A new methodology incorporating public participation within Cuba's ICZM program

Although public participation (PP) has influenced some integrated coastal zone management (ICZM) programs around the world, researchers have rarely analyzed this component specifically inside an ICZM cycle. Furthermore, the approach for integrating environmental energy planning tools within the ICZM Programs for the Small Island Developing States (SIDS) has presented an ongoing challenge for specialists involved in management issues. In Cuba, plans for coastal development are supported by land use planning activities and environmental planning tools. However, the functions and outputs of those tools are “non-obvious”, precluding sufficient integration among them. As these aforementioned actions have not been systematically carried out in the Cuban territory, and the systems of inter-institutional relationships with local communities have presented some insufficiencies, the national marine-terrestrial interphase has suffered some negative environmental impacts impossible to be solved by the national authorities. Designing a new methodology that incorporates PP and environmental energy planning tools in the stages of an ICZM program is the objective of this article. The methodology was named MePuPa and has improved current tools for land use planning and ICZM in Cuba. Previously selected “Local Indicators of Environmental Sustainability”, applied in two geo-systemic units in the southeastern region of Cuba, were used to demonstrate the methodology. The qualitative and qualitative methods in the proposed MePuPa were also applied. Finally, the MePuPa methodology was tested for four of its five stages. Six advantages and five learned lessons were identified during the Preparation to Proposal stages. MePuPa resulted in a useful local management tool for environmental energy planning, ICZM, economic and agricultural activities, strategic ecosystems recovery, as well as improvements to the governance and decision-making processes in one SIDS

The Use of Corticosteroids or Tocilizumab in COVID-19 Based on Inflammatory Markers

SEMI-COVID-19 Network.[Background] The inflammatory cascade is the main cause of death in COVID-19 patients. Corticosteroids (CS) and tocilizumab (TCZ) are available to treat this escalation but which patients to administer it remains undefined.[Objective] We aimed to evaluate the efficacy of immunosuppressive/anti-inflammatory therapy in COVID-19, based on the degree of inflammation. .[Design] A retrospective cohort study with data on patients collected and followed up from March 1st, 2020, to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Patients under treatment with CS vs. those under CS plus TCZ were compared. Effectiveness was explored in 3 risk categories (low, intermediate, high) based on lymphocyte count, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and d-dimer values.[Patients] A total of 21,962 patients were included in the Registry by May 2021. Of these, 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ).[Main Measures] The primary outcome of the study was in-hospital mortality. Secondary outcomes were the composite variable of in-hospital mortality, requirement for high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission.[Key Results] A total of 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). No significant differences were observed in either the low/intermediate-risk category (1.5% vs. 7.4%, p=0.175) or the high-risk category (23.1% vs. 20%, p=0.223) after propensity score matching. A statistically significant lower mortality was observed in the very high–risk category (31.9% vs. 23.9%, p=0.049).[Conclusions] The prescription of CS alone or in combination with TCZ should be based on the degrees of inflammation and reserve the CS plus TCZ combination for patients at high and especially very high risk.Peer reviewe

Autoimmune Diseases and COVID-19 as Risk Factors for Poor Outcomes: Data on 13,940 Hospitalized Patients from the Spanish Nationwide SEMI-COVID-19 Registry

(1) Objectives: To describe the clinical characteristics and clinical course of hospitalized patients with COVID-19 and autoimmune diseases (ADs) compared to the general population. (2) Methods: We used information available in the nationwide Spanish SEMI-COVID-19 Registry, which retrospectively compiles data from the first admission of adult patients with COVID-19. We selected all patients with ADs included in the registry and compared them to the remaining patients. The primary outcome was all-cause mortality during admission, readmission, and subsequent admissions, and secondary outcomes were a composite outcome including the need for intensive care unit (ICU) admission, invasive and non-invasive mechanical ventilation (MV), or death, as well as in-hospital complications. (3) Results: A total of 13,940 patients diagnosed with COVID-19 were included, of which 362 (2.6%) had an AD. Patients with ADs were older, more likely to be female, and had greater comorbidity. On the multivariate logistic regression analysis, which involved the inverse propensity score weighting method, AD as a whole was not associated with an increased risk of any of the outcome variables. Habitual treatment with corticosteroids (CSs), age, Barthel Index score, and comorbidity were associated with poor outcomes. Biological disease-modifying anti-rheumatic drugs (bDMARDs) were associated with a decrease in mortality in patients with AD. (4) Conclusions: The analysis of the SEMI-COVID-19 Registry shows that ADs do not lead to a different prognosis, measured by mortality, complications, or the composite outcome. Considered individually, it seems that some diseases entail a different prognosis than that of the general population. Immunosuppressive/immunoregulatory treatments (IST) prior to admission had variable effects

Estimación del gasto energético en el paciente quemado mediante la utilización de ecuaciones predictivas; revisión bibliográfica

Introducción: La valoración de las necesidades calóricas del paciente quemado se ha basado en la medición del gasto energético en reposo (GER) mediante calorimetría indirecta, no siempre disponible en las unidades de quemados, o en su estimación mediante el uso de ecuaciones predictivas. Objetivos: analizar la historia y estado del arte del uso de las ecuaciones predictivas de GER en el paciente quemado crítico, y determinar su validez. Métodos: revisión bibliográfica de estudios y revisiones en español y en inglés entre 1989 y 2013. Resultados: Se han diseñado más de 190 ecuaciones para estimar el gasto energético que pueden ser imprecisas por estar basadas en mediciones con metodología heterogénea y en grupos heterogéneos. Describimos los distintos parámetros que aplican las distintas fórmulas predictivas (factores de estrés y de actividad, superficie corporal quemada, tiempo desde la lesión, masa corporal magra), la influencia de la edad en el cálculo de las necesidades calóricas y las fórmulas más utilizadas en el momento actual. También describimos los artículos que evalúan exactitud de las fórmulas cuando se comparan con mediciones mediante calorimetría indirecta. Conclusiones: Las ecuaciones predictivas son poco precisas en general en el paciente quemado. Hasta que se desarrollen ecuaciones predictivas más precisas, recomendamos calcular los requerimientos nutricionales de los pacientes quemados basándose en la medición del gasto energético por calorimetría indirecta

Comparative Reduction of Egg Yolk Cholesterol Using Anionic Chelating Agents

Egg yolk is used as an emulsifying agent. Nevertheless, its high concentration of cholesterol is linked to chronic degenerative diseases that cause cardiovascular disease. In this study, three methods for reducing the level of cholesterol in egg yolks were studied. The first method consisted of physical separation of the granules contained in the yolk (NaG). The second method applied was the use of anionic chelating biopolymers, such as arabic gum solution (AG) and mesquite gum solution (MG), and the third method was extraction with a solvent (SA). For this purpose, the cholesterol present in egg yolks, the microstructure, particle size, zeta potential, and its emulsifying capacity were determined. The amount of cholesterol removed was 97.24% using 1% mesquite gum (MG1%), and 93.26% using 1% Arabic gum (AG1%). The zeta potential was determined, and the isoelectric point (ζ = 0) of egg yolk was identified as pH 4.6. While, at this pH, the zeta potential of mesquite gum was −14.8 mV, the zeta potential for the arabic gum was −16 mV. The emulsifying capacity of MG1% was 62.95%, while the emulsifying capacity of AG1% was 63.57%. The complex obtained can be used in the development of functional foods reduced in cholesterol

Otro título: [Música folklórica peruana]

Intérpretes: Roberto Tello. Mariza Rodríguez. Trío Los Ávalos. Óscar AvilésMadrid, Instituto de Cultura Hispánica. Domingo, 30 de julio a las siete de la tardeAmores de ocasión / Adalberto Ore Lara – Min. 02.44: Historia de mi vida / Mario Cavagnaro – Min. 05.51: La jarana de Doña Ana / Enrique Martínez – Min. 08.56: La perla del chira / Guillermo Riofrío – Min. 12.05: Lima de octubre / Mario Cavagnaro – Min. 14.58: Caminito, caminito / José Dávalos – Min. 17.45: Embrujo / Luis Abelardo Núñez – Min. 21.25: Locos suspiros / Felipe Pingl