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    Resilience of mobility network to dynamic population response across COVID-19 interventions: Evidences from Chile
    (Public Library of Science (PLoS), 2025-02-20)
    Pasquale Casaburi
    ;
    Lorenzo Dall’Amico
    ;
    Nicolò Gozzi
    ;
    Kyriaki Kalimeri
    ;
    Anna Sapienza
    The COVID-19 pandemic highlighted the importance of non-traditional data sources, such as mobile phone data, to inform effective public health interventions and monitor adherence to such measures. Previous studies showed how socioeconomic characteristics shaped population response during restrictions and how repeated interventions eroded adherence over time. Less is known about how different population strata changed their response to repeated interventions and how this impacted the resulting mobility network. We study population response during the first and second infection waves of the COVID-19 pandemic in Chile and Spain. Via spatial lag and regression models, we investigate the adherence to mobility interventions at the municipality level in Chile, highlighting the significant role of wealth, labor structure, COVID-19 incidence, and network metrics characterizing business-as-usual municipality connectivity in shaping mobility changes during the two waves. We assess network structural similarities in the two periods by defining mobility hotspots and traveling probabilities in the two countries. As a proof of concept, we simulate and compare outcomes of an epidemic diffusion occurring in the two waves. While differences exist between factors associated with mobility reduction across waves in Chile, underscoring the dynamic nature of population response, our analysis reveals the resilience of the mobility network across the two waves. We test the robustness of our findings recovering similar results for Spain. Finally, epidemic modeling suggests that historical mobility data from past waves can be leveraged to inform future disease spatial invasion models in repeated interventions. This study highlights the value of historical mobile phone data for building pandemic preparedness and lessens the need for real-time data streams for risk assessment and outbreak response. Our work provides valuable insights into the complex interplay of factors driving mobility across repeated interventions, aiding in developing targeted mitigation strategies.
      2
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      3Scopus© Citations 24
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      1Scopus© Citations 3
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    The Presence of Associated Injuries in Pediatric Radial Neck Fractures: A Systematic Review of the Literature and Meta-Analysis of Pooled Individual Patient Data
    (MDPI AG, 2025-02-27)
    Lisette C. Langenberg
    ;
    Joyce L. Benner
    ;
    Nazira Bernal Bader  
    ;
    Christiaan J. A. van Bergen
    ;
    Joost W. Colaris
    <jats:p>Background: Pediatric radial neck fractures (pRNFs) can occur in isolation or in association with concomitant injuries. It is unknown whether the presence of associated injuries should influence the choice of treatment. The aim of this study is to assess the incidence of associated injuries in pRNF and their correlation with fracture angulation (Judet grade) or the patient’s age (under or over ten years of age). Methods: A systematic literature review was performed following PRISMA-IPD guidelines, including case series on pRNF with a minimum of five cases of children until 16 years of age. The quality assessment included a risk of bias analysis and evaluation using the MINORS criteria. Individual patient data on age, Judet classification and associated injuries were extracted from the included studies and pooled for the meta-analysis. The correlation between the presence of associated injury and the patient’s age or Judet classification was depicted in two forest plots. Results: A total of 20 articles published sufficient individual patient data (n = 371) on associated injuries. All but one were retrospective case series. Fifteen articles had MINORS scores of 8 or higher. The incidence of associated injuries was 33% (123 of 371 cases). Almost half of the associated injuries included an olecranon fracture (61/123). There was no correlation between Judet classification (p = 0.243) and incidence nor between patient age and the incidence of associated injuries (p = 0.694). Conclusions: Surgeons should be aware of potential associated injuries in over a third of pRNF cases, regardless of the patient’s age or fracture angulation. Deduction of the trauma mechanism may be a more useful tool for assessing the potential presence of associated injuries than the most frequently used fracture classification or the patient’s age. More research is needed regarding the requirements for enhanced diagnostic imaging, specific treatment or follow-up adaptations in children with pRNFs and associated injuries.</jats:p>
      4Scopus© Citations 1
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    Acute confusional syndrome and surgery: A note of caution
    (Elsevier BV, 2025-04)
    Guillermo Lema
    ;
    Martin Lacassie
      2
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    Cáncer de vesícula: ¿Es momento de modificar el GES?
    (SciELO Agencia Nacional de Investigacion y Desarrollo (ANID), 2024-10)
    Camila P. Samaniego
    ;
    Xabier de Aretxabala
    ;
    Felipe Castillo
    ;
    Álvaro Paredes
    ;
    M. Trinidad González
      14
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    A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development
    (Springer Science and Business Media LLC, 2024-12-18)
    Cristóbal Vacarezza
    ;
    Julieta Araneda
    ;
    Pamela Gonzalez
    ;
    Oscar Arteaga
    ;
    Katherine Marcelain
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Introduction</jats:title> <jats:p>Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy.</jats:p> </jats:sec><jats:sec> <jats:title>Objectives</jats:title> <jats:p>Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.</jats:p> </jats:sec>
      8
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    Documentary Analysis of Hypericum perforatum (St. John’s Wort) and Its Effect on Depressive Disorders
    (MDPI AG, 2024-12-03)
    María Carolina Otero
    ;
    CERIC GARRIDO, FRANCISCO JOSE  
    ;
    Sebastián Miranda-Rojas
    ;
    Carolina Carreño
    ;
    Rachelly Escares
    <jats:p>Hypericum perforatum, also known as St. John’s Wort, pericon, or yellow grass, is known for its antidepressant potential. It could represent a natural alternative to current pharmacological antidepressant treatments, which have a high incidence of side effects in patients and therefore lead to early dropouts. Through a bibliographic revision of clinical trials and information collected from scientific articles during the first period of 2020, we aimed to evaluate whether its administration could be beneficial in the treatment of mild-to-moderate depression, with fewer side effects compared to synthetic drugs. Among the main components, hypericin and hyperforin have been related to the observed antidepressant activity; therefore, their possible mechanism of action was reviewed and highlighted. Furthermore, patients receiving Hypericum extracts were less likely to withdraw from studies because of adverse effects compared to those receiving older standard antidepressants. This review aims to provide suggestions for an alternative treatment of mild-to-moderate depression disorder under the supervision of a medical doctor, since, although it appears to be a potentially efficient treatment with a low presence of adverse effects in comparison to synthetic antidepressants, it might also interact with other medications and lead to therapeutic failures if misused for self-medication.</jats:p>
      3Scopus© Citations 19
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    Efectividad y seguridad de la vacuna recombinante para herpes zóster en diferentes poblaciones: revisión sistemática y metaanálisis
    (2024-01-01)
    Bengolea, Agustín
    ;
    Chamorro, Florencia
    ;
    Ramos, José T.
    ;
    Rada, Gabriel  
    ;
    Catalano, Hugo N.
    Varicella-zoster virus infections have increased globally, with complications such as postherpetic neuralgia and neurological sequelae. The recombinant vaccine against herpes zoster is proposed as a preventive strategy. This systematic review evaluates its effectiveness and safety in healthy and high-risk populations. A systematic review of randomized controlled trials comparing the effectiveness and safety of the vaccine was conducted. The search was carried out in Epistemonikos. Two researchers independently assessed the eligibility of the studies and the risk of bias was evaluated using the Cochrane Risk of Bias 2 tool. A meta-analysis of homogeneous results was conducted, and the certainty of the evidence was evaluated using GRADE. A minimally contextualized approach was adopted using predetermined thresholds. Nine randomized controlled trials were selected. The vaccine demonstrated a significant reduction in the incidence of herpes zoster in high-risk populations (risk difference of 140 fewer per 1000) with high certainty. However, in healthy populations, the effect was trivial (28 fewer per 1000). No significant differences were observed in postherpetic neuralgia in any of the populations analyzed. Adverse events increased in both populations, though no discrepancies in serious adverse events were noted. In high-risk populations, where the incidence of herpes zoster and its complications is higher, the vaccine demonstrated effectiveness in lowering the incidence of the disease, though not in that of postherpetic neuralgia. Conversely, in healthy populations, the impact of the vaccine was trivial. Individualized and informed recommendations are crucial when considering this vaccine.
    Scopus© Citations 2  2
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    Disparities in Stroke Incidence Over Time by Sex and Age in Latin America and the Caribbean Region 1997 to 2021: A Systematic Review and Meta‐Analysis
    (2023)
    Marilaura Nuñez
    ;
    Carlos Delfino
    ;
    Claudia Asenjo‐Lobos  
    ;
    SCHILLING REDLICH, ANDREA INGRID  
    ;
    LAVADOS GERMAIN, PABLO MANUEL  
    <jats:sec sec-type="background" xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en">High‐income country studies show unfavorable trends in stroke incidence (SI) in younger populations. We aimed to estimate temporal change in SI disaggregated by age and sex in Latin America and the Caribbean region.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> A search strategy was used in MEDLINE, WOS, and LILACS databases from 1997 to 2021, including prospective population‐based observational studies with first‐ever stroke incidence in Latin America. Reports without data broken down by age and sex were excluded. Risk of bias was assessed with The Joanna Briggs Institute's guide. The main outcomes were incidence rate ratio and relative temporal trend ratio of SI, comparing time periods before 2010 with after 2010. Pooled relative temporal trend ratios considering only studies with 2 periods in the same population were calculated by random‐effects meta‐analysis. Meta‐regression analysis was used to evaluate incidence rate determinants. From 9242 records identified, 6 studies were selected including 4483 first‐ever stroke in 4 101 084 individuals. Crude incidence rate ratio in younger subjects (&lt;55 years) comparing before 2010:after 2010 periods showed an increase in SI in the past decade (incidence rate ratio, 1.37 [95% CI, 1.23–1.50]), in contrast to a decrease in older people during the same period (incidence rate ratio, 0.83 [95% CI, 0.76–0.89]). Overall relative temporal trend ratio (&lt;55:≥55 years) was 1.65 (95 CI%, 1.50–1.80), with higher increase in young women (pooled relative temporal trend ratio, 3.08 [95% CI, 1.18–4.97]; <jats:italic>P</jats:italic> for heterogeneity &lt;0.001). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en">An unfavorable change in SI in young people, especially in women, was detected in population‐based studies in the past decade in Latin America and the Caribbean. Further investigation of the explanatory variables is required to ameliorate stroke prevention and inform local decision‐makers.</jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Registration</jats:title> <jats:p xml:lang="en"> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/prospero/">https://www.crd.york.ac.uk/prospero/</jats:ext-link> Identifier: CRD42022332563. </jats:p> </jats:sec>
      7Scopus© Citations 5