Issues of sustainable food production in Latvia

The article presents main results of the first in Latvia study addressing the issues of the development of Latvia’s sustainable food production. For detailed research two main themes for Latvia’s agri-food sector’s sustainability were chosen: 1) the issues related to further development of the organic farming and processing; where the special attention has been paid to organic milk processing; and obtaining of organic pigmeat and beef in different Latvia’s regions; 2) quality and environment management systems enforcement - mandatory and voluntary and the trends of implementation of the international management standards (ISO 9001, ISO 22000; HACCP DS 3027:2002; ISO 14001). The publications, legal documents and databases of Latvia’s governmental and nongovernmental institutions were used as materials and the qualitative and quantitative research methods were applied for this empirical research. The assessment of present situation and the proposals for further development has been given

Современные возможности эндохирургической биопсии у детей с хроническими болезнями печени

Chronic liver diseases in children are a group of pathological conditions which varies greatly in etiopathogenetic features heterogeneity and clinical picture, tends to progress if associated with cirrhosis and decompensate hepatic functions consequently following by orthotopic transplantation. Despite the introduction of many non-invasive methods of examination, biopsy continues to be a standard in the diagnosis of histopathological changes in liver tissue. The article reflects modern ideas about the efficacy and safety of various methods of liver biopsy in children. Comparative analysis results on the informative value of hepatobioptates obtained by various puncture techniques are provided.Хронические болезни печени у детей представляют обширную, неоднородную по этиопатогенетическим признакам и клинической картине группу патологических состояний, неуклонно прогрессирующих с развитием цирроза и декомпенсацией печеночных функций, что в конечном итоге может потребовать ортотопической трансплантации. Несмотря на внедрение множества неинвазивных методов обследования, биопсия остается ключевым методом диагностики гистопатологических изменений печени. В статье отражены современные представления об эффективности и безопасности различных методов биопсии печени у детей. Приведены данные сравнительного анализа информативности гепатобиоптатов, полученных посредством различных методик пункции (чрескожной, трансъюгулярной, лапароскопической).КОНФЛИКТ ИНТЕРЕСОВАвторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи

New Series of Red-Light Phosphor Ca9−xZnxGd0.9(PO4)7:0.1Eu3+ (x = 0–1)

In this study, a new series of phosphors, Ca9−xZnxGd0.9(PO4)7:0.1Eu3+ (x = 0.00–1.00, step dx 0.05), was synthesized, consisting of centro- and non-centrosymmetric phases with β-Ca3(PO4)2-type structure. Crystal structures with space groups R3c (0.00 ≤ x < 0.35) and R3¯c (x > 0.8) were determined using X-ray powder diffraction and the method of optical second harmonic generation. In the region 0.35 ≤ x ≤ 0.75, phases R3c and R3¯c were present simultaneously. Refinement of the Ca8ZnGd(PO4)7 crystal structure with the Rietveld method showed that 71% of Gd3+ ions are in M3 sites and 29% are in M1 sites. A luminescent spectroscopy study of Ca9−xZnxGd0.9(PO4)7:0.1Eu3+ indicated the energy transfer from the crystalline host to the Gd3+ and Eu3+ luminescent centers. The maximum Eu3+ luminescence intensity corresponds to the composition with x = 1

Modern Possibilities of Endosurgical Biopsy in Children with Chronic Liver Diseases

Chronic liver diseases in children are a group of pathological conditions which varies greatly in etiopathogenetic features heterogeneity and clinical picture, tends to progress if associated with cirrhosis and decompensate hepatic functions consequently following by orthotopic transplantation. Despite the introduction of many non-invasive methods of examination, biopsy continues to be a standard in the diagnosis of histopathological changes in liver tissue. The article reflects modern ideas about the efficacy and safety of various methods of liver biopsy in children. Comparative analysis results on the informative value of hepatobioptates obtained by various puncture techniques are provided

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