Aplicación de la biotecnología en cítricos para el desarrollo de plantas libres de patógenos en Paraguay

The objective of this work was to review the status of citrus in Paraguay and to evaluate the biotechnological strategies applied to obtain plants free of pathogens. There are two main research centers in Paraguay: The Paraguayan Institute of Agrarian Technology (IPTA) and the Faculty of Agrarian Sciences of the National University of Asuncion (UNA), through which the main diseases are reported. These include psorosis, cancrosis, the citrus sadness virus (CTV) and the Huanglongbing virus (HLB). Through the Citrus Improvement Program, disease-free plants have been obtained by applying biotechnological techniques, mainly the in vitro shoot apex micrografting, which allows the development of a more efficient and productive citrus crop, in short periods of time compared with the conventional techniques.El presente trabajo tuvo como objetivo realizar una revisión acerca del estado de la citricultura en Paraguay y evaluar cuáles son las estrategias biotecnológicas que se aplican para la obtención de plantas libres de patógenos. En Paraguay, existen dos centros principales de investigación, el Instituto Paraguayo de Tecnología Agraria (IPTA) y la Facultad de Ciencias Agrarias de la Universidad Nacional de Asunción (UNA), a través de los cuales se da a conocer las principales enfermedades, la psorosis, cancrosis, el virus de la tristeza de los cítricos (CTV) y el Huanglongbing (HLB). A través del Programa de Mejoramiento Cítrico se han obtenido plantas libres de enfermedades mediante la aplicación de técnicas biotecnológicas principalmente el microinjerto de ápices caulinares in vitro, que permite el desarrollo de una citricultura más eficiente y productiva, en períodos de tiempo cortos comparado con las técnicas convencionales

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

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)