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Barriers to access to insulin pumps in Chile: A qualitative study of a high-cost technology
(Elsevier BV, 2025-03)
CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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Paula Madrid
;
Daniela Paredes
2Scopus© Citations 2
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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
2
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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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Adherence to an Early Exercise Plan Promotes Visceral Fat Loss in the First Month Following Bariatric Surgery
(Springer Science and Business Media LLC, 2025-02-14)
Johanna Pino-Zuñiga
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Paloma Lillo-Urzua
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Mariela Olivares-Galvez
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Ana Palacio-Aguero
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Juan Camilo Duque
3Scopus© Citations 2
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Myocardial perfusion imaging in advanced coronary artery disease
(Wiley, 2025-03-18)
Roel Hoek
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Pepijn A. van Diemen
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Yvemarie B. O. Somsen
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Ruben W. de Winter
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Ruurt A. Jukema
Myocardial perfusion imaging (MPI) is widely adapted as a noninvasive technique to assess the presence and extent of ischemia in patients with symptoms suggestive of obstructive coronary artery disease (CAD). However, as CAD advances, several factors can complicate the interpretation of MPI, subsequently impacting clinical decision‐making. This review focuses on the utility of MPI by means of cardiac magnetic resonance (CMR) imaging, single‐photon emission computed tomography (SPECT) and positron emission tomography (PET) in patients with advanced CAD—the latter characterized by documented CAD (i.e. prior myocardial infarction [MI] and/or percutaneous coronary intervention [PCI]), prior coronary artery bypass grafting (CABG) or the presence of a chronic total occlusion (CTO). It will discuss factors impacting the interpretation of MPI, the diagnostic performance for detecting obstructive CAD and coronary microvascular dysfunction (CMD), as well as the role of MPI in guiding revascularization.
Scopus© Citations 1 2
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Gut Microbiota‐Derived Extracellular Vesicles Influence Alcohol Intake Preferences in Rats
(Wiley, 2025-03)
Macarena Díaz‐Ubilla
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Aliosha I. Figueroa‐Valdés
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Hugo E. Tobar
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María Elena Quintanilla
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Eugenio Díaz
<jats:title>ABSTRACT</jats:title><jats:p>Growing preclinical and clinical evidence suggests a link between gut microbiota dysbiosis and problematic alcohol consumption. Extracellular vesicles (EVs) are key mediators involved in bacteria‐to‐host communication. However, their potential role in mediating addictive behaviour remains unexplored. This study investigates the role of gut microbiota‐derived bacterial extracellular vesicles (bEVs) in driving high alcohol consumption. bEVs were isolated from the gut microbiota of a high alcohol‐drinking rat strain (UChB rats), either ethanol‐naïve or following chronic alcohol consumption and administered intraperitoneally or orally to alcohol‐rejecting male and female Wistar rats. Both types of UChB‐derived bEVs increased Wistar's voluntary alcohol consumption (three bottle choice test) up to 10‐fold (<jats:italic>p</jats:italic> < 0.0001), indicating that bEVs are able and sufficient to transmit drinking behaviour across different rat strains. Molecular analysis revealed that bEVs administration did not induce systemic or brain inflammation in the recipient animals, suggesting that the increased alcohol intake triggered by UChB‐derived bEVs operates through an inflammation‐independent mechanism. Furthermore, we demonstrate that the vagus nerve mediates the bEV‐induced increase in alcohol consumption, as bilateral vagotomy completely abolished the high drinking behaviour induced by both intraperitoneally injected and orally administered bEVs. Thus, this study identifies bEVs as a novel mechanism underlying gut microbiota‐induced high alcohol intake in a vagus nerve‐dependent manner.</jats:p>
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Emergency Department Workflow Times of Intravenous Thrombolysis with Tenecteplase versus Alteplase in Acute Ischemic Stroke: A Prospective Cohort Study before and during the COVID-19 Pandemic
(S. Karger AG, 2025-02-03)
Matias Guzman
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LAVADOS GERMAIN, PABLO MANUEL
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Gabriel Cavada
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Alejandro M. Brunser
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Veronica V. Olavarria
Introduction: Tenecteplase (TNK) has demonstrated to be non-inferior to alteplase (ALT) for intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). There are potential workflow benefits associated with TNK use, aiming to reduce patient length of stay in the emergency department. Our aim was to investigate whether the routine use of TNK during the COVID-19 pandemic influenced workflow times compared to historical use of ALT, while maintaining non-inferior clinical outcomes in a non-drip and ship scenario of a comprehensive stroke center. Methods: We included patients with AIS admitted from September 2019 to September 2022 and compared those treated with TNK during the COVID-19 pandemic to those treated with ALT in the period immediately before. We compared emergency department length of stay (EDLOS), door-to-needle time (DTN), door-to-groin puncture time (DTG), clinical and safety outcomes with adjusted general linear regression models. Results: 110 patients treated with TNK and 111 with ALT were included in this study. Mean EDLOS was 251 (SD = 164) min for TNK users versus 240 (SD = 148) min for ALT (p = 0.62). Mean DTN was 43 (SD = 25) min for TNK versus 46 (SD = 27) min for ALT users (p = 0.39). Mean DTN under 60 min was achieved in 86 (78.2%) patients and in 85 (76.5%) patients of the TNK and ALT groups, respectively (p = 1.0). DTN under 45 min was achieved in 65.4% and 58.6% (p = 0.65) of the TNK and ALT groups, respectively. DTG time was 114 (SD = 43) min for TNK versus 111 (58 = SD) min in the ALT group (p = 0.88). DTG under 90 min was achieved in 32% of the TNK group and 35% of the ALT group (p = 0.69). There were no differences in any of the clinical or safety outcomes between groups at 90 days. Conclusions: The adoption of TNK during COVID-19 pandemic did not result in a change in EDLOS, DTN, or DTG times when compared to ALT in this cohort. Safety and clinical outcomes were similar between groups. Probably a greater benefit could have been seen in a drip and ship thrombolysis setting. Further research is needed to assess the potential advantages of TNK in drip and ship scenarios of IVT.
Scopus© Citations 2 2
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Patterns of brain activity in choice or instructed go and no-go tasks
(Springer Science and Business Media LLC, 2025-02-21)
Sanaz Attaripour Isfahani
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Patrick McGurrin
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VIAL UNDURRAGA, FELIPE AGUSTIN
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Mark Hallett
The goal of this study was to investigate the decision making process for choosing what movements to make. We used electroencephalography (EEG) to investigate patterns of the contingent negative variation (CNV) associated with free-choice decisions to move or abstain, comparing them to conditions where actions were commanded. Our primary hypothesis was that choice tasks would differ significantly from each other and exhibit EEG patterns akin to their command-driven counterparts after the decisions were made, at least, in the 50 ms block of time prior to movement. A secondary analysis evaluated post hoc comparisons of time, in 50 ms blocks, to understand the temporal development of the CNV for each condition. We also conducted an exploratory analysis of EEG event-related desynchronization (ERD) to identify patterns of brain activity associated with the decision-making process. This approach was taken due to the exploratory nature of our hypotheses concerning the spatial and temporal characteristics of EEG activity during these free-choice versus commanded tasks. We studied 12 right-handed healthy volunteers (7 women, mean age 53 years, range 39–73 years) with no prior history of neurological or major psychiatric illness. A CNV paradigm encompassing commanded and choice tasks was devised, with a 2500 ms interval between S1 and S2, while recording EEG and electromyography (EMG). S1 provided full information about the upcoming task, which was to be executed at the time of S2. We assessed CNV and explored whole scalp EEG activity, including both voltage as well as power in the alpha and beta frequency ranges. Clear and similar CNVs were observed for command and choice go tasks prior to the movements, contrasting with near-zero CNVs for the command and choice no-go tasks. Separation of CNVs for command go and no-go tasks occurred around 1600 ms post-S1, and choice CNVs separated about 2150 ms post-S1. Exploratory analysis revealed that beta power provided information about decision and preparation processes much earlier. The left dorsolateral prefrontal cortex (DLPFC) exhibited the initial sign of decision approximately 500 ms post-S1 for all tasks, with subsequent preparation for movement or restraint involving distinct activity in various brain regions. The localization of effects in the left DLPFC was determined by visual analysis of the informative electrode sites. The CNVs separate about 2 s after S1, and it appears that this process represents preparation for movement (or no movement). Exploration of the beta activity suggests an earlier decision process which leads eventually to subsequent task preparation and activation. Choice decisions lag slightly behind command decisions, with the CNV apparently reflecting motor implementation rather than the decision-making process. In a simple motor task with an exploratory analysis, both commanded and choice-based decisions are rapidly initiated in the left DLPFC. While the CNV distinguishes between go and no-go conditions, it primarily appears to signify preparation for implementation of the task following the earlier decision. Further controlled studies will be needed to confirm these results.
Scopus© Citations 3 1
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The Power of Food Advertisements: A Brief Mindfulness Instruction Does Not Prevent Psychophysiological Responses Triggered by Food Ads
(MDPI AG, 2025-02-25)
Constanza Baquedano
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David Martinez-Pernia
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Vicente Soto
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Álvaro Rivera-Rei
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Antonia Zepeda
Exposure to visually appealing food items can enhance their subjective realism, leading to increased cravings, salivation, and automatic approach tendencies. Prior research suggests that brief mindfulness instructions promoting dereification—recognizing stimuli as transient mental events—can mitigate these automatic reactions. Objectives: This study assesses whether brief mindfulness instruction can mitigate automatic consumption tendencies induced by food advertisements, exploring the corresponding behavioral, physiological, and neurophysiological mechanisms. Methods: Sixty participants were randomly assigned to two groups: one receiving brief mindfulness instruction and the other a non-dereifying control instruction while exposed to advertised foods. This was followed by an approach–avoidance task (AAT), during which behavioral data, salivary volume, event-related potentials (ERPs) from electroencephalogram recordings, and self-reports were collected. Results: The results showed no significant differences in approach behaviors between the groups. Hunger, food craving, and salivation levels increased uniformly in response to food cues for both groups. The N1, N2, P3, and late positive potential (LPP) ERPs remained unaltered by the instructions and consistent with the established AAT literature. Advertising heightened the appeal of neutral foods, as evidenced by increased N2, P3, and LPP responses. Conclusions: The brief mindfulness instruction failed to shield participants from the automatic responses elicited by food advertising, contrasting with the effects seen with non-advertised food.
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Qualitative and quantitative educational disparities and brain signatures in healthy aging and dementia across global settings
(Elsevier BV, 2025-04)
Raul Gonzalez-Gomez
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Josephine Cruzat
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Hernán Hernández
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Joaquín Migeot
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Agustina Legaz
Scopus© Citations 4 3

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