Soluble MIC-A, IPI, and response to treatment strongly predict survival in patients with germinal center diffuse large B cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is the most frequent lymphoma. MIC-A and MIC-B are the natural ligands for NKG2D, a receptor expressed in NK cells. MIC-A soluble isoforms (sMICA) have been described in different malignancies. OBJECTIVES: To analyze lymphocyte subsets and sMIC-A in germinal center DLBCL. MATERIALS AND METHODS: sMICA, sMICB, and peripheral blood lymphocyte subsets (CD4+, CD8+, NK, NKT, γδ T cells, and dendritic cells) were analyzed in 59 patients and 60 healthy donors. RESULTS: Patients had decreased numbers of type 1 and type 2 dendritic cells, NK, iNKT, CD4 T, and CD8 T cells, and higher levels of sMIC-A. The 2-year PFS for high IPI scores and high sMIC-A was 24% and 28%, respectively. The 2-year OS for high IPI scores and high sMIC-A was 42% and 33%. The 2-year PFS and OS for patients not achieving response to treatment were 0% and 10%, respectively. The MICPI score (one point each for high IPI score and high sMIC-A) showed that those patients summing two points had worse PSF and OS. CONCLUSIONS: Patients with DLBCL have decreased numbers of peripheral lymphocyte subsets and high levels of sMIC-A. The addition of sMIC-A to IPI could improve its prognostic relevance.

Lymphocyte subsets and soluble forms of MIC-A and MIC-B are prognostic factors in non-Hodgkin lymphoma patients.

MIC-A and MIC-B are the natural ligands for NKG2D, an activator receptor expressed in NK cells. Soluble isoforms of MIC-A and MIC-B (sMICA, sMICB) have been identified in different malignancies, affecting NK cells' cytotoxicity. The study was performed to determine the levels of sMICA, sMICB, the expression of MIC-A, and MIC-B on tumor tissues, and lymphocyte subpopulations (CD4 + , CD8 + , NK, NKT, Tγδ cells, B cells, monocytes) in 94 patients with non-Hodgkin's lymphoma (NHL) and 72 healthy donors.The most frequent lymphoma was diffuse large B cell lymphoma (48%). Patients with NHL had decreased numbers of CD4 T cells, CD8 T cells, B cells, monocytes, NK cells, type 1 dendritic cells, γδ T cells, and increased iNKT cells. Patients showed higher levels of sMIC-A and similar serum levels of sMIC-B.Survival was poorer in patients having higher LDH values and lower numbers of CD4 T cells, type 1 dendritic cells, gamma-delta T cells, and high levels of sMIC-A.In conclusion, high levels of sMIC and decreased numbers in circulating lymphocyte subsets are related to poor outcomes in NHL.

Successful treatment with durvalumab: A case report and review.

Stage III non-small-cell lung cancer (NSCLC) represents a heterogeneous group of disease entities with multimodality treatments. For most patients, platinum-based doublet with concurrent chemoradiotherapy (CRT) has become the first-choice treatment over the past decade. Immune checkpoint inhibition has revolutionized the management of metastatic NSCLC; however, no major advances in systemic therapy for Stage III NSCLC have been made. The following report is the case of a patient with unresectable Stage IIIA NSCLC successfully treated with durvalumab. The patient completed 1 year of treatment without interruptions, and disease control has been maintained for more than 20 months since the start of durvalumab.

Successful treatment of Verona integron-encoded metallo-ß-lactamase-producing Klebsiella pneumoniae infection using the combination of ceftazidime/avibactam and aztreonam.

The case of a female who had an accident that caused an open fracture is reported. During hospitalisation, Verona integron-encoded metallo-ß-lactamase (VIM)-producing Klebsiella pneumoniae was isolated. Antimicrobial susceptibility testing revealed resistance to ß-lactam antibiotics, quinolones, trimethoprim/sulfamethoxazole, and susceptibility to tigecycline, colistin, fosfomycin and aminoglycosides. Synergistic activity of ceftazidime-avibactam and aztreonam was proved in vitro and a combined therapy with tigecycline was started. Combination with aminoglycosides was ruled out as it was not described in the literature and also in order to avoid side effects. Colistin was rejected because of its nephrotoxicity profile. The antibiotic treatment was assessed by a multidisciplinary team with a pharmacist who closely monitored adverse effects and interactions with other drugs. The total duration of this combination was 25 days, without any adverse events reported. Fourteen weeks after the accident the patient was discharged. After 2 months of follow-up neither relapses nor reinfections have been reported.

Can Bacterial Endophytes Be Used as a Promising Bio-Inoculant for the Mitigation of Salinity Stress in Crop Plants?-A Global Meta-Analysis of the Last Decade (2011-2020).

Soil salinity is a major problem affecting crop production worldwide. Lately, there have been great research efforts in increasing the salt tolerance of plants through the inoculation of plant growth-promoting endophytic bacteria. However, their ability to promote plant growth under no-stress and salinity-stress conditions remains largely uncertain. Here, we carried out a global meta-analysis to quantify the plant growth-promoting effects (improvement of morphological attributes, photosynthetic capacity, antioxidative ability, and ion homeostasis) of endophytic bacteria in plants under no-stress and salinity-stress conditions. In addition, we elucidated the underlying mechanisms of growth promotion in salt-sensitive (SS) and salt-tolerant (ST) plants derived from the interaction with endophytic bacteria under no-stress and salinity-stress conditions. Specifically, this work encompassed 42 peer-reviewed articles, a total of 77 experiments, and 24 different bacterial genera. On average, endophytic bacterial inoculation increased morphological parameters. Moreover, the effect of endophytic bacteria on the total dry biomass, number of leaves, root length, shoot length, and germination rate was generally greater under salinity-stress conditions than no-stress conditions. On a physiological level, the relative better performance of the bacterial inoculants under the salinity-stress condition was associated with the increase in total chlorophyll and chlorophyll-b, as well as with the decrease of 1-aminocylopropane-1-carboxylate concentration. Moreover, under the salinity-stress condition, bacterial inoculation conferred a significantly higher increase in root K+ concentration and decrease in leaf Na+ concentration than under the no-stress condition. In SS plants, bacterial inoculation induced a higher increase in chlorophyll-b and superoxide dismutase activity, as well as a higher decrease in abscisic acid content, than in ST plants. Under salinity-stress, endophytic bacterial inoculation increased root K+ concentration in both SS and ST plants but decreased root Na+ concentration only in ST plants. Overall, this meta-analysis suggests that endophytic bacterial inoculation is beneficial under both no salinity-stress and salinity-stress conditions, but the magnitude of benefit is definitely higher under salinity-stress conditions and varies with the salt tolerance level of plants.

The Perception of Rhizosphere Bacterial Communication Signals Leads to Transcriptome Reprogramming in Lysobacter capsici AZ78, a Plant Beneficial Bacterium.

The rhizosphere is a dynamic region governed by complex microbial interactions where diffusible communication signals produced by bacteria continuously shape the gene expression patterns of individual species and regulate fundamental traits for adaptation to the rhizosphere environment. Lysobacter spp. are common bacterial inhabitants of the rhizosphere and have been frequently associated with soil disease suppressiveness. However, little is known about their ecology and how diffusible communication signals might affect their behavior in the rhizosphere. To shed light on the aspects determining rhizosphere competence and functioning of Lysobacter spp., we carried out a functional and transcriptome analysis on the plant beneficial bacterium Lysobacter capsici AZ78 (AZ78) grown in the presence of the most common diffusible communication signals released by rhizosphere bacteria. Mining the genome of AZ78 and other Lysobacter spp. showed that Lysobacter spp. share genes involved in the production and perception of diffusible signal factors, indole, diffusible factors, and N-acyl-homoserine lactones. Most of the tested diffusible communication signals (i.e., indole and glyoxylic acid) influenced the ability of AZ78 to inhibit the growth of the phytopathogenic oomycete Pythium ultimum and the Gram-positive bacterium Rhodococcus fascians. Moreover, RNA-Seq analysis revealed that nearly 21% of all genes in AZ78 genome were modulated by diffusible communication signals. 13-Methyltetradecanoic acid, glyoxylic acid, and 2,3-butanedione positively influenced the expression of genes related to type IV pilus, which might enable AZ78 to rapidly colonize the rhizosphere. Moreover, glyoxylic acid and 2,3-butanedione downregulated tRNA genes, possibly as a result of the elicitation of biological stress responses. On its behalf, indole downregulated genes related to type IV pilus and the heat-stable antifungal factor, which might result in impairment of twitching motility and antibiotic production in AZ78. These results show that diffusible communication signals may affect the ecology of Lysobacter spp. in the rhizosphere and suggest that diffusible communication signals might be used to foster rhizosphere colonization and functioning of plant beneficial bacteria belonging to the genus Lysobacter.

Characterisation of the Antibiotic Profile of Lysobacter capsici AZ78, an Effective Biological Control Agent of Plant Pathogenic Microorganisms.

Determining the mode of action of microbial biocontrol agents plays a key role in their development and registration as commercial biopesticides. The biocontrol rhizobacterium Lysobacter capsici AZ78 (AZ78) is able to inhibit a vast array of plant pathogenic oomycetes and Gram-positive bacteria due to the release of antimicrobial secondary metabolites. A combination of MALDI-qTOF-MSI and UHPLC-HRMS/M was applied to finely dissect the AZ78 metabolome and identify the main secondary metabolites involved in the inhibition of plant pathogenic microorganisms. Under nutritionally limited conditions, MALDI-qTOF-MSI revealed that AZ78 is able to release a relevant number of antimicrobial secondary metabolites belonging to the families of 2,5-diketopiperazines, cyclic lipodepsipeptides, macrolactones and macrolides. In vitro tests confirmed the presence of secondary metabolites toxic against Pythium ultimum and Rhodococcus fascians in AZ78 cell-free extracts. Subsequently, UHPLC-HRMS/MS was used to confirm the results achieved with MALDI-qTOF-MSI and investigate for further putative antimicrobial secondary metabolites known to be produced by Lysobacter spp. This technique confirmed the presence of several 2,5-diketopiperazines in AZ78 cell-free extracts and provided the first evidence of the production of the cyclic depsipeptide WAP-8294A2 in a member of L. capsici species. Moreover, UHPLC-HRMS/MS confirmed the presence of dihydromaltophilin/Heat Stable Antifungal Factor (HSAF) in AZ78 cell-free extracts. Due to the production of HSAF by AZ78, cell-free supernatants were effective in controlling Plasmopara viticola on grapevine leaf disks after exposure to high temperatures. Overall, our work determined the main secondary metabolites involved in the biocontrol activity of AZ78 against plant pathogenic oomycetes and Gram-positive bacteria. These results might be useful for the future development of this bacterial strain as the active ingredient of a microbial biopesticide that might contribute to a reduction in the chemical input in agriculture.

Isolation of 2,5-diketopiperazines from Lysobacter capsici AZ78 with activity against Rhodococcus fascians.

Inhibitory activity of the biocontrol bacterial strain Lysobacter capsici AZ78 is related to the production of cyclo(l-Pro-l-Tyr), a 2,5-diketopiperazine with in vitro and in vivo toxic activity against Phytophthora infestans and Plasmopara viticola. Further investigation of culture filtrate organic extracts showed its ability to produce other 2,5-diketopiperazines. They were isolated and identified by spectroscopic (1H NMR and ESIMS) and physic (specific optical rotation) methods as cyclo(l-Pro-l-Val), cyclo(d-Pro-d-Phe), cyclo(l-Pro-l-Leu), and cyclo(d-Pro-l-Tyr). When tested against the phytopathogenic Gram-positive bacterium Rhodococcus fascians LMG 3605, cyclo(l-Pro-l-Val) showed a toxic activity similar to chloramphenicol at a comparable concentration. Overall, these data suggest that 2,5-diketopiperazines represent a class of metabolites characterizing the metabolome of L. capsici AZ78. Furthermore, the toxic activity showed by cyclo(l-Pro-l-Val) against R. fascians LMG 3605 broaden the spectrum activity of 2,5-diketopiperazines against phytopathogenic microorganisms enforcing their potential development as biopesticides.[Figure: see text].

Clinical relevance of NKT cells and soluble MIC-A in Hodgkin lymphoma.

Previous studies demonstrated that the majority of Hodgkin lymphoma (HL) patients achieve response after treatment, while 5% become refractory. Studies analyzing the role of lymphocyte subsets in peripheral blood are limited. This investigation sought to evaluate peripheral blood lymphocyte subsets and soluble MHC class I chain-related proteins A and B (sMIC-A/B) and their correlation with survival in patients with newly diagnosed HL. The study recruited 36 patients and 72 healthy donors. HL patients showed a decrease in CD4, B, monocytes, NK, and NKT cells; and an increase in γ-δ T cells and soluble MIC-A serum levels. Higher values of s-MIC-A  >100 ng/mL and NKT cells >40 µL correlated with poor overall survival (OS). In conclusion, in HL peripheral blood CD4 T and B cells, monocytes, NK, and NKT cells were decreased, while s-MIC-A and γ-δ T cells increased. Higher values of s-MIC-A and NKT cells correlated with poor survival.

Implementation of a novel home delivery service during pandemic.

INTRODUCTION: During the COVID-19 pandemic, measures have been put in place to adapt to patients' needs during home quarantine, such as "telehealthcare". With this service, hospital pharmacists develop a distinct role via the implementation of pharmacovigilance services and pharmaceutical care plans for patients with comorbidities, and for special populations as immunosuppressed patients.MethodsCross-sectional study involving hospital and community pharmacists actively practising during the COVID-19 pandemic. Patients who could not come to the hospital pharmacy department were provided with a delivery service to the community pharmacy of their choice. RESULTS: A total of 1186 patients requested this service. Erythropoiesis-stimulating agents were the most in-demand medication, followed by rheumatoid arthritis and antiretroviral drugs. 125 patients responded to the telephone survey, most of whom stated that they would use the delivery service again, and expressed their desire to continue doing so. DISCUSSION: Without a doubt, telepharmacy and medication delivery services have provided multiple benefits during home quarantine. The delivery service enabled us to provide drugs to patients in their immediate environment through a service that was free for both the patient and the hospital pharmacy service. However, at present, the available evidence of the impact of telepharmacy models is sparse. CONCLUSIONS: This medication delivery service has provided multiple benefits to patients during home quarantine. Although the users of this service seem to be satisfied with the current model, in the future, we should consider which patients would benefit most from this service and shape it to individual needs.

Bartonella henselae encephalopathy in a paediatric patient: A case report and treatment review.

WHAT IS KNOWN AND OBJECTIVES: Bartonella henselae is the etiologic agent of "cat scratch disease (CSD)". We describe a case of atypical CSD in a paediatric patient and include a review of the antibiotic treatment for this disease. CASE DESCRIPTION: A 2-year-old child, with convulsive status and loss of consciousness, was admitted to hospital. Several antiepileptics and antibiotics were prescribed due to suspected central nervous system infection. When serology revealed Bartonella henselae antibodies, targeted antibiotic therapy was initiated and symptoms improved. However, seizures reappeared days after finishing the treatment so antiepileptics and antibiotics were reintroduced. WHAT IS NEW AND CONCLUSION: A wide variety of antibiotic regimens have been used for the treatment of atypical CSD in paediatric patients. This report includes the case of a paediatric patient diagnosed with atypical CSD who presented neurological manifestations, and for which a regimen consisting of azithromycin and rifampin was employed to achieve recovery.

Guselkumab in moderate-to-severe plaque psoriasis: effectiveness in real clinical practice / Guselkumab en placa de moderada a grave psoriasis: eficacia en la práctica clínica real

Introducción: La psoriasis es una enfermedad cutánea inflamatoria crónica inmunomediada que afecta a casi el 1-2% de la población mundial. El tratamiento biológico de la psoriasis moderada a grave ha cambiado el paradigma de manejo de la enfermedad, permitiendo un mejor control de la misma. Métodos: Se llevo a cabo un estudio observacional retrospectivo que incluyó a pacientes con psoriasis moderada a grave que fueron tratados durante al menos 36 semanas con guselkumab. La eficacia se evaluó mediante la estimación de pacientes que alcanzaron las respuestas PASI 75, PASI 90 y PASI 100 en las semanas 16, 24 y 36. Se utilizó la prueba T de Student para muestras pareadas para determinar la significación estadística entre PASI al inicio y respuesta PASI en las semanas 16, 24 y 36. Resultados: Se incluyeron 22 pacientes, 14 mujeres (63, 6%), con una edad media de 48, 7 ± 15, 5 años. El tratamiento con guselkumab redujo el PASI medio de 10, 3 ± 6 al inicio del estudio a 2, 4 ± 2 (p = 0,003), 1, 3 ± 1, 8 (p = 0,001) y 0, 3 ± 0, 6 (p = 0,001) a las 16, 24 y 36 semanas, respectivamente. Discusión: El primer fármaco en unirse al arsenal terapéutico anti-IL23 fue guselkumab. La eficacia obtenida fue superior a la observada en estudios fase III para PASI 90 y 100 a la semana 36. Existen algunos estudios que han evaluado la eficacia a corto plazo de guselkumab en la práctica clínica real; sin embargo, este fármaco se ha comercializado recientemente, limitando la posibilidad de evaluación durante períodos de tiempo más prolongados. Conclusión: Guselkumab presenta buenos resultados en el manejo de la psoriasis en adultos. La práctica clínica real a medio y largo plazo será fundamental, con un mayor tamaño muestral y período de seguimiento.

Introduction: Psoriasis is a chronic immune­ mediated inflammatory skin disease that affects nearly 1­2% of the population worldwide. Biologic treatment of moderate-to-severe psoriasis has changed the disease management paradigm, allowing for better disease control. Methods: A retrospective observational study including patients with moderate-to-severe psoriasis who were treated for at least 36 weeks with guselkumab. Efficacy was evaluated by estimating the proportion of patients achieving PASI 75, PASI 90 and PASI 100 responses at weeks 16, 24 and 36. The Student t-test for paired samples was used to determine the significant difference in outcome of patients between PASI at baseline and PASI response at weeks 16, 24 and 36. Reslts: 22 patients were included, 14 women (63.6%), with mean age of 48.7±15.5. Guselkumab treatment decreased mean PASI from 10.3±6 at baseline to 2.4±2 (p=0.003), 1.3±1.8 (p=0.001) and 0.3±0.6 (p=0.001) at 16, 24 and 36 weeks, respectively. Discussion: The first anti-IL23 drug family to join the therapeutic arsenal is guselkumab. The efficacy obtained is higher than that observed in phase III studies for PASI 90 and 100 at week 36. There are some studies that have evaluated the short-term effectiveness of guselkumab in real clinical practice; however, this drug has only recently been marketed, limiting the possibility of as yet longer treatment periods. Conclusion: Guselkumab shows great results in the management of psoriasis in adults. Medium- and long-term real clinical practice will be essential, with a larger sample size and longer follow-up period.

Concepts and applications of foliar spray for microbial inoculants.

Damages of the (agro)ecosystem by extensive use of chemical fertilizers and pesticides, the global dying of bee populations possibly linked to pesticide spraying, and stricter regulations for pesticide use together with successful use of microbials in IPM programs are pushing on the development and commercialization of new microbial products and a large and growing biostimulants and biocontrol market. This review focuses on microbial inoculants including bacteria, fungi, and viruses used as biostimulant or biocontrol agent for foliar application and covers all important steps from inoculant development to successful field application. Topics presented comprise typical spraying equipment including the importance of the spraying process and relating effects, furthermore formulation development including classification and adjuvants, and thirdly regulatory aspects as currently applied or under discussion. Microbial inoculants for foliar spray reported in scientific literature are summarized and contrasted with selected commercial products. Special attention is given to factors most important in microbial spray: (a) type of active ingredient (bacteria, fungi, viruses), (b) mode of action (ingestion, contact, competition), (c) interaction with the plant leaf surface, (d) droplet size in terms of microbe concentration and leaf coverage, and (e) environmental conditions during spraying. Finally, we want to emphasize that timely administration is of utmost importance for successful spraying and maximum efficacy. This might be supported by weather stations and disease/pest models as an important step towards precision farming.

Maintenance and assessment of cell viability in formulation of non-sporulating bacterial inoculants.

The application of beneficial, plant-associated microorganisms is a sustainable approach to improving crop performance in agriculture. However, microbial inoculants are often susceptible to prolonged periods of storage and deleterious environmental factors, which negatively impact their viability and ultimately limit efficacy in the field. This particularly concerns non-sporulating bacteria. To overcome this challenge, the availability of protective formulations is crucial. Numerous parameters influence the viability of microbial cells, with drying procedures generally being among the most critical ones. Thus, technological advances to attenuate the desiccation stress imposed on living cells are key to successful formulation development. In this review, we discuss the core aspects important to consider when aiming at high cell viability of non-sporulating bacteria to be applied as microbial inoculants in agriculture. We elaborate the suitability of commonly applied drying methods (freeze-drying, vacuum-drying, spray-drying, fluidized bed-drying, air-drying) and potential measures to prevent cell damage from desiccation (externally applied protectants, stress pre-conditioning, triggering of exopolysaccharide secretion, 'helper' strains). Furthermore, we point out methods for assessing bacterial viability, such as colony counting, spectrophotometry, microcalorimetry, flow cytometry and viability qPCR. Choosing appropriate technologies for maintenance of cell viability and evaluation thereof will render formulation development more efficient. This in turn will aid in utilizing the vast potential of promising, plant beneficial bacteria as sustainable alternatives to standard agrochemicals.

Metodología de la valoración del impacto en salud de instrumentos de planeamiento urbanístico en Andalucía / Health impact assessment methodology for urban planning projects in Andalusia (Spain)

Objetivo: Se describe la herramienta desarrollada en Andalucía para llevar a cabo el análisis y la valoración prospectiva de los impactos en la salud de instrumentos de planificación urbana y el proceso seguido para su diseño. Método: Se identificaron los impactos en la salud derivados de la configuración urbana según la evidencia científica existente, y los posibles métodos para su evaluación. Una vez obtenido el proyecto de la nueva herramienta, esta se pilotó mediante distintos procesos de validación interna y externa (reuniones, talleres y entrevistas con informantes clave). Resultados: Se obtuvo una herramienta que consta de siete fases estructuradas en dos grandes etapas. La primera etapa, descriptiva, nos guía en cómo recabar la información necesaria para describir el proyecto y caracterizar a la población afectada. La segunda, de análisis, nos permite, a través de distintas fases y el uso de diversos instrumentos de ayuda, descartar o identificar los posibles impactos significativos derivados. Conclusiones: Tanto en la fase de pilotaje como durante su aplicación sistemática, dado que la entrada en vigor del Decreto 169/2014 (16 de junio de 2015) materializó la obligación de someter determinados instrumentos de planificación urbana a evaluación del impacto en la salud, la herramienta que se describe ha mostrado sensibilidad en la identificación de potenciales impactos significativos en la salud relacionados con las medidas propuestas en dichos proyectos. No obstante, se configura como una herramienta viva y con espíritu de cambio conforme la experiencia derivada de su uso lo vaya aconsejando (AU)

Objective: To describe the tool developed in Andalusia (Spain) to conduct an analysis and prospective assessment of health impacts from urban planning projects as well as the process followed to design it. Method: On the one hand, direct and indirect relationships between urban setting and health were identified in light of the best scientific evidence available; and, on the other hand, methods and tools in impact assessment were reviewed. After the design of the tool, it was tested via both internal and external validation processes (meetings, workshops and interviews with key informants). Results: The tool consists of seven phases, structured in two stages. A first descriptive stage shows how to obtain information about goals, objectives and general points pertaining the project and also to characterise the potentially affected population. The second one indicates, in several phases, how to identify and sort out potential impacts from the project using different supporting tools. Conclusions: Both in the testing phase and through its implementation since the entry into force of Andalusian Decree 169/2014 (16 June 2015) and forced all urban planning projects to be subjected to an Health Impact Assessment, this methodology has proved responsive, identifying major potential health impacts from the measures included in those projects. However, the tool has been shaped as a living tool and will be adapted in line with the experience acquired in its use (AU)

Design and development of a workflow for microbial spray formulations including decision criteria.

Herein, we present a workflow for the development of talc-based microbial inoculants for foliar spray consisting of four steps. These include together with decision-making criteria (1) the selection of additives based on their capability to wet juvenile maize leaves, (2) their adhesion on the plant, (3) their interaction with the biological systems, and (4) the choice of thickener for good dispersion stability. In total, 29 additives including polysaccharides and proteins, polyols, glycosides, oils, waxes, and surfactants (e.g., chitosan, gelatin, glycerol, saponin, castor oil, polyethylene, rhamnolipid) were evaluated. Contact angle and spreading index measurements revealed that the use of 5% Geloil, 1% rhamnolipid, or suitable combinations of Geloil + rhamnolipid and Nurture Yield S 2002 + rhamnolipid enhanced wetting of hydrophobic maize leaves and adherence, similarly to the commercial wetting agents recommended for plant protection 1% Prev B2 and 1% Trifolio S Forte. Interaction of additives with biological systems was based on biocompatibility and phytotoxicity assays, and cell viability monitoring using the endophytic Gram-negative bacterium Paraburkholderia phytofirmans PsJN. Results from biocompatibility assays indicated that in contrast to rhamnolipid and Prev B2 Geloil, Nurture Yield S 2002 and Trifolio S Forte fully supported bacterial growth within a concentration range of 1 to 5%. Dose-dependent phytotoxicity was observed in plants treated with rhamnolipid. Most efficient formulation was composed of PsJN, talc, xanthan, and Geloil. Beyond that, the proposed workflow is expected to generally provide guidance for the development of spray formulations and help other researchers to optimize their choices in this area.

[Health impact assessment methodology for urban planning projects in Andalusia (Spain)]. / Metodología de la valoración del impacto en salud de instrumentos de planeamiento urbanístico en Andalucía.

OBJECTIVE: To describe the tool developed in Andalusia (Spain) to conduct an analysis and prospective assessment of health impacts from urban planning projects as well as the process followed to design it. METHOD: On the one hand, direct and indirect relationships between urban setting and health were identified in light of the best scientific evidence available; and, on the other hand, methods and tools in impact assessment were reviewed. After the design of the tool, it was tested via both internal and external validation processes (meetings, workshops and interviews with key informants). RESULTS: The tool consists of seven phases, structured in two stages. A first descriptive stage shows how to obtain information about goals, objectives and general points pertaining the project and also to characterise the potentially affected population. The second one indicates, in several phases, how to identify and sort out potential impacts from the project using different supporting tools. CONCLUSIONS: Both in the testing phase and through its implementation since the entry into force of Andalusian Decree 169/2014 (16 June 2015) and forced all urban planning projects to be subjected to an Health Impact Assessment, this methodology has proved responsive, identifying major potential health impacts from the measures included in those projects. However, the tool has been shaped as a living tool and will be adapted in line with the experience acquired in its use.

Institucionalización de la evaluación del impacto en la salud en Andalucía / A strategy for institutionalisation of health impact assessment in Andalusia (Spain)

La evaluación del impacto en la salud (EIS) es una herramienta que persigue incorporar la salud y el bienestar de la ciudadanía como componente vital en la formulación de políticas. Para muchos autores, si se incorporara de manera sistemática en los procesos de toma de decisión permitiría la consecución de dicho objetivo. Para ello es necesario superar una serie de dificultades, entre las que cabe destacar la obligatoriedad de su empleo, la concienciación de los distintos sectores cuyas decisiones pueden tener impactos significativos en la salud, su diseño de manera que permita un abordaje integral de los determinantes de salud y la capacitación de los profesionales responsables de su aplicación. Andalucía ha incluido en su legislación la EIS de manera preceptiva y vinculante para la aprobación de proyectos en ámbitos como el planeamiento urbanístico, actividades sometidas a instrumentos de prevención y control ambiental, y planes y programas aprobados por Consejo de Gobierno. Su implantación ha requerido integrarla en los procedimientos de autorización, la capacitación de grupos multidisciplinarios de profesionales de salud pública, la elaboración de guías metodológicas de asesoramiento y la celebración de distintas jornadas de difusión y formación específica por sectores objeto de su ámbito de aplicación (AU)

Health impact assessment (HIA) aims to incorporate people's health and wellbeing as a key feature in policy-making. Many authors believe that HIA might be systematically integrated into all decision-making processes as a way to achieve that goal. To that end, there is need to overcome a number of challenges, including the fact that Andalusia (Spain) has made HIA compulsory by law, the need for awareness of all public sectors whose decisions might have substantial impacts on health and for a methodology that would enable a comprehensive approach to health determinants and inequalities, and the training of both the public health staff and professional sectors responsible for its application. In Andalusia, a law provides mandatory and binding health impact reports for most authorisation procedures in different areas: from sectoral plans to urban planning schemes, and especially projects subject to environmental assessment. Implementation of this law has required its integration into authorisation procedures, the training of interdisciplinary working groups in public health, the preparation of technical guidelines, and the organisation of dissemination and training seminars for developers (AU)

[A strategy for institutionalisation of health impact assessment in Andalusia (Spain)]. / Institucionalización de la evaluación del impacto en la salud en Andalucía.

Health impact assessment (HIA) aims to incorporate people's health and wellbeing as a key feature in policy-making. Many authors believe that HIA might be systematically integrated into all decision-making processes as a way to achieve that goal. To that end, there is need to overcome a number of challenges, including the fact that Andalusia (Spain) has made HIA compulsory by law, the need for awareness of all public sectors whose decisions might have substantial impacts on health and for a methodology that would enable a comprehensive approach to health determinants and inequalities, and the training of both the public health staff and professional sectors responsible for its application. In Andalusia, a law provides mandatory and binding health impact reports for most authorisation procedures in different areas: from sectoral plans to urban planning schemes, and especially projects subject to environmental assessment. Implementation of this law has required its integration into authorisation procedures, the training of interdisciplinary working groups in public health, the preparation of technical guidelines, and the organisation of dissemination and training seminars for developers.

Cuidado de enfermería en una unidad de cuidado intensivo oncológico pediátrico: la importancia del perdón / Nursing care in a pediatric cancer intensive care unit: importance of forgiveness

Resumen:

Objetivos: analizar a través de una “situación de enfermería” el cuidado integral enfermero en cuidado intensivo oncológico pediátrico. Método: con base en la guía para el análisis de situaciones de enfermería desarrollada por el Grupo de Cuidado al Paciente Crónico y su Familia, de la Universidad Nacional de Colombia, se tomó una historia que sucedió en una unidad de cuidado intensivo oncológico pediátrico, para identificar en ella los componentes teórico-conceptuales del cuidado integral de enfermería.

Resultados: la “situación de enfermería” analizada refleja la visión filosófica integrativa-interactiva de la enfermería, permite analizar los conceptos que se evidencian en la práctica clínica y explorar los conocimientos que exige el cuidado integral de un paciente pediátrico con cáncer en cuidados intensivos, donde se ponen en evidencia los principios y valores profesionales e institucionales. Conclusión: la “situación de enfermería” vivida con una niña atendida en cuidado intensivo oncológico pediátrico y su familia, permite comunicar los conocimientos de cuidado que requiere una enfermera. La aplicación de una guía para reflexionar sobre la propia práctica clínica facilita el análisis y comprensión del cuidado, así como los valores y principios que lo respaldan.

Abstract:

Purpose: to analyze integral nursing care through a "nursing situation" in pediatric cancer intensive care. Methods: based on a guideline for nursing situation analysis developed by the Group for Chronic Patients and Families Care at National University of Colombia, a narrative was used in a pediatric cancer intensive care unit, in order to recognize theoretical-conceptual elements in integral nursing care. Results: this “nursing situation” reflects an integrative-interactive philosophical view of nursing and allows concepts shown in clinical practice to be analyzed. Moreover, knowledge required by integral care of pediatric cancer patients in intensive care units is explored with principles and professional and institutional values being shown.

Conclusion: a “nursing situation” in a girl being admitted in a pediatric cancer intensive care unit and her relatives allows knowledge on nursing care to be communicated. Use of a guideline to think about nursing clinical practice helps to analyze and understand both nursing care and underlying values and principles.

Objetivo: para analisar através de uma "situação de enfermagem" cuidados de enfermagem globais em oncologia pediátrica de tratamento intensivo. Método: com base na orientação para a análise de situações de enfermagem desenvolvido pelo Grupo de Assistência ao Paciente Crônico e Família da Universidade Nacional da Colômbia, uma narrativa que aconteceu em uma unidade de oncologia pediátrica de terapia intensiva foi feita para identificar que componentes teóricos conceituais de cuidados de enfermagem globais. Resultados: o "status de Enfermagem" reflete analisados integrativa visão filosófica de enfermagem interativo, para analisar os conceitos que são evidentes na prática clínica e explorar o conhecimento necessário cuidado integral aos pacientes pediátricos de câncer em cuidados intensivos, onde Eles destacam os princípios e valores profissionais e institucionais. Conclusão: "situação de Enfermagem" vivia com uma menina tratada em oncologia de terapia intensiva pediátrica e sua família, podem se comunicar conhecimento dos cuidados exigidos por uma enfermeira. Aplicando um guia para refletir sobre a prática clínica própria facilita a análise e compreensão dos cuidados, bem como os valores e princípios que a sustentam.