14 research outputs found
Tools in Spanish Universities to facilitate the transmission from High School to University and their assessment.
Incoming students in the University have education deficiencies, so universities studies require a sound basis of scientific knowledge. In this project are analysed instruments to reinforcing knowledge in those areas related to the studies that students are about to embark on public Spanish universities. There are important differences among universities and, in each university there are great differences among titles. Initial courses (cursos cero) are widespread (in 50% of universities) that selfevaluation instruments (14 % of universities). It is necessary to improve diffusion of those instruments because it is not possible to evaluate them. So are proposed the next actuations: to make regular standard surveys for professors and students; to publish results of surveys; public universities should institutionalize their basic training offer and improve the dissemination of this offer especially through the web. This paper presents a questionnaire to assess student opinion about these tools. To analyze the effectiveness, and make an initial estimate of the evaluation of these tools, we conducted a pilot test of the questionnaire with 68 students at the University of Extremadura. The results of preliminary statistical analysis conducted on the pilot test indicate that the survey results are reliable. A global evaluation of both tools, with a scale of 1 to 5, gave an average score of 3.29 for initial courses and 3.41 for selfevaluation. The 72.9% of the students consider the "self assessment" more effective than the "initial course
Thin-Wall Machining of Light Alloys: A Review of Models and Industrial Approaches
Thin-wall parts are common in the aeronautical sector. However, their machining presents
serious challenges such as vibrations and part deflections. To deal with these challenges, di erent
approaches have been followed in recent years. This work presents the state of the art of thin-wall
light-alloy machining, analyzing the problems related to each type of thin-wall parts, exposing the
causes of both instability and deformation through analytical models, summarizing the computational
techniques used, and presenting the solutions proposed by di erent authors from an industrial point
of view. Finally, some further research lines are proposed
Analysis of the information about Doctoral Degrees presented in the Spanish universities websites.
Globalization has intensified competition, as evidenced by the growing number of international classification systems (rankings) and the attention paid to them. Doctoral education has an international character in itself. It should promote opportunities for graduate students lo participate in these international studies. The quality and competitiveness are two of the most important issues for universities. To promote the interest of graduates to continue their education after the graduate level, it would be necessary to improve the published information of ihe doctoral programs. It should increase the visibility and provide high-quality, easily accessible and comparable information which includes all the relevant aspects of these programs. The authors analysed the website contents of doctoral programs, it was observed a lack of quality of them and very poor information about the contents, so that it was decided that any of them could constitute a model for creating new websites. The recommendations on the format and contents in the web were made by a discussion group. They recommended an attractive design; a page with easy access to contents and easy to find on Ihe net and with the information in more than one language. It should include complete program and academic staff information. It should also be included the study's results which should be easily accessible and includes quantitative data, such as number of students who completed scholars, publications, research projects, average duration of the studies, etc. It will facilitate the choice of progra
Safety and efficacy of ribociclib plus letrozole in patients with HR+, HER2â advanced breast cancer: Results from the Spanish sub-population of the phase 3b CompLEEment-1 trial
Background: Breast cancer is the most common malignancy and the second leading cause of cancer-related mortality in Spanish women. Ribociclib in combination with endocrine therapy (ET) has shown superiority in prolonging survival in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) vs. ET alone.Methods: CompLEEment-1 is a single-arm, open-label phase 3b trial evaluating ribociclib plus letrozole in a broad population of patients with HR+, HER2- ABC. The primary endpoints were safety and tolerability. Here we report data for Spanish patients enrolled in CompLEEment-1.Results: A total of 526 patients were evaluated (median follow-up: 26.97 months). Baseline characteristics showed a diverse population with a median age of 54 years. At study entry, 56.5% of patients had visceral metastases and 8.7% had received prior chemotherapy for advanced disease. Rates of all-grade and Grade >= 3 adverse events (AEs) were 99.0% and 76.2%, respectively; 21.3% of patients experienced a serious AE, and 15.8% of AEs led to treatment discontinuation. AEs of special interest of neutropenia, increased alanine aminotransferase, increased aspartate aminotransferase and QTcF prolongation occurred in 77.8%, 14.8%, 11.4% and 4.0% of patients, respectively. Patients aged >70 years experienced increased rates of all-grade and Grade >= 3 neutropenia and anemia. Efficacy results were consistent with the global study.Conclusions: Results from Spanish patients enrolled in CompLEEment-1 are consistent with global data showing efficacy and a manageable safety profile for ribociclib plus letrozole treatment in patients with HR+, HER2-ABC, including populations of interest (NCT02941926).Trial registration: ClinicalTrials.gov NCT0294192
Downregulation of both gene expression and activity of Hsp27 improved maturation of mouse oocyte in vitro
Considerations and consequences of allowing DNA sequence data as types of fungal taxa
Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.Peer reviewe
Prediction of early mortality in patients with cancer-associated thrombosis in the RIETE Database
Considerations and consequences of allowing DNA sequence data as types of fungal taxa
Abstract
Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.Publisherâs Note
A first version of this text was prepared by the first eight authors and the last one, given here. The other listed co-authors in the article PDF support the content, and their actual contributions varied from only support to additions that substantially improved the content. The full details of all co-authors, with their affiliations, are included in Supplementary Table 1 after p.175 of the article for reasons of clarity and space.
SlavomĂr AdamÄĂk Institute of Botany, Plant Science and Biodiversity Centre, Slovak Academy of Sciences, DĂșbravskĂĄ cesta 9, 845 23 Bratislava, Slovakia
Teuvo Ahti Finnish Museum of Natural History, P.O. Box 7, 00014 University of Helsinki, Finland
M. Catherine Aime Purdue University, 915 W. State St., West Lafayette, Indiana 47907, U.S.A.
A. Martyn Ainsworth Royal Botanic Gardens, Kew, Richmond, Surrey, TW9 3AB, United Kingdom
Låszló Albert Hungarian Mycological Society, 1087 Könyves Kålmån krt. 40, Budapest, Hungary
Edgardo AlbertĂł Instituto de Investigaciones BiotecnolĂłgicas-Instituto TecnolĂłgico de ChascomĂșs, Universidad Nacional de San Martin-Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas, Buenos Aires, Argentina
Alberto AltĂ©s GarcĂa Facultad de BiologĂa, Ciencias Ambientales y QuĂmica, Universidad de AlcalĂĄ, 28805 AlcalĂĄ de Henares, Madrid, Spain
Dmitry Ageev SIGNATEC Ltd., 630090, Novosibirsk, Akademgorodok (Novosibirsk Scientific Center), Inzhenernaya str., 22, Russia
Reinhard Agerer Ludwig-Maximilians-UniversitĂ€t MĂŒnchen, Menzinger Str. 67, 80638 MĂŒnchen, Germany
Begona Aguirre-Hudson Royal Botanic Gardens, Kew, Richmond, Surrey, TW9 3AB, United Kingdom
Joe Ammirati University of Washington, Seattle, Washington 98195-1800, U.S.A.
Harry Andersson Eichhahnweg 29a, 38108 Braunschweig, Germany
Claudio Angelini JardĂn BotĂĄnico Nacional Dr. Rafael Ma. Moscoso, Apartado 21-9, Santo Domingo, Dominican Republic
VladimĂr AntonĂn Moravian Museum, Zeny trh 6, 659 37 Brno, Czech Republic
Takayuki Aoki Genetic Resources Center, National Agriculture and Food Research Organization, 2-1-2 Kannondai, Tsukuba, Ibaraki 305-8602, Japan
André Aptroot ABL Herbarium, G.v.d.Veenstraat 107, 3762 XK Soest, The Netherlands
Didier Argaud 40 rue du Justemont, 57290 Fameck, France
Blanca Imelda Arguello Sosa Instituto TecnolĂłgico de Ciudad Victoria, TecnolĂłgico Nacional de MĂ©xico, Ciudad Victoria, Tamaulipas, Mexico
Arne Aronsen TorĂždveien 54, 3135 TorĂžd, Norway
Ulf Arup Biological Museum, Lund University, Box 117, 221 00 Lund, Sweden
Bita Asgari Iranian Research Institute of Plant Protection, Agricultural Research, Education and Extension Organization, Tehran, Iran
Boris Assyov Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 2 Gagarin Str., 1113 Sofia, Bulgaria
Violeta Atienza Facultad de Ciencias BiolĂłgicas, Universitat de ValĂšncia, C/Dr Moliner 50, 46100, Burjasot, Valencia, Spain
Ditte Bandini Panoramastr 47, 69257 Wiesenbach, Germany
JoĂŁo LuĂs Baptista-Ferreira Instituto de Biossistemas e CiĂȘncias Integrativas, Faculdade de CiĂȘncias da Universidade de Lisboa, 1749-016 Lisboa, Portugal
Hans-Otto Baral Blaihofstr. 42, 72074 TĂŒbingen, Germany
Tim Baroni The State University of New York, 340 Bowers Hall, P.O. Box 2000, Cortland, New York 13045, U.S.A.
Robert Weingart Barreto Universidade Federal de Viçosa, 36570-000, Viçosa, Minas Gerais, Brazil
Henry Beker (1) Royal Holloway, University of London, United Kingdom; (2) Botanic Garden Meise, Nieuwelaan 38, 1860 Meise, Belgium
Ann Bell 45 Gurney Road, Lower Hutt, New Zealand
Jean-Michel Bellanger CEFE UMR5175, CNRS, Université de Montpellier, Université Paul-Valéry Montpellier, EPHE, INSERM, 1919 Route de Mende, 34293 Montpellier Cédex 5, France
Francesco BellĂč Naturmusem of Bolzano, CP 104, 39100, Bolzano, Italy
Martin Bemmann KleingemĂŒnderstraĂe 111, 69118 Heidelberg, Germany
Mika Bendiksby NTNU, University Museum, Norwegian University of Science and Technology, 7491 Trondheim, Norway
Egil Bendiksen Norwegian Institute for Nature Research, Gaustadalleen 21, 0349 Oslo, Norway
Katriina Bendiksen Natural History Museum, University of Oslo, P.O. Box 1172 Blindern, 0318 Oslo, Norway
Lajos Benedek Szent Istvan University, Hungary
Anna BĂ©reĆĄovĂĄ-GuttovĂĄ Institute of Botany, Plant Science and Biodiversity Centre, Slovak Academy of Sciences, DĂșbravskĂĄ cesta 9, 845 23 Bratislava, Slovakia
Franz Berger University of Salzburg, Salzburg, Austria
Reinhard Berndt Herbaria Z+ZT, ETH ZĂŒrich, CHN D37, UniversitĂ€tstr. 16, 8092 ZĂŒrich, Switzerland
Annarosa Bernicchia Via A. Guidotti 39, 40134 Bologna, Italy
Alona Yu. Biketova Institute of Biochemistry, BRC-HAS, 6726 Szeged, Temesvari krt. 62, 6726 Szeged, Hungary
Enrico Bizio SocietĂ Veneziana di Micologia, SocietĂ Veneziana di Scienze Naturali, Fontego dei Turchi, Santa Croce 1730, 30135 Venice, Italy
Curtis Bjork UBC Herbarium, Beaty Biodiversity Museum, University of British Columbia, Canada
Teun Boekhout (1) Westerdijk Fungal Biodiversity Institute, P.O. Box 85167, 3508 AD, Utrecht, The Netherlands; (2) Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
David Boertmann Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
Tanja Böhning AG Geobotanik Schleswig-Holstein & Hamburg, c/o University of Kiel, OlshausenstraĂe 75, 24098 Kiel, Germany
Florent Boittin Ascomycete.org, 36 rue de la Garde, 69005 Lyon, France
Carlos G. Boluda Conservatoire et Jardin botaniques de la Ville de GenĂšve, 1292 GenĂšve, Switzerland
Menno W. Boomsluiter T.v.Lohuizenstraat 34, 8172xl, Vaassen, The Netherlands
Jan BoroviÄka Institute of Geology, Czech Academy of Sciences, Rozvojova 269, 165 00 Prague 6, Czech Republic
Tor Erik Brandrud Norwegian Institute for Nature Research, Gaustadalleen 21, 0349 Oslo, Norway
Uwe Braun Martin-Luther-UniversitĂ€t, Institut fĂŒr Biologie, Bereich Geobotanik, und Botanischer Garten, Herbarium, Neuwerk 21, 06099 Halle, Germany
Irwin Brodo Canadian Museum of Nature, 240 McLeod Street, Ottawa, Ontario, Canada
Tatiana Bulyonkova A.P. Ershov Institute of Informatics Systems, Russian Academy of Sciences, Siberian Branch, 6 Acad. Lavrentjev pr., Novosibirsk 630090, Russia
Harold H. Burdsall Jr. Fungal & Decay Diagnostics, LLC, 9350 Union Valley Road, Black Earth, Wisconsin 53515, U.S.A.
Bart Buyck MusĂ©um National dâHistoire Naturelle, CP 39, ISYEB, UMR 7205 CNRS MNHN UPMC EPHE, 12 rue Buffon, 75005 Paris, France
Ana Rosa Burgaz Facultad de Ciencias BiolĂłgicas, Universidad Complutense de Madrid, 28040 Madrid, Spain
Vicent Calatayud FundaciĂłn CEAM, c/ Charles R. Darwin, 14, Parque TecnolĂłgico, 46980 Paterna, Valencia, Spain
Philippe Callac INRA, MycSA, CS 20032, 33882 Villenave dâOrnon, France
Emanuele Campo Associazione Micologica Bresadola, Via Alessandro Volta 46, 38123 Trento, Italy
Massimo Candusso Via Ottone Primo 90, 17021, Alassio, Savona, Italy
Brigitte Capoen Queffioec, rue de Saint Gonval, 22710 Penvenan, France
Joaquim CarbĂł Roser, 60, 17257 Torroella de MontgrĂ, Girona, Spain
Matteo Carbone Via Don Luigi Sturzo 173 16148 Genova, Italy
Rafael F. Castañeda-Ruiz Instituto de Investigaciones Fundamentales en Agricultura, Tropical âAlejandro de Humboldtâ, OSDE, Grupo AgrĂcola, Calle 1 Esq. 2, Santiago de Las Vegas, C. Habana 17200, Cuba
Michael A. Castellano USDA, Forest Service, Northern Research Station, Corvallis, Oregon 97330, U.S.A.
Jie Chen Mae Fah Luang University, Chang Wat Chiang Rai 57100, Thailand
Philippe Clerc Conservatoire et Jardin botaniques de la Ville de GenĂšve, 1292 GenĂšve, Switzerland
Giovanni Consiglio Via C. Ronzani 61, 40033 Casalecchio Bologna, Italy
Gilles Corriol National Botanical Conservatory for Pyrenees and Midi-Pyrénées Region of France and BBF Herbarium, Vallon de Salut. B.P. 315. 65203 BagnÚres-de-Bigorre, France
Régis Courtecuisse Université Lille, Fac. Pharma. Lille, EA4483 IMPECS, 59000 Lille, France
Ana Crespo Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
Cathy Cripps Plant Sciences & Plant Pathology, 119 Plant Biosciences Building, Montana State University, Bozeman, Montana 59717, U.S.A.
Pedro W. Crous Westerdijk Fungal Biodiversity Institute, P.O. Box 85167, 3508 AD, Utrecht, The Netherlands
Gladstone Alves da Silva Universidade Federal de Pernambuco, Centro de BiociĂȘncias, Avenida da Engenharia, S/N, Cidade UniversitĂĄria, Recife, Pernambuco, Brazil
Meiriele da Silva Universidade Federal de Viçosa, 36570-000, Viçosa, Minas Gerais, Brazil
Marjo Dam Hooischelf 13, 6581 SL Malden, The Netherlands
Nico Dam Hooischelf 13, 6581 SL Malden, The Netherlands
Frank DĂ€mmrich The Bavarian Natural History Collections (SNSB Munich), Menzinger Strasse 71, 80638, MĂŒnchen, Germany
Kanad Das Botanical Survey of India, Cryptogamic Unit, P.O. Botanic Garden, Howrah 711103, W.B., India
Linda Davies Centre for Environmental Policy, Imperial College London, SW7 2AZ, United Kingdom
Eske De Crop Ghent University K.L. Ledeganckstraat 35, 9000 Ghent, Belgium
Andre De Kesel Botanic Garden Meise, Nieuwelaan 38, 1860 Meise, Belgium
Ruben De Lange Ghent University, K.L. Ledeganckstraat 35, 9000 Gent, Belgium
BĂĄrbara De Madrignac Bonzi Instituto de BotĂĄnica del Nordeste, Universidad Nacional de Nordeste-Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas, Sargento Cabral 2131, CC 209, Corrientes Capital, Argentina
Thomas Edison E. dela Cruz University of Santo Tomas, Espana 1008 Manila, Philippines
Lynn Delgat Ghent University, K.L. Ledeganckstraat 35, 9000 Gent, Belgium
Vincent Demoulin Institut de Botanique, B.22, Université de LiÚge, 4000 LiÚge I, Belgium
Dennis E. Desjardin HD Thiers Herbarium (SFSU), San Francisco State University, 1600 Holloway Ave, San Francisco, California 94132, U.S.A.
Paul Diederich MusĂ©e national dâhistoire naturelle, 25 rue MĂŒnster, 2160 Luxembourg, Luxembourg
Bålint Dima (1) Institute of Biology, Eötvös Lorånd University, Påzmåny Péter sétåny 1/c, 1117 Budapest, Hungary; (2) Viikki Plant Science Centre, University of Helsinki, P.O. Box 65, 00014 Helsinki, Finland
Maria Martha Dios Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Catamarca, Av Belgrano 300, 4700 San Fernando del Valle de Catamarca, Argentina
Pradeep Kumar Divakar Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain
Clovis Douanla-Meli Julius KĂŒhn-Institut, Federal Research Centre for Cultivated Plants, Institute for National and International Plant Health, Messeweg 11-12, 38104 Braunschweig, Germany
Brian Douglas Royal Botanic Gardens, Kew, Richmond, Surrey, TW9 3AB, United Kingdom
Elisandro Ricardo Drechsler-Santos Universidade Federal de Santa Catarina, Campus UniversitĂĄrio Reitor JoĂŁo David Ferreira Lima, Trindade, FlorianĂłpolis, Santa Catarina CEP 88040-900, Brazil
Paul S. Dyer School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
Ursula Eberhardt Abt. Botanik, Staatliches Museum fĂŒr Naturkunde Stuttgart, Rosenstein 1, 70191 Stuttgart, Germany
Damien Ertz Botanic Garden Meise, Nieuwelaan 38, 1860 Meise, Belgium
Fernando Esteve-RaventĂłs Facultad de BiologĂa, Ciencias Ambientales y QuĂmica, Universidad de AlcalĂĄ, 28805 AlcalĂĄ de Henares, Madrid, Spain
Javier Angel Etayo Salazar Navarro Villoslada 16, 3Âș dcha., 31003 Pamplona, Navarra, Spain
Vera Evenson Sam Mitchel Herbarium of Fungi, Denver Botanic Gardens, 1007 York Street, Denver, Colorado 80206, U.S.A.
Guillaume Eyssartier MusĂ©um national dâhistoire naturelle, Jardin des plantes, 57 rue Cuvier, 75005 Paris, France
Edit Farkas Institute of Ecology and Botany, MTA Centre for Ecological Research, 2163 VĂĄcrĂĄtĂłt, Hungary
Alain Favre FĂ©dĂ©ration Mycologique et Botanique DauphinĂ© Savoie, Le PrieurĂ©, 144 Place de lâEglise, 74320 Sevrier, France
Anna G. Fedosova Komarov Botanical Institute of the Russian Academy of Sciences, 2 Prof. Popov Street, St. Petersburg, 197376, Russia
Mario Filippa Regione Monsarinero 36, 14041 Agliano Terme, Italy
Péter Finy 8000 Székesfehérvår, Zsombolyai u. 56, Hungary
Adam Flakus W. Szafer Institute of Botany, Polish Academy of Sciences, Lubicz 46, 31-512 Krakow, Poland
SimĂłn Fos Facultad de Ciencias BiolĂłgicas, Universitat de ValĂšncia, C/Dr Moliner 50, 46100, Burjasot, Valencia, Spain
Jacques Fournier Las Muros, F. 09420 Rimont, France
André Fraiture Botanic Garden Meise, Nieuwelaan 38, 1860 Meise, Belgium
Paolo Franchi Associazione Micologica Bresadola, Via Alessandro Volta 46, 38123 Trento, Italy
Ana Esperanza Franco Molano Escuela de MicrobiologĂa, Universidad de Antioquia, AA1226, FundaciĂłn Biodiversa Colombia, MedellĂn, Colombia
Gernot Friebes Centre of Natural History, Botany & Mycology, Universalmuseum Joanneum, WeinzöttlstraĂe 16, 8045 Graz, Austria
Andreas Frisch NTNU, University Museum, Norwegian University of Science and Technology, 7491 Trondheim, Norway
Alan Fryday Michigan State University, East Lansing, Michigan 48824, U.S.A.
Giuliana Furci The Fungi Foundation, Paseo Bulnes 79 of. 112A, Santiago, Chile
Ricardo GalĂĄn MĂĄrquez Facultad de BiologĂa, Ciencias Ambientales y QuĂmica, Universidad de AlcalĂĄ, 28805 AlcalĂĄ de Henares, Madrid, Spain
Matteo Garbelotto University of California, 130 Mulford Hall #3114 Berkeley, California 94720, U.S.A.
Joaquina Maria Garcia-Martin Real JardĂn BotĂĄnico-CSIC, Plaza de Murillo 2, 28014, Madrid, Spain
MĂłnica A. GarcĂa OtĂĄlora Herbaria Z+ZT, ETH ZĂŒrich, CHN D37, UniversitĂ€tstr. 16, 8092 ZĂŒrich, Switzerland
Dania GarcĂa SĂĄnchez Universitat Rovira i Virgili, C/ Sant Llorenç 21, 43201 Reus, Tarragona, Spain
Alain Gardiennet 14 rue Roulette, 21260 VĂ©ronnes, France
Sigisfredo Garnica Instituto de BioquĂmica y MicrobiologĂa, Universidad Austral de Chile, Isla Teja Campus, Casilla 567, Valdivia, Chile
Isaac Garrido Benavent Real JardĂn BotĂĄnico-CSIC, Plaza de Murillo 2, 28014, Madrid, Spain
Genevieve Gates Tasmanian Institute of Agriculture, Private Bag 54, Hobart, Tasmania 7001, Australia
Alice da Cruz Lima Gerlach Conservatoire et Jardin Botaniques de la ville de GenĂšve, GenĂšve, Switzerland
Masoomeh Ghobad-Nejhad Iranian Research Organization for Science and Technology, P.O. Box 15815-3538, Tehran 15819, Iran
Tatiana B. Gibertoni Universidade Federal de Pernambuco, Centro de BiociĂȘncias, Avenida da Engenharia, S/N, Cidade UniversitĂĄria, Recife, Pernambuco, Brazil
Tine Grebenc Slovenian Forestry Institute, Vecna pot 2, 100 Ljubljana, Slovenia
Irmgard Greilhuber University of Vienna, Rennweg 14, 1030 Vienna, Austria
Bella Grishkan Institute of Evolution, University of Haifa, Aba Khoushi Ave. 199, Mt. Carmel, Haifa 3498838, Israel
Johannes Z. Groenewald Westerdijk Fungal Biodiversity Institute, P.O. Box 85167, 3508 AD, Utrecht, The Netherlands
Martin Grube Institute of Biology, University of Graz, Holteiasse 6, 8010 Graz, Austria
GĂ©rald Gruhn Office National des ForĂȘts, 2 Avenue de Saint-MandĂ©, 75570 Paris Cedex 12, France
CĂ©cile Gueidan CSIRO â Australian National Herbarium, Clunies Ross Street, Canberra ACT 2601, Australia
Gro Gulden Natural History Museum, University of Oslo, P.O. Box 1172 Blindern, 0318 Oslo, Norway
Luis FP GusmĂŁo Universidade Estadual de Feira de Santana, Av. Transnordestina, s/n, Bairro Novo Horizonte, CEP:44036-900, Feira de Santana, Bahia, Brazil
Josef Hafellner Institute of Biology, University of Graz, Holteiasse 6, 8010 Graz, Austria
Michel Hairaud 2 Impasse des Marronniers, 79360 Poivendre de Marigny, France
Marek Halama Museum of Natural History, WrocĆaw University, ul. H. Sienkiewicza 5, 50-335 WrocĆaw, Poland
Nils Hallenberg University of Gothenburg, Box 461, 40530 Göteborg, Sweden
Roy E. Halling Institute of Systematic Botany, New York Botanical Garden, 2900 Southern Blvd, Bronx, New York 10458-5126, U.S.A.
Karen Hansen Swedish Museum of Natural History, P.O. Box 50007, 104 05 Stockholm, Sweden
Christoffer Bugge Harder Texas Tech University, Box 42122, Lubbock, Texas 79409, U.S.A.
Jacob Heilmann-Clausen Natural History Museum of Denmark, Universitetsparken 15, 2100 KĂžbenhavn, Denmark
Stip Helleman Sweelinck 78, 5831KT Boxmeer, The Netherlands
Alain Henriot Mycological Society of France, 20 rue Rottembourg, 12th arrondissement, Paris, France
Margarita Hernandez-Restrepo Westerdijk Fungal Biodiversity Institute, P.O. Box 85167, 3508 AD, Utrecht, The Netherlands
Raphaël Herve 24 rue des FougÚres, 86550 Mignaloux-Beauvoir, France
Caroline Hobart 84 Stafford Road, Sheffield, South Yorkshire S2 2SF, United Kingdom
Mascha Hoffmeister Julius KĂŒhn-Institut, Institute for Epidemiology and Pathogen Diagnostics, Braunschweig, Germany
Klaus HĂžiland University of Oslo, P.O.Box 1066, Blindern, 0316 Oslo, Norway
Jan Holec National Museum, Herbarium PRM, CirkusovĂĄ 1740, 193 00 Praha 9, Czech Republic
HĂ„kon Holien Faculty of Bioscience and Aquaculture, NORD University, P.O. Box 2501, 7729 Steinkjer, Norway
Karen Hughes University of Tennessee, Knoxville, Tennessee 37996, U.S.A.
Vit Hubka Faculty of Science, Charles University, BenĂĄtskĂĄ 2, 128 01 Praha 2, Czech Republic
Seppo Huhtinen Herbarium TUR, Biodiversity Unit, University of Turku, 20014 Turku, Finland
Boris IvanÄeviÄ Natural History Museum, NjegoĆĄeva 51, P.O. Box 401, 11000 Belgrade, Serbia
Marian Jagers Reelaan 13, 7522 LR Enschede, The Netherlands
Walter Jaklitsch Institute of Forest Entomology, Forest Pathology and Forest Protection, University of Natural Resources and Life Sciences Vienna, Vienna, Austria
AnnaElise Jansen Stationsstraat 10, 6701 AM Wageningen, the Netherlands
Ruvishika S. Jayawardena Mae Fah Luang University, Chang Wat Chiang Rai 57100, Thailand
Thomas Stjernegaard Jeppesen Global Biodiversity Information Facility, Universitetsparken 15, 2100 KĂžbenhavn Ă, Denmark
Mikael Jeppson Lilla HÄjumsgatan 4, 46135 TrollhÀttan, Sweden
Peter Johnston Manaaki Whenua Landcare Research, Private Bag 92170, Auckland 1072, New Zealand
Per Magnus JÞrgensen University of Bergen, Allégaten 41, P.O. Box 7800, 5020 Bergen, Norway
Ingvar KĂ€rnefelt Biological Museum, Lund University, Box 117, 221 00 Lund, Sweden
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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)