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

Caracterización de los genes mat 1-1 y mat 1-2 del hongo mycosphaerella fijiensis, agente causal de la sigatoca negra, en la provincia del Guayas

El hongo Mycosphaerella fijiensis Morelet es el causante de la enfermedad foliar llamada Sigatoka Negra y ataca a las plantas de banano. La Sigatoka Negra es la enfermedad más importante en las plantaciones de banano. La reproducción sexual de Mycosphaerella fijiensis se da por compatibilidad genética o tipo de “sexo o mating types” (tipos de acoplamiento). Esto quiere decir que sólo las líneas de “mating” genéticamente opuestas, son capaces de cruzarse y producir ascosporas. En los hongos ascomicetos heterotálicos la compatibilidad sexual entre individuos haploides depende de los genes que se encuentran en el locus MAT que existe como dos alelos alternos Mat1–1 y Mat1–2. Este trabajo estudió los genes que actúan para que el apareamiento de M. fijiensis sea posible. Los aislados de M. fijiensis fueron pertenecientes a tres zonas de la provincia del Guayas (Taura, Balao y Mariscal Sucre) y se utilizaron primers específicos para amplificar las regiones de los alelos relacionados con la interacción sexual de las cepas de M. fijiensis. Los aislados de hongos fueron proporcionados por el Centro de Investigaciones Biotecnológicas del Ecuador (CIBE). Esta tesis utilizó estos mismos aislados de hongos monospóricos con el objetivo de identificar a nivel molecular, en la provincia del Guayas, los tipos de alelos sexuales que se presentan en el hongo que causa la Sigatoka Negra Mycosphaerella fijiensis. Se determinó la frecuencia y la proporción que guardan estos alelos entre ellos siendo esta de 2:1 entre Mat 1-1 y Mat 1-2 respectivamente. El análisis de estos resultados determinó que ni las condiciones de las zonas geográficas, ni la forma de manejar los cultivos en las que se encuentran las muestras afectan esta frecuencia. Estudiar y entender la reproducción sexual de M. fijiensis tiene una enorme importancia para poder contribuir en futuros estudios de prevención y tratamiento de la grave y cuantiosa enfermedad que provoca

A multipronged flavor comparison of Ecuadorian CCN51 and Nacional cocoa cultivars

Two cocoa types are predominantly being cultivated in Ecuador, the highly appreciated fine Nacional and the high-yielding and disease-resistant CCN51, classified as bulk. With the introduction of foreign germplasm in Ecuador and the international demand for high-quality Nacional cocoa, the present study aims to characterize and compare the flavor profile of Nacional hybrids (EET103, EET559, EET576 and EET577) and CCN51, and to assess the effect of the genotype. The fermented dried beans were processed into liquor and their sensory properties, volatile composition and odor fingerprint were analyzed by trained panelists, headspace-solid phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC-MS), and GC electronic nose (e-nose), respectively, combined with multivariate statistics. Seventy volatiles were identified and semi-quantified, among them, 16 and 14 volatiles conferring fruity and floral aroma notes, respectively. CCN51 was mainly characterized by undesirable odor-active volatiles, whereas the EET cultivars contained the highest concentration of most fruity and floral volatiles, with differences in between EET cultivars. Sensory data highlighted organoleptic differences between the fine and bulk liquors, i.e. the fruity and acid EET flavor strongly differed from the bitter, astringent and off-flavor attributes of CCN51. Principal component analysis (PCA) discriminated firstly between fine and bulk, and secondly between EET identity. Partial least squares analysis identified possible correlations between sensory attributes and volatile compounds. Besides, e-nose proved its usefulness for rapid assessment of the liquors' sensory profile. The results provide a foundation for understanding the genotype's contribution to and the compositional basis of Ecuadorian fine and bulk cocoa flavor

A multipronged flavor comparison of Ecuadorian CCN51 and Nacional cocoa cultivars

Two cocoa types are predominantly being cultivated in Ecuador, the highly appreciated fine Nacional and the high-yielding and disease-resistant CCN51, classified as bulk. With the introduction of foreign germplasm in Ecuador and the international demand for high-quality Nacional cocoa, the present study aims to characterize and compare the flavor profile of Nacional hybrids (EET103, EET559, EET576 and EET577) and CCN51, and to assess the effect of the genotype. The fermented dried beans were processed into liquor and their sensory properties, volatile composition and odor fingerprint were analyzed by trained panelists, headspace–solid phase microextraction gas chromatography–mass spectrometry (HS–SPME–GC–MS), and GC electronic nose (e-nose), respectively, combined with multivariate statistics. Seventy volatiles were identified and semi-quantified, among them, 16 and 14 volatiles conferring fruity and floral aroma notes, respectively. CCN51 was mainly characterized by undesirable odor-active volatiles, whereas the EET cultivars contained the highest concentration of most fruity and floral volatiles, with differences in between EET cultivars. Sensory data highlighted organoleptic differences between the fine and bulk liquors, i.e. the fruity and acid EET flavor strongly differed from the bitter, astringent and off-flavor attributes of CCN51. Principal component analysis (PCA) discriminated firstly between fine and bulk, and secondly between EET identity. Partial least squares analysis identified possible correlations between sensory attributes and volatile compounds. Besides, e-nose proved its usefulness for rapid assessment of the liquors’ sensory profile. The results provide a foundation for understanding the genotype’s contribution to and the compositional basis of Ecuadorian fine and bulk cocoa flavor.status: publishe

Dimensiones territoriales de la guerra y la paz

Este libro tiene como propósito contribuir a la comprensión, al debate y a la búsqueda de alternativas para la superación del conflicto colombiano. El texto centra su atención en el análisis de los procesos y dinámicas territoriales del conflicto. / Contenido. Preliminares; Capítulo 1 - Grandes problemas socioterritoriales de Colombia; Capítulo 2 - Conflicto colombiano: ¿la amenaza regional?; Capítulo 3 - El conflicto armado colombiano y su expresión territorial: presencia de los actores; Capítulo 4 - Conflicto y desigualdades socioespaciales; Capítulo 5 - Características físicas del territorio y procesos de guerra y paz en la región andina; Capítulo 6 - Guerra y paz en el Caribe Colombiano; Capítulo 7 - Conflicto armado y procesos de Paz en el suroriente colombiano y sus fronteras; Capítulo 8 - Procesos de guerra y Paz en el litoral pacífico; Anexo

De la Constitución de 1991 a la realidad. Debates políticos, jurídicos, territoriales e internacionales

Este libro presenta las reflexiones que sobre los efectos de la Constitución de 1991 y sus modificaciones han hecho profesores e investigadores de las facultades de Ciencia Política y Gobierno de la Universidad del Rosario, así como de la Facultad de Jurisprudencia de esta misma institución, expertos del Centro Colombiano de Derecho Procesal Constitucional y personalidades reconocidas de la vida nacional, en cuanto al equilibrio de poderes y el poder de reforma, las políticas públicas y la participación política, el Estado Social de Derecho, la perspectiva de nuestras relaciones internacionales y el ordenamiento territorial. Como todo texto jurídico-político, la Constitución Política de 1991 cobra vida y revela sus complejidades a través de su aplicación material día a día, práctica mucho más compleja que la original enunciación de sus contenidos escritos. Dos décadas del nuevo ordenamiento constitucional, de su ejecución dentro del propósito de impulsar el Estado Democrático Constitucional Social de Derecho, nos permiten reflexionar acerca de múltiples logros pero también de las enormes inquietudes y discusiones que hemos expuesto, las cuales serán revisadas y profundizadas a lo largo del presente estudio

Yellow fever reemergence in Venezuela – Implications for international travelers and Latin American countries during the COVID-19 pandemic

Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigacíon Biomedicina. Pereira, Risaralda, Colombia / Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Fundación Universitaria Autónoma de las Américas. Grupo de Investigacíon GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia / Instituto para la Investigación en Ciencias Biomédicas. Emerging Infectious Diseases and Tropical Medicine Research Group. Pereira, Risaralda, Colombia / Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Universidad Cientifica del Sur. Master of Clinical Epidemiology and Biostatistics. Lima, Peru / Institución Universitaria Visión de las Américas. Faculty of Medicine. Grupo de Investigacón Biomedicina. Pereira, Risaralda, Colombia / Institución Universitaria Visión de las Américas. Grupo de Investigación GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Fundación Universitaria Autónoma de las Américas. Grupo de Investigacíon GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia / Instituto para la Investigación en Ciencias Biomédicas. Emerging Infectious Diseases and Tropical Medicine Research Group. Pereira, Risaralda, Colombia / Institución Universitaria Visión de las Américas. Grupo de Investigación GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Instituto Conmemorativo Gorgas de Estudios de la Salud. Clinical Research Deparment. Investigador SNI Senacyt Panama. Panama City, Panama.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / University of Colorado Anschutz Medical Center. Department of Medicine. Division of Infectious Diseases. Aurora, CO, USA / Hospital Infantil de México. Federico Góomez, Méexico City, Mexico.Biomedical Research and Therapeutic Vaccines Institute. Ciudad Bolivar, Venezuela.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Universidad de Cordoba. Instituto de Investigaciones Biológicas del Trópico. Colombia.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Hospital Universitario de Sincelejo. Infectious Diseases and Infection Control Research Group. Sincelejo, Sucre, Colombia / Universidad del Atlático. SUE Caribe. Programa del Doctorado de Medicina Tropical. Barranquilla, Colombia.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Universidad Cooperativa de Colombia. Grupo de Investigación en Ciencias Animales. Bucaramanga, Colombia.Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigacíon Biomedicina. Pereira, Risaralda, Colombia / Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Instituto para la Investigación en Ciencias Biomédicas. Emerging Infectious Diseases and Tropical Medicine Research Group. Pereira, Risaralda, Colombia / Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Semillero de Investigación en Infecciones Emergentes y Medicina Tropical. Pereira, Risaralda, Colombia / Institución Universitaria Visión de las Américas. Faculty of Medicine. Grupo de Investigacón Biomedicina. Pereira, Risaralda, Colombia.Instituto Médico La Floresta. Caracas, Venezuela.Universidad del Norte and Hospital Universidad del Norte. Department of Medicine, Health Sciences Division. Barranquilla, Colombia.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Universidad Central de Venezuela. Faculty of Medicine. Caracas, Venezuela.Institute of Infectious Diseases Emilio Ribas, São Paulo, SP, Brazil.Universidad Estatal del Sur de Manabí. Carrera de Laboratorio Clínico. Cantón Jipijapa, Ecuador.Universidad Católica del Maule. Vicerrectoría de Investigación y Postgrado. Chile.Universidad Central de Venezuela. Faculty of Medicine. Hospital Universitario de Caracas. Department of Internal Medicine. Cardiology Division. Caracas, Venezuela.Hospital José María Vargas. La Guaira, Vargas, Venezuela.Universidad Castilla La Mancha. Facultad de Medicina. Complejo Hospitalario Universitario de Albacete. Servicio de Anatomía Patológica. Albacete, Spain.International Airport Camilo Daza. Health Care Service. Cúcuta, Norte de Santander, Colombia.Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil.Universidad Técnica de Ambato. Ambato, Ecuador.Hospital Transfrontalier Cerdayna. Catalonia, Spain.University of Illinois. Department of Internal Medicine. Division of Infectious Diseases. Chicago, IL, USA.Hospital Evangélico de Montevideo. Montevideo, Uruguay.Universidad Cooperativa de Colombia. Grupo de Investigación en Ciencias Animales. Bucaramanga, Colombia.Instituto Nacional de Salud del Niño San Borja. Infectious Diseases Division. Lima, Peru / Universidad Privada de Tacna. Facultad de Ciencias de la Salud. Tacna, Peru.Hospital Universitario Departamental de Nariño. Pasto, Nariño, Colombia.Universidad de Manizales. School of Medicine. Coordination of Microbiology. Manizales, Caldas, Colombia / Grupo de Resistencia Antibiótica de Manizales. Manizales, Caldas, Colombia.Clínica San Josée. Cúcuta, Norte de Santander, Colombia / Hospital Universitario Erasmo Meoz. Cúcuta, Norte de Santander, Colombia.Hospital de Niños J. M. de Los Ríos. Division of Infectious Diseases. Caracas, Venezuela / Venezuelan Society of Infectious Diseases. Executive Board. Caracas, Venezuela.University of Colorado Anschutz Medical Center. Department of Medicine. Division of Infectious Diseases. Aurora, CO, USA.Universidad Industrial de Santander. Department of Internal Medicine. Bucaramanga, Santander, Colombia.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / aq Universidade Federal do Para. Faculdade de Medicina. Belém, PA, Brasil.Hospital de Infecciosas F. Muñíz. Buenos Aires, Argentina.GSK Vaccines. Clinical Research & Development and Medical Affairs. Rio de Janeiro, RJ, Brazil.Hospital de Trauma y Emergencias Federico Abete. Buenos Aires, Argentina.Hospital Británico de Buenos Aires. Buenos Aires, Argentina.Pontificia Universidad Católica de Chile. School of Medicine. Department of Pediatric Infectious Diseases and Immunology. Santiago de Chile, Chile.Hospital de Infecciosas F. Muñíz. Buenos Aires, Argentina.Hospital de Infecciosas F. Muñíz. Buenos Aires, Argentina / Universidad de Buenos Aires. Buenos Aires, Argentina.Latin American Society for Travel Medicine. Panel of Sports and Travel. Buenos Aires, Argentina.Universidad Internacional SEK. Health Sciences Faculty. Research Group of Emerging Diseases, Ecoepidemiology and Biodiversity. Quito, Ecuador / Universidad Central de Venezuela. Facultad de Ciencias. Instituto de Zoología y Ecología Tropical. Caracas, Venezuela.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Instituto de Investigaciones Biomédicas. Clínica IDB Cabudare. Department of Infectious Diseases and Tropical Medicine. Lara, Venezuela / Venezuelan Science Incubator and the Zoonosis and Emerging Pathogens Regional Collaborative Network. Infectious Diseases Research Branch. Lara, Venezuela / Instituto de Estudios Avanzados. Laboratorio de Señalización Celular y Bioquímica de Parásitos. Caracas, Caracas, Venezuela / Academia Nacional de Medicina. Caracas, Venezuela / The Mount Sinai Hospital-Icahn School of Medicine at Mount Sinai. Department of Pathology, Molecular and Cellbased Medicine. Direction of Microbiology. New York, USA

The DUNE Far Detector Vertical Drift Technology, Technical Design Report

International audienceDUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals