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Childhood socioemotional development and growth mindset preceding schizophrenia: case–control study using prospectively collected data
(Royal College of Psychiatrists, 2026-04-06)
Javiera Vasquez-Nuñez
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José Conejeros
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Camila Díaz-Dellarrossa
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Cristian Mena
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UNDURRAGA FOURCADE, JUAN PABLO
<jats:sec id="S2056472426110047_as1"> <jats:title>Background</jats:title> <jats:p>Understanding premorbid socioemotional trajectories in schizophrenia is crucial for early identification and potential primary prevention. Studies in adults with schizophrenia suggest similar socioemotional premorbid difficulties, but are limited by their retrospective design.</jats:p> </jats:sec> <jats:sec id="S2056472426110047_as2"> <jats:title>Aims</jats:title> <jats:p>To contribute new insights into the premorbid socioemotional characteristics of schizophrenia, beyond the biases of retrospective studies, this research investigates three educational socioemotional dimensions in children who later developed the disorder.</jats:p> </jats:sec> <jats:sec id="S2056472426110047_as3"> <jats:title>Method</jats:title> <jats:p> We conducted a case–control study using prospectively collected data, examining childhood differences in perceived parental support, self-esteem and school motivation, and growth mindset (intelligence can improve through effort) among individuals who later developed schizophrenia ( <jats:italic>n</jats:italic> = 341) and their classmates ( <jats:italic>n</jats:italic> = 20 567). We constructed <jats:italic>z</jats:italic> -normalised indicators based on standardised national tests administered in fourth, eighth and tenth grades in Chile. Mixed linear models accounted for repeated measures and adjusted for educational level, gender, grade point average, school and year. </jats:p> </jats:sec> <jats:sec id="S2056472426110047_as4"> <jats:title>Results</jats:title> <jats:p> Children later diagnosed with schizophrenia reported less parental educational support compared with their classmates ( <jats:italic>β</jats:italic> = −0.276, 95% CI −0.388 to −0.163). Only girls who later developed schizophrenia reported lower self-esteem and school motivation than their peers ( <jats:italic>β</jats:italic> = −0.290, 95% CI −0.498 to −0.131). Contrary to our hypothesis, children who later developed schizophrenia showed a higher growth mindset ( <jats:italic>β</jats:italic> = 0.287, 95% CI 0.077–0.497). </jats:p> </jats:sec> <jats:sec id="S2056472426110047_as5"> <jats:title>Conclusions</jats:title> <jats:p>Our results suggest that premorbid socioemotional characteristics in schizophrenia are detectable in childhood and may vary by gender. These findings highlight the potential of educational settings as platforms for preventive interventions aimed at enhancing parental support and monitoring students’ psycho-emotional well-being, while acknowledging gender-specific developmental trajectories and heterogeneity in premorbid functioning.</jats:p> </jats:sec>
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Premorbid school performance trajectories in patients with treatment-resistant schizophrenia prescribed clozapine in the public health system in Chile: a case-control study, 2007–2020
(Cambridge University Press (CUP), 2025)
Jose Conejeros-Pavez
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Javiera Vasquez
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Camila Diaz
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Cristian Mena
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UNDURRAGA FOURCADE, JUAN PABLO
Background The premorbid phase of treatment-resistant schizophrenia (TRS) may reveal underlying mechanisms and inform early interventions. According to the neurodevelopmental hypothesis, treatment resistance may be linked to pronounced developmental impairments. We examined school grades and attendance trajectories in children who later developed TRS.Methods This case-control study analyzed school grade point average and attendance among all individuals born after 1990 and started on clozapine in Chile's public health system as a proxy for TRS. Control groups included children later diagnosed with treatment-responsive schizophrenia, bipolar disorder, and unaffected classmates. Linear mixed models accounted for individual and school-level confounders.Results We included 1072 children (9929 observations, 29.3% female) subsequently diagnosed with TRS, 323 (2802 observations, 25.7% female) with schizophrenia, 175 (1784 observations, 53.8% female) bipolar disorder, and 273,260 (533,335 observations, 47% female) unaffected classmates. Children who later developed TRS had worse grades across levels than their classmates (-0.26 SD [-0.2, -0.4]), but not treatment-responsive schizophrenia. All severe mental illness groups showed grade declines in later school levels, with TRS showing steeper linear decline than treatment-responsive schizophrenia (groupxage of -0.03; 95%CI -0.04, -0.01) and steeper quadratic decline than bipolar disorder (groupxage 2 of -0.005; -0.01, -0.001). Attendance declined over time in the two groups developing schizophrenia compared to their classmates. Those developing TRS experienced the sharpest drop (groupxage compared to schizophrenia -0.03; -0.05, -0.01 and bipolar disorder -0.027; -0.049, -0.006).Conclusions TRS may stem from a more aggressive pathological process or pronounced late-maturation abnormality, rather than an early premorbid impairment, suggesting an intervention target.
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Cost-effectiveness of screening, decolonisation and isolation strategies for carbapenem-resistant Enterobacterales and methicillin-resistant Staphylococcus aureus infections in hospitals: a sex-stratified mathematical modelling study
(Elsevier BV, 2025-03)
Kasim Allel
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Patricia Garcia
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Anne Peters
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MUNITA SEPULVEDA, JOSE MANUEL
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Eduardo A. Undurraga
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Geographic divergence of methicillin-resistant Staphylococcus aureus ST5-SCCmecI in the aftermath of a major earthquake and tsunami: impact of a plasmid harboring heavy metal resistance genes
(American Society for Microbiology, 2025-04-09)
Jose R. W. Martínez
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Manuel Alcalde-Rico
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Estefanía Jara-Videla
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Jinnethe Reyes
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Lina P. Carvajal
(MRSA) is a major public health menace. The global spread of MRSA is characterized by successive waves of epidemic clones dominating specific geographical regions. The acquisition of genes encoding resistance to heavy metals (HMRGs) is thought to be a key feature in the geographic divergence of MRSA. However, the cause-effect relationship between the presence of HMRGs and the divergence of MRSA clones remains to be clarified. In this study, we assessed the role that HMRGs may have played in the evolutionary divergence of the MRSA ST5-SCC <jats:italic>mec</jats:italic> I lineage in Latin America. We conducted a genomic characterization of 113 MRSA clinical isolates from six Latin American healthcare centers, including 53 isolates collected from two cities in Chile (Santiago and Concepción). We found a plasmid (pSCL4752) harboring arsenic, cadmium, and mercury resistance genes in 65% ( <jats:italic>n</jats:italic> = 71) of the ST5-SCC <jats:italic>mec</jats:italic> I isolates. We also observed a geographic divergence associated with the presence of pSCL4752 in Chilean isolates, with a higher frequency in isolates from Concepción (88%) compared to Santiago (29%). Interestingly, a molecular clock analysis revealed that this divergence occurred in the aftermath of an 8.8 Mw earthquake and tsunami that struck the Concepción area in 2010. Moreover, our results demonstrate that the carriage of pSCL4752 can be beneficial or detrimental for ST5-SCC <jats:italic>mec</jats:italic> I isolates, depending on the environmental availability of these heavy metals. Our results suggest that the divergence of the ST5-SCC <jats:italic>mec</jats:italic> I MRSA lineage in Latin America could have been fostered by environmental disasters and influenced by the presence/absence of HMRGs harbored in a plasmid. </jats:p> <jats:sec> <jats:title>IMPORTANCE</jats:title> <jats:p> Methicillin-resistant <jats:italic>Staphylococcus aureus</jats:italic> (MRSA) is a major cause of life-threatening infections worldwide and a growing public health concern. The rise of antibiotic-resistant bacteria, such as MRSA, is often linked to genetic adaptations that enhance their survival. Our research sheds light on how environmental changes, such as those triggered by a natural disaster, can influence the evolution and geographic spread of a highly resistant MRSA lineage in Latin America. We identified a plasmid carrying genes for resistance to arsenic, cadmium, and mercury, which was associated with the geographic divergence of the ST5-SCC <jats:italic>mec</jats:italic> I MRSA lineage, with striking differences in its prevalence between regions affected by a major earthquake and tsunami. By linking environmental events to pathogen evolution, our study highlights the role of ecological pressures in the spread of MRSA. These findings emphasize the need to integrate environmental monitoring into public health strategies to better understand the global challenge of antimicrobial resistance.
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Prevalence and Distribution of Salmonella in Water Bodies in South America: A Systematic Review
(MDPI AG, 2025-02-22)
Makarena Sofia Gonzalez Reyes
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Rayana Santos Araujo Palharini
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Felipe Ferreira Monteiro
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Salvador Ayala
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Eduardo A. Undurraga
The presence of Salmonella in rivers, lakes, or beaches in South America represents a challenge to public health and aquatic ecosystems. This review explores the distribution, prevalence, and the main factors contributing to the survival and spread of Salmonella, including wastewater discharge, agricultural runoff, and climatic variables such as high temperatures and precipitation. These factors also facilitate the distribution of multidrug-resistant strains in water. The review is based on bibliographic searches in various databases, focusing on Salmonella species, South American countries, and types of water bodies. Predominant serovars include S. Enteritidis and S. Typhimurium, with S. Typhi and S. Panama frequently detected in Chile, S. Enteritidis in Argentina, and S. Typhimurium in Brazil. Less common serovars, including S. Dublin and S. Paratyphi B, were identified, along with subspecies such as diarizonae and houtenae. These findings highlight the role of environmental, physicochemical, and anthropogenic factors influencing Salmonella dynamics. The review identifies research gaps, advocating for further studies to better understand the interactions between Salmonella, climate change, and human activity. Strengthening surveillance and mitigation strategies is crucial to protect water resources and public health in South America.
Scopus© Citations 3 1
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Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022
(2024)
Kasim Allel
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Anne Peters
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Hassan Haghparast-Bidgoli
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Maria Spencer-Sandino
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Jose Conejeros
Scopus© Citations 2 4
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Surveillance infrastructure is essential to address antimicrobial resistance in the Americas
(2024)
Eduardo A. Undurraga
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Anne Sophie Peters
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Cesar A. Arias
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MUNITA SEPULVEDA, JOSE MANUEL
Scopus© Citations 1 1
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Surveillance infrastructure is essential to address antimicrobial resistance in the Americas
(2024)
Eduardo A. Undurraga
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Anne Peters
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Cesar A. Arias
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MUNITA SEPULVEDA, JOSE MANUEL
Scopus© Citations 1 3
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Lives lost and disease burden related to antimicrobial resistance in the Americas can no longer be ignored
(2023)
Eduardo A. Undurraga
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Anne Peters
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Cesar A. Arias
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MUNITA SEPULVEDA, JOSE MANUEL
2Scopus© Citations 4
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Effectiveness of the second COVID-19 booster against Omicron: a large-scale cohort study in Chile
(2023)
Alejandro Jara
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Cristobal Cuadrado
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Eduardo A. Undurraga
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Christian García
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Manuel Nájera
<jats:title>Abstract</jats:title><jats:p>In light of the ongoing COVID-19 pandemic and the emergence of new SARS-CoV-2 variants, understanding the effectiveness of various booster vaccination regimens is pivotal. In Chile, using a prospective national cohort of 3.75 million individuals aged 20 or older, we evaluate the effectiveness against COVID-19-related intensive care unit (ICU) admissions and death of mRNA-based second vaccine boosters for four different three-dose background regimes: BNT162b2 primary series followed by a homologous booster, and CoronaVac primary series followed by an mRNA booster, a homologous booster, and a ChAdOx-1 booster. We estimate the vaccine effectiveness weekly from February 14 to August 15, 2022, by determining hazard ratios of immunization over non-vaccination, accounting for relevant confounders. The overall adjusted effectiveness of a second mRNA booster shot is 88.2% (95%CI, 86.2–89.9) against ICU admissions and 90.5% (95%CI 89.4–91.4) against death. Vaccine effectiveness shows a mild decrease for all regimens and outcomes, probably linked to the introduction of BA.4 and BA.5 Omicron sub-lineages and the waning of immunity. Based on our findings, individuals might not need additional boosters for at least 6 months after receiving a second mRNA booster shot in this setting.</jats:p>
Scopus© Citations 11 2

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