27 research outputs found

    Desempeño de la Biomasa Microalgal para la microproducción de Biodiesel a partir de una brecha de potencial energético

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    It was identified the energy potential (PE) of biodiesel generated by microproducers in Arequipa is 8042.2495 MJ * Kg-1 obtained from 50 gallons of biodiesel (B100), for this reason the present research work aimed at the implications techniques to reach the main gaps that must be overcome in research and development (R & D) to achieve the desired PE in the microalgal biomass as the main source of transesterified oil, the research showed that it is possible to obtain0.82 g / l Biomass microalgal from Chlorella sp. in a Raceway system managing to extract 614.90 g / kg of oil from dry microalgal biomass at your reach 554.32 g / Kg of transesterified oil (Biodiesel-B100), to carry out an investigation as a model for the ALDECO microenterprise. The results were determined for a microproducer looking for an energy potential (PE) of 8042.2495 MJ Kg-1 with a feasible production potential (PPP) of 50 gal / month implying anarea of 2.35 ha under a yield determined by the available biomass potential (PBD) of 820 g / m3 and of generated fuel (PCG) of 28.55 g / m3 in BBM culture medium.Se identificó que el potencial energético (PE) del biodiesel generado por microproductores en Arequipa es de 8042,2495 MJ*Kg-1 obtenido a partir de 50 gal de biodiesel (B100), por tal razón el presente trabajo de investigación tuvo como objetivo determinar las implicancias técnicas para alcanzar las brechas principales que deben superar los esfuerzos en investigación y desarrollo (I+D) para alcanzar el PE deseado utilizando biomasa microalgal como principal fuente deaceite transesterificado, la investigación demostró que es posible obtener 0,82g/L de biomasa microalgal a partir de Chlorella sp. en un sistema Raceway logrando extraer 614,90g/kg de aceite a partir de biomasa microalgal seca alcanzando a generar 554,32 g/Kg de aceite transesterificado (Biodiesel-B100), para realizar la investigación se utilizó como modelo a la microempresa ALDECO. Los resultados determinaron que para un microproductor que busca alcanzar un potencial energético (PE) de 8042,2495 MJ Kg-1 a partir de un potencial de producción factible (PPF) de 50 gal/mes que implica destinar un área de 2,35 ha bajo un rendimiento determinado por el potencial de biomasa disponible (PBD) de 820g/m3 y de combustible generado (PCG) de 28,55 g/m3 en medio de cultivo BBM

    Coping Responses During the COVID-19 Pandemic: A Cross-Cultural Comparison of Russia, Kyrgyzstan, and Peru

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    Background. The COVID-19 pandemic has subjected people around the world to severe stress, evoking a variety of coping responses. Coping responses can be broadly classified into four strategies: 1) problem-focused coping; 2) emotion-focused coping; 3) socially supported coping; and 4) avoidance. While there is a wide variability of individual coping responses, to some extent they are also culturally specific. Objective. This study aimed to compare the differences in the prevalence and factor structure of coping responses during COVID-19 pandemic in three countries: Russia, Kyrgyzstan, and Peru. Design. The sample included 501 participants from Russia, 456 participants from Kyrgyzstan, and 354 participants from Peru. The mean age of participants was 28 years in Russia (SD = 13.5); 24 years in Kyrgyzstan (SD = 10.0); and 30 years in Peru (SD = 12.3). In Russia and Kyrgyzstan, coping strategies were assessed with an abbreviated Russian adaptation of the COPE (Coping Orientations to Problems Experienced) questionnaire. In Peru, coping responses were assessed using the Spanish version of the Brief COPE questionnaire. The average scores from fifteen COPE scales were used as the input data for linear modelling and factor analysis. Results. The coping scores varied substantially within each country. Differences between countries accounted for 17.7% of the total variability in religious coping; 15.8% in acceptance; 13.9% in mental disengagement; and less than 7% in the other coping strategies. No difference in the prevalence of coping responses was found between Russian and Kyrgyz participants after accounting for age and gender. In all three countries the coping responses were associated with the same four coping domains: problem-focused coping, socially supported coping, avoidance, and emotion-focused coping. Four factors explained up to 44% of the total variation in the COPE scores. Religious coping and mental disengagement were classified into different coping domains in the three countries. Conclusion. The results suggest that during the COVID-19 pandemic, people from different countries apply the full range of coping responses within the four universal coping strategies. Religious coping and mental disengagement differed the most across the countries, suggesting that some coping behaviors can take on different roles within the system of coping responses to stressful events. We attribute these differences to differing cultural and socioeconomic characteristics, and the different measures taken by governments in response to COVID-19. © 2020. Lomonosov Moscow State University. All Rights Reserved.is study was supported by Russian Foundation for Basic Research (Project No. 20-04-60394)

    Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

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    BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

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

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    Background 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&lt;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&lt;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

    Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

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    Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

    Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

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    BACKGROUND: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences. METHODS: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes. RESULTS: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1–6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2<90% for 60 s) was reported in 40%. No associated risk factors could be identified among co-morbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality. CONCLUSIONS: The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event

    The European Solar Telescope

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    The European Solar Telescope (EST) is a project aimed at studying the magnetic connectivity of the solar atmosphere, from the deep photosphere to the upper chromosphere. Its design combines the knowledge and expertise gathered by the European solar physics community during the construction and operation of state-of-the-art solar telescopes operating in visible and near-infrared wavelengths: the Swedish 1m Solar Telescope, the German Vacuum Tower Telescope and GREGOR, the French Télescope Héliographique pour l’Étude du Magnétisme et des Instabilités Solaires, and the Dutch Open Telescope. With its 4.2 m primary mirror and an open configuration, EST will become the most powerful European ground-based facility to study the Sun in the coming decades in the visible and near-infrared bands. EST uses the most innovative technological advances: the first adaptive secondary mirror ever used in a solar telescope, a complex multi-conjugate adaptive optics with deformable mirrors that form part of the optical design in a natural way, a polarimetrically compensated telescope design that eliminates the complex temporal variation and wavelength dependence of the telescope Mueller matrix, and an instrument suite containing several (etalon-based) tunable imaging spectropolarimeters and several integral field unit spectropolarimeters. This publication summarises some fundamental science questions that can be addressed with the telescope, together with a complete description of its major subsystems

    Mortality of emergency abdominal surgery in high-, middle- and low-income countries

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    Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)
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