Catalog and distribution atlas of the Scarabaeoidea (Insecta: Coleoptera) of El Salvador

Menos del 1% de la literatura sobre la biodiversidad de El Salvador es sobre invertebrados terrestres, lo que limita nuestro conocimiento de la diversidad, riqueza y distribución de este grupo en el territorio. Los Scarabaeoidea son megadiversos en múltiples ecosistemas y cumplen muchas funciones. Este trabajo tiene como objetivo catalogar los Scarabaeoidea en El Salvador. Se realizó una revisión exhaustiva de la literatura publicada y se revisaron numerosas colecciones entomológicas con material relevante. Se construyeron mapas para visualizar la distribución conocida de cada especie en el país. Existen 295 especies de escarabajos (incluyendo 19 nuevos registros en el país) representando 106 géneros en 7 familias en El Salvador. Se conocen seis especies precursoras. Veintidós especies se descartan como presentes en El Salvador, ya sea porque no son especies válidas o por identificaciones erróneas o registros dudosos. Este trabajo es la primera aproximación al conocimiento de los Scarabaeoidea en El Salvador, un territorio que usualmente se considera de nula importancia para la conservación de la biodiversidad regional debido a su reducida superficie, alta tasa de deforestación y sobrepoblación. Los resultados de este trabajo refuerzan la necesidad de realizar prospección biológica en el territorio para conocer, conservar y proteger la biodiversidad remanente. 2023 Universidad Nacional Autónoma de México. Todos los derechos reservados.Less than 1% of the literature on El Salvador s biodiversity is about terrestrial invertebrates, which limits our knowledge of this group s diversity, richness, and distribution in the territory. Scarabaeoidea are megadiverse in multiple ecosystems and perform many functions. This work aims to catalog the Scarabaeoidea in El Salvador. We conducted an exhaustive review of published literature and reviewed numerous entomological collections with relevant material. Maps were constructed to visualize the known distribution of each species in the country. There are 295 scarab beetle species (including 19 new country records) representing 106 genera in 7 families in El Salvador. Six precinctive species are known. Twenty-Two species are discarded as occurring in El Salvador, either because they are not valid species or because of misidentifications or dubious records. This work is the first approach to knowing the Scarabaeoidea in El Salvador, a territory that is usually considered of no importance for the conservation of regional biodiversity due to its small area, high rate of deforestation, and overpopulation. The results of this work reinforce the need for biological prospecting in the territory to know, conserve, and protect the remaining biodiversity. © 2023 Universidad Nacional Autonoma de Mexico. All rights reserved

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