Productos ANID

AbstractBackgroundEvidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time.MethodsWe used national register data from Chile including all people, 10–65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20–F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest.ResultsWe identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18–39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7–19.1]. Multilevel Poisson regression identified a strong age–sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0–59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4–30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed.ConclusionOur findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.

AbstractSeveral challenges exist for referral and transport of critically ill children in resource-limited regions such as Latin America; however, little is known about factors associated with clinical outcomes. Thus, we aimed to describe the characteristics of critically ill children in Latin America transferred to pediatric intensive care units for acute respiratory failure to identify risk factors for mortality. We analyzed data from 2,692 patients admitted to 28 centers in the Pediatric Collaborative Network of Latin America Acute Respiratory Failure Registry. Among patients referred from another facility (773, 28%), nonurban transports were independently associated with mortality (adjusted odds ratio = 9.4; 95% confidence interval: 2.4–36.3).

Abstract Study Objectives Our aim is to evaluate the presence of REM sleep without atonia (RWA), the objective hallmark of REM sleep Behaviour Disorder (RBD), as prodromal marker of Parkinson’s disease (PD), in an adult cohort of 22q11.2 deletion syndrome (22qDS). Methods Sleep quality was assessed by means of Pittsburgh quality scale index (PSQI), and RBD symptoms by means of RBD questionnaire-Hong-Kong (RBDQ-HK). Attended domiciliary video-Polysomnography (v-PSG) were performed in 26 adults (18–51 years, 14 females) 22qDS patients. Electromyogram during REM sleep was analyzed by means of SINBAR procedure at 3-second time resolution (miniepochs). Results An overall poor sleep quality was observed in the cohort and high RBDQ-HK score in 7 of the 26 patients, two additional patients with positive dream enactment reported by close relatives had low score of RBDQ-HK. Nevertheless, SINBAR RWA scores were lower than cut-off threshold for RWA (mean 5.5%, range 0–12.2%). TST and the percentage of light sleep (N1) were increased, with preserved proportions of N2 and N3. Participants reported poor quality of sleep (mean PSQI > 5), with prolonged sleep latency in the v-PSG. No subjects exhibit evident dream enactment episodes during recording sessions. Conclusions RWA was absent in the studied cohort of 22qDS adult volunteers according to validated polysomnographic criteria. High RBDQ-HK scores do not correlate with v-PSG results among 22qDS individuals.

Abstract The exposure of a research team to chigger mites in southern Chile allowed the first identification of a trombiculid species as vector and reservoir of scrub typhus outside the tsutsugamushi triangle, providing unique insights into the ecology and transmission of this recently discovered rickettsial infection in South America.

A novel approach for two-dimensional modeling of elastomeric bearings using three springs in parallel is presented. This simplified element model considers as follows: (1) an elastoplastic spring with a smooth transition between branches; (2) a linear elastic spring; and (3) a non-linear elastic spring, and is fully defined by only six parameters. The main advantages of the simplified model are twofold: (1) versatility, as a single model is capable of accurately reproducing the main characteristics of the hysteretic behavior of different types of rubber-based seismic isolators, including low damping rubber bearings (LDRBs), high damping rubber bearings (HDRBs), and lead-core rubber bearings (LRBs) and (2) simplicity, as it requires fewer parameters and it is easier to calibrate from experimental cyclic test results than most currently available models. Model parameters’ identification is illustrated using quasi-static cyclic and earthquake simulator tests of HDRBs and LRBs, demonstrating that the model shows a good agreement between the test-measured and model-predicted hysteretic behavior. Different objective functions are evaluated in the optimization procedure, and their effect on the identified parameters is studied and discussed. This practitioner-oriented model is particularly amenable for implementation in general-purpose structural analysis software. Its usage is strongly recommended as an initial-stage design tool to select the optimal isolation system for a specific project.

AbstractUnderstand the degree to which a Sense of Community at School can predict the Life Satisfaction of Chilean students in the fifth and seventh grades. The classroom and school components will be presented separately. The research was designed as a descriptive study using a survey with a probabilistic sample made up of 1959 students (52.6% male and 47.4% female) in the fifth and seventh grades at elementary schools in the cities of Concepción and Santiago in Chile. A multiple linear regression analysis was done using the Multidimensional Scales of School Sense of Community (SOC‐S) and Classroom Sense of Community (SOC‐C) as predictors of life satisfaction measured with the Student Life Satisfaction Scale (SLSS). Multigroup analysis was conducted to make comparisons by sex and grade. The dimension of “sense of belonging and emotional connection” of the SOC‐C and the dimension of “belonging” of the SOC‐S predict life satisfaction for fifth grade students. The additional dimension of “emotional connection” of the SOC‐S scale was included for the seventh‐grade students. The sense that one is part of the school community is a dimension that affects childhood life satisfaction. Its level of contribution varies by age, with the sense of belonging and emotional connection variables being the relevant ones.

Abstract Background Vancomycin-resistant enterococci (VRE) are major therapeutic challenges. Prospective contemporary data characterizing the clinical and molecular epidemiology of VRE bloodstream infections (BSIs) are lacking. Methods The Vancomycin-Resistant Enterococcal BSI Outcomes Study (VENOUS I) is a prospective observational cohort of adult patients with enterococcal BSI in 11 US hospitals. We included patients with Enterococcus faecalis or Enterococcus faecium BSI with ≥1 follow-up blood culture(s) within 7 days and availability of isolate(s) for further characterization. The primary study outcome was in-hospital mortality. Secondary outcomes were mortality at days 4, 7, 10, 12, and 15 after index blood culture. A desirability of outcome ranking was constructed to assess the association of vancomycin resistance with outcomes. All index isolates were subjected to whole genome sequencing. Results Forty-two of 232 (18%) patients died in hospital and 39 (17%) exhibited microbiological failure (lack of clearance in the first 4 days). Neutropenia (hazard ratio [HR], 3.13), microbiological failure (HR, 2.4), VRE BSI (HR, 2.13), use of urinary catheter (HR, 1.85), and Pitt BSI score ≥2 (HR, 1.83) were significant predictors of in-hospital mortality. Microbiological failure was the strongest predictor of in-hospital mortality in patients with E faecium bacteremia (HR, 5.03). The impact of vancomycin resistance on mortality in our cohort changed throughout the course of hospitalization. Enterococcus faecalis sequence type 6 was a predominant multidrug-resistant lineage, whereas a heterogeneous genomic population of E faecium was identified. Conclusions Failure of early eradication of VRE from the bloodstream is a major factor associated with poor outcomes.

Abstract 22q11.2 deletion syndrome (22q11.2DS) is a genetic neurodevelopmental disorder that represents one of the greatest known risk factors for psychosis. Previous studies in psychotic subjects without the deletion have identified a dopaminergic dysfunction in striatal regions, and dysconnectivity of striatocortical systems, as an important mechanism in the emergence of psychosis. Here, we used resting-state functional MRI to examine striatocortical functional connectivity in 22q11.2DS patients. We used a 2 × 2 factorial design including 125 subjects (55 healthy controls, 28 22q11.2DS patients without a history of psychosis, 10 22q11.2DS patients with a history of psychosis, and 32 subjects with a history of psychosis without the deletion), allowing us to identify network effects related to the deletion and to the presence of psychosis. In line with previous results from psychotic patients without 22q11.2DS, we found that there was a dorsal to ventral gradient of hypo- to hyperstriatocortical connectivity related to psychosis across both patient groups. The 22q11.2DS was additionally associated with abnormal functional connectivity in ventral striatocortical networks, with no significant differences identified in the dorsal system. Abnormalities in the ventral striatocortical system observed in these individuals with high genetic risk to psychosis may thus reflect a marker of illness risk.

AbstractBackgroundCognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls.MethodsWe included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments.ResultsPatients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology.ConclusionsPatients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.

Labor and delivery entail a complex and sequential metabolic and physiologic cascade, culminating in most circumstances in successful childbirth, although delivery can be a risky episode if oxygen supply is interrupted, resulting in perinatal asphyxia (PA). PA causes an energy failure, leading to cell dysfunction and death if re-oxygenation is not promptly restored. PA is associated with long-term effects, challenging the ability of the brain to cope with stressors occurring along with life. We review here relevant targets responsible for metabolic cascades linked to neurodevelopmental impairments, that we have identified with a model of global PA in rats. Severe PA induces a sustained effect on redox homeostasis, increasing oxidative stress, decreasing metabolic and tissue antioxidant capacity in vulnerable brain regions, which remains weeks after the insult. Catalase activity is decreased in mesencephalon and hippocampus from PA-exposed (AS), compared to control neonates (CS), in parallel with increased cleaved caspase-3 levels, associated with decreased glutathione reductase and glutathione peroxidase activity, a shift towards the TIGAR-dependent pentose phosphate pathway, and delayed calpain-dependent cell death. The brain damage continues long after the re-oxygenation period, extending for weeks after PA, affecting neurons and glial cells, including myelination in grey and white matter. The resulting vulnerability was investigated with organotypic cultures built from AS and CS rat newborns, showing that substantia nigra TH-dopamine-positive cells from AS were more vulnerable to 1 mM of H2O2 than those from CS animals. Several therapeutic strategies are discussed, including hypothermia; N-acetylcysteine; memantine; nicotinamide, and intranasally administered mesenchymal stem cell secretomes, promising clinical translation.

In this study, we analyze how 9–10-year-old pupils work with equations, a central aspect of algebraic thinking in early grades and a cornerstone for more formal learning of algebra. Specifically, we seek: (a) to describe the main characteristics of the tasks that support algebraic thinking through a translation process from arithmetic word problems to algebraic language and vice versa, and (b) to identify how pupils refer to indeterminate quantities in these contexts and what meaning they give to them. The analysis focuses on the semantic congruence of the expressions proposed by them and on the dialogue they held during the translation process. We analyzed the oral discussion in the pools and the written responses to the problem that pupils posed. The results show that arithmetic word problems allow the indeterminate to become an object of thought for pupils, who represent it in multiple ways and refer to it when proposing equations that represent the structure of each problem. Another finding highlights that reflection on the interpretation of the equations supports the identification of two meanings associated with indeterminate quantities, namely, unknown and variable.

An experimental method to measure forces of small magnitude with a strain gauge as a force sensor in the fluid–wall interaction of open water channels is presented. Six uniaxial strain gauges were employed for this purpose, which were embedded across the entire sensing area and subjected to pure bending, employing two-point bending tests. Sixteen two-point bending tests were performed to determine the existence of a direct relationship between the load and the instrument signal. Furthermore, a regression analysis was used to estimate the parameters of the model. A data acquisition system was developed to register the behavior of the strain gauge relative to the lateral displacement induced by the loading nose of the universal testing machine. The results showed a significant linear relationship between the load and the instrumental signal, provided that the strain gauge was embedded between 30% and 45% of the central axis in the sensing area of the sensor (R2 > 0.99). Thus, the proposed sensor can be employed to measure forces of small magnitude. Additionally, the linear relationship between the load and the instrumental signal can be used as a calibration equation, provided that the strain gauge is embedded close to the central axis of the sensing area.