Cultivo de mojarra lora (oreochrom1s niloticus) en jaulas flotantes a diferentes densidades de siembra utilizando una dieta comercial, en el embalse del guajiro la peña (atlantico).

El embalse del Guájaro (figura No 1), es un medio natural que por su alta productividad ha sido tradicionalmente una zona de pesca que por años ha servido de base para la economía de las comunidades que en ella habita. Sin embargo, en los últimos años se ha notado una disminución en la extracción del recurso pesquero, a pesar del incremento del esfuerzo de captura, generando serios problemas socio-económicos. Esta disminución en el volumen de capturas puede atribuirse a múltiples causas, como la sobre-explotación y el uso de métodos no convencionales tal como el empleo de redes con ojo de malla no permitido, el zangarreo, dinamita, trasmallo, habiéndoée tornado así la pesca en una labor antieconómica y cada vez más decepcionante. Dado que en la región se ha venido trabajando con programas que permiten observar e identificar los principales factores que determinan el comportamiento del sistema del Guájaro, con especies icticas de mayor importancia comercial y la ineficacia de los instrumentos legislativos existentes en el país, para controlar la pesca irracional. La extracción del recurso íctico se ha convertido en un factor limitante para el desarrollo de las comunidades pesqueras del Embalse del Guájaro, por el cual se deben presentar proyectos que permitan aplicar la piscicultura en cualquiera de sus variaciones: cultivo en estanques, corrales y jaulas como alternativa del aprovechamiento del medio hídrico natural. El cultivo en jaulas incluye específicamente, el mantenimiento de especies en cautiverio dentro de un espacio cerrado pero con un flujo continuo de agua, dicho cultivo permite favorecer y proteger el crecimiento de especies que se encuentran en extinción aprovechando las características favorables que presenta el embalse del Guájaro y además, dando al pescador una alternativa que permita cosechar en períodos de tiempo controlados. La finalidad del presente trabajo es la de implementar el cultivo de Mojarra Lora (Oreochromis niloticus) en jaulas y su comercialización por los campesinos de esta región

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

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease