Conclusions of the II International and IV Spanish Hydration Congress. Toledo, Spain, 2nd-4th December, 2015

Water is the major component of our organism representing about 60% of total body weight in adults and has to be obtained through the consumption of different foods and beverages as part of our diet. Water is an essential nutrient performing important functions, including transport of other nutrients, elimination of waste products, temperature regulation, lubrication and structural support. In this context, hydration through water has an essential role in health and wellness, which has been highly acknowledged in recent years among the health community experts such as nutritionists, dietitians, general practitioners, pharmacists, educators, as well as by physical activity and sport sciences experts and the general population

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Recomendaciones para el dise\uf1o y ejecuci\uf3n de programas educativos en el marco del aprendizaje a lo largo de la vida. Experiencias de las universidades socias del Proyecto TRALL (programa ALFAIII de la Comisi\uf3n Europea).

The publication contains a compilation of lifelong learning innovations. Sharing of experiences and strategies on lifelong learnings integral to UIL\u92s mission and in line with this spirit, the three year TRALL project has shown the importance of promoting synergies instead of the usual dispersion of efforts in the Latin American region. Such projects as TRALL and the resulting publicationare an important way to add value to the many learning reforms different actors are conducting in the different countries in the Latin American region. Imparting and taking on board good practices lead to common understanding and convergence in outlook. At the same time, learning from different country contexts is considered to be relevant for promoting the idea of social diversity. The report Learning to Be commissioned by UNESCO in 1972 (Faure et al., 1972) advocated lifelong education in both developed and developing countries, recognising education as universal and lifelong, and open to all. The UNESCO Report Learning: the Treasure Within (Delors et al., 1996), acknowledged lifelong learning as one of the guiding and organising principles of educational action and reform that underlines the essential role learning plays for both society and individuals.Despite the integrative understanding lifelong learning promoted since 1972, today most education systems are still not in a position to offer quality lifelong learning opportunities for all. Making it a reality implies holistic and sector-wide educational reform involving all sub-sectors and education levels of the education system to ensure the creation of learning opportunities in all settings or delivery modalities (formal, non-formal and informal) for people of all ages, and meeting a wide range of learning needs. Recent developments have reinforced the relevance of lifelong learning. These include an increasingly globalised world, the need for maintain peace and security, the introduction of new technologies, the exponential growth and changing nature of information, demographic shifts and social transformations, climate change and sustainable development, and the need of citizens to upgrade competences to meet labour market, social and environmental demands. Lifelong learning policies in the Latin American region need to be supported by broad social consensus,legislative instruments and coordination mechanism. As lifelong learning activities no longer fall exclusively within the domain of Ministries of Education, a mechanism for facilitating collaboration among various sectors and stakeholder is indispensable. Certain support structures are needed to facilitate lifelong learning. These include on the one hand, a full range of provision of education and learning opportunities, including guidance and counselling; as well as effective information and communication tools, and conducive learning environments and resources. To facilitate lifelong learning and provide incentives for learners, a learning outcomes-based qualifications framework and a coordinated approach to assessment and recognition of learning outcomes in non-formal and informal settings are required

GIARPS: commissioning and first scientific results

GIARPS (GIAno and haRPS) is a project devoted to have on the same focal station of the Telescopio Nazionale Galileo (TNG) both high resolution spectrographs, HARPS-N (VIS) and GIANO-B (NIR), working simultaneously. This could be considered the first and unique worldwide instrument providing cross-dispersed echelle spectroscopy at a resolution of 50,000 in the NIR range and 115,000 in the VIS and over in a wide spectral range (0.383-2.45 μm) in a single exposure. The science case is very broad, given the versatility of such an instrument and its large wavelength range. A number of outstanding science cases encompassing mainly extra-solar planet science starting from rocky planets search and hot Jupiters to atmosphere characterization can be considered. Furthermore both instruments can measure high precision radial velocities by means the simultaneous thorium technique (HARPS-N) and absorbing cell technique (GIANO-B) in a single exposure. Other science cases are also possible. GIARPS, as a brand new observing mode of the TNG started after the moving of GIANO-A (fiber fed spectrograph) from Nasmyth-A to Nasmyth-B where it was re-born as GIANO-B (no more fiber feed spectrograph). The official Commissioning finished on March 2017 and then it was offered to the community. Despite the work is not finished yet. In this paper we describe the preliminary scientific results obtained with GIANO-B and GIARPS observing mode with data taken during commissioning and first open time observations

Introducing GOFIO: a DRS for the GIANO-B near-infrared spectrograph

The NIR echelle spectrograph GIANO-B at the Telescopio Nazionale Galileo is equipped with a fully automated online DRS: part of this pipeline is the GOFIO reduction software, that processes all the observed data, from the calibrations to the nodding or stare images. GOFIO reduction process includes bad pixel and cosmic removal, flat-field and blaze correction, optimal extraction, wavelength calibration, nodding or stare group processing. An offline version of GOFIO will allow the users to adapt the reduction to their needs, and to compute the radial velocity using telluric lines as a reference system. GIANO-B may be used simultaneously with HARPS-N in the GIARPS observing mode to obtain high-resolution spectra in a wide wavelength range (383-2450 nm) with a single acquisition. In this framework, GOFIO, as part of the online DRS, provides fast and reliable data reduction during the night, in order to compare the infrared and visible observations on the fly

Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

Aim: Patient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method: This was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien\u2013Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. Results: In all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10\u20134.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13\u20133.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20\u20134.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08\u20131.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07\u20131.37). Conclusion: Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients