Naturaleza y artefacto: operaciones diversas en la construcción de la ribera del Paraná en el tramo san Javier-Coronda

¿Cómo se construyó la ribera fluvial entre las localidades de San Javier y Coronda en la Provincia de Santa Fe (Argentina)? ¿Tuvo en cuenta su vulnerabilidad hídrica? ¿Es este proceso el resultado de una antropización sustentable? Este territorio es una de las áreas de más antigua ocupación de la provincia de Santa Fe. En el siglo XVI (1573) se establece Santa Fe La Vieja (actual parque arqueológico de Cayastá), la ciudad fundada por Juan de Garay que se trasladó en el siglo XVII a su actual emplazamiento con el nombre de Santa Fe de la Vera Cruz. Esta ciudad fue el epicentro de distintos intentos de domesticación del territorio que incluyen reducciones, fuertes y estancias, situación que terminó confluyendo en el siglo XIX en la creación de colonias agrícolas, o en la conversión de pueblos en colonias. La ciudad de Coronda, por su parte, no fue ajena a este proceso y se definió como un centro poblado, primero vinculado a la pacificación del territorio provincial en el siglo XVIII y, más tarde, a la administración departamental, a la producción frutihortícola y al desarrollo de la cárcel modelo. En los siglos XX y XXI las ciudades que ocupan esta franja del territorio santafesino han ido cambiando sus dimensiones y actividades productivas pero lo que se ha mantenido inalterado es su alta vulnerabilidad hídrica dado que se desarrollan en la planicie de inundación del río Paraná por lo que, en su concepción, se han reflejado distintos paradigmas de intervención, algunos más respetuosos del paisaje y las dinámicas naturales y otros más agresivos y transformadores. Se recupera aquí la idea del rizoma como estructura resiliente para el tramo La Guardia – San Javier (Bertuzzi, 2015), se sostiene que esa estructura es aplicable para el tramo Santo Tomé – Coronda y se identifican las estrategias de antropización del paisaje, valorizando aquellas que suponen una mayor resiliencia, conservación del mismo y construcción de calidad paisajística.How was the river bank built between the towns of San Javier and Coronda in the Province of Santa Fe (Argentina)? Did it take into account its water vulnerability? Is this process the result of sustainable anthropization? This territory is one of the oldest occupied areas of the province of Santa Fe. In the XVI century (1573) Santa Fe La Vieja (current Cayastá) is established, the city founded by Juan de Garay that moved in the seventeenth century to its current location with the name of Santa Fe de la Vera Cruz. This city was the epicenter of various attempts to domesticate the territory that include indian reservations, forts and agricultural quarters, situation that ended up coming together in the 19th century in the creation of agricultural colonies, or in the conversion of small villages into colonies.The city of Coronda was not alien to this process and was defined as a populated center, first linked to the pacification of the provincial territory in the 18th century and, later, to the departmental administration, to fruit and vegetable production and to the development of the model prison. In the 20th and 21st centuries, the cities that occupy this stretch of Santa Fe's territory have been changing their size and productive activities but what has remained unchanged is their high water vulnerability since they develop in the flood plain of the Paraná River. In its conception, different intervention paradigms have been reflected, some more respectful of the landscape and the natural dynamics and others more aggressive and transformative. The idea of the rhizome is recovered as a resilient structure for the section La Guardia - San Javier (Bertuzzi, 2015), it is argued that this structure is applicable for the Santo Tomé - Coronda stretch and the strategies of anthropization of the landscape are identified, valuing those that suppose a greater resilience, conservation and construction of landscape quality.Mesa 1: Historia de las relaciones entre lo urbano y lo fluvialUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU

Naturaleza y artefacto: operaciones diversas en la construcción de la ribera del Paraná en el tramo san Javier-Coronda

¿Cómo se construyó la ribera fluvial entre las localidades de San Javier y Coronda en la Provincia de Santa Fe (Argentina)? ¿Tuvo en cuenta su vulnerabilidad hídrica? ¿Es este proceso el resultado de una antropización sustentable? Este territorio es una de las áreas de más antigua ocupación de la provincia de Santa Fe. En el siglo XVI (1573) se establece Santa Fe La Vieja (actual parque arqueológico de Cayastá), la ciudad fundada por Juan de Garay que se trasladó en el siglo XVII a su actual emplazamiento con el nombre de Santa Fe de la Vera Cruz. Esta ciudad fue el epicentro de distintos intentos de domesticación del territorio que incluyen reducciones, fuertes y estancias, situación que terminó confluyendo en el siglo XIX en la creación de colonias agrícolas, o en la conversión de pueblos en colonias. La ciudad de Coronda, por su parte, no fue ajena a este proceso y se definió como un centro poblado, primero vinculado a la pacificación del territorio provincial en el siglo XVIII y, más tarde, a la administración departamental, a la producción frutihortícola y al desarrollo de la cárcel modelo. En los siglos XX y XXI las ciudades que ocupan esta franja del territorio santafesino han ido cambiando sus dimensiones y actividades productivas pero lo que se ha mantenido inalterado es su alta vulnerabilidad hídrica dado que se desarrollan en la planicie de inundación del río Paraná por lo que, en su concepción, se han reflejado distintos paradigmas de intervención, algunos más respetuosos del paisaje y las dinámicas naturales y otros más agresivos y transformadores. Se recupera aquí la idea del rizoma como estructura resiliente para el tramo La Guardia – San Javier (Bertuzzi, 2015), se sostiene que esa estructura es aplicable para el tramo Santo Tomé – Coronda y se identifican las estrategias de antropización del paisaje, valorizando aquellas que suponen una mayor resiliencia, conservación del mismo y construcción de calidad paisajística.How was the river bank built between the towns of San Javier and Coronda in the Province of Santa Fe (Argentina)? Did it take into account its water vulnerability? Is this process the result of sustainable anthropization? This territory is one of the oldest occupied areas of the province of Santa Fe. In the XVI century (1573) Santa Fe La Vieja (current Cayastá) is established, the city founded by Juan de Garay that moved in the seventeenth century to its current location with the name of Santa Fe de la Vera Cruz. This city was the epicenter of various attempts to domesticate the territory that include indian reservations, forts and agricultural quarters, situation that ended up coming together in the 19th century in the creation of agricultural colonies, or in the conversion of small villages into colonies.The city of Coronda was not alien to this process and was defined as a populated center, first linked to the pacification of the provincial territory in the 18th century and, later, to the departmental administration, to fruit and vegetable production and to the development of the model prison. In the 20th and 21st centuries, the cities that occupy this stretch of Santa Fe's territory have been changing their size and productive activities but what has remained unchanged is their high water vulnerability since they develop in the flood plain of the Paraná River. In its conception, different intervention paradigms have been reflected, some more respectful of the landscape and the natural dynamics and others more aggressive and transformative. The idea of the rhizome is recovered as a resilient structure for the section La Guardia - San Javier (Bertuzzi, 2015), it is argued that this structure is applicable for the Santo Tomé - Coronda stretch and the strategies of anthropization of the landscape are identified, valuing those that suppose a greater resilience, conservation and construction of landscape quality.Mesa 1: Historia de las relaciones entre lo urbano y lo fluvialUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU

Modalidades de ocupación y posibilidades de crecimiento futuro en el área metropolitana de Santa Fe, Sauce Viejo-Arroyo Leyes

El área de estudio de este trabajo se circunscribe al tramo comprendido entre Sauce Viejo y Arroyo Leyes, en la denominada Área Metropolitana Santa Fe (Argentina). Las localidades que la integran se encuentran ubicadas en la planicie de inundación del río Paraná, por lo tanto, en sus procesos de crecimiento ha sido sustancial su relación con diversos cuerpos de agua y otras formaciones propias de esta geografía. En el desarrollo del conocimiento sobre el área se plantea el siguiente interrogante: ¿cómo se relaciona el Área Metropolitana de Santa Fe con los cuerpos de agua que la circundan? Para ello es indispensable construir información cartográfica que habilite el cruce de datos censales, físicos y legales y posibilitar así un abordaje sensible de las problemáticas que lo atraviesan. Este trabajo reconoce y enumera esas problemáticas (entre ellas, el crecimiento poblacional de las ciudades centrales, la absorción de ese crecimiento por parte de las localidades vecinas, la transformación de los usos del suelo, la escasez de información geográfica vinculada al tema), a la vez que avanza sobre la construcción de cartografía a partir de diversas fuentes consultadas.The study area of this work is limited to the section between Sauce Viejo and Arroyo Leyes, in the so-called Santa Fe Metropolitan Area (Argentina). The cities that integrate it are located in the flood plain of the Paraná River, therefore, in its growth processes has been substantial its relationship with various bodies of water and other formations in this geography. In the development of knowledge about the area the following question arises: How does the Metropolitan Area of Santa Fe relate to the bodies of water that surround it? For this it is essential the construction of cartographic information that enables the crossing of census, physical and legal data; and thus enable a sensitive approach to the problems that run through it. This work recognizes and lists these problems (among them, the population growth of the central cities, the absorption of that growth by neighboring cities, the modification of land uses, the scarcity of geographic information linked to the topic). At the same time, it advances on the construction of cartography from different sources consulted.Mesa 2: Gestión de los territorios fluviales en áreas urbanas y periurbanasUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU

Naturaleza y artefacto: operaciones diversas en la construcción de la ribera del Paraná en el tramo san Javier-Coronda

¿Cómo se construyó la ribera fluvial entre las localidades de San Javier y Coronda en la Provincia de Santa Fe (Argentina)? ¿Tuvo en cuenta su vulnerabilidad hídrica? ¿Es este proceso el resultado de una antropización sustentable? Este territorio es una de las áreas de más antigua ocupación de la provincia de Santa Fe. En el siglo XVI (1573) se establece Santa Fe La Vieja (actual parque arqueológico de Cayastá), la ciudad fundada por Juan de Garay que se trasladó en el siglo XVII a su actual emplazamiento con el nombre de Santa Fe de la Vera Cruz. Esta ciudad fue el epicentro de distintos intentos de domesticación del territorio que incluyen reducciones, fuertes y estancias, situación que terminó confluyendo en el siglo XIX en la creación de colonias agrícolas, o en la conversión de pueblos en colonias. La ciudad de Coronda, por su parte, no fue ajena a este proceso y se definió como un centro poblado, primero vinculado a la pacificación del territorio provincial en el siglo XVIII y, más tarde, a la administración departamental, a la producción frutihortícola y al desarrollo de la cárcel modelo. En los siglos XX y XXI las ciudades que ocupan esta franja del territorio santafesino han ido cambiando sus dimensiones y actividades productivas pero lo que se ha mantenido inalterado es su alta vulnerabilidad hídrica dado que se desarrollan en la planicie de inundación del río Paraná por lo que, en su concepción, se han reflejado distintos paradigmas de intervención, algunos más respetuosos del paisaje y las dinámicas naturales y otros más agresivos y transformadores. Se recupera aquí la idea del rizoma como estructura resiliente para el tramo La Guardia – San Javier (Bertuzzi, 2015), se sostiene que esa estructura es aplicable para el tramo Santo Tomé – Coronda y se identifican las estrategias de antropización del paisaje, valorizando aquellas que suponen una mayor resiliencia, conservación del mismo y construcción de calidad paisajística.How was the river bank built between the towns of San Javier and Coronda in the Province of Santa Fe (Argentina)? Did it take into account its water vulnerability? Is this process the result of sustainable anthropization? This territory is one of the oldest occupied areas of the province of Santa Fe. In the XVI century (1573) Santa Fe La Vieja (current Cayastá) is established, the city founded by Juan de Garay that moved in the seventeenth century to its current location with the name of Santa Fe de la Vera Cruz. This city was the epicenter of various attempts to domesticate the territory that include indian reservations, forts and agricultural quarters, situation that ended up coming together in the 19th century in the creation of agricultural colonies, or in the conversion of small villages into colonies.The city of Coronda was not alien to this process and was defined as a populated center, first linked to the pacification of the provincial territory in the 18th century and, later, to the departmental administration, to fruit and vegetable production and to the development of the model prison. In the 20th and 21st centuries, the cities that occupy this stretch of Santa Fe's territory have been changing their size and productive activities but what has remained unchanged is their high water vulnerability since they develop in the flood plain of the Paraná River. In its conception, different intervention paradigms have been reflected, some more respectful of the landscape and the natural dynamics and others more aggressive and transformative. The idea of the rhizome is recovered as a resilient structure for the section La Guardia - San Javier (Bertuzzi, 2015), it is argued that this structure is applicable for the Santo Tomé - Coronda stretch and the strategies of anthropization of the landscape are identified, valuing those that suppose a greater resilience, conservation and construction of landscape quality.Mesa 1: Historia de las relaciones entre lo urbano y lo fluvialUniversidad Nacional de La Plata (UNLP) - Facultad de Arquitectura y Urbanismo (FAU

Overall Survival with Adjuvant Pembrolizumab in Renal-Cell Carcinoma

BackgroundAdjuvant pembrolizumab therapy after surgery for renal-cell carcinoma was approved on the basis of a significant improvement in disease-free survival in the KEYNOTE-564 trial. Whether the results regarding overall survival from the third prespecified interim analysis of the trial would also favor pembrolizumab was uncertain.MethodsIn this phase 3, double-blind, placebo-controlled trial, we randomly assigned (in a 1:1 ratio) participants with clear-cell renal-cell carcinoma who had an increased risk of recurrence after surgery to receive pembrolizumab (at a dose of 200 mg) or placebo every 3 weeks for up to 17 cycles (approximately 1 year) or until recurrence, the occurrence of unacceptable toxic effects, or withdrawal of consent. A significant improvement in disease-free survival according to investigator assessment (the primary end point) was shown previously. Overall survival was the key secondary end point. Safety was a secondary end point.Download a PDF of the Research Summary.ResultsA total of 496 participants were assigned to receive pembrolizumab and 498 to receive placebo. As of September 15, 2023, the median follow-up was 57.2 months. The disease-free survival benefit was consistent with that in previous analyses (hazard ratio for recurrence or death, 0.72; 95% confidence interval [CI], 0.59 to 0.87). A significant improvement in overall survival was observed with pembrolizumab as compared with placebo (hazard ratio for death, 0.62; 95% CI, 0.44 to 0.87; P=0.005). The estimated overall survival at 48 months was 91.2% in the pembrolizumab group, as compared with 86.0% in the placebo group; the benefit was consistent across key subgroups. Pembrolizumab was associated with a higher incidence of serious adverse events of any cause (20.7%, vs. 11.5% with placebo) and of grade 3 or 4 adverse events related to pembrolizumab or placebo (18.6% vs. 1.2%). No deaths were attributed to pembrolizumab therapy.ConclusionsAdjuvant pembrolizumab was associated with a significant and clinically meaningful improvement in overall survival, as compared with placebo, among participants with clear-cell renal-cell carcinoma at increased risk for recurrence after surgery. (Funded by Merck Sharp and Dohme, a subsidiary of Merck; KEYNOTE-564 ClinicalTrials.gov number, NCT03142334.

Adjuvant Pembrolizumab after Nephrectomy in Renal-Cell Carcinoma

BACKGROUND: Patients with renal-cell carcinoma who undergo nephrectomy have no options for adjuvant therapy to reduce the risk of recurrence that have high levels of supporting evidence. METHODS: In a double-blind, phase 3 trial, we randomly assigned, in a 1:1 ratio, patients with clear-cell renal-cell carcinoma who were at high risk for recurrence after nephrectomy, with or without metastasectomy, to receive either adjuvant pembrolizumab (at a dose of 200 mg) or placebo intravenously once every 3 weeks for up to 17 cycles (approximately 1 year). The primary end point was disease-free survival according to the investigator's assessment. Overall survival was a key secondary end point. Safety was a secondary end point. RESULTS: A total of 496 patients were randomly assigned to receive pembrolizumab, and 498 to receive placebo. At the prespecified interim analysis, the median time from randomization to the data-cutoff date was 24.1 months. Pembrolizumab therapy was associated with significantly longer disease-free survival than placebo (disease-free survival at 24 months, 77.3% vs. 68.1%; hazard ratio for recurrence or death, 0.68; 95% confidence interval [CI], 0.53 to 0.87; P = 0.002 [two-sided]). The estimated percentage of patients who remained alive at 24 months was 96.6% in the pembrolizumab group and 93.5% in the placebo group (hazard ratio for death, 0.54; 95% CI, 0.30 to 0.96). Grade 3 or higher adverse events of any cause occurred in 32.4% of the patients who received pembrolizumab and in 17.7% of those who received placebo. No deaths related to pembrolizumab therapy occurred. CONCLUSIONS: Pembrolizumab treatment led to a significant improvement in disease-free survival as compared with placebo after surgery among patients with kidney cancer who were at high risk for recurrence. (Funded by Merck Sharp and Dohme, a subsidiary of Merck; KEYNOTE-564 ClinicalTrials.gov number, NCT03142334.)

Evidence of response to pembrolizumab in a patient with Lynch syndrome-related metastatic colon cancer

Pamela Salman,1 Sergio Panay,1 René Fernández,2 Mauricio Mahave,1 Cristian Soza-Ried1 1Department of Medical Oncology, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile; 2Department of Nuclear Medicine, Instituto Oncológico Fundación Arturo López Pérez, Santiago, Chile Abstract: Patients with Lynch Syndrome (LS) are at high risk of developing colorectal cancer at an early age. Germline mutations in DNA mismatch repair genes and microsatellite instability are clear signatures of this autosomal dominant disorder. Here, we report the clinical history of a 38-year-old patient with LS-related metastatic colon cancer treated in Chile with immunotherapy (pembrolizumab). The patient exhibited a pathogenic deletion in Epithelial cell Adhesion Molecule (EPCAM) and mutS homolog 2 (MSH2) genes, and after diagnosis received 12 cycles of FOLFOX. The tumor mass, however, continued to grow, and a new metastatic mucinous adenocarcinoma of 13 mm appeared at the level of the 11th right dorsal vertebra. To treat these lesions, the patient received immunotherapy scheme with pembrolizumab (200 mg every 21 days). After only four cycles, the patient’s symptoms improved and the lesions showed less metabolic activity. After 12 cycles with pembrolizumab, the patient started palliative radiation and systemic second-line treatment with FOLFIRI and Avastin. The immunotherapy scheme with pembrolizumab was capable of delaying the second-line treatment for at least 8 months, becoming a useful therapeutic option for this patient. Thus, our study highlights the importance of implementing immunotherapy treatment programs for LS-colorectal cancer patients in South American countries. Keywords: immunotherapy, DNA mismatch repair proteins, EPCAM, MSH

Systemic and Intracranial Outcomes With First-Line Nivolumab Plus Ipilimumab in Patients With Metastatic NSCLC and Baseline Brain Metastases From CheckMate 227 Part 1.

In CheckMate 227 Part 1, nivolumab plus ipilimumab prolonged overall survival (OS) versus chemotherapy in patients with metastatic NSCLC, regardless of tumor programmed death-ligand 1 (PD-L1) expression. Here, we report post hoc exploratory systemic and intracranial efficacy outcomes and safety by baseline brain metastasis status at 5 years' minimum follow-up. Treatment-naive adults with stage IV or recurrent NSCLC without EGFR or ALK alterations, including asymptomatic patients with treated brain metastases, were enrolled. Patients with tumor PD-L1 greater than or equal to 1% were randomized to nivolumab plus ipilimumab, nivolumab, or chemotherapy; patients with tumor PD-L1 less than 1% were randomized to nivolumab plus ipilimumab, nivolumab plus chemotherapy, or chemotherapy groups. Assessments included OS, systemic and intracranial progression-free survival per blinded independent central review, new brain lesion development, and safety. Brain imaging was performed at baseline (all randomized patients) and approximately every 12 weeks thereafter (patients with baseline brain metastases only). Overall, 202 of 1739 randomized patients had baseline brain metastases (nivolumab plus ipilimumab: 68; chemotherapy: 66). At 61.3 months' minimum follow-up, nivolumab plus ipilimumab prolonged OS versus chemotherapy in patients with baseline brain metastases (hazard ratio = 0.63; 95% confidence interval: 0.43-0.92) and in those without (hazard ratio = 0.76; 95% confidence interval: 0.66-0.87). In patients with baseline brain metastases, 5-year systemic and intracranial progression-free survival rates were higher with nivolumab plus ipilimumab (12% and 16%, respectively) than chemotherapy (0% and 6%). Fewer patients with baseline brain metastases developed new brain lesions with nivolumab plus ipilimumab (4%) versus chemotherapy (20%). No new safety signals were observed. With all patients off immunotherapy for more than or equal to 3 years, nivolumab plus ipilimumab continued to provide a long-term, durable survival benefit in patients with or without brain metastases. Intracranial efficacy outcomes favored nivolumab plus ipilimumab versus chemotherapy. These results further support nivolumab plus ipilimumab as an efficacious first-line treatment for patients with metastatic NSCLC, regardless of baseline brain metastasis status

Seroconversion and Abundance of IgG Antibodies against S1-RBD of SARS-CoV-2 and Neutralizing Activity in the Chilean Population

COVID-19 is a pandemic caused by SARS-CoV-2. In Chile, half a million people have been infected and more than 16,000 have died from COVID-19. As part of the clinical trial NCT04384588, we quantified IgG against S1-RBD of SARS-CoV-2 (anti-RBD) in recovered people in Santiago and evaluated their suitability as COVID-19 convalescent plasma donors. ELISA and a luminescent SARS-CoV-2 pseudotype were used for IgG and neutralizing antibody quantification. 72.9% of the convalescent population (468 of 639) showed seroconversion (5-55 μg/mL anti-RBD IgG) and were suitable candidates for plasma donation. Analysis by gender, age, and days after symptom offset did not show significant differences. Neutralizing activity correlated with an increased concentration of anti-RBD IgG (p<0.0001) and showed a high variability between donors. We confirmed that the majority of the Chilean patients have developed anti-SARS-CoV-2 antibodies. The quantification of anti-RBD IgG in convalescent plasma donors is necessary to increase the detection of neutralizing antibodies