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Item type:Publication, Barriers to access to insulin pumps in Chile: A qualitative study of a high-cost technology(Elsevier BV, 2025-03); ; ;Paula MadridDaniela Paredes2Scopus© Citations 2 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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 ;Paloma Lillo-Urzua ;Mariela Olivares-Galvez ;Ana Palacio-AgueroJuan Camilo Duque3Scopus© Citations 2 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Risk and impact of stroke across 38 countries and territories of the Americas from 1990 to 2021: a population-based trends analysis from the Global Burden of Disease Study 2021(Elsevier BV, 2025-03) ;Ramón Martinez; ;Pedro Ordunez ;Felipe FregniCarlos AbantoScopus© Citations 22 3 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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; ;Gabriel Cavada ;Alejandro M. BrunserVeronica V. OlavarriaIntroduction: 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 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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 ;Patrick McGurrin; Mark HallettThe 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 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Qualitative and quantitative educational disparities and brain signatures in healthy aging and dementia across global settings(Elsevier BV, 2025-04) ;Raul Gonzalez-Gomez ;Josephine Cruzat ;Hernán Hernández ;Joaquín MigeotAgustina LegazScopus© Citations 4 3 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IL-10 and IL-6/IL-10 as predictive biomarkers for treatment response in non-infectious uveitis(Frontiers Media SA, 2025-05-13) ;Rodrigo A. Valenzuela ;Fabian Vega-Tapia ;Nathaly Elizalde ;Ivan FloresFelipe M. RojasUveitis, a group of heterogeneous diseases causing ocular inflammation, is a major contributor to vision loss globally. While systemic corticosteroids (CS) are the mainstay treatment, identifying CS-refractory patients remains a significant challenge. This study aimed to explore cytokine expression and Glucocorticoid Receptor (GR) levels as biomarkers for the early detection of CS-refractory cases in non-infectious uveitis. We assayed blood samples from 19 patients with non-infectious uveitis, for the expression of IL-6, IL-17A, TNF-α, IL-10 and GRα. The cohort included 11 refractory and 8 sensitive patients, categorized based on their clinical response to corticosteroids (prednisone 1 mg/kg/day). Blood draws were conducted at three time points (at baseline, day 7- and day 14 after CS initiation), and peripheral blood mononuclear cells (PBMCs) were isolated to measure cytokine and GRα transcript levels via real-time PCR. The expression levels of GRα and cytokines IL-6, IL-17A and TNF-α did not show significant changes between CS-sensitive and CS-refractory patients on the different days of treatment. However, IL-10 expression levels as the day14-to-day7 ratio were significantly higher in patients sensitive to CS therapy. A higher day14-to-day7 ratio was also found for the IL-6/IL-10, IL-17A/IL-10 and GRα/IL-10 ratios. ROC curve analysis demonstrated a robust predictive performance of IL-10 mRNA expression and the IL-6/IL-10 ratio for identifying CS-refractory patients. In conclusion, the expression of IL-10 and the IL-6/IL-10 ratio hold promise as early predictive biomarkers for CS treatment refractoriness in patients with non-infectious uveitis. These findings offer valuable insights into personalized treatment strategies, potentially leading to improved clinical outcomes.Scopus© Citations 6 1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Patient centered outcomes in stroke: utility-weighted modified Rankin Scale results in a community-based study(Frontiers Media SA, 2025-03-21) ;Carlos Delfino ;Gabriel Cavada; ; Background and aims</jats:title><jats:p>The transformation of modified Rankin Scale (mRS) scores based on the corresponding utilities of health-related quality of life questionnaires can facilitate the capture of Patient-Centered Outcomes (PCO) in stroke. We aimed to derive utility-weighted modified Rankin Scale (UW-mRS) values by mapping mRS functional status to EQ-5D-3L scores in a population-based cohort of stroke patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The UW-mRS was obtained by analyzing the EQ5-D-3 L and mRS scores at 180 days after any stroke in the ÑANDU study, a large prospective community-based study in Chile. The mRS prediction was estimated using a linear regression adjusted by the EQ-5D-3L value. Generalized linear and binary logistic regression models were constructed to determine influencing factors of the UW-mRS, using STATA software (version 18.0).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included 773 patients presenting with any stroke during 2015–2016: 48% were female, with a mean age of 71 years (SD 13.8), and 85% had an acute ischemic stroke (AIS). 82% of patients had a low socioeconomic status, 50% had less than 12 years of formal education, and only 32% lived in urban areas. UW-mRS values for mRS categories 0–6 at 180 days were 0.913, 0.694, 0.425, 0.249, −0.102, −0.347 and 0, respectively. Multivariable analysis identified age &gt; 70 years (Coefficient <jats:italic>β</jats:italic> [β] -0.038 [Standard error SE 0.018], <jats:italic>p</jats:italic> = 0.032), prior mRS score 3–5 (<jats:italic>β</jats:italic> −0.556 [SE 0.197], <jats:italic>p</jats:italic> &lt; 0.001), ischemic stroke (β −0.066 [SE 0.025], <jats:italic>p</jats:italic> = 0.010), and National Institutes of Health Stroke Scale (NIHSS) at admission&gt;5 (<jats:italic>β</jats:italic> −0.015 [SE 0.002], <jats:italic>p</jats:italic> &lt; 0.001) as significant predictors of worse UW-mRS scores (R<jats:sup>2</jats:sup> = 70%) in the overall group. Sex-disaggregated analysis showed that age &gt; 70 years was a significant predictor in males (β −0.069 [SE 0.024], <jats:italic>p</jats:italic> = 0.006), while presenting an AIS had a greater impact on female’s worse UW-mRS score (β −0.087 [SE 0.033], <jats:italic>p</jats:italic> = 0.010).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>These results present UW-mRS values derived from a population-based stroke study. Key determinants of health-related quality of life in post-stroke patients included age, prior disability, and stroke severity. Sex-disaggregated analysis revealed age being significant for males and AIS for females. Incorporating PCO as UW-mRS in stroke research can provide a more nuanced understanding of the impact of stroke on survivors, offering valuable insights for clinical decision-making and rehabilitation strategies across diverse healthcare contexts.<Scopus© Citations 1 6 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Retrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients(Medwave Estudios Limitada, 2025-04-10); ;Teresa Ip ;Lea Maureira ;Cesar SanchezClaudia OsorioIntroduction Breast cancer is the most common malignancy in the Americas, and the second leading cause of cancer death. Disparities in the time to treatment can significantly impact patient outcomes and typically affect lower socioeconomic individuals and/or ethnic minorities. Our study sought to evaluate disparities in time to treatment at three health institutions in Chile according to their type of health insurance (public or private). Methods Our study analyzed a database of breast cancer patients diagnosed between 2017 and 2018. Analyses included descriptive statistics and a linear regression model that incorporated clinical and demographic variables. Additionally, using a proportional risks model, we analyzed the association between clinical variables and mortality. Results Public health insurance (National Health Fund, FONASA) was associated with longer time-to-treatment and extended treatment times versus private health insurance (Social Security Institutions, ISAPRE; p < 0.0001). As expected, a more advanced stage at diagnosis was associated with lower survival. Our proportional risks model found that age was a predictor of breast cancer mortality in stage II patients. Also, total treatment time significantly increased the risk of breast cancer mortality in stage I patients. Conversely, total treatment time did not affect mortality on stages II or III. Conclusions We found significant disparities in the time to treatment of Chilean breast cancer patients using FONASA versus private ISAPRE. FONASA patients experience delays in the initiation of treatment and longer total treatment times compared to their private insurance counterparts. Finally, longer time-to-treatment was associated with more advanced stages and increased mortality.3 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Barriers to accessing formal cancer care from the perspective of informal caregivers: a qualitative study(Springer Science and Business Media LLC, 2025-04-21); ; ; ;Francisca VezzaniAngela Estay5