4 research outputs found
Comportamiento termal de mezclas forrajeras (ray grass, pasto azul, trébol) en la hacienda el Rosario- Cumbijin.
- Publication venue
- Ecuador: Latacunga: Universidad Técnica de Cotopaxi (UTC).
- Publication date
- 01/02/2020
- Field of study
This research project aims to evaluate the optimal thermal time in the fodder mixture for dairy cattle of the Hda. El Rosario, initiating the need to obtain a good pasture for a better production in the livestock, taking into account the analysis of the pasture and analyzing some characteristics of it such as: the growth, composition, leaves' morphology, pasture's quality and type, the rotation of each pasture, which will improve the future of the design and management of the pastures to obtain a greater benefit and, consequently, lead to the owner to have a better profitability in his exploitation (cost - benefit).
The research was conducted in Hda. The Rosario that is in Salcedo canton in Cumbijín community that is at an initial altitude of approximately 2900 meters above sea level and with a maximum height of 3400 meters above sea level, there is found a good part of pastures for dairy production with breeds such as Jersey, Holstein, Brown Swiss, F1 (Holstein with Jersey). The use of grass with a load between 1-2 AU / ha, is rotational in pastures with approximately 45% of Ryegrass (Lolium perennial) - 25% of Bluegrass (Dactylis glomerata) - 30% of Clover (Trifolium repens) comes by Sample system of it, to which they have daily access. Agrotechnics in the areas are managed with organic fertilization (chicken manure).El presente proyecto de investigación tiene como objetivo evaluar el tiempo termal óptimo en mezcla forrajera para bovinos lecheros de la Hda. El Rosario, iniciando de la necesidad de obtener un buen pasto para una mejor producción en la ganadería propiamente dicha, basándose en el análisis del pasto teniendo en cuenta y analizando algunas características del mismo como: el crecimiento, composición, morfología de las hojas, calidad de pastura, tipo de pastura, rotación de cada potrero, que a futuro será utilizada para mejorar los pastizales el diseño y el manejo de los mismos para obtener mayor beneficio y con eso llevar a que el propietario tenga una mejor rentabilidad en su explotación (costo- beneficio).
La investigación se realizó en la Hda. El Rosario que se encuentra ubicada en el Cantón Salcedo en la comunidad de Cumbijin que se encuentra a una altitud aproximada inicial 2900 msnm y con una altura máxima de 3400 msnm, dedicada en una buena parte a pastizales para ganadería de leche con razas como Jersey, Holstein, Brown Swiss, F1(Holstein con Jersey). El uso del pasto con carga entre 1-2 UA/ha, es en forma rotacional en pasturas con aproximadamente 45 % de Ryegrass (Lolium perenne)- 25 % de Pasto azul (Dactylis glomerata)- 30% de Trébol (Trifolium repens) comprobada por muestreo sistemático de la misma, a la cual tienen acceso diariamente. La agrotecnia de las áreas se maneja con fertilización orgánica (abono de gallina)
Ejemplaridad de los modelos en España en los siglos XVI y XVII
- Author
- Alonso Veloso María José
- Antonucci Fausta
- Aragüés Aldaz José
- Aranda María
- Arellano Ignacio
- Artois Florence d'
- Azaustre Galiana Antonio
- Canavaggio Jean
- Carlos Villamarín Helena de
- Couderc Christophe
- Críez Garcés Pedro Luis
- Darnis Pierre
- Díaz Marroquín Lucía
- Framiñán de Miguel M.ª Jesús
- Gómez Jesús
- Gómez Canseco Luis
- Herzig Carine
- Pedraza Jiménez Felipe B.
- Pedrosa José Manuel
- Quero Fabrice
- Rodríguez Cáceres Milagros
- Rodríguez Mansilla Fernando
- Sáez Raposo Francisco
- Tobar Quintanar María José
- Ulla Lorenzo Alejandra
- Publication venue
- 'OpenEdition'
- Publication date
- 23/04/2020
- Field of study
Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain
- Author
- Adoración Valiente
- Adriana Hernández Belmonte
- Adriana Sánchez Serrano
- Adrián Sánchez Montalvá
- Agustín Rojas-Vieyra
- Aida Gutiérrez García
- Aina Gabarrell Pascuet
- Aina Gomila Grange
- Ainhoa Urrutia Losada
- Alba Alastrué Violeta
- Alba Bergas
- Alba Rueda López
- Albert Sabater Gil
- Alberto Arranz Caso
- Alberto Bahamonde Carrasco
- Alberto Delgado-Iribarren
- Alberto Oreja
- Alberto Serrano Martínez
- Alejandra Duarte Borges
- Alejandra Pérez García
- Alejandro Aguirre Vila-Cora
- Alejandro Callejas Díaz
- Alejandro García García
- Alejandro Suárez-Benjumea
- Alex Smithson Amat
- Alex Soriano
- Alexander Rombauts
- Alexandre Pérez González
- Alexia Costanza Espiño Álvarez
- Alexy Inciarte
- Alfonso Cabello Úbeda
- Alfredo Mican
- Alicia Hernández Torres
- Almudena Villa Martí
- Alí Martakoush
- Amparo Blasco Claramunt
- Amparo López-Bernus
- Ana Alguacil
- Ana Barrios Blandino
- Ana Camón
- Ana del Cielo Pérez Jaén
- Ana Escoresca
- Ana Fernández Cruz
- Ana Ferrer Ribera
- Ana González-Cordón
- Ana Isabel Cañabate
- Ana Isabel Peláez Ballesta
- Ana Josefa Tebar Martínez
- Ana Lérida Urteaga
- Ana Mariño Callejo
- Ana Martínez Sapiña
- Ana María Garijo Saiz
- Ana Milagro Beamonte
- Ana Such Diaz
- Ana Vegas Serrano
- Ander González Sarria
- Andrea Espigares Correa
- Andrea Pérez Rodríguez
- André Barbosa Ventura
- Andrés Canut Blasco
- Andrés Felipe Cardona Arias
- Andrés Javier Ruiz Fernández
- Anna Ferrer Santolaria
- Antonio García Pardo
- Antonio Oteo Revuelta José
- Antonio Ramos Martínez
- Antonio Rezusta López
- Arantzazu Mera Fidalgo
- Aránzazu Villasante de la Puente
- Asier Aranguren Arostegui
- Asunción Díaz
- Beatriz Dietl Gómez-Luengo
- Beatriz Loureiro Rodríguez
- Beatriz María Sanjuan
- Beatriz Mestre Gómez
- Beatriz Pérez-Monte Mínguez
- Beatriz Rodríguez-Alonso
- Beatriz Álvarez Zapatero
- Beatriz Álvarez Álvarez
- Belén Alejos
- Belén Gutiérrez-Gutiérrez
- Belén Loeches Yagüe
- Benito Almirante
- Berta Torres
- Blanca Alonso
- Blanca Martínez Cifre
- Blanca Marzo
- Camilo Sanz Zamudio
- Carlos Bea Serrano
- Carlos Iniesta
- Carlos Jesús Dueñas Gutiérrez
- Carlos Rodríguez Franco
- Carlos Ruiz Martínez
- Carlota Gudiol
- Carmen Ardanuy
- Carmen Busca Arenzana
- Carmen Herrero Rodríguez
- Carmen Infante
- Carmen Martínez Cilleros
- Carmen Quereda
- Carmen Sáez Barberá
- Carmen Yera Bergua
- Carmen Yllera Gutiérrez
- Carmina Oltra
- Carolina Hernández Carballo
- Carolina Roldán Fontana
- Cecilia Tortajada Alamilla
- Celia Salamanca
- Chen
- Chen
- Chiara Fanciulli
- Cintia María Martínez Mateu
- Clara Muñoz Aguirre
- Clara Sala Jofre
- Claudia González Rico
- Claudio Bueno
- Concepción Amador Prous
- Concepción García García
- Conchita Pérez-Jorge Peremarch
- Constanza Muñoz Hornero
- Covadonga Morcate Fernández
- Cristina Carbonell
- Cristina Cervera Acedo
- Cristina Chico Chumillas
- Cristina Díez
- Cristina Gómez-Ayerbe
- Cristina Hernán García
- Cristina Hernández Gutiérrez
- Cristina López Mestanza
- Cristina Morales García
- Cristina Moreno
- Cristina Roca
- Cristóbal Manuel Rodríguez Leal
- Cummings
- Daniel Molina Morant
- Daniel Podzamczer
- Daniel Roger Zapata
- Daniel Useros Brañas
- David Alonso Menchén
- David Roa
- David Vinuesa García
- Delia Quilez Ágreda
- Docherty
- Domingo García-Jiménez
- Eduardo Malmierca Corral
- Efrén Sánchez Vidal
- Elena Chamarro Martí
- Elena Isaba Ares
- Elena López Tizón
- Elena María Aranda Rife
- Elena Morcillo Rodríguez
- Elena Morte
- Elena Múñez Rubio
- Elena Resino Foz
- Elena Salamanca
- Elena Trigo Esteban
- Elena Álvaro Alonso
- Elisa Cordero-Matía
- Elisa García Vázquez
- Elisabet Delgado Sánchez
- Elizabet Petkova Saiz
- Elsa Izquierdo García
- Encarnación Moral Escudero
- Enrique Míguez Rey
- Enrique Peral
- Esperanza Bejarano Tello
- Esteban Martínez
- Estel Pons Viñas
- Ester Sáez de Adana Arróniz
- Esther Aznar Muñoz
- Esther Expósito Palomo
- Esther Fraile Villarejo
- Esther García Almodóvar
- Eva Jiménez González de Buitrago
- Eva María León Jiménez
- Eva María Romay Lema
- Eva Pilar García Villalba
- Eva Talavera García
- Eva Van den Eynde Otero
- Felipe Villar Álvarez
- Fernando de la Calle Prieto
- Fernando González-Romo
- Francesc Albertí
- Francesca Gioia
- Francesca Norman
- Francisco Alcántara Nicolás
- Francisco Arnaiz de las Revillas
- Francisco Javier Membrillo de Novales
- Francisco Mora Gómez
- Francisco Muñoz Beamud
- Francisco Parras
- Francisco Rodríguez Gómez
- Francisco Tejerina
- Fátima Brañas Baztán
- Félix Gutiérrez Rodero
- Gabriel Gaspar Alonso-Vega
- Gabriela Abelenda-Alonso
- Gema Barbeito Castiñeiras
- Gema Domínguez de Pablos
- Gema Muñiz
- Germán Ramírez-Olivencia
- Ginger Giorgiana Cabrera Tejada
- Goyal
- Grasselli
- Guan
- Guillermo Cuervo
- Guillermo Cuevas Tascon
- Guillermo Estrada Fernández
- Guillermo Jiménez Álvarez
- Guillermo Maestro de la Calle
- Guillermo Martín
- Harris
- Helem Haydee Vilchez
- Helena Mozas Moriñigo
- Henar Calvo Sánchez
- Hernando Knobel
- Huang
- Huang
- Héctor Meijide Míguez
- Ianire Virto Peña
- Ignacio De los Santos Gil
- Inmaculada Jarrín
- Inmaculada Jarrín
- Inmaculada Martín Pérez
- Inmaculada Poquet Catala
- Inés Fernández Jiménez
- Inés Pérez Zapata
- Inés Suárez-García
- Irene Carrillo Acosta
- Irene Díaz de la Torre
- Irene Martín Rubio
- Iris Pedrola Gorrea
- Isabel A. Pérez Hernández
- Isabel Barrio López
- Isabel Gutiérrez
- Isabel Jiménez Martínez
- Isabel Pérez-Tamayo
- Isabel Rábago Lorite
- Ismail Zakariya-Yousef Breval
- Itziar Diego Yagüe
- Ivette Abascal Cambras
- Iván Castro Hernández
- Iván Navas Clemente
- Iván Pelegrín Senent
- Iván Piñero
- Jamil Cedeño
- Jara Llenas García
- Javier Coy Coy
- Javier De la Torre Lima
- Javier Nieto Arana
- Javier Oliver Ortega
- Javier Sánchez-Lora
- Jerónimo Pachón
- Jerónimo Pachón
- Jessica Abadia Otero
- Jesús Rodriguez Baño
- Jesús Rodríguez-Baño
- Jesús Ruiz Aragón
- Jesús Santos González
- Jesús Sanz Sanz
- Jesús Sojo
- Jesús Sánchez-Gómez
- Jesús Troya García
- Jhon Rojas
- Joan Gómez-Junyent
- Joaquín López-Contreras González
- Jon Ugalde Espiñeira
- Jonathan Cámara Fernández
- Jordi Carratalà
- Jordi Carratalà
- Jordi Mancebo Cortés
- Jordi Niubó
- Jorge Alba Fernández
- Jorge Anel Pedroche
- Jorge Calderón Parra
- Jorge Calvo
- Jorge Martínez Jordán
- Jorge Parra Ruiz
- Jorge Valencia de la Rosa
- Jose David Ampuero Martinich
- Joseba Portu Zapirain
- Josefa Serralta Buades
- Josefina García García
- Josune Goikoetxea Agirre
- José Antonio Peregrina
- José Antonio Pérez de León
- José Bravo-Ferrer
- José Hernández Quero
- José Ignacio Bernardino de la Serna
- José Luis Blanco
- José Luis Díaz de Tuesta del Arco
- José Luis García Fogeda
- José Luis Velasco Garrido
- José Luís Del Pozo León
- José M. Azcona Gutiérrez
- José Manuel Vázquez Comendador
- José María Aguado
- José María Marimón Ortiz de Zárate
- José María Milicua Muñoz
- José Miguel Cisneros
- José Mª García de Lomas Guerrero
- José R. Blanco Ramos
- José Ramón Arriba
- José Ramón Arribas López
- José Román Muñoz del Rey
- José Sanz Moreno
- José Tomas Algado Rabasa
- Juan Berenguer
- Juan Berenguer
- Juan Cantón de Seoane
- Juan Carlos Abad Almendro
- Juan Carlos Gainzarain Arana
- Juan Carlos López
- Juan Carlos Ramos Ramos
- Juan Cuadros González
- Juan Emilio Losa García
- Juan Espinosa Pereiro
- Juan Pablo Avilés
- Juan Pablo Horcajada
- Juan Salillas Hernando
- Juan Torres Macho
- Judit Villar-García
- Julen Cadiñaños Loidi
- Julia Pareja Coca
- Julia Praena
- Julio García Rodríguez
- Justo Menéndez
- Júlia Sellarés
- Karim Mohamed Ramírez
- Kass
- Klein
- Kuderer
- Kwong
- Lagunas-Rangel
- Laia Lorenzo-Esteller
- Lara Montes Andújar
- Laura Castelo Corral
- Laura Iglesias Llorente
- Laura Mao Martín
- Laura Muñoz López
- Laura Prieto Pérez
- Leire Balerdi Sarasola
- Leire Pérez-Latorre
- Liang
- Lidia Martín
- Lighter
- Liu
- Lorea Arteche Eguizabal
- Lorena De la Mora
- Loreto Vidaur Tello
- Lourdes Herrera Pacheco
- Lucia Boix Palop
- Lucia Cajuela
- Lucia Suárez Pérez
- Lucio García-Fraile
- Lucy Abella Vázquez
- Lucía Fernández de Orueta
- Lucía Gómez García
- Lucía Marín-Barrera
- Lucía Ramos Merino
- Luis Alberto Nieto Fernández del Campo
- Luis E. López-Cortés
- Luis Falgueras López
- Luis Force Sanmartín
- Luis Metola Sacristán
- Luis Puente
- Luisa Sorli Redò
- Lydia Gálvez-Benítez
- Lydia Martín González
- M. Teresa Pérez-Rodríguez
- Maialen Ibarguren Pinilla
- Manuel Cervantes García
- Manuela Aguilar-Guisado
- Mar Masiá Canuto
- Mar Mosquera
- Marcelino Hayek Peraza
- Marco Antonio Sempere Alcocer
- Marcos Díez Martínez
- Marcos López Dosil
- Margarita Ramírez-Schacke
- Maria Álvarez de Castro
- Maribel Zamora Cintas
- Marina Pacheco Martínez-Atienza
- Mario Fernández-Ruiz
- Mario José Rodriguez Dominguez
- Mario Pérez Butragueño
- Marta Alvarado Blasco
- Marta Arsuaga Vicente
- Marta Díaz Menéndez
- Marta Lamata Subero
- Marta Miarons
- Marta Mora Rillo
- Marta Navarro Vilasaró
- Marta Rava
- Marta Rico Rodríguez
- Marta Robledo del Prado
- Marta Ruiz-Alguero
- Marta Santos Peña
- Marta Vizcaíno Callejón
- María Aroca Ferri
- María Aránzazu Galindo Martín
- María Carmen Fariñas Álvarez
- María Cecilia Cánepa
- María de la Luz Padilla Salazar
- María del Carmen Navarro Sáez
- María del Mar Alonso Socas
- María Dolores Avilés
- María E. García-Leoni
- María Isabel Quijano Contreras
- María Jesús Domínguez Santalla
- María José Blanco Vidal
- María José Ruiz Rodríguez
- María Larrosa
- María Lorén Vargas
- María Luisa Machado Sicilia
- María López-Jódar
- María Milagro Montero
- María Novella Mena
- María Paz García Butenegro
- María Pilar García García
- María Rexach Fumaña
- María Roca Toda Savall
- María Rodríguez Mahía
- María Simón Sacristán
- María Yllescas
- María Ángeles Domínguez
- María Ángeles Garcinuño
- Melania Íñigo Pestaña
- Melchor Riera Jaume
- Melchor Álvarez de Mon Soto
- Melissa Carreres Candela
- Merce Cardona Rivera
- Merce Sirisi
- Mercedes Clemente Presas
- Mercedes Guillamón Sánchez
- Mercedes San Franco
- Mercedes Villarreal García-Lomas
- Mercè Gurguí Ferrer
- Miguel Cervero
- Miguel Corral Saracho
- Miguel Fernández-Huerta
- Miguel Górgolas Hernández-Mora
- Miguel Pedromingo Kus
- Miguel Salavert Lletí
- Miguel Sampedro Núñez
- Miguel Torralba González de Suso
- Miguel Villamarín
- Miguel Ángel Moran Rodríguez
- Mikel del Álamo Martínez de Lagos
- Ministerio de Sanidad
- Miquel Pujol
- Mireia Puig Campmany
- Miriam Estébanez Muñoz
- Miriam García Gómez
- Miriam Latorre-Millán
- Moncef Belhassen-García
- Montaña Jiménez Álvaro
- Montserrat Laguno
- Montserrat Sanmarti Vilamala
- Mª Antonia Sepúlveda Berrocal
- Mª Carmen Sánchez Arenas
- Mª del Mar Lago Núñez
- Mª Ángeles Marcos
- Mónica González Bardanca
- Mónica Gozalo
- Mónica Liébana Gómez
- Natalia Carrasco Fons
- Natividad Benito Hernández
- Nerea Carrasco Antón
- Nicolas Merchante Gutiérrez
- Nieves Valcarce Pardeiro
- Noelia Arenal Andrés
- Nora Izko Gartzia
- Nuria Fernández
- Nuria Parra Arribas
- Nuria Rabella García
- Núria Trullen
- Olalla Martínez Macias
- Oriol Gasch Blasi
- Oscar del Río Pérez
- Oscar Sanz Peláez
- Pablo Fernández-González
- Pablo Marguenda Contreras
- Pablo Pascual Alonso
- Pablo Ryan
- Pablo Ryan
- Paloma Merino Amador
- Patricia González Muñiz
- Patricia González- Ruano
- Patricia Martínez Martín
- Patricia Pérez-Palacios
- Patricia Sorní Moreno
- Paula Runza Buznego
- Paula Santibáñez Sáenz
- Paula Sáez Escolano
- Paula Villares Fernández
- Pedro Gil Divasson
- Pere Comas Casanova
- Pere Domingo Pedrol
- Pilar Catalán
- Pilar Hernández Machín
- Pilar Retamar
- Pilar Toledano Sierra
- Pilar Vizcarra
- Rafael Cantón Moreno
- Rafael Padrós Selma
- Rafael Silvariño Fernández
- Rafael Torres Perea
- Ramón Pérez Tanoira
- Raquel Aranega
- Raquel Barrós González
- Raquel Elisa Rodríguez Tarazona
- Raquel Martínez Goñi
- Raquel Álvarez Franco
- Rebeca Izquierdo
- Remedios Alemán Valls
- Ricardo Fernández Roblas
- Richard Rojas
- Richardson
- Robert Torres Sánchez del Arco
- Roberto Güerri-Fernández
- Roberto Vates Gómez
- Rocío Martínez Avilés
- Rodrigo Alonso Navarro
- Rodrigo Sierra Rodríguez
- Roi Suárez Gil
- Rosa de Miguel Buckley
- Rosana Rouco Esteves Marques
- Ruth Brea Aparicio
- Ruth Figueroa Cerón
- Sadaf Zafar Iqubal-Mirza
- Salvador Álvarez Martin
- Sandra Pérez-Recio
- Santos Del Campo
- Sara Fernández Rodríguez
- Sara Heili Frades
- Sara Lidia Kamal
- Sara Medrano Pardo
- Sara Rodrigo González
- Sarah Caro Bragado
- Schiffrin
- Sergio España Cueto
- Sergio Gilaberte Reyzábal
- Sergio Pérez Pinto
- Silvana Fiorante
- Silvia Castañeda Espinosa
- Silvia Hernáez Crespo
- Silvia Loscos
- Silvia Paulos Viñas
- Silvia Suárez Diaz
- Silvia Valero Rovira
- Silvia Álvarez Kaelis
- Simonnet
- Singh
- Sonia Calzado Isbert
- Sonia García
- Sonia García Calvo
- Sonia Vega Molpeceres
- Susana Casas Rodríguez
- Tamara Manso Gómez
- Teresa Aldabó
- Teresa Aldámiz-Echevarría
- Teresa García Delange
- Teresa Álvarez de Espejo Montiel
- Tomás Tosco Núñez
- Valvanera Ibarra Cucalón
- Vanessa Alende Castro
- Verónica Cano Llorente
- Vicente Boix
- Vicente Ferrer Díaz de Brito Fernández
- Victoria Hernando
- Violeta Ramos Sesma
- Virginia Fernández Espinilla
- Virginia Molina Peinado
- Virginia Naranjo Velasco
- Virginia Pomar Solchaga
- Virginia Pérez Doñate
- Víctor Asensi Álvarez
- Víctor J. Moreno Cuerda
- Wadhera
- World Health Organization
- Xabier Kortajarena Urkola
- Xavier Bonfill Cosp
- Yang
- Yolanda Martínez Martínez
- Yolanda Meije
- Yolanda Posada Franco
- Young
- Zaira R. Palacios
- Zeltia Valcarce González
- Zhou
- Zhou
- Zineb Karroud
- Zuriñe Ortiz de Zárate Ibarra
- Álvaro Navarro Batet
- Álvaro Varela Plaza
- Ángeles García Flores
- Publication venue
- 'Elsevier BV'
- Publication date
- Field of study
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- Abellán Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Akçay Özlem
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia González
- Aleem Muhammad
- Alegre Inês
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz Amorós
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-Díez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado Fabíola
- Amador Cristina García
- Amanullah Nazli
- Amaral Hélida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
- Ammar Mona Ahmed
- Ammendola Michele
- Ammerata Giorgio
- Amorim Edgar
- Ancans Guntis
- Anderson Tom
- Andrade Diogo
- Andrejevic Predrag
- Andrés Beatriz Díaz San
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- Vigneswaran Natalia
- Vigorita Vincenzo
- Vihervaara Hanna
- Vijayagopal Kesav Aditya
- Vijayan Varun
- Vilain Luciano Ferreira
- Villa Gianluca
- Villalobos Santiago
- Villarino-Villa Laura
- Vino Smila
- Viola Marcelo
- Viscosi Francesca
- Vishnoi Jeewan Ram
- Vlad Catalin
- Volkoviene Gerda
- Volturo Lino
- Vural Ummuhan
- Vázquez-Fernández Andrea
- Väyrynen Antti
- Wagdy Michael
- Waha James
- Waheed Mariam
- Waindeskar Vaishali
- Wakkaf Habib
- Walsh Adam
- Walędziak Maciej
- Wang Jaw Yuan
- Wani Rauf
- Wanshantha Dinamulla
- Waqar Usama
- Ward Nicholas
- Watanabe Jun
- Wells Johanna
- Westzaan Natalia
- Wickramarathne Rasika
- Wickramasinghe Dakshitha
- Widatalla Abu Bakr H
- Widyaningsih Rizky
- Wijenayake Wasantha
- Wilson Jeremy
- Wilson Kasmira
- Windels An
- Witjes Caroline
- Wong Siew Ching
- Woodward Andrew
- Wright Deborah
- Wright Jonathan
- Wu Scott
- Wątroba Anna
- Xanthis Athanasios
- Xavier Ruben
- Xenaki Sofia
- Xynos Evangelos
- Yadav Ram Kishan
- Yadev I P
- Yague Julio
- Yakout Nadia
- Yakunina Natalia
- Yalkin Ömer
- Yanishev Alexey
- Yao Hongwei
- Yazici Pinar
- Yemez Kursat
- Yew Chor Kuan
- Yılmaz Gülseren
- Yilmazlar Tuncay
- Yiğit Direnç
- Yoldas Tayfun
- Yonekura Hiroshi
- Yorkmui Liu
- Yoshino Kenji
- Younes Lina
- Young Trudi
- Yule Michael
- Yusoff Zakiah Mohd
- Zaari Fatimazahraa
- Zabiyaka Mikhail
- Zadrożna Monika
- Zafar Madiha
- Zagaynov Eugeny
- Zaidi Syed-Nadeem
- Zaimis Tilemachos
- Zain Wan Zainira Wan
- Zainy Rhendra Hardy Mohamad
- Zakaria Andee Dzulkarnaen
- Zakaria Maheen
- Zakaria Zaidi
- Zamudio-Bautista Jorge Luis
- Zanc Loredana
- Zanoni Andrea
- Zanus Giacomo
- Zapparoli Alessandro
- Zappone Anna
- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah Kağan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Álvarez-Llano Laura
- Ângelo Miguel Duarte
- ÓSullivan Sara Nuñez
- Özçelik Mehmet Faik
- Ćoza Ivo
- Şanlı Ahmet Necati
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)