Guía para escribir con claridad en la Administración

Guía elaborada por la Cátedra Rafael del Riego de Buen Gobierno dependiente de la Universidad de Oviedo, en colaboración con la Dirección General de de Gobernanza Pública, Transparencia, Participación Ciudadana y Agenda 2030. Dirección y ejecución del proyecto: Eva Mª Menéndez Sebastián, Directora de la Cátedra Rafael del Riego de Buen Gobierno de la Universidad de Oviedo. Con la colaboración de: Grupo de investigación del Proyecto «La ciudadanía digital y su reflejo administrativo/Digital citizenship: administrative implications», ref. TED2021-129283B-I00, financiado por MCIN/AEI/10.13039/501100011033 y la Unión Europea NextGenerationEU/PRTR

Outcomes of COVID-19 in peritoneal dialysis patients: A report by the European Renal Association COVID-19 Database

Abstract Background: The clinical course of COVID-19 in peritoneal dialysis (PD) patients has so far only been analysed in relatively small, often single-centre case series. Therefore, we studied patient- and disease-related characteristics and outcomes of COVID-19 in a larger European cohort of PD patients. Methods: We used data from the European Renal Association COVID-19 Database (ERACODA) on PD and haemodialysis (HD) patients with COVID-19 (presentation between February 2020 and April 2021). Hazard ratios (HR) for mortality at 3 months were calculated using Cox proportional-hazards regression. In addition, we examined functional and mental health status among survivors at this time point as determined by their treating physician. Results: Of 216 PD patients with COVID-19, 80 (37%) were not hospitalised and 136 (63%) were hospitalised, of whom 19 (8.8%) were admitted to an intensive care unit. Mortality at 3 months for these subgroups was 18%, 40%, and 37%, respectively (p ¼ 0.0031). Compared with HD patients, PD patients had higher mortality (crude HR: 1.49; 95% CI: 1.33–1.66), even when adjusted for patient characteristics and disease severity (adjusted HR: 1.56; 95% CI: 1.39–1.75). Follow-up data on 67 of 146 patients who survived COVID-19 showed functional recovery to pre-COVID-19 levels in 52 (78%) and mental recovery in 58 patients (87%) at 3 months after the COVID-19 diagnosis.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

The secretome atlas of two mouse models of progeria

Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic disease caused by nuclear envelope alterations that lead to accelerated aging and premature death. Several studies have linked health and longevity to cell-extrinsic mechanisms, highlighting the relevance of circulating factors in the aging process as well as in age-related diseases. We performed a global plasma proteomic analysis in two preclinical progeroid models (LmnaG609G/G609G and Zmpste24−/− mice) using aptamer-based proteomic technology. Pathways related to the extracellular matrix, growth factor response and calcium ion binding were among the most enriched in the proteomic signature of progeroid samples compared to controls. Despite the global downregulation trend found in the plasma proteome of progeroid mice, several proteins associated with cardiovascular disease, the main cause of death in HGPS, were upregulated. We also developed a chronological age predictor using plasma proteome data from a cohort of healthy mice (aged 1–30 months), that reported an age acceleration when applied to progeroid mice, indicating that these mice exhibit an “old” plasma proteomic signature. Furthermore, when compared to naturally-aged mice, a great proportion of differentially expressed circulating proteins in progeroid mice were specific to premature aging, highlighting secretome-associated differences between physiological and accelerated aging. This is the first large-scale profiling of the plasma proteome in progeroid mice, which provides an extensive list of candidate circulating plasma proteins as potential biomarkers and/or therapeutic targets for further exploration and hypothesis generation in the context of both physiological and premature aging.European Research Council. Grant Number: 742067 Ministerio de Ciencia e Innovación. Grant Numbers: PDI2020-118394RB-100, PID2021-126372OB-I00, RTI2018-096479-A-I00, SAF2017-87811-

Chronic Kidney Disease–Associated Pruritus and Quality of Life: Learning from Our Patients

Chronic kidney disease–associated pruritus is itching directly related to kidney disease that cannot be explained by any other condition. Despite technological advances in the different aspects of dialysis sessions and the best treatment for chronic kidney disease patients, it is still a common problem in our patients. The many complex physiological mechanisms involved, the different hypotheses made over the years on the aetiology of the condition, and the great clinical variability may partially explain the limited knowledge about this problem and the difficulties in treating it. The presence of all these factors leads to the persistence of unpleasant symptoms, which must affect the disease burden and quality of life of kidney patients. Through the presentation of an illustrative clinical case, the aim of this review article is to highlight the need for adequate diagnosis and an improved approach to all aspects of chronic kidney disease–associated pruritus, in view of the heavy burden of the disease and the huge impact on the patient’s quality of life.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

Serum phosphate is associated with increased risk of bone fragility fractures in haemodialysis patients

Background. Bone fragility fractures are associated with high morbidity and mortality. This study analysed the association between the current biochemical parameters of chronic kidney disease–mineral and bone disorders (CKD-MBD) and bone fragility fractures in the COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) project. Methods. COSMOS is a 3-year, multicentre, open cohort, prospective, observational study carried out in 6797 haemodialysis patients (227 centres from 20 European countries). The association of bone fragility fractures (outcome) with serum calcium, phosphate and parathyroid hormone (PTH) (exposure), was assessed using standard Cox proportional hazards regression and Cox proportional haz- ards regression for recurrent events. Additional analyses were performed considering all-cause mortality as a competitive event for bone fragility fracture occurrence. Multivariable models were used in all strategies, with the fully adjusted model including a total of 24 variables. Results. During a median follow-up of 24 months, 252 (4%) patients experienced at least one bone fragility fracture (incident bone fragility fracture rate 28.5 per 1000 patient-years). In the fractured and non-fractured patients, the percentage of men was 43.7% and 61.4%, mean age 68.1 and 63.8 years and a haemodialysis vintage of 55.9 and 38.3 months, respectively. Baseline serum phosphate > 6.1 mg/dL (reference value 4.3–6.1 mg/dL) was significantly associated with a higher bone fragility fracture risk in both regression models {hazard ratio (HR) 1.53 [95% confidence interval (CI) 1.10–2.13] and HR 1.44 (95% CI 1.02–2.05)}. The significant association persisted after competitive risk analysis [subHR 1.42 (95% CI 1.02–1.98)] but the finding was not confirmed when serum phosphate was considered as a continuous variable. Baseline serum calcium showed no association with bone fragility fracture risk in any regression model. Baseline serum PTH > 800 pg/mL was significantly associated with a higher bone fragility fracture risk in both regression models, but the association disappeared after a competitive risk analysis. Conclusions. Hyperphosphatemia was independently and consistently associated with an increased bone fracture risk, suggesting serum phosphate could be a novel risk factor for bone fractures in haemodialysis patients.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

Hospital surge capacity preparedness in disasters and emergencies: a systematic review

Abstract Background: Adequate and effective emergency preparedness for hospital surge capacity is a prerequisite to ensuring standard healthcare services for disaster victims. This study aimed to identify, review, and synthesize the preparedness activities for and the barriers to hospital surge capacity in disasters and emergencies. Methods: We systematically searched seven databases (PubMed, MEDLINE, CINAHL, Scopus, Embase, Ovid, and PsycINFO). We included all English peer-reviewed studies published in January 2016 and July 2022 on surge capacity preparedness in hospital settings. Two independent researchers screened titles and abstracts, reviewed the full texts, and conducted data extractions using CADIMA software. We assessed the rigor of the included studies using the NIH quality assessment tools for quantitative studies, the Noyes et al. guidelines for qualitative studies, and the MMAT tool for mixed methods studies and summarized findings using the narrative synthesis method. We also used PRISMA reporting guidelines. Results: From the 2560 studies identified, we finally include 13 peer-reviewed studies: 10 quantitative, one qualitative, and two mixed methods. Five studies were done in the USA, three in Iran (n ¼ 3), and the remaining in Australia, Pakistan, Sweden, Taiwan, and Tanzania. The study identified various ways to increase hospital surge capacity preparedness in all four domains (staff, stuff, space, and system); among them, the use of the Hospital Medical Surge Preparedness Index and the Surge Simulation Tool for surge planning was noteworthy. Moreover, nine studies (69%) recognized several barriers to hospital surge capacity preparedness. Conclusion: The review provides synthesized evidence of contemporary literature on strategies for and barriers to hospital surge capacity preparedness. Despite the risk of selection bias due to the omission of gray literature, the study findings could help hospital authorities, public health workers, and policymakers to develop effective plans and programs for improving hospital surge capacity preparedness with actions, such as enhancing coordination, new or adapted flows of patients, disaster planning implementation, or the development of specific tools for surge capacity.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

Guía de respuesta a solicitudes de acceso a información pública (SAIP)

Guía elaborada por la Universidad de Oviedo en colaboración con la Dirección General de de Gobernanza Pública, Transparencia, Participación Ciudadana y Agenda 2030 y coordinada por Eva Menéndez Sebastián.La Administración del Principado de Asturias y su sector público tienen un firme compromiso con la ciudadanía y con la denominada gobernanza pública, una nueva forma de gestión pública que trata de dar respuesta a la idea de una relación entre sociedad y poderes públicos renovada, basada en la transparencia, la ética pública, la participación, la rendición de cuentas, la eficiencia y eficacia, la innovación y, especialmente, la igualdad e inclusión. En este contexto un pilar fundamental de esa nueva relación es el acceso a la información pública, pues ello permite que los/as ciudadanos/as conozcan a la Administración, qué está haciendo, pueden valorar si su actuación es correcta, pueden participar con criterio en la acción pública, etc. En definitiva, la transparencia es en cierto modo el presupuesto básico o elemento que conecta en gran medida los otros aspectos clave de un buen gobierno y de una Administración eficaz y responsable (ética pública, participación, rendición de cuentas, etc.).En esta dirección el Principado de Asturias cuenta con un portal de transparencia que ha sido el mejor valorado entre todas las páginas de las Administraciones públicas en la evaluación realizada por el CTBG de España (en adelante CTBG) en los últimos años. No obstante, junto a la transparencia pasiva que es a la que responde el portal de transparencia, también es preciso atender a la transparencia activa, es decir, aquella que da respuesta al ejercicio del derecho de acceso a la información pública. En aras de mejorar esa respuesta y facilitar la labor que a este respecto lleva a cabo el personal encargado de estas solicitudes, se ofrece aquí una guía básica con conceptos, criterios y modelos que permitan alcanzar una mayor seguridad jurídica y uniformidad en el ejercicio de esta función

Las células senescentes como factores patogénicos y posibles dianas terapéuticas en osteoporosis

Cellular senescence is a process induced by various types of stress that irreversibly cause cell cycle arrest and changes to the characteristics and functionality of cells, as well as the acquisition of a secretory phenotype that generates a pro-in-flammatory environment. While, in certain contexts, it is beneficial for tissues and promotes organism development, senes-cence is a cellular fate implicated in the process of aging and age-related degenerative conditions. Senolytics are drugs that specifically eliminate senescent cells, and senomorphics are drugs that suppress their senescence-associated secretory phenotype (SASP) without inducing cell death. Therefore, therapeutic strategies targeting senescent cells (senolytics and senomorphics) as an underlying mechanism of aging emerge as an alternative with great potential to fight age-related diseases as a whole rather than individually. One of these conditions is osteoporosis where it has been experimentally described that drugs such as zoledronic acid have effects on preosteoblasts and act on senescent cells extending survival and opening up the possibility of treating age-related diseases with drugs already used in practice, which may have effects beyond the bone itself and increase overall survival. In this study, a review will be conducted in this rapidly growing field in recent years of undeniable translational interest.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

Plan de Acción de Gobierno Abierto 2022-2023 (Presentación)

El pasado mes de mayo de 2022, el Principado de Asturias se incorporó a la Alianza para el Gobierno Abierto Local (OGP, por las siglas del inglés Open Government Partnership), una organización que incluye a más de un centenar de gobiernos de todo el mundo que trabajan con organizaciones de la sociedad civil para promover la transparencia y la rendición de cuentas e impulsar una gestión pública participativa, inclusiva y responsable. Formar parte de esta alianza internacional supone la renovación del compromiso de esta administración para seguir avanzando en materia de gobernanza pública, con el firme propósito de ser cada vez más transparente, colaborativa, participativa, ética y con una clara vocación de rendición de cuentas a la ciudadanía

Klotho, Oxidative Stress, and Mitochondrial Damage in Kidney Disease

Abstract: Reducing oxidative stress stands at the center of a prevention and control strategy for mitigating cellular senescence and aging. Kidney disease is characterized by a premature aging syndrome, and to find a modulator targeting against oxidative stress, mitochondrial dysfunction, and cellular senescence in kidney cells could be of great significance to prevent and control the progression of this disease. This review focuses on the pathogenic mechanisms related to the appearance of oxidative stress damage and mitochondrial dysfunction in kidney disease. In this scenario, the anti-aging Klotho protein plays a crucial role by modulating signaling pathways involving the manganese-containing superoxide dismutase (Mn-SOD) and the transcription factors FoxO and Nrf2, known antioxidant systems, and other known mitochondrial function regulators, such as mitochondrial uncoupling protein 1 (UCP1), B-cell lymphoma-2 (BCL-2), Wnt/ -catenin, peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1 alpha), transcription factor EB, (TFEB), and peroxisome proliferator-activated receptor gamma (PPAR-gamma). Therefore, Klotho is postulated as a very promising new target for future therapeutic strategies against oxidative stress, mitochondria abnormalities, and cellular senescence in kidney disease patients.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA