Transferencia de una experiencia educativa en turismo rural: La Emilia-Romagna, Italia

Fil: Scatizzi, Mónica. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina

Usos del tiempo y del espacio de jóvenes de Mar del Plata

La presente ponencia se inscribe en el Programa de Investigación Usos del Tiempo Libre y forma parte de un proyecto de investigación en curso, cuyo propósito es analizar las actividades realizadas por los jóvenes y su distribución en el espacio y en el tiempo, en relación con los horarios en que se desarrollan y los desplazamientos que se originan. El proyecto a desarrollar se centra en el análisis espacio-temporal de la actividad cotidiana, donde a través del estudio del uso del tiempo se analizará la localización temporal, frecuencia, secuencia y duración de las actividades sociales y su distribución espacial.Fil: Benseny, Graciela. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.Fil: Scatizzi, Mónica. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina

Update on Clinical Evidence Supporting Hemodiafiltration

The aim of this chapter is to define hemodiafiltration target efficiency, to clarify the concept of “optimal convective dose,” and to facilitate hemodiafiltration (HDF) implementation in clinical practice by addressing the need for the establishment of best clinical practices for HDF. The approach taken was to conduct a comprehensive summary of clinical evidence supporting HDF. Convective dose is the total ultrafiltered volume and is complementary to diffusive dose (urea Kt/V) as a dose‐dependent parameter. It can be quantified and adjusted to patient characteristics. Factors affecting convective dose are discussed: patient characteristics, prescription‐dependent factors, and technical and machine‐dependent factors. The key issue of HDF prescription and implementation of best practices is addressed as are intermediary and endpoint clinical outcomes. The main messages are as follows: (1) HDF is safe and effective provided that best clinical practices are followed and the right convective dose is delivered; (2) HDF is easy to perform with new technology; and (3) depending on the convection volume, HDF reduces all‐cause and cardiovascular mortality. Open challenges remain, namely, the implementation of best practices to (a) achieve optimal convection volume, (b) define patient subsets that would benefit more from HDF, and (c) evaluate new tools that fine‐tune HDF prescription according to individual patient needs

"Munay-Koi" Un sendero holístico para la conservación de la vida

La Reserva Natural Municipal Laguna de Los Padres, Partido de Gral. Pueyrredon, Buenos Aires, Argentina, es un ambiente apto para el desarrollo sustentable de actividades turísticas, recreativas y educativas. La propuesta se basa en la realización de Ecoturismo con énfasis en el senderismo y la observación de avifauna. También se pretende combinar éstas actividades con Educación e Interpretación Ambiental para la toma de conciencia de los visitantes sobre temas de conservación, valoración de los ecosistemas y del patrimonio cultural existente. Es un área protegida con importantes valores tanto naturales como culturales, muy utilizada ya sea por turistas como por habitantes de ciudades cercanas para el disfrute de fin de semana o de días festivos. Actualmente, cuenta con un Plan de Manejo aprobado y reglamentado pero que no se aplica en su totalidad. El objetivo del Proyecto es poner en valor la Reserva para permitir la conservación de la biodiversidad y de los servicios ambientales que ella nos provee, también garantizar la calidad de la experiencia turística de los visitantes, a través de un enfoque holístico de planificación de desarrollo. Con la creación de senderos interpretativos, los visitantes participarán de forma activa en el aprendizaje, ya que no sólo se pretende que descubran la belleza paisajística del sitio, sino que también, mediante experiencias directas con el recurso, su recorrido les genere estímulos donde puedan expresar sus conocimientos previos para lograr una experiencia enriquecedora. Por último, al propósito lo conforma una visión dinámica, interactiva y creativa para la planificación holística, donde se puede combinar el Turismo, la Recreación y la Educación con la Conservación y la Utilización Sustentable de la Reserva.The Municipal Natural Reserve Laguna de Los Padres, Partido of General Pueyrredon, Buenos Aires, Argentina, is a suitable environment for the sustainable development of tourist, recreational and educational activities. The proposal is based on the on the realization of Ecotourism, with emphasis on trekking and bird watching. It is also intended to combine these activities with Education and Environmental Interpretation for the awareness of visitors about conservation issues, valuation of ecosystems and existing cultural heritage. It is a protected area, with important natural and cultural values, very used by tourists and residents of nearly cities, for enjoyment of weekends or holidays. In the present, has an approved and regulated management plan, but it does not apply entirely. The objective of the project is to value the Reserve to allow the conservation of biodiversity and the environmental services that it provides us, also guarantee the quality of the tourist experience of visitors through a holistic approach to development planning. With the creation of interpretive trails, visitors participate actively in learning, since it is not only intended to discover the scenic beauty of the site, but also, through direct experiences with resource, its route will generate stimuli, where they can express your previous knowledge, to achieve an enriching experience. Finally, the purpose is dynamic, interactive and creative vision for planning holistic, where you can combine tourism recreation and education, with conservation and the sustainable use of the Reserve.Fil: Scatizzi, Mónica. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.Fil: Cicchino, Sandra. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales; Argentina

Combined loss of proapoptotic genes Bak or Bax with Bim synergizes to cause defects in hematopoiesis and in thymocyte apoptosis

The proapoptotic members of the Bcl-2 family can be subdivided into members that contain several Bcl-2 homology (BH) domains and those that contain only the BH3 domain. Although it is known that BH3-only proteins and the multi-BH domain proteins, Bak and Bax, are essential for programmed cell death, the overlapping role of these two subgroups has not been examined in vivo. To investigate this, we generated Bak/Bim and Bax/Bim double deficient mice. We found that although Bax−/−Bim−/−, but not Bak−/−Bim−/−, mice display webbed hind and front paws and malocclusion of the incisors, both groups of mice present with dysregulated hematopoiesis. Combined loss of Bak and Bim or Bax and Bim causes defects in myeloid and B-lymphoid development that are more severe than those found in the single knock-out mice. Bak−/−Bim−/− mice have a complement of thymocytes that resembles those in control mice, whereas Bax−/−Bim−/− mice are more similar to Bim−/− mice. However, thymocytes isolated from Bak−/−Bim−/− or Bax−/−Bim−/− mice are markedly more resistant to apoptotic stimuli mediated by the intrinsic pathway as compared with thymocytes from single-knockout mice. These data suggest an essential overlapping role for Bak or Bax and Bim in the intrinsic apoptotic pathway

Systemic Autoimmunity and Lymphoproliferation Are Associated with Excess IL-7 and Inhibited by IL-7Rα Blockade

Lupus is characterized by disturbances in lymphocyte homeostasis, as demonstrated by the marked accumulation of activated/memory T cells. Here, we provide evidence that proliferation of the CD8+ precursors for the accumulating CD4–CD8– T cells in MRL-Faslpr lupus-predisposed mice is, in part, driven by commensal antigens. The ensuing lymphadenopathy is associated with increased production of IL-7 due to expansion of fibroblastic reticular cells, the primary source of this cytokine. The excess IL-7 is not, however, consumed by CD4–CD8– T cells due to permanent down-regulation of IL-7Rα (CD127), but instead supports proliferation of autoreactive T cells and progression of autoimmunity. Accordingly, IL-7R blockade reduced T cell activation and autoimmune manifestations even when applied at advanced disease stage. These findings indicate that an imbalance favoring production over consumption of IL-7 may contribute to systemic autoimmunity, and correction of this imbalance may be a novel therapeutic approach in lymphoproliferative and autoimmune syndromes

Identidad local: el turismo como un recurso pedagógico

La ciudad de Mar del Plata es hoy en día el 7 mayor conglomerado urbano del país, aunque paradójicamente su historia no deja de ser breve (130 años). Esto nos marca obviamente un crecimiento demográfico, geográfico-espacial y socio económico bastante anárquico. Por ello lamentablemente no sorprende que muchos niños en edad escolar, no conozcan o disfruten cabalmente el mar y los atractivos de la ciudad por vivir en barrios alejados y por carecer de recursos económicos para desplazarse. En este marco, desde el año 2008, estamos trabajando sobre la profundización del sentimiento de pertenencia local, mediante la inclusión socio recreativa de niños y niñas que cursan sus estudios primarios en 4to año de escuelas públicas municipales de Mar del Plata, así como de sus docentes y directivos. Principalmente abordando el conocimiento de los recursos naturales, culturales e históricos del barrio/entorno donde habitan y se radica su escuela, primeramente; y de los del resto de la ciudad a posteriori, focalizando en los que poseen cierto valor turístico recreativo. El Proyecto contiene además una etapa final complementaria que consistirá en la realización de talleres y cursos de concientización con la comunidad de 3 barrios de la ciudad, articulando con instituciones socio-culturales allí radicadas. Se pretende orientar a los niños en la construcción y reconocimiento de la historia de su barrio y de la ciudad, relacionada esta íntimamente con los recursos de valor cultural y natural, como aporte fundamental a la conformación de su identidad local. Se prevé la realización de capacitaciones a docentes primarios; talleres audiovisuales participativos con los niños en las escuelas; acciones en las sociedades de fomento y centros culturales mediante talleres de reflexión con las comunidades de los barrios involucrados; recorridos y visitas por el barrio y la ciudad; realización de muestras artísticas en base a las experiencias vividas por los niños, etc. Para ello, además de los docentes y graduados universitarios, de los docentes primarios y de las instituciones intermedias barriales; estudiantes voluntarios realizando sus prácticas profesionales socio comunitarias colaborarán en una tarea mancomunada con los niños, sus docentes y familiares en el reconocimiento de los puntos de interés del barrio, y en la demostración de los atractivos circundantes y de la ciudad, sean estos tangibles e intangibles.Fil: Zaballa, Esteban. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.Fil: Murillo, Romina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.Fil: Scatizzi, Mónica. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.Fil: Iconoclasta, F. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.Fil: Marchese, L. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina

Blood Transfusions and Adverse Events after Colorectal Surgery: A Propensity-Score-Matched Analysis of a Hen-Egg Issue

Blood transfusions are considered a risk factor for adverse outcomes after colorectal surgery. However, it is still unclear if they are the cause (the hen) or the consequence (the egg) of adverse events. A prospective database of 4529 colorectal resections gathered over a 12-month period in 76 Italian surgical units (the iCral3 study), reporting patient-, disease-, and procedure-related variables, together with 60-day adverse events, was retrospectively analyzed identifying a subgroup of 304 cases (6.7%) that received intra- and/or postoperative blood transfusions (IPBTs). The endpoints considered were overall and major morbidity (OM and MM, respectively), anastomotic leakage (AL), and mortality (M) rates. After the exclusion of 336 patients who underwent neo-adjuvant treatments, 4193 (92.6%) cases were analyzed through a 1:1 propensity score matching model including 22 covariates. Two well-balanced groups of 275 patients each were obtained: group A, presence of IPBT, and group B, absence of IPBT. Group A vs. group B showed a significantly higher risk of overall morbidity (154 (56%) vs. 84 (31%) events; OR 3.07; 95%CI 2.13-4.43; p = 0.001), major morbidity (59 (21%) vs. 13 (4.7%) events; OR 6.06; 95%CI 3.17-11.6; p = 0.001), and anastomotic leakage (31 (11.3%) vs. 8 (2.9%) events; OR 4.72; 95%CI 2.09-10.66; p = 0.0002). No significant difference was recorded between the two groups concerning the risk of mortality. The original subpopulation of 304 patients that received IPBT was further analyzed considering three variables: appropriateness of BT according to liberal transfusion thresholds, BT following any hemorrhagic and/or major adverse event, and major adverse event following BT without any previous hemorrhagic adverse event. Inappropriate BT was administered in more than a quarter of cases, without any significant influence on any endpoint. The majority of BT was administered after a hemorrhagic or a major adverse event, with significantly higher rates of MM and AL. Finally, a major adverse event followed BT in a minority (4.3%) of cases, with significantly higher MM, AL, and M rates. In conclusion, although the majority of IPBT was administered with the consequence of hemorrhage and/or major adverse events (the egg), after adjustment accounting for 22 covariates, IPBT still resulted in a definite source of a higher risk of major morbidity and anastomotic leakage rates after colorectal surgery (the hen), calling urgent attention to the implementation of patient blood management programs

A cell-cycle independent role for p21 in regulating synovial fibroblast migration in rheumatoid arthritis

Rheumatoid arthritis (RA) is characterized by synovial hyperplasia and destruction of cartilage and bone. The fibroblast-like synoviocyte (FLS) population is central to the development of pannus by migrating into cartilage and bone. We demonstrated previously that expression of the cell cycle inhibitor p21 is significantly reduced in RA synovial lining, particularly in the FLS. The aim of this study was to determine whether reduced expression of p21 in FLS could alter the migratory behavior of these cells. FLS were isolated from mice deficient in p21 (p21((-/-))) and were examined with respect to growth and migration. p21((-/-) )and wild-type (WT) FLS were compared with respect to migration towards chemoattractants found in RA synovial fluid in the presence and absence of cell cycle inhibitors. Restoration of p21 expression was accomplished using adenoviral infection. As anticipated from the loss of a cell cycle inhibitor, p21((-/-) )FLS grow more rapidly than WT FLS. In examining migration towards biologically relevant RA synovial fluid, p21((-/-) )FLS display a marked increase (3.1-fold; p < 0.05) in migration compared to WT cells. Moreover, this effect is independent of the cell cycle since chemical inhibitors that block the cell cycle have no effect on migration. In contrast, p21 is required to repress migration as restoration of p21 expression in p21((-/-) )FLS reverses this effect. Taken together, these data suggest that p21 plays a novel role in normal FLS, namely to repress migration. Loss of p21 expression that occurs in RA FLS may contribute to excessive invasion and subsequent joint destruction

Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients

Introduction The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a precise snapshot of the absolute and relative changes of emergency surgical admissions at the outbreak of the pandemic. Materials and methods Datasets of patients admitted as general surgical emergencies into 45 internationally distributed emergency surgical units during the months of March and April 2020 (Covid-19 pandemic outbreak) were collected and compared with those of patients admitted into the same units during the months of March and April 2019 (pre-Covid-19). Primary endpoint was to evaluate the relative variation of the presentation symptoms and discharge diagnoses between the two study periods. Secondary endpoint was to identify the possible change of therapeutic strategy during the same two periods. Results Forty-five centres participated sent their anonymised data to the study hub, for a total of 6263 patients. Of these, 3810 were admitted in the pre-Covid period and 2453 in the Covid period, for a 35.6% absolute reduction. The most common presentation was abdominal pain, whose incidence did not change between the two periods, but in the Covid period patients presented less frequently with anal pain, hernias, anaemia and weight loss. ASA 1 and low frailty patients were admitted less frequently, while ASA&gt;1 and frail patients showed a relative increase. The type of surgical access did not change significantly, but lap-to-open conversion rate halved between the two study periods. Discharge diagnoses of appendicitis and diverticulitis reduced significantly, while bowel ischaemia and perianal ailments had a significant relative increase. Conclusions Our audit demonstrates a significant overall reduction of emergency surgery admissions at the outbreak of the Covid-19 pandemic with a minimal change of the proportions of single presentations, diagnoses and treatments. These findings may open the door to new ways of managing surgical emergencies without engulfing the already busy hospitals