Prácticas investigativas de jóvenes investigadores en Sucre, Colombia Vol. 2

Los invitamos a sumergirse en un fascinante viaje a través del esfuerzo y la dedicación de veinte jóvenes investigadores del Departamento de Sucre. Este libro trasciende la mera recopilación de sus experiencias, es un testimonio de su inquebrantable compromiso con el conocimiento y su incansable búsqueda de respuestas en un mundo lleno de incertidumbre y desafíos. A lo largo de un año de intenso entrenamiento, como parte del proyecto “Desarrollo de capacidades y habilidades de investigación, desarrollo tecnológico e innovación en jóvenes profesionales del Departamento de Sucre”, a través de becas-pasantías de investigación, veinte jóvenes valientes del departamento fueron guiados de la mano experta de investigadores destacados. Estos maestros los acompañaron para convertir su pasión por la ciencia en un vehículo de cambio y progreso para nuestra comunidad. Cada capítulo de esta obra refleja las reflexiones, inquietudes, expectativas, miedos y vivencias de estos talentosos investigadores, quienes han asumido el timón de su destino y se han convertido en voces influyentes en la construcción de un futuro más prometedor. Su contribución es fundamental para abordar la falta de desarrollo de capacidades y habilidades en Ciencia, Tecnología e Innovación (CTeI) en jóvenes profesionales de la región.1. La sostenibilidad ambiental y los desafíos en educación en el siglo XXI: una revisión sistemática de la literatura Environmental Sustainability and the Challenges in Education in the 21st Century: a Systematic Review of the Literature Héctor Hernández Navarro, Jorge Luis Barboza Hernández, Mario Gándara Molino, Nubia Hernández Flórez 2. Salud mental en niños y adolescentes víctimas del conflicto armado: una revisión de literatura. Mental Health in Children and Adolescents Victims of the Armed Conflict: a literature Review Jonathan Jesús Aníbal Sierra, Liliana Margarita Meza Cueto , Daymar Junior Navarro Villamizar 3. Gestión del conocimiento como herramienta para la competitividad turística: una revisión de literatura Knowledge Management as a Tool for Tourism Competitiveness: a Literature Review Sol Maira Carrasco Canoles, Emily Andrea Lugo Hernández 4. Herramientas digitales empleadas para la educación del razonamiento clínico en estudiantes de fisioterapia: revisión de literatura Digital Tools Used for the Education of Clinical Reasoning in Physiotherapy Students: a Review of the Literature Elizabeth Abad Suárez, Meryene Cecilia Barrios Barreto 5. Segunda revolución cuántica y el desarrollo de nuevas tecnologías Second Quantum Revolution and the Development of New Technologies María Camila Vásquez Monterroza, Orlando José García Mojica, Dairo Alfredo Causil Zúñiga 6. Valorización de residuos orgánicos para producir biofertilizantes: revisión bibliométrica de tendencias y avances Valorization of Organic Waste to Produce Biofertilizers: Bibliometric Review of Trends and Advances Nathaly A. Torres Gallo, Daniel D. Otero Meza, Jairo Salcedo Mendoza, Jorge E. Hernández Ruydíaz 7. La diversidad de la familia Araneidae (arachnida: araneae) enColombia: una actualización del listado de especies The Diversity of the Family Araneidae (arachnida: araneae) in Colombia: an Update of the List of Species Yeison López Miranda, José Tovar Márquez, Deivys Moisés Álvarez García 8. Perspectivas agroindustriales de las variedades de yuca cultivadas en el departamento de Sucre: una revisión Agroindustrial Perspectives of Yucca Varieties Cultivated in the Department Sucre: a Review Yoseth David Blanquiceth Támara, Juan José Hoyos Sebá, José David Arias Teherán, María José Tavera Quiroz 9. Uso de tecnologías interactivas en la práctica fonoaudiológica parael lenguaje infantil Use of Interactive Technologies in Speech-Language Practice for Children’s Language Sandra Milena Paternina Pacheco, Marivel Montes Rotela 10. Utilización de residuos agroindustriales en la elaboración de materiales Use of Agroindustrial Waste in the Manufacture of Materials Dayana Paola Morales Escobar, Álvaro Ángel Arrieta Almario1r

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