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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
(2025) Allel, Kasim; Garcia, Patricia; Peters, Anne; Munita, José; Undurraga, Eduardo A.; Yakob, Laith
Background Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacterales (CRE)impose the greatest burden among critical bacterial pathogens. Evidence for sex differences among antibiotic resistant bacterial infections is increasing but a focus on policy implications is needed. We assessed impact of CRE/MRSA on excess length of hospital stay, intensive care unit admission, and mortality by sex from a retrospective cohort study (n = 873) of patients in three Chilean hospitals, 2018–2021.
Methods We used inverse-probability weighting combined with descriptive, logistic, and competing-risks analyses.
We developed a sex-stratified deterministic compartmental model to analyse hospital transmission dynamics and the cost-effectiveness of nine interventions. We compared interventions based on the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained and estimated net benefits.
Findings The adjusted odds of women acquiring CRE and MRSA were 0.44 (0.28–0.70; p = 0.0013) and 0.73 (95% CI = 0.48–1.01; p = 0.050), respectively. Competing-risk models indicated higher mortality rates among women, compared to men. Mathematical model projections showed that pre-emptive isolation across all newly admitted high-risk men was the most cost-effective intervention (ICER = $1366/QALY and $1083/QALY for CRE and MRSA, respectively). Chromogenic agar coupled with MRSA decolonisation was the second most cost-effective intervention ($2099/QALY), followed by screening plus isolation or pre-emptive isolation strategies (ICER ranged between $2411/QALY and $4216/QALY across CRE and MRSA models). Probabilistic sensitivity analysis showed that strategies were ICER < willingness-to-pay in 80% of simulations, except for testing plus digestive decolonisation for CRE. At a 20% national hospital coverage at least $12.2 million could be saved.
Interpretation Our model suggests that targeted infection control strategies would effectively address rising CRE and MRSA infections. Maximising health-economic gains may be achieved by focusing on control measures for men as primary drivers for transmission, thereby reducing the disproportionate disease burden borne by women.
Facilitating and Hindering Factors in Teaching Interculturality to Future Healthcare Professionals: Exploring through Phenomenography
(2025) Pérez, Claudia; Medina, José
In the context of a globalized and culturally diverse society, there are currently unique challenges and opportunities in the field of health, where interculturality has become a critical component for new health professionals. The aim of this study is to understand the facilitating and hindering factors in the teaching of interculturality to healthcare professionals from the perspective of students, faculty, and authorities of the medical school. This research is an exploratory study using phenomenographic qualitative methods, in which 26 key agents were interviewed. We conclude that this study offers a solid foundation to reconfigure and strengthen intercultural teaching in the training of health professionals. It highlights the importance of a systematic educational intervention, continuous teacher training and curricular adaptation as fundamental pillars to address the challenges and take advantage of the opportunities of an increasingly heterogeneous society. The need for comprehensive strategies for teaching interculturality in the health sciences is highlighted.
En el contexto de una sociedad globalizada y culturalmente diversa, actualmente se presentandesafíos y oportunidades únicas en el campo de la salud, donde la interculturalidad se ha vuelto un componente crítico para los nuevos profesionales sanitarios. El objetivo de este estudio es comprender los factores facilitadores y obstaculizadores de la enseñanza de la interculturalidad en profesionales de la salud desde la perspectiva de estudiantes, docentes y autoridades de la
facultad de medicina. La investigación es un estudio de métodos cualitativos fenomenográfico, en el cual se entrevistó a 26 agentes claves. Concluimos que este estudio ofrece una base sólida para reconfigurar y fortalecer la enseñanza intercultural en la formación de profesionales de la salud. Destaca la importancia de una intervención educativa sistemática, la capacitación docente continua y la adaptación curricular como pilares fundamentales para abordar los desafíos y aprovechar las oportunidades de una sociedad cada vez más heterogénea. Se subraya la necesidad de estrategias integrales para una enseñanza de interculturalidad en las ciencias de la salud.
Fluid removal improves muscle performance and weakness in critically ill patients: a pilot study
(2025) Arancibia, Nicolás; López, René
Background: Fluid overload in critically ill patients has been associated with muscle edema, decreased tissue quality, and the development of intensive care unit-acquired weakness (ICU-AW). Continuous renal replacement therapy (CRRT) with ultrafiltration (UF) contributes to removing excess extracellular fluid. This study aimed to evaluate whether UF is associated with changes in muscle ultrasound parameters and strength in critically ill patients.
Methods: Critically ill patients with resolved hypoperfusion undergoing CRRT with fluid removal via UF were prospectively enrolled and compared with a control group without UF. Muscle ultrasound assessments included rectus femoris and vastus intermedius thickness, echogenicity, and subcutaneous tissue. Global muscle strength was assessed using the Medical Research Council Sum Score (MRC-SS). Assessments were performed at CRRT initiation (T1) and again 36 h later (T2).
Results: Twenty-eight patients were enrolled, 18 in the UF group and 10 patients in the control group. All ultrasonographic variables measured were different between the UF and control groups. In the UF group, median rectus femoris thickness decreased from 1.74 to 1.57 cm (p = 0.03), vastus intermedius from 1.14 to 0.95 cm (p < 0.01), echogenicity from 91.7 to 78.3 grayscale units (p < 0.01), and subcutaneous tissue thickness from 1.98 to 1.79 cm (p < 0.01). MRC-SS increased from 45.0 to 49.0 points (p = 0.05). A positive correlation was found between UF volume (mL/kg) and MRC-SS at T2 (ρ = 0.71, p < 0.01), and a negative correlation between UF volume and change in muscle echogenicity (ρ = - 0.49, p = 0.039). ROC curve analysis identified that a UF volume ≥ 82 mL/kg was associated with MRC-SS > 48 points obtaining an AUC of 0.982 (95% CI: 0.928-1.000), sensitivity 92.9%, and specificity 100%.
Conclusion: Ultrafiltration was associated with changes in muscle echogenicity and subcutaneous tissue as well as an increase in MRC scoring at follow-up. These results suggest a potential relationship between fluid balance and muscle ultrasound parameters. No causal inferences can be drawn; therefore, further studies are needed.
People who smoke and formerly smoked do support a smoking ban in open spaces during and after the COVID-19 pandemic in Spain
(2025) Peruga, Armando; Fu, Marcela; Castellano, Yolanda; Tigova, Olena; Driezen, Pete; Quah, Anne; Fong, Geoffrey; Fernández, Esteve
Background: Spain implemented an extensive outdoor smoking ban during the COVID-19 pandemic in 2020. We examined support for this restriction during and beyond the pandemic among people who currently and formerly smoked.
Methods: Cross-sectional study. The 2021 ITC EUREST-PLUS Spain Survey used a multistage sampling to obtain a representative sample of people who currently or formerly smoked (n=1006). We estimated prevalence ratios (PRs) to examine associations with ban support during and after the pandemic. Analyses accounted for the complex sampling design and were weighted to ensure representativeness.
Results: Most people who currently (79.2%) and formerly smoked (94.6%) supported the outdoor smoking ban when a safe interpersonal distance could not be maintained during the pandemic. Support for a permanent ban remained substantial (61.4% and 87.2%, respectively). Those who currently smoke were more likely to support bans during and after the pandemic if they had smoke-free homes (PR=1.11; PR=1.29, respectively), understood secondhand smoke harms to health (PR=1.40; PR=1.65), had tried to quit (PR=1.14; PR=1.30) and self-reported as healthy (PR=1.40; PR=1.47). Those who formerly smoked were more likely to support bans during the pandemic if they had smoke-free homes (PR=1.08) and did not self-report as healthy (PR=0.95); and after the pandemic if they had quit smoking for ≥6 months (PR=1.23) and used alternative tobacco products (PR=1.17).
Conclusions: Most people who currently or formerly smoked in Spain supported the outdoor smoking ban during and after the COVID-19 pandemic. This high acceptance suggests that the pandemic may have created an opportunity to strengthen tobacco control.
PKR-driven ISR signaling controls synaptic translation and structural plasticity in an age-dependent manner
(2025) Martínez, Nicolás; Gómez, Felipe; Tapia, Ariel; Roa, Juan; Moreso, Fernanda; Liu, Yuwei; Jara, Claudia; Tapia, Cheril; Alfaro, Ivan; Costa, Mauro; Matus, Soledad
The integrated stress response (ISR) modulates protein homeostasis in response to both intracellular and extracellular signals. The four kinases involved in the ISR all phosphorylate the same target, the alpha subunit of eukaryotic initiation factor 2 (eIF2α), to integrate various stress signals, thereby regulating cell fate. The activation of the ISR reprograms the proteome by inhibiting general protein synthesis while increasing the translation of specific mRNAs. In the brain, the ISR regulates the type of synaptic plasticity necessary for forming long-term memory. More importantly, the activation of the ISR has emerged as a causal mechanism underlying cognitive decline associated with a wide range of neurological disorders, prompting several pharmaceutical companies to target the ISR to promote brain health. However, whether the ISR acts at specific localities within neurons, including synapses, remains unclear. Here, we examined the presence, activity, and spatial arrangement of the ISR branch driven by the double-stranded RNA-dependent protein kinase (PKR) (PKR-eIF2α axis) in synapses and assessed the role of PKR in maintaining synaptic proteostasis over time. Our findings demonstrate that both PKR and eIF2α are localized at synapses, where a dynamic PKR-eIF2α axis regulates synaptic size and the abundance of synaptic proteins in an age-dependent manner. Moreover, PKR deficiency leads to an increase in protein synthesis in synapse-enriched fractions. Thus, the PKR branch of the ISR serves as a new regulator of synaptic structural plasticity.
Appearance of basal cell carcinoma on untreated capillary malformation
(2025) Buchroithner, Catalina; Lobos, Nelson; Madrid, Arturo; Neely, Gabriel; Darlic, Valentina; Castro,Alex
Protocol for the development of enhanced recovery after surgery (ERAS) recommendations for individuals undergoing surgery for degenerative cervical myelopathy
(2025) Treanor, Caroline; Anderson, David; Davies, Benjamin; Chhabra, Harvinder; Hutton,Mike; Venkatraghavan, Laskhmikumar; Lazarus, Jed; Singh, Anoushka; Smith, Kieran; Stubbs, Daniel; Vedantam, Aditya; Zamorano, Juan José; Zipser, Carl; Wainwright, Thomas; Wardropper, Jay; Fehlings, Michael
Study design: Protocol for the development of enhanced recovery after surgery (ERAS) recommendations for DCM surgery.
Objectives: To develop ERAS recommendations in collaboration with the ERAS Society to optimize care for individuals having surgery for degenerative cervical myelopathy (DCM)-the most common type of nontraumatic spinal cord injury.
Methods: The study protocol was developed in line with the AGREE II checklist for clinical practice guidelines and the ERAS Society standards for guideline development. A multidisciplinary international guideline development group (GDG) including a representative from the ERAS society, clinical experts in the surgical care of people with DCM, and people with lived experience of having surgery for DCM has been established. The recommendations will follow the GRADE methodology and will therefore include the following steps. 1) Framing the health care questions. 2) Selecting and rating the importance of outcomes for each ERAS candidate interventiont. 3) Summarizing the evidence for each ERAS candidate intervention. 4) Judging the quality of evidence for each ERAS candidate intervention. 5) Judging the strength of the recommendations for each ERAS candidate intervention. 6) Developing recommendations statements for the included ERAS interventions and achieving consensus on the ERAS intervention statements to be included in the final guideline. Following the recommendation statements' development, key stakeholders will be invited to externally review the guidelines.
Conclusion: ERAS recommendations for DCM aim to reduce the incidence and severity of adverse events, optimize patient outcomes, improve the efficiency and quality of care, and patients' experience and satisfaction with care.
Prevalence and Distribution of Salmonella in Water Bodies in South America: A Systematic Review
(2025) Gonzalez, Makarena; Palharini, Rayana; Ferreira, Felipe; Ayala, Salvador; Undurraga, Eduardo
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 multidrugresistant 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.
A Comparative Analysis of Universal and Sentinel Surveillance Data for Coronavirus Disease 2019: Insights From Argentina, Chile, and Mexico (2020–2022)
(2026) Redondo, Lidia; Zureick, Kinda; Voto, Carla; Molina, Xaviera; Flores, Laura; Fowlkes, Ashley; Lummato, Luciana; Giovacchini, Carlos; Olivares, Maria; Rodriguez, Paula; Gutiérrez, Rosaura; Zaragoza, Christian; García, Gabriel; López, Hugo; Rodríguez, Ángel; Couto, Paula; Rondy, Marc; Vicari, Andrea
Background: In 2020, countries implemented universal surveillance to detect and monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases. Although crucial for early monitoring efforts, universal surveillance is resource intensive. To understand the implications of transitioning from universal to sentinel surveillance for monitoring SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness, we compared measures of SARS-CoV-2 reported from both surveillance strategies in Argentina, Chile, and Mexico.
Methods: We obtained weekly case counts in Argentina, Chile, and Mexico, in periods when both universal and sentinel surveillance were ongoing. To assess the countries' surveillance strategies, we measured the proportion of total sites that were included in sentinel surveillance. We compared 8 measures of SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness between sentinel and universal surveillance and assessed the correlation between the 2 strategies for the 8 measures. Pearson and Spearman correlation was classified as very strong (rs = 0.8-1.0), strong (rs = 0.60-0.79), moderate (rs = 0.50-0.59), or poor (r < 0.50).
Results: The proportion of total sites included in sentinel surveillance was 5.8% for Argentina, 1.1% for Chile, and 7.6% for Mexico. A total of 21 measures were calculated (8 for Mexico, 8 for Chile, and 5 for Argentina). Of these, 17 showed consistency between the 2 surveillance strategies, with strong or very strong correlations (r = 0.66-0.99): all 8 measures for Mexico, 6 of 8 measures for Chile, and 3 of 5 measures for Argentina. Each country had ≥1 measure reflecting transmissibility and ≥1 reflecting morbidity and mortality for which the correlation was strong or very strong. Chile and Mexico also had ≥1 measure of disease seriousness for which the correlation was strong.
Conclusions: Our findings suggest that the integration of SARS-CoV-2 into national sentinel surveillance can yield information comparable to that provided by nationwide universal surveillance for measures related to SARS-CoV-2 transmissibility, morbidity and mortality, and seriousness of disease.
Perceptions of the Effect of COVID-19 on the Health of Mapuche Young Adults in Chile
(2025) Olivella, Marc; Molina, Xaviera; Maass, Maria; Vanegas, Jairo; Correa, Eliana; Pasarín, M. Isabel; Muñoz, Claudio; Pérez, Gloria
We aimed to investigate the perceptions of Mapuche young adults in Araucanía, Chile, regarding the impact of the COVID-19 pandemic on their communities, adherence to restrictions, and coping responses. Eight Mapuche individuals were included in this qualitative study, segmented by gender. Interviews with a semi-structured script were carried out between February and May 2023. A thematic analysis of the discourse was used with subsequent triangulation and validation of the results. The people interviewed believed that, although the pandemic affected their communities, this challenge strengthened ties and contributed to the recovery of the ancestral worldview. There was a temporal dynamic in adherence to restrictions, with initial distrust but high compliance, including vaccination. There was complementarity between Western and traditional Mapuche medicine, which highlights the importance of intercultural health strategies. The pandemic had an impact on young Mapuche adults by altering community dynamics and cultural practices, with the potential to exacerbate inequalities in their communities. This study emphasizes the need to integrate the indigenous worldview in decisions about restrictions and advocates considering cultural diversity in future health crises.
Age and primary vaccination schedule impact humoral and cellular immunity with an inactivated SARS-CoV-2 vaccine
(2025) Martínez, Yohana; Rodríguez, Linmar; Méndez, Constanza; Ríos, Mariana; Rivera, Daniela; Moreno, Daniela; Reyes, Humberto; Pereira, Patricia; Orellana, Claudia; Cabrera, Alex; Schultz, Bárbara; Duarte, Luisa; Gálvez, Nicolás; Melo, Felipe; Soto, Jorge; Iturriaga, Carolina; Urzúa, Marcela; Navarrete, Marıía; Rojas, Álvaro; Fasce, Rodrigo; Fernández, Jorge; Mora, Judith; Ramíez, Eugenio; Weiskopf, Daniela; Grifoni, Alba; Sette, Alessandro; Zeng, Gang; Meng, Weining; CoronaVac03CL Study Group; Alvarez, María; González, Jose; Domínguez, M. Angélica; González, Pablo; Abarca, Katia; Peñaloza, Hernán; Bueno, Susan; Kalergis, Alexis
Despite widespread COVID-19 vaccination, questions remain about vaccine safety and immunogenicity in vulnerable populations, such as older adults. We evaluated the safety and immunogenicity of four doses of CoronaVac in adults above and below 60 who received the first two doses in two different schedules (0-14 and 0-28 days apart). While CoronaVac demonstrated excellent safety across age groups, older adults showed reduced reactogenicity. In the 0-28 schedule, both age groups exhibited similar frequencies of SARS-CoV-2-specific CD4+ and CD8+ T cells, though memory T cell distribution patterns differed. Notably, adults over 60 showed diminished virus-neutralizing antibody responses compared to younger participants. The 0-14 schedule produced equivalent cellular and neutralizing antibody responses between age groups, albeit at lower levels than the 0-28 schedule. Our data indicate that primary vaccination schedules can influence the humoral immune responses and memory T cell distribution between age groups.
Sofrimento moral em residentes de medicina de universidades chilenas
(2025) Jofré, Pamela; Vergara, Rodrigo; Suau , Thelma; Bastidas, Jaime; De la Barra, Diego; Salas Ibarra, Sofía Patricia
Resumo
O sofrimento moral, definido como o sofrimento que uma pessoa experimenta quando é obrigada a executar ações ou omissões que contradizem seus valores, tem sido descrito em todas as profissões da área da saúde e na formação delas, associando-se a consequências como despersonalização nos cuidados, baixa motivação no trabalho, questionamento vocacional e vínculo com o burnout. No Chile, tem sido pouco estudado e menos ainda em estudantes de medicina. Foi realizado um estudo observacional, descritivo e misto com internos de medicina de quatro universidades chilenas, por meio de um questionário distribuído eletronicamente, para conhecer sua frequência e principais fatores desencadeantes. Participaram 56 estudantes. Os resultados expressam a presença transversal de sofrimento moral nos estudantes das universidades exploradas. Destaca-se como principal fonte a dificuldade em obter o consentimento informado dos pacientes. Os resultados fornecem conhecimento útil para projetar programas educativos que abordem o sofrimento moral e suas principais fontes associadas.
Abstract
Moral distress, defined as the suffering a person experiences when forced to actions or omissions that contradict their values, has been described in all medical professions and related training, associated with consequences such as depersonalization in care, low motivation at work, vocational questioning, and in connection with burnout. In Chile, moral distress has been scarcely researched, and even less in medical students. This is an observational, descriptive and mixed research with medical residents from four universities in Chile using an electronically distributed questionnaire to study its frequency and main triggering factors. Participants included 56 students. The results show transversal occurrence of moral distress in students from the researched universities. The difficulty in obtaining informed consent from patients is noted as the main moral distress source. The results provide useful knowledge for designing educational programs that address moral distress and its main associated sources.
Resumen
La angustia moral, definida como el sufrimiento que experimenta una persona cuando se ve obligada a ejecutar acciones u omisiones que contradicen sus valores, ha sido descrita en todas las profesiones sanitarias y también en la formación de ellas, asociándose a consecuencias como despersonalización en los cuidados, baja motivación laboral, cuestionamiento vocacional y vinculación al burnout. En Chile, ha sido poco estudiada y menos aún en estudiantes de medicina. Se realizó un estudio observacional, descriptivo y mixto en internos de medicina de 4 universidades chilenas, mediante un cuestionario distribuido electrónicamente, para conocer su frecuencia y principales factores desencadenantes. Participaron 56 estudiantes. Los resultados expresan la presencia transversal de angustia moral en los estudiantes de las universidades exploradas. Destaca como fuente principal la dificultad en obtener el consentimiento informado de los pacientes. Los resultados aportan conocimiento útil para diseñar programas educativos que aborden la angustia moral y sus principales fuentes asociadas.
Patentes farmacéuticas en Chile: Mecanismos institucionales que condicionan la entrada de competidores tras el vencimiento de la exclusividad
(Universidad del Desarrollo. Facultad de Gobierno, 2026) Alvear Guerrero, Luis Ignacio; Castillo Laborde, Carla Cecilia; Matute Willemsen, María Isabel
Esta investigación analiza por qué, en Chile, el vencimiento de las patentes farmacéuticas no garantiza por sí solo una reducción de precios ni la entrada efectiva de competidores. Bajo un enfoque cualitativo de carácter exploratorio-descriptivo, combina el análisis documental de fuentes normativas, institucionales y técnicas, con entrevistas en profundidad a actores del ecosistema sanitario, contrastando el diseño formal del régimen con su funcionamiento práctico. Los hallazgos muestran que los mecanismos que condicionan la entrada no se concentran exclusivamente en la figura de la patente, sino que se distribuyen en varios niveles: la regla formal, su aplicación práctica, las capacidades de los organismos que la administran y, en último término, el financiamiento. En el plano formal, el régimen consagra varias capas de exclusividad —patente, protección suplementaria y datos de prueba, en buena parte de recepción ADPIC-plus— cuya prolongación mediante patentamiento secundario efectivamente ocurre, mientras los contrapesos pro-competencia, como la licencia obligatoria, permanecen sin uso por el costo político de activarlos. En general, la competencia se desplaza desde el precio hacia la marca, mediada por la prescripción y la confianza del paciente; a ello se suma, en los fármacos biológicos, una dificultad normativa para la sustitución que bloquea la intercambiabilidad donde se concentra el mayor gasto. Operan, además, una separación informacional entre el INAPI y el ISP, que impide vincular el vencimiento de una patente con el medicamento sustituible, y una capacidad estatal insuficiente para vigilar esos vencimientos y convocar a la competencia. Aun resueltas la entrada y la sustitución, el acceso efectivo depende de la inclusión del medicamento en los instrumentos de cobertura, de modo que el límite último es de financiamiento. Sobre esta base, se proponen recomendaciones de política en interoperabilidad informativa entre agencias, fiscalización, prescripción por denominación común internacional y revisión del régimen de sustitución de biológicos
La incidencia de la potestad reglamentaria en la implementación de políticas públicas: Estudio de caso de la Ley N° 21.760 de adopción en Chile
(Universidad del Desarrollo. Facultad de Gobierno, 2026) Atton Eguillor, Constanza Valentina; Couyoumdjian, Juan Pablo; Arellano Falcón, Rodrigo
Desde esa perspectiva, esta investigación no busca determinar si el contenido de la Ley N.° 21.760 fue modificado durante el proceso reglamentario. Busca
analizar cómo el ejercicio de la potestad reglamentaria incidió en la implementación de una reforma ya aprobada por el legislador y cómo, durante ese proceso, interactuaron factores institucionales, administrativos y políticos que condicionaron su puesta en marcha.
Análisis ex post de la ejecución contrato de obra Puente Cau Cau y accesos
(Universidad del Desarrollo. Facultad de Gobierno, 2026) De la Fuente Poblete, Patricio Arturo; Troncoso Olchevskaia, Rodrigo; Calderón, Paula
La presente investigación adopta un enfoque cualitativo, el cual se define como el más idóneo para abordar fenómenos sociales y administrativos de alta complejidad en el ámbito de las políticas públicas. A diferencia de los estudios meramente cuantitativos que buscan generalizaciones estadísticas, el enfoque cualitativo permite explorar con profundidad las dinámicas interinstitucionales y los procesos de toma de decisiones en entornos de alta incertidumbre
The proportion of genetic similarity for liability for neuroticism in mother-child and mother-father dyads is associated with reported relationship quality
(2025) Pearson, Rebecca; Braithwaite, Elizabeth; Cadman, Tim; Culpin, Iryna; Costantini, Ilaria; Cordero, Miguel; Bornstein, Marc; James, Deborah; Kwong, Alex; Jones, Hannah; Sallis, Hannah
This study aims to explore the influence of genetic similarity for neuroticism liability in mother's reported quality of relationship with her child and partner. Such understanding could provide insight into the role of genetic similarity in neuroticism liability in close relationships. Molecular genetic data in 4,704 mothers, partners, and children in the Avon Longitudinal Study Parents And Children (ALSPAC) study were used to derive the proportion of genetic similarity in neuroticism liability between mother and child, and mother and partner, for genetic variants associated with neuroticism. Associations between genetic similarity in neuroticism liability scores and mothers' reported enjoyment and conflict in the parenting relationship (child ages 0-3) and her reported partner relationship were examined. For a one standard deviation (SD) increase in similarity in mother and child genetic variants associated with neuroticism, there was a 0.15SD (95%CI = 0.003 to 0.500, p = 0.046) increase in maternal reported enjoyment in their relationship. This association was greater where mother and child were both in the top quartile for high neuroticism (standardised beta = 0.29, 95%CI = 0.02 to 0.56, p = 0.034). Similar patterns of results emerged for similarity for genetic variants associated with neuroticism between mothers and partners, and the quality of the mother-partner relationship. These results highlight how phenotypic variation (i.e. the link between PGS scores and mothers reported enjoyment) linked to genetic liability in one individual may be linked with the genetic liability of those around them (i.e. the genetic liability of the infant). In other words, parenting and intimate partner relationships as perceived by the mother were explained not by one or the other's genetic score, but by the similarity between them These exploratory findings present an intriguing mechanism by which similarity between genetic liability might be linked to family relationships.
Programas after school y su relación con la inserción laboral femenina: un estudio comparativo en establecimientos de la Fundación Acompañando Pasos, zona central de Chile
(Universidad del Desarrollo. Facultad de Gobierno, 2026) Merino, Bernardita; Rojas, Armando; Bilbao, Gilda
El presente estudio analiza la relación entre la participación en programas after school y la inserción laboral de mujeres con hijos e hijas en edad escolar, a partir de un diseño cuantitativo, no experimental, transversal y comparativo.
No evidence for exosome treatment in reducing alcohol relapse – a failed confirmatory multi-center study
(2025) Meinhardt, Marcus; Habelt, Bettina; Skorodumov, Ivan; Schwarz, Cindy; Bernhardt, Nadine; Winter, Christine; Hardar, Ravit; Müller, Christian; Israel, Yedy; Ezquer, Fernando; Spanagel, Rainer
Preclinical studies have suggested that intranasal administration of mesenchymal stem cell-derived exosomes can reduce alcohol intake and relapse-like behavior in rodents. To assess the translational potential of these findings, we conducted a preregistered, multi-center preclinical randomized controlled trial (preRCT) across several German research sites. Using the alcohol deprivation effect (ADE) model in both male and female Wistar rats, we evaluated whether exosome treatment attenuates relapse-like drinking behavior following repeated deprivation phases. Given the hurdles in standardizing exosome isolation, dosage, and intranasal delivery into the brain, we performed first a functional validation experiment of intranasally delivered exosomes. For providing such a functional proof, we conducted electrocorticography (ECoG) recording and showed that exosomes are capable of mitigating impaired electrophysiological activity in the prefrontal cortex in rats that underwent the ADE procedure. However, contrary to previously published positive findings, our confirmatory multi-site preRCT results did not demonstrate a significant reduction in ethanol consumption during an ADE in Wistar rats following exosome treatment. No sex or site-specific effects were observed. Given the absence of efficacy, the study was terminated early in alignment with the 3R principles of animal research ethics. These findings suggest that the previously reported benefits of exosome treatment may be model-specific and do not generalize to a broader genetic background or experimental model. Our results emphasize the necessity of replication across diverse preclinical models and rat lines prior to clinical translation and highlight the importance of publishing null results to improve transparency and reproducibility in addiction research.
Characterization of Hydrogel Beads for the Gradual Release of Origanum vulgare L. Essential Oil and Evaluation of Their Antifungal Activity Against Candida albicans
(2025) Concha, Victoria; Díaz, Mario; Duarte, Luisa; Jara, José; Molina, Alfredo
Candida albicans infections are associated with high morbidity and mortality worldwide. Current antifungal therapies are limited by adverse effects and the emergence of resistant strains, which compromise long-term efficacy. Previous studies have shown that Origanum vulgare L. essential oil (OvEO) possesses strong antifungal activity; however, its volatility and physicochemical instability hinder clinical application. The aim of this study was to encapsulate OvEO in a hydrogel and evaluate its release kinetics, chemical composition, structural properties, and antifungal activity. We assessed its release kinetics, chemical composition, structural characteristics (FTIR; SEM), and antifungal activity against C. albicans. OvEO was successfully encapsulated into hydrogel beads, enabling a gradual release profile, with in vitro release of phenolic compounds reaching 100% at 48 min. SEM revealed an irregular surface with small pores and crystalline aggregates distributed across the bead surface. OvEO-loaded hydrogel beads inhibited C. albicans growth with an IC50 of 0.15 ± 0.05 mg/L for strain 90029 and 0.2 ± 0.06 mg/L for strain 10231. At these concentrations, adhesion to abiotic surfaces was reduced by 60–80%. These findings support the potential of OvEO-loaded hydrogel beads as an alternative approach for the treatment of fungal infections, offering a complementary strategy to current antifungal agents.
Polygenic scores contribution to Parkinson's disease comorbidities
(2025) Hernández, Carlos; Villaman, Camilo; Tejos, Cristian; Repetto, Gabriela; Leu, Costin; Lal, Dennis; Mata, Ignacio; Klein, Andrés; Pérez Palma, Eduardo
Comorbidities are common in Parkinson's disease and significantly impact the disease progression and management. While polygenic scores have been widely used to assess genetic risk for complex diseases, their role in comorbidity presentation in Parkinson's disease remains unclear. This study investigates whether genetic predisposition to comorbidities, as measured by polygenic scores, differs between individuals with Parkinson's disease and the general population and explores how genetic risk influences disease onset and sex-related differences. We analysed data from 4144 individuals with Parkinson's disease and 370 480 individuals from the general population in the UK Biobank, focusing on four comorbidities with high-quality genome-wide association study data: Type 2 diabetes, major depressive disorder, migraine headaches and epilepsy. We first compared polygenic score distributions between individuals with Parkinson's disease and the general population. While our findings indicate that comorbidities and polygenic risk scores do not significantly differ between individuals with Parkinson's disease and the general population, we show an association with disease onset and sex-specific differences. Individuals with earlier disease onset (50-70 years old) had higher genetic risk for major depressive disorder (odds ratio: 2.19, P-value: 1.27 × 10⁻¹⁵) and epilepsy (odds ratio: 1.58, P-value: 0.00845). Additionally, a female participant with Parkinson's disease exhibited higher genetic risk scores for major depressive disorder (odds ratio: 1.5, P-value: 0.0119) and migraine headaches (odds ratio: 2.1, P-value: 0.0155), while a male participant displayed higher genetic risk scores for Type 2 diabetes (odds ratio: 2.7, P-value: 2.11 × 10⁻¹⁷). Comorbidity-polygenic score did not differ between people with versus without Parkinson's disease, yet within Parkinson's disease, a higher genetic burden for specific comorbidities was linked to earlier onset and sex-specific presentation, implicating common variants as modifiers of clinical heterogeneity rather than the primary disease risk. These results enhance our understanding of the genetic influences shaping the broader clinical presentation of Parkinson's disease and highlight the need for further research into the interplay between genetic risk factors, comorbidities and disease heterogeneity.