Diferencias del contenido nutricional de hojas jóvenes y maduras de dos especies de puya (Puya santosii Cuatrec., Puya goudotiana Mez; Bromeliaceae), en la región del Guavio, Cundinamarca, Colombia

La puya es uno de los recursos alimenticios más importantes en la dieta del oso andino, por lo que el contenido nutricional de sus hojas podría ser un criterio importante para la selección de las especies, los individuos a consumir y la cantidad consumida. El objetivo de esta investigación fue comparar si existen diferencias nutricionales entre las hojas maduras y jóvenes de dos especies de puya (Puya goudotiana y Puya santosii) en Gachetá, Colombia. Para cada individuo se tomaron dos muestras por estadio de maduración desde la base de la hoja. Se tomaron muestras de suelo para evaluar si este afectaba los nutrientes foliares. Los resultados revelan una marcada diferencia entre especies, siendo P. goudotiana la que presentó mayores concentraciones de la mayoría de elementos con excepción del calcio. También se encontraron diferencias significativas entre las hojas jóvenes y maduras de cada especie, pues en hojas jóvenes el contenido del fósforo, potasio y nitrógeno fue mayor, mientras el contenido de calcio fue más alto en las hojas maduras. No se encontró relación entre el contenido nutricional de las hojas y el suelo. Se discuten las razones que pueden generar estas diferencias y las posibles consecuencias en la dieta del oso andino

Diferencias del contenido nutricional de hojas jóvenes y maduras de dos especies de puya (Puya santosii Cuatrec., Puya goudotiana Mez; Bromeliaceae), en la región del Guavio, Cundinamarca, Colombia

Because the genus Puya is one of the most important food resource for Andean bears, the nutritional content of its leaves might be important for choosing the individuals, species or quantity in order to meet the bears’ nutritional requirements. The objective of this research was to compare whether or not there are differences between mature and young leaves of two Puya species (Puya goudotiana and Puya santosii) in the paramo ecosystems of the Guavio Region, Colombia. Two leaves per individual were collected from the base of the leaf. Soil samples were also collected in each sample point in order to evaluate if soil related to leaf nutrient content. Results showed marked differences between species. P. goudotiana exhibited the highest concentrations of all elements except for calcium. Also, significant differences were found between conspecific mature and young leaves. The latter showed higher values of phosphorus, potassium and nitrogen, meanwhile mature leaves were higher in calcium. No relationship between soils chemical composition and leaf nutrient content was found. The reasons for these differences and the consequences in the Andean bear diet are discussed.La puya es uno de los recursos alimenticios más importantes en la dieta del oso andino, por lo que el contenidonutricional de sus hojas podría ser un criterio importante para la selección de las especies, los individuosa consumir y la cantidad consumida. El objetivo de esta investigación fue comparar si existen diferenciasnutricionales entre las hojas maduras y jóvenes de dos especies de puya (Puya goudotiana y Puya santosii)en Gachetá, Colombia. Para cada individuo se tomaron dos muestras por estadio de maduración desde la basede la hoja. Se tomaron muestras de suelo para evaluar si este afectaba los nutrientes foliares. Los resultadosrevelan una marcada diferencia entre especies, siendo P. goudotiana la que presentó mayores concentracionesde la mayoría de elementos con excepción del calcio. También se encontraron diferencias significativas entrelas hojas jóvenes y maduras de cada especie, pues en hojas jóvenes el contenido del fósforo, potasio y nitrógenofue mayor, mientras el contenido de calcio fue más alto en las hojas maduras. No se encontró relación entre elcontenido nutricional de las hojas y el suelo. Se discuten las razones que pueden generar estas diferencias y lasposibles consecuencias en la dieta del oso andino

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Diferencias del contenido nutricional de hojas jóvenes y maduras de dos especies de puya (Puya santosii Cuatrec., Puya goudotiana Mez; Bromeliaceae), en la región del Guavio, Cundinamarca, Colombia

La puya es uno de los recursos alimenticios más importantes en la dieta del oso andino, por lo que el contenidonutricional de sus hojas podría ser un criterio importante para la selección de las especies, los individuosa consumir y la cantidad consumida. El objetivo de esta investigación fue comparar si existen diferenciasnutricionales entre las hojas maduras y jóvenes de dos especies de puya (Puya goudotiana y Puya santosii)en Gachetá, Colombia. Para cada individuo se tomaron dos muestras por estadio de maduración desde la basede la hoja. Se tomaron muestras de suelo para evaluar si este afectaba los nutrientes foliares. Los resultadosrevelan una marcada diferencia entre especies, siendo P. goudotiana la que presentó mayores concentracionesde la mayoría de elementos con excepción del calcio. También se encontraron diferencias significativas entrelas hojas jóvenes y maduras de cada especie, pues en hojas jóvenes el contenido del fósforo, potasio y nitrógenofue mayor, mientras el contenido de calcio fue más alto en las hojas maduras. No se encontró relación entre elcontenido nutricional de las hojas y el suelo. Se discuten las razones que pueden generar estas diferencias y lasposibles consecuencias en la dieta del oso andino.Artículo revisado por pare

In Patients With Obesity, the Number of Adipose Tissue Mast Cells Is Significantly Lower in Subjects With Type 2 Diabetes

This work was supported by Instituto de Salud Carlos III (grant PI15/01361), Spain; and MINECO (grant DPI2017-84439-R), Madrid and FEDER. DL-P is a predoctoral fellow ("Programa de doctorado en Bioquimica y Biologia Molecular", B16.56.1) funded by the Spanish Ministry of Science and Innovation (" Formacion de profesorado universitario" grant FPU18/ 04432). DL-P participated in this work thanks to a grant from University of Granada ("Becas de iniciacion a la investigacion del plan propio de la UGR").Type 2 diabetes (T2D) is a rising global health problem mainly caused by obesity and a sedentary lifestyle. In healthy individuals, white adipose tissue (WAT) has a relevant homeostatic role in glucose metabolism, energy storage, and endocrine signaling. Mast cells contribute to these functions promoting WAT angiogenesis and adipogenesis. In patients with T2D, inflammation dramatically impacts WAT functioning, which results in the recruitment of several leukocytes, including monocytes, that enhance this inflammation. Accordingly, the macrophages population rises as the WAT inflammation increases during the T2D status worsening. Since mast cell progenitors cannot arrive at WAT, the amount of WAT mast cells depends on how the new microenvironment affects progenitor and differentiated mast cells. Here, we employed a flow cytometry-based approach to analyze the number of mast cells from omental white adipose tissue (o-WAT) and subcutaneous white adipose tissue (s-WAT) in a cohort of 100 patients with obesity. Additionally, we measured the number of mast cell progenitors in a subcohort of 15 patients. The cohort was divided in three groups: non-T2D, pre-T2D, and T2D. Importantly, patients with T2D have a mild condition (HbA1c <7%). The number of mast cells and mast cell progenitors was lower in patients with T2D in both o-WAT and s-WAT in comparison to subjects from the pre-T2D and non-T2D groups. In the case of mast cells in o-WAT, there were statistically significant differences between non-T2D and T2D groups (p = 0.0031), together with pre-T2D and T2D groups (p=0.0097). However, in s-WAT, the differences are only between non-T2D and T2D groups (p=0.047). These differences have been obtained with patients with a mild T2D condition. Therefore, little changes in T2D status have a huge impact on the number of mast cells in WAT, especially in o-WAT. Due to the importance of mast cells in WAT physiology, their decrease can reduce the capacity of WAT, especially o-WAT, to store lipids and cause hypoxic cell deaths that will trigger inflammation.Instituto de Salud Carlos III PI15/01361MINECO, Madrid DPI2017-84439-REuropean CommissionSpanish Ministry of Science and Innovation (" Formacion de profesorado universitario" grant) FPU18/04432 B16.56.1University of Granada ("Becas de iniciacion a la investigacion del plan propio de la UGR"