through project AyA2017-84089, the Galician Regional Government, Xunta de Galicia, through grants ED431B-2021/36, ED481A-2019/155, and ED481A-2021/296, the Centro de Investigación en Tecnolog as de la Información y las Comunicaciones (CITIC), funded by the Xunta de Galicia and the European Union (European Regional Development Fund – Galicia 2014-2020 Programme), through grant ED431G-2019/01, the Red Española de Supercomputación (RES) computer resources at MareNostrum, the Barcelona Supercomputing Centre – Centro Nacional de Supercomputación (BSC-CNS) through activities AECT-2017-2-0002, AECT-2017-3-0006, AECT-2018-1-0017, AECT-2018-2-0013, AECT-2018-3-0011, AECT-2019-1-0010, AECT-2019-2-0014, AECT-2019-3-0003, AECT-2020-1-0004, and DATA-2020-1-0010, the Departament d’Innovació, Universitats i Empresa de la Generalitat de Catalunya through grant 2014-SGR-1051 for project ‘Models de Programació i Entorns d’Execució Parallels’ (MPEXPAR), and Ramon y Cajal Fellowship RYC2018-025968-I funded by MICIN/AEI/10.13039/501100011033 and the European Science Foundation (‘Investing in your future’); the Swedish National Space Agency (SNSA/Rymdstyrelsen); the Swiss State Secretariat for Education, Research, and Innovation through the Swiss Activités Nationales Complémentaires and the Swiss National Science Foundation through an Eccellenza Professorial Fellowship (award PCEFP2_194638 for R. Anderson); the United Kingdom Particle Physics and Astronomy Research Council (PPARC), the United Kingdom Science and Technology Facilities Council (STFC), and the United Kingdom Space Agency (UKSA) through the following grants to the University of Bristol, the University of Cambridge, the University of Edinburgh, the University of Leicester, the Mullard Space Sciences Laboratory of University College London, and the United Kingdom Rutherford Appleton Laboratory (RAL): PP/D006511/1, PP/D006546/1, PP/D006570/1, ST/I000852/1, ST/J005045/1, ST/K00056X/1, ST/K000209/1, ST/K000756/1, ST/L006561/1, ST/N000595/1, ST/N000641/1, ST/N000978/1, ST/N001117/1, ST/S000089/1, ST/S000976/1, ST/S000984/1, ST/S001123/1, ST/S001948/1, ST/S001980/1, ST/S002103/1, ST/V000969/1, ST/W002469/1, ST/W002493/1, ST/W002671/1, ST/W002809/1, and EP/V520342/1. Further acknowledgments can be found at https://gea.esac.esa.int/archive/documentation/GEDR3/Miscellaneous/sec_acknowl/.Peer reviewe

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

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

Pasados y presente. Estudios para el profesor Ricardo García Cárcel

Ricardo García Cárcel (Requena, 1948) estudió Historia en Valencia bajo el magisterio de Joan Reglà, con quien formó parte del primer profesorado de historia moderna en la Universidad Autónoma de Barcelona. En esta universidad, desde hace prácticamente cincuenta años, ha desarrollado una extraordinaria labor docente y de investigación marcada por un sagaz instinto histórico, que le ha convertido en pionero de casi todo lo que ha estudiado: las Germanías, la historia de la Cataluña moderna, la Inquisición, las culturas del Siglo de Oro, la Leyenda Negra, Felipe II, Felipe V, Austrias y Borbones, la guerra de la Independencia, la historia cultural, los mitos de la historia de España... Muy pocos tienen su capacidad para reflexionar, ordenar, analizar, conceptualizar y proponer una visión amplia y llena de matices sobre el pasado y las interpretaciones historiográficas. A su laboriosidad inimitable se añade una dedicación sin límites en el asesoramiento de alumnos e investigadores e impulsando revistas, dosieres, seminarios o publicaciones colectivas. Una mínima correspondencia a su generosidad lo constituye este volumen a manera de ineludible agradecimiento

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