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      2Scopus© Citations 22
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    Prevalence Distribution of Chronic Obstructive Pulmonary Disease (COPD) in the City of Osorno (Chile) in 2018, and Its Association with Fine Particulate Matter PM2.5 Air Pollution
    (2024)
    Ricardo Fernández
    ;
    Romina Peña
    ;
    Jaime Bravo-Alvarado
    ;
    Kevin R. Maisey
    ;
    <jats:p>Outdoor air pollution and biomass smoke exposure are related to the prevalence of chronic obstructive pulmonary disease (COPD). Since Osorno, Chile, is saturated with fine particulate matter (PM2.5), the aim of this work is to determine the prevalence distribution of COPD patients in the Primary Health Care (PHC) system in the city of Osorno, and its relationship with PM2.5. A cross-sectional descriptive study was carried out on COPD patients enrolled in the six PHC centers (PHCCs) of the city to assess the adjusted prevalence (population over 40 years). Gender- and territory-associated odds ratios (ORs) were also determined. In addition, an urban analysis of the distribution of PM2.5 and an exploratory analysis of the spatial behavior of enrolled COPD patients through featured binning were carried out. In 2018, the city of Osorno had 809 enrolled COPD patients in the PHC system (55.1% female), with a 1.3% age-adjusted prevalence (inhabitants over 40 years old), which was 11.7% after underdiagnosis correction. The COPD patients were mainly between 70 and 79 years old (34.3%). The urban area under the administration of the PHCC Rahue Alto (PHCC-RA) had a higher OR (1.98 [1.73–2.26]) compared to the situation of the city. Also, air pollution (PM2.5) was the highest in the PHCC-RA area, which could account for the observed prevalence. The number of COPD patients in this area is the highest in the commune, which increases the risk of complications derived from the disease and air pollution. Thus, territories with the highest COPD prevalence have the largest OR, which could complicate patients’ condition due to the high levels of outdoor air pollution.</jats:p>
    Scopus© Citations 1  1
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    Educational disparities in brain health and dementia across Latin America and the United States
    (2024)
    Raul Gonzalez‐Gomez
    ;
    Agustina Legaz
    ;
    Sebastián Moguilner
    ;
    Josephine Cruzat
    ;
    Hernán Hernández
    <jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND</jats:title><jats:p>Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>Education influenced brain measures, explaining 24%–98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions.</jats:p></jats:sec><jats:sec><jats:title>DISCUSSION</jats:title><jats:p>The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research.</jats:p></jats:sec><jats:sec><jats:title>Highlights</jats:title><jats:p><jats:list list-type="bullet"> <jats:list-item><jats:p>Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD).</jats:p></jats:list-item> <jats:list-item><jats:p>Latin American cohorts have lower educational levels compared to the those in the United States.</jats:p></jats:list-item> <jats:list-item><jats:p>Educational disparities majorly drive brain health differences between regions.</jats:p></jats:list-item> <jats:list-item><jats:p>Educational differences were significant in both conditions, but more in AD than FTLD.</jats:p></jats:list-item> <jats:list-item><jats:p>Education stands as a critical factor in classifying aging and dementia across regions.</jats:p></jats:list-item> </jats:list></jats:p></jats:sec>
    Scopus© Citations 15  2
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    Multivariate word properties in fluency tasks reveal markers of Alzheimer's dementia
    (2023)
    Franco J. Ferrante
    ;
    Joaquín Migeot
    ;
    Agustina Birba
    ;
    Lucía Amoruso
    ;
    Gonzalo Pérez
    <jats:title>Abstract</jats:title><jats:sec><jats:title>INTRODUCTION</jats:title><jats:p>Verbal fluency tasks are common in Alzheimer's disease (AD) assessments. Yet, standard valid response counts fail to reveal disease‐specific semantic memory patterns. Here, we leveraged automated word‐property analysis to capture neurocognitive markers of AD vis‐à‐vis behavioral variant frontotemporal dementia (bvFTD).</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>Patients and healthy controls completed two fluency tasks. We counted valid responses and computed each word's frequency, granularity, neighborhood, length, familiarity, and imageability. These features were used for group‐level discrimination, patient‐level identification, and correlations with executive and neural (magnetic resonanance imaging [MRI], functional MRI [fMRI], electroencephalography [EEG]) patterns.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>Valid responses revealed deficits in both disorders. Conversely, frequency, granularity, and neighborhood yielded robust group‐ and subject‐level discrimination only in AD, also predicting executive outcomes. Disease‐specific cortical thickness patterns were predicted by frequency in both disorders. Default‐mode and salience network hypoconnectivity, and EEG beta hypoconnectivity, were predicted by frequency and granularity only in AD.</jats:p></jats:sec><jats:sec><jats:title>DISCUSSION</jats:title><jats:p>Word‐property analysis of fluency can boost AD characterization and diagnosis.</jats:p></jats:sec><jats:sec><jats:title>Highlights</jats:title><jats:p><jats:list list-type="bullet"> <jats:list-item><jats:p>We report novel word‐property analyses of verbal fluency in AD and bvFTD.</jats:p></jats:list-item> <jats:list-item><jats:p>Standard valid response counts captured deficits and brain patterns in both groups.</jats:p></jats:list-item> <jats:list-item><jats:p>Specific word properties (e.g., frequency, granularity) were altered only in AD.</jats:p></jats:list-item> <jats:list-item><jats:p>Such properties predicted cognitive and neural (MRI, fMRI, EEG) patterns in AD.</jats:p></jats:list-item> <jats:list-item><jats:p>Word‐property analysis of fluency can boost AD characterization and diagnosis.</jats:p></jats:list-item> </jats:list></jats:p></jats:sec>
      3Scopus© Citations 10
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    Evaluating the reliability of neurocognitive biomarkers of neurodegenerative diseases across countries: A machine learning approach
    (2020)
    M. Belen Bachli
    ;
    Lucas Sedeño
    ;
    Jeremi K. Ochab
    ;
    Olivier Piguet
    ;
    Fiona Kumfor
      16  1Scopus© Citations 56
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    Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations
    (2024)
    Sebastian Moguilner
    ;
    Sandra Baez
    ;
    Hernan Hernandez
    ;
    Joaquín Migeot
    ;
    Agustina Legaz
    <jats:title>Abstract</jats:title><jats:p>Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (<jats:italic>R</jats:italic>² = 0.37, <jats:italic>F</jats:italic>² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging.</jats:p>
    Scopus© Citations 33  2
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    Design of an eOSCE for the Chilean Healthcare Context
    Objective Structured Clinical Examination (OSCE) is the standard to assess and train clinical skills in healthcare students. However, conducting an OSCE demands expensive resources such as time, qualified personnel, and adequate facilities. The aim to provide more cost-effective examinations has promoted the emergence of electronic versions of OSCEs (eOSCEs). However, existing eOSCEs available in the market do not adequately adapt to diverse local contexts. For a Spanish-speaking country such as Chile, implementing foreign eOSCEs requires to adjust the examination to unfamiliar terminology, archetypes, and procedures, thus hindering the quality of the assessment. This article reports on the design of Ch-eOSCE, an eOSCE tailored for the Chilean local context and culture. Ch-eOSCE is comprised of a mobile application and a back-end system. A prototype of the application was developed and tested with three healthcare experts to gather their perception of usability and coherence, yielding an overall evaluation of 4.5 in a scale range of 5. The preliminary results reveal that Ch-eOSCE has the potential to become a viable solution for a context-specific eOSCE for the Chilean healthcare context.
      1Scopus© Citations 2  4
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      1Scopus© Citations 34  1
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      17  1Scopus© Citations 8