A new genus and species of Planopinae (Xenarthra: Tardigrada) from the Miocene of Santa Cruz Province, Argentina

Prepoplanops boleadorensis, a new genus and species of Planopinae (Xenarthra, Tardigrada), is described herein. The new taxon is based on a nearly complete specimen recovered from the Cerro Boleadoras Formation (Miocene, Río Zeballos Group), in northwestern Santa Cruz Province, Argentina. The shape and length of the predentary region of the skull and the length of the diastema of Prepoplanops boleadorensis differ from those present in the species of Planops. The posterolateral opening of the mandibular canal and the position of the posterior margin of the mandibular symphysis differ from those of species of Prepotherium. In addition, Prepoplanops boleadorensis differs from Planops martini in the size of the humeral tuberosities, the development of the deltoid crest, the position of the distal margin of the humeral trochlea, the shape and position of the olecranon, the development of the femoral epicondyles, and the shape of the medial margins of the patellar trochlea and medial condyle. On the other hand, it differs from Prepotherium potens in the shape of the medial margin of the medial condyle. The recognition of Prepoplanops boleadorensis increases the diversity of Planopinae for the Miocene of Patagonia, Argentina.Fil: Carlini, Alfredo Armando. Universidad Nacional de la Plata. Facultad de Ciencias Naturales y Museo. División Paleontología Vertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Brandoni, Diego. Provincia de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Universidad Autónoma de Entre Ríos. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Centro de Investigaciones Científicas y Transferencia de Tecnología a la Producción; ArgentinaFil: Dal Molin, Carlos N.. Secretaría de Industria y Minería. Servicio Geológico Minero Argentino; Argentin

Hoja Geológica 4172-II, San Martín de los Andes, Provincias de Río Negro y Neuquén

La Hoja Geológica 4172-II San Martín de los Andes incluye un sector del sur de la provincia del Neuquén y una pequeña porción del noroeste de la provincia de Río Negro. Ocupa un área de aproximadamente 9.000 km2 y está delimitada por los paralelos 40º y 41º de latitud sur, el meridiano 70º 30’ de longitud oeste y el límite con Chile. Abarca parte del segmento norte de la Cordillera Patagónica Septentrional, el extremo austral de la Precordillera Neuquina Sur, gran parte de la Fosa de Collón Curá y una pequeña porción del Macizo Norpatagónico. Las rocas más antiguas aflorantes en la comarca forman parte del basamento cristalino; en la región cordillerana corresponden al Complejo Colohuincul (Devónico-Carbonífero), en tanto que otras unidades están ubicadas en una franja nortesur en el sector más oriental de la Hoja y están integradas por las formaciones Cushamen (DevónicoPérmico), Mamil Choique (Carbonífero- Pérmico) y Lipetrén (Pérmico-Triásico). Sedimentitas continentales con alto contenido fosilífero de las formaciones Paso Flores (Triásico superior) y Nestares (Jurásico inferior) afloran en áreas aledañas al embalse Piedra del Águila. Rocas piroclásticas de la Formación Sañicó (Triásico superior-Jurásico inferior) y sedimentitas de ambiente marino-continental de la Formación Piedra Pintada (Jurásico inferior) se hallan en la región extraandina. En tanto, en la cordillera, rocas volcánicas y sedimentarias de la Formación Montes de Oca (Jurásico inferior) alojaron los granitoides de la Formación Los Machis (JurásicoCretácico). Un pequeño afloramiento de conglomerados y areniscas rojas de la Formación Angostura Colorada (Cretácico superior) está situado en el extremo sureste de la hoja y escasos asomos de basaltos cretácicos, al oeste del dique de Alicurá. El Paleógeno, caracterizado por una importante actividad volcánica asociada a la evolución del margen continental andino, está representado por extensos y potentes afloramientos de volcanitas de las formaciones Huitrera, Ventana y Lolog. Coladas de basaltos de la Formación Cerro Petiso (Mioceno inferior) formaron planicies estructurales en la región del río Limay, y fueron cubiertas por los depósitos de la Formación María Sofía (Mioceno) que se caracteriza por la presencia de paleosuelos. Durante el Mioceno medio-superior se rellenó la cuenca de Collón Curá con potentes espesores de sedimentitas, tobas, ignimbritas y basaltos de las formaciones Collón Curá y Caleufú. El Mioceno de la región cordillerana está representado por granodioritas, granitos y pórfidos graníticos pertenecientes a la Formación Coluco, que intruyen al Complejo Colohuincul y a las volcanitas de la Formación Ventana. Durante el Plioceno inferior se produjo una importante actividad volcánica, con emisiones de basaltos y andesitas de la Formación Chapelco en el cordón del mismo nombre. En la región más oriental de la Hoja se advierten amplias extensiones de coladas de basaltos olivínicos de la Formación Chenqueniyeu. Intrusivos riolíticos del Plioceno superior, aflorantes al norte y noreste de San Martín de los Andes se reunieron en la Formación Los Pinos. En el Plioceno-Pleistoceno en la cordillera se derramaron basaltos olivínicos y andesitas de las formaciones Aseret y Paso Mirador. En el Pleistoceno fueron acumulados, a lo largo de la cordillera, en áreas aledañas a los lagos, sedimentos relacionados con la acción glaciar, tales como depósitos glaciares, fluvioglaciares y glacilacustres. En el Holoceno se derramaron coladas de basaltos, en varias áreas de la Hoja, como en el cordón de Chapelco, en la pampa de Alicurá y en el cerro La Horqueta. En un amplio sector cordillerano, asomos ocasionales de material piroclástico no consolidado de la Formación Río Pireco tapizan el relieve. Completan el registro estratigráfico los depósitos modernos correspondientes a depósitos aluviales, de remoción en masa y coluviales. En el ámbito de la Hoja está muy bien expuesta a lo largo de la Cordillera Patagónica, donde se observan importantes estructuras representativas, la fase compresiva Andina. Hacia el este se halla la cuenca de Collón Curá a lo largo del río del mismo nombre, limitada hacia el oriente por las estribaciones australes de la Precordillera Neuquina Sur. La geomorfología de la región presenta tres áreas netamente diferenciables: una occidental más elevada, a lo largo de la cordillera, con predominio del paisaje glaciario, una región central volcánica y una oriental con un relieve mesetiforme. No se conocen en el área de la Hoja antecedentes relativos a explotaciones mineras de tipo alguno, con excepción de aquellas referidas al aprovechamiento de gravas o arenas destinadas a cubrir las necesidades locales.The Geological Sheet 4172-II San Martín de los Andes includes a sector in the south of Neuquén province and a little portion in the northwest of Río Negro province. It occupies an area of about 9.000 km2 and is bounded by the parallels 40º and 41º of south latitude, meridian 70º 30’ of west latitude and the border with Chile. The Sheet encompasses part of the northern segment of the Cordillera Patagónica Austral, the southern end of the Precordillera Neuquina Sur, most of the Collón Curá trough and a little portion of the Macizo Norpatagónico. The oldest exposed rocks in the region are part of the crystalline basement; they are the Colohuincul Complex (Devonian-Carboniferous) in the mountainous region, while other units are located in a north-south belt in the eastern sector of the sheet integrated by Cushamen (Devonian-Permian), Mamil Choique (Carboniferous- Permian) and Lipetrén (Permian-Triassic) Formations. Continental sediments with great fossil content of Paso Flores (Triassic) and Nestares (Lower Jurassic) Formations, outcrop in areas surrounding the Piedra del Águila dam. Pyroclastic rocks of the Sañicó Formation (Upper Triassic-Lower Jurassic) and marine-continental sediments of the Piedra Pintada Formation (Lower Jurassic) outcrop in the extra-Andean region. Meanwhile, in the mountains, volcanic and sedimentary rocks of the Montes de Oca Formation (Lower Jurassic) are intruded by granitoids of the Los Machis Formation (Jurassic-Cretaceous). A small outcrop of conglomerates and red sandstones of the Angostura Colorada Formation (Upper Cretaceous) is located on the southeastern tip of the sheet, and scarce showings of Cretaceous basalt appear to the west of Alicurá dam. The Paleogene, characterized by significant volcanic activity associated with the evolution of the Andean continental margin, is represented by large and thick volcanic outcrops of Huitrera, Ventana and Lolog Formations. Basaltic lava flows of Cerro Petiso (lower Miocene) formed structural plains in the region of the Limay River, and were covered by deposits of Maria Sofia Formation (Miocene) characterized by the presence of paleosols. During the Middle-Upper Miocene the Collón Curá was filled with thick sediments, tuffs, ignimbrites and basalts of the Caleufú and Collón Curá Formations. Miocene rocks in the mountainous region are represented by granodiorites, granites and granitic porphyry belonging to the Coluco Formation, which intrudes the Colohuincul Complex and the volcanics of Ventana Formation. During the Pliocene there was a significant volcanic activity, with basaltic and andesitic emissions forming the Chapelco Formation in the montain range of the same name. In the eastern region of the sheet, large tracts of olivine basaltic flows of the Chenqueniyeu Formation are seen. Rhyolitic intrusive of the Upper Pliocene outcropping north and northeast of San Martín de los Andes integrate the Los Pinos Formation. During PliocenePleistocene olivine basaltic and andesitic flows of the Aseret and Paso Mirador Formations spilled in the Cordillera. In the Pleistocene, glacier-related deposits such as glacial, fluvioglacial and glacilacustrine sediments were deposited along the Cordillera, in areas adjacent to the lakes. Holocene basaltic lava flows spilled in several areas of the sheet, as in the Chapelco Range, in the Pampa de Alicurá and Cerro La Horqueta. Occasional showings of unconsolidated pyroclastic material of the Río Pireco Formation cover the relief in a large mountain sector. The stratigraphic record is completed with modern alluvial, landslides and colluvial deposits. The structure in the area of the sheet is well exposed along the Patagonian Andes, where important representative structures of the Andean compressive phase are observed. To the East, Collón Curá basin is located along the river of the same name, bounded on the east by the southern foothills of the Precordillera Neuquina Sur. Geomorphologically, the region has three clearly differentiated areas: a higher western area, along the Cordillera, dominated by glacial landscape, a central volcanic area and an eastern plateau-shaped area. Mining of any kind is unknown for the area, except for those related with the use of activity gravel or sand to cover local needs.Fil: Escosteguy, Leonardo Darío. No especifica;Fil: Geuna, Silvana Evangelina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Geociencias Basicas, Aplicadas y Ambientales de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Geociencias Basicas, Aplicadas y Ambientales de Buenos Aires; ArgentinaFil: Franchi, María Luisa. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gonzalez Diaz, Emilio Fernando. No especifica;Fil: Dal Molin, Carlos N.. No especifica

Cenozoic intraplate tectonics in Central Patagonia: Record of main Andean phases in a weak upper plate

Contraction in intraplate areas is still poorly understood relative to similar deformation at plate margins. In order to contribute to its comprehension, we study the Patagonian broken foreland (PBF) in South America whose evolution remains controversial. Time constraints of tectonic events and structural characterization of this belt are limited. Also, major causes of strain location in this orogen far from the plate margin are enigmatic. To unravel tectonic events, we studied the Cenozoic sedimentary record of the central sector of the Patagonian broken foreland (San Bernardo fold and thrust belt, 44°30′S-46°S) and the Andes (Meseta de Chalia, 46°S) following an approach involving growth-strata detection, U-Pb geochronology and structural modeling. Additionally, we elaborate a high resolution analysis of the effective elastic thickness (Te) to examine the relation between intraplate contraction location and variations in lithospheric strength. The occurrence of Eocene growth-strata (~ 44–40 Ma) suggests that contraction in the Andes and the Patagonian broken foreland was linked to the Incaic phase. Detection of synextensional deposits suggests that the broken foreland collapsed partially during Oligocene to early Miocene. During middle Miocene times, the Quechua contractional phase produced folding of Neogene volcanic rocks and olistostrome deposition at ~ 17 Ma. Finally, the presented Te map shows that intraplate contraction related to Andean phases localized preferentially along weak lithospheric zones (Te < 15 km). Hence, the observed strain distribution in the PBF appears to be controlled by lateral variations in the lithospheric strength. Variations in this parameter could be related to thermo-mechanical weakening produced by intraplate rifting in Paleozoic-Mesozoic times.Fil: Gianni, Guido Martin. Universidad Nacional de San Juan. Facultad de Ciencias Exactas, Físicas y Naturales. Instituto Geofísico Sismológico Volponi; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Echaurren Gonzalez, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos ; ArgentinaFil: Folguera Telichevsky, Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos ; ArgentinaFil: Likerman, Jeremias. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos ; ArgentinaFil: Encinas, A.. Universidad de Concepción; ChileFil: Garcia, Hector Pedro Antonio. Universidad Nacional de San Juan. Facultad de Ciencias Exactas, Físicas y Naturales. Instituto Geofísico Sismológico Volponi; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Dal Molin, Carlos N.. Secretaría de Industria y Minería. Servicio Geológico Minero Argentino; ArgentinaFil: Valencia, V. A.. Washington State University; Estados Unido

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p&lt;0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p&lt;0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research