The Central Andes and sustainable development: The Mendoza High Mountains Strategic Plan, Argentina

The Mendoza High Mountains Strategic Plan (MHMSP) is a key instrument for the public management and land-use planning of the Aconcagua region, Argentina. It involves stakeholders from government, the private sector, scientists and local communities in the Central Andes to promote collective action for making Aconcagua a sustainable tourism destination, within the context of climate change and COVID-19. The MHMSP is supported by the Federal Investment Council of Argentina and the Inter-American Development Bank. The Commission for Sustainable Development of the High Mountains of Mendoza comprises actors from the public and private sectors and was created to monitor the plan’s follow-up. Climate change adaptation and mitigation are part of the process outlined in the MHMSP, and support for the adoption and incorporation of new technologies plays a central role. Local communities whose livelihoods depend on snow tourism are vulnerable to the impact of climate change. Different mechanisms have been incorporated into the plan to promote mountain villages’ adaptation to climate change, to reduce their vulnerability.Fil: Reynoso, Marcelo. Gobierno de la Provincia de Mendoza. Ministerio de Turismo; ArgentinaFil: Rubio, María Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Salinas, Pamela. Provincia de Mendoza. Subsecretaría de Agricultura; ArgentinaFil: Morabito, Federico. Provincia de Mendoza. Subsecretaría de Agricultura; ArgentinaFil: Abraham, Elena Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Rubio, María Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Díaz, Fabián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Gil Fain Binda, Lorena. Provincia de Mendoza. Subsecretaría de Agricultura; ArgentinaFil: Zabala, Cecilia. Provincia de Mendoza. Subsecretaría de Agricultura; ArgentinaFil: Lo Bello, Silvia. Provincia de Mendoza. Subsecretaría de Agricultura; ArgentinaFil: Betancourt, Pablo. Betancourt Photographic Studio; ArgentinaFil: García, Gustavo. Betancourt Photographic Studio; Argentin

Avaliação de uma intervenção educacional (edworkcases) envolvendo casos clínicos e estudantes de Enfermagem: um estudo observacional transversal

Objective: to evaluate the impact of the (edworkcases) educational intervention on students’ evaluation outcomes in their clinical practices, their attitudes towards Nursing diagnoses, and their satisfaction. Method: this study used a cross-sectional observational design. The participants were 69 third-year Nursing students from a public university in Madrid, Spain. The data analysed in the study were the grades obtained by students for their clinical practices, as well as pre-post intervention scores on the Positions on Nursing Diagnosis Scale and a satisfaction survey. A means comparison by participation in the project (yes/no) was carried out using Student’s t-test. A means comparison by professor was conducted using Kruskal-Wallis tests. Results: participation rate: 72.4%; 92% of the participants were women; median age = 21 years old. Statistically significant differences were found between participants and non-participants in terms of mean score in the Overall Evaluation and in the Case Study Evaluation, with higher scores found among the group of participants. The mean score for attitudes towards Nursing diagnoses was 99.9 (SD=2.8) before the intervention and 111.1 (SD=2.9) after the intervention [95% CI: 3.3-19.2]. Conclusion: the use of (edworkcases) as part of the practical training was considered satisfactory, enabling theory and practice to be combined and improving students’ attitudes towards Nursing diagnoses.Objetivo: evaluar el efecto de la intervención educativa (edworkcases) sobre los resultados de la evaluación de los estudiantes en sus prácticas clínicas, sus actitudes hacia los diagnósticos de Enfermería y su nivel de satisfacción. Método: en este estudio se empleó un diseño transversal y observacional. Los participantes fueron 68 estudiantes de tercer año de la carrera de Enfermería de una universidad pública de Madrid, España. Los datos que se analizaron en el estudio fueron las calificaciones obtenidas por los estudiantes en sus prácticas clínicas, al igual que las puntuaciones antes y después de la intervención en la Escala de Posicionamiento ante el Diagnóstico de Enfermería y en una encuesta de satisfacción. Se utilizó la prueba t de Student para realizar una comparación de valores medios por participación en el proyecto (sí/no). La comparación de valores medios por profesor se llevó a cabo por medio de pruebas Kruskal-Wallis. Resultados: índice de participación: 72,4%; el 92% de los participantes eran mujeres, con una mediana de edad de 21 años. Se encontraron diferencias estadísticamente significativas entre participantes y no participantes en cuanto a la puntuación media en la Evaluación General y en la Evaluación de Estudios de Caso, con puntuaciones más elevadas en el grupo de participantes. Las puntuaciones medias correspondientes a las actitudes con respecto a los diagnósticos de Enfermería fueron 99,9 (SD=2,8) y 111.1 (SD=2.9) antes y después de la intervención, respectivamente [IC 95%: 3,3-19,2]. Conclusión: se consideró satisfactorio utilizar edworkcases como parte te la capacitación práctica, lo que permitió combinar teoría y práctica y mejorar las actitudes de los estudiantes con respecto a los diagnósticos de Enfermería.Objetivo: avaliar o impacto da intervenção educacional (edworkcases) nos resultados da avaliação dos alunos em suas práticas clínicas, suas atitudes em relação aos diagnósticos de Enfermagem e sua satisfação. Método: estudo observacional transversal, realizado com 69 estudantes do terceiro ano de Enfermagem de uma universidade pública de Madri, Espanha. Os dados analisados foram obtidos das notas dos alunos em suas práticas clínicas, bem como, os escores pré- e pós-intervenção na Escala de Posições frente ao Diagnóstico de Enfermagem e uma pesquisa de satisfação. A comparação de médias por participação no projeto (sim/não) foi realizada por meio do teste t de Student. A comparação de médias por professor foi realizada por meio de testes de Kruskal-Wallis. Resultados: taxa de participação: 72,4%; 92% dos participantes eram mulheres; mediana de idade de 21 anos. Foram encontradas diferenças estatisticamente significativas entre participantes e não participantes em termos de pontuação média na Avaliação Geral e na Avaliação do Estudo de Caso, com maiores pontuações encontradas entre o grupo de participantes. A pontuação média das atitudes em relação aos diagnósticos de Enfermagem foi de 99,9 (DP=2,8) antes da intervenção e 111,1 (DP=2,9) após a intervenção [IC 95%: 3,3-19,2]. Conclusão: a utilização de edworkcases como parte do treinamento prático foi considerada satisfatória, permitindo a articulação teoria e prática e melhorando as atitudes dos alunos em relação aos diagnósticos de Enfermagem

ZnO-mesoporous glass scaffolds loaded with osteostatin and mesenchymal cells improve bone healing in a rabbit bone defect.

The use of 3D scaffolds based on mesoporous bioactive glasses (MBG) enhanced with therapeutic ions, biomolecules and cells is emerging as a strategy to improve bone healing. In this paper, the osteogenic capability of ZnO-enriched MBG scaffolds loaded or not with osteostatin (OST) and human mesenchymal stem cells (MSC) was evaluated after implantation in New Zealand rabbits. Cylindrical meso-macroporous scaffolds with composition (mol %) 82.2SiO2–10.3CaO–3.3P2O5–4.2ZnO (4ZN) were obtained by rapid prototyping and then, coated with gelatin for easy handling and potentiating the release of inorganic ions and OST. Bone defects (7.5 mm diameter, 12 mm depth) were drilled in the distal femoral epiphysis and filled with 4ZN, 4ZN+MSC, 4ZN+OST or 4ZN+MSC+OST materials to evaluate and compare their osteogenic features. Rabbits were sacrificed at 3 months extracting the distal third of bone specimens for necropsy, histological and microtomography (µCT) evaluations. Systems investigated exhibited bone regeneration capability. Thus, trabecular bone volume density (BV/TV) values obtained from µCT showed that the good bone healing capability of 4ZN was significantly improved by the scaffolds coated with OST and MSC. Our findings in vivo suggest the interest of these MBG complete systems to improve bone repair in the clinical practice

Osteogenic Effect of ZnO-Mesoporous Glasses loaded with Osteostatin

Mesoporous Bioactive Glasses (MBGs) are a family of bioceramics widely investigated for their putative clinical use as scaffolds for bone regeneration. Their outstanding textural properties determine high bioactivity when compared with other bioactive materials. Moreover, their great pore volumes allow these glasses to be loaded with a wide range of biomolecules to stimulate new bone formation. In this study, an MBG with composition, in mol-%, 80%SiO2–15%CaO–5%P2O5 (Blank, BL) was compared with two analogous glasses containing 4% and 5% of ZnO (4ZN and 5ZN) before and after impregnation with osteostatin, a C-terminal peptide from parathyroid hormone-related protein (PTHrP107-111). Zn2+ ions were included in the glass for their bone growth stimulator properties, whereas osteostatin was added by its osteogenic properties. Glasses were characterized, and their cytocompatibility investigated in pre-osteoblastic MC3T3-E1 cell cultures. The simultaneous additions of osteostatin and Zn2+ ions provoked enhanced MC3T3-E1 cell viability and higher differentiation capacity, compared with either raw BL or MBGs supplemented only with osteostatin or Zn2+. These in vitro results show that osteostatin enhances the osteogenic effect of Zn2+-enriched glasses, suggesting the potential of this combined approach in bone tissue engineering applications

Osteostatin potentiates the bioactivity of mesoporous glass scaffolds containing Zn2+ ions in human mesenchymal stem cell cultures

There is an urgent need of biosynthetic bone grafts with enhanced osteogenic capacity. In this study, we describe the design of hierarchical meso-macroporous 3D-scaffolds based on mesoporous bioactive glasses (MBGs), enriched with the peptide osteostatin and Zn2+ ions, and their osteogenic effect on human mesenchymal stem cells (hMSCs) as a preclinical strategy in bone regeneration. The MBG compositions investigated were 80%SiO2– 15%CaO–5%P2O5 (in mol-%) Blank (BL), and two analogous glasses containing 4% ZnO (4ZN) and 5% ZnO (5ZN). By using additive fabrication techniques, scaffolds exhibiting hierarchical porosity: mesopores (around 4 nm), macropores (1-600 m) and big channels ( 1000 m), were prepared. These MBG scaffolds with or without osteostatin were evaluated in cell cultures of hMSCs. Zinc promoted hMSCs colonization (both the surface and inside) of MBG scaffolds. Moreover, Zn2+ ions and osteostatin together, but not independently, in the scaffolds were found to induce the osteoblast differentiation genes runt related transcription factor-2 (RUNX2) and alkaline phosphatase (ALP) in hMSCs after 7 d of culture in the absence of an osteogenic differentiation-promoting medium. These results add credence to the combined use of zinc and osteostatin as an effective strategy for bone regeneration applications

Transient acute kidney injury after chimeric antigen receptor T-cell therapy in patients with hematological malignancies

CAR-T therapy; Acute kidney injury; OnconephrologyTerapia CAR-T; Lesión renal aguda; OnconefrologíaTeràpia CAR-T; Lesió renal aguda; OnconefrologiaBackground Acute kidney injury (AKI) occurs in 30% of patients infused with chimeric antigen receptor (CAR) T-cells. The purpose of this study was to identify risk factors and long-term outcomes after AKI in patients who received CAR T-cell therapy. Methods Medical records of 115 adult patients with R/R hematological malignancies treated with CD19-targeted CAR T-cells at Vall d'Hebron University Hospital between July 2018 and May 2021. Baseline demographic data including age, gender, ethnicity, body mass index (BMI), and co-morbidities, as well as the type of hematological neoplasia and prior lines of therapy were collected. Laboratory parameters including serum creatinine and whole blood hemoglobin were retrospectively reviewed and values were gathered for days +1, +7, +14, +21, and +28 post-infusion. Results A total of 24/115 (21%) patients developed AKI related to CAR T-cell therapy; 6/24 with AKI over chronic kidney disease (CKD). Two patients had AKI in the context of lymphodepleting (LD) chemotherapy and the other 22 after CAR T-cell infusion, starting at day+1 in 3 patients, day+7 in 13 patients, day +14 in 1 patient, day+21 in 2 patients, and day+28 in 3 patients. Renal function was recovered in 19/24 (79%) patients within the first month after infusion. Male gender, CKD, cytokine release syndrome (CRS), and immune effector cell-associated neurotoxicity syndrome (ICANS) were associated with AKI. Male gender, CKD, ICANS grade ≥3 and CRS grade ≥2 were identified as independent risk factors for AKI on multivariable analysis. In terms of the most frequent CAR T-cell related complications, CRS was observed in 95 (82%) patients and ICANS in 33 (29%) patients. Steroids were required in 34 (30%) patients and tocilizumab in 37 (32%) patients. Six (5%) patients were admitted to the intensive care unit (1 for septic shock, 4 for CRS grade ≥2 associated to ICANS grade ≥2, and 1 for CRS grade ≥3). A total of 5 (4.4%) patients died in the first 30 days after CAR T-cell infusion for reasons other than disease progression, including 4 cases of infectious complications and 1 of heart failure. Conclusion Our results suggest that AKI is a frequent but mild adverse event, with fast recovery in most patients.P.B. received research funding from the Carlos III Health Institute (PI21/0199,INT23/00072), Asociación Española contra el Cáncer (Ideas Semilla 2019) and a PERIS 2018-2020 grant from the Generalitat de Catalunya (BDNS357800). This research was funded by ISCIIII-FEDER and ISCIII RETICS REDinREN, grant number PI21/01292, ERA PerMed JTC2022 grant number AC22/00029, Río Hortega CM23/00213, Marató TV3 421/C/2020, Marató TV3 215/C/2021, and RICORS RD21/0005/0016. Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), enfermedades glomerulares complejas

Complicación neurológica por dengue: reporte de un caso neurológico

La fiebre del dengue tiene una alta prevalencia a nivel mundial y nacional; esta puede cursar con manifestaciones clínicas atípicas como las neurológicas, que están en aumento con una incidencia entre 1% y el 5%. Presentamos el caso de una paciente mujer, de 80 años de edad, procedente de Laredo en el departamento de La Libertad, con cuadro clínico de Dengue y que cumplía con los criterios de encefalitis por dengue. El diagnóstico se apoyó en el análisis clínico y de laboratorio. Se propone que la edad y una probable infección previa por dengue intervinieron en el desarrollo de la encefalitis. Mediante el conocimiento de la clínica de la encefalitis por dengue y demás facetas  de  la  enfermedad  puede  darse  un  diagnóstico  temprano  y  así  orientar  el  manejoterapéutico apropiado que reduzca la mortalidad y secuelas en el paciente.Palabras clave: Dengue, Aedes aegypti, encefaliti

Adenocarcinoma de próstata metastásico a pene: reporte de un caso.

Objective: Describe a case report of a patient with prostatic adenocarcinoma metastatic to penis due to shortage reports of similar cases to perform a literature review. Methods: We identified a case of a patient with prostatic adenocarcinoma, who during de the course of a cystoscopy at Hospital Universitario San Jose (Third-level Public Hospital in Popayan, Colombia) a suspicious nodule of malignancy was observed in the penis. We described the clinical case in order to proceed to a literature search for the discussion. Results: 72-year-old patient diagnosed with prostatic adenocarcinoma Gleason Score 4+5=9, treated with bilateral orchiectomy and a suspicious nodule of malignancy incidentally observed in the penis, currently undergoing palliative care with Karnofsky score of 30 points. Conclusion: cutaneous metastases are rare; indicate longstanding disease and poor prognosis.Objetivo: Describir un caso clínico de un paciente con adenocarcinoma de próstata metastásico a pene debido a la escasez de reportes de casos similares y llevar a cabo una revisión de la literatura. Métodos: Se identificó un caso de un paciente con adenocarcinoma de próstata, a quien durante la realización de una cistoscopia en el Hospital Universitario San José de Popayán (HUSJ) se evidenció un nódulo sospechoso de malignidad en el pene. Se describió el caso clínico y se procedió a hacer una búsqueda de la literatura en diferentes bases de datos para su discusión. Resultados: Paciente de 72 años, con diagnóstico de adenocarcinoma de próstata con score Gleason 4+5=9, con orquidectomia bilateral, en quien se descubre incidentalmente un nódulo sospechoso de malignidad en pene, actualmente se encuentra en tratamiento paliativo por oncología con Índice Karnofsky de 30. Conclusión: las metástasis cutáneas son infrecuentes, si se presentan indican evolución de la enfermedad y pronóstico sombrío

Parental Burnout Assessment (PBA) in Different Hispanic Countries: An Exploratory Structural Equation Modeling Approach

Parental burnout is a unique and context-specific syndrome resulting from a chronic imbalance of risks over resources in the parenting domain. The current research aims to evaluate the psychometric properties of the Spanish version of the Parental Burnout Assessment (PBA) across Spanish-speaking countries with two consecutive studies. In Study 1, we analyzed the data through a bifactor model within an Exploratory Structural Equation Modeling (ESEM) on the pooled sample of participants (N = 1,979) obtaining good fit indices. We then attained measurement invariance across both gender and countries in a set of nested models with gradually increasing parameter constraints. Latent means comparisons across countries showed that among the participants' countries, Chile had the highest parental burnout score, likewise, comparisons across gender evidenced that mothers displayed higher scores than fathers, as shown in previous studies. Reliability coefficients were high. In Study 2 (N = 1,171), we tested the relations between parental burnout and three specific consequences, i.e., escape and suicidal ideations, parental neglect, and parental violence toward one's children. The medium to large associations found provided support for the PBA's predictive validity. Overall, we concluded that the Spanish version of the PBA has good psychometric properties. The results support its relevance for the assessment of parental burnout among Spanish-speaking parents, offering new opportunities for cross-cultural research in the parenting domain

Metastatic prostate adenocarcinoma penis: Case report

Objective: Describe a case report of a patient with prostatic adenocarcinoma metastatic to penis due to shortage reports of similar cases to perform a literature review. Methods: We identified a case of a patient with prostatic adenocarcinoma, who during de the course of a cystoscopy at Hospital Universitario San Jose (Third-level Public Hospital in Popayan, Colombia) a suspicious nodule of malignancy was observed in the penis. We described the clinical case in order to proceed to a literature search for the discussion. Results: 72-year-old patient diagnosed with prostatic adenocarcinoma Gleason Score 4+5=9, treated with bilateral orchiectomy and a suspicious nodule of malignancy incidentally observed in the penis, currently undergoing palliative care with Karnofsky score of 30 points. Conclusion: cutaneous metastases are rare; indicate longstanding disease and poor prognosis