Local adaptation of Dromiciops marsupials (Microbiotheriidae) from southern South America: Implications for species management facing climate change.

The two species of the microbiotheriid marsupial genus Dromiciops (Dromiciops bozinovici: "Panchos's monito del monte" and Dromiciops gliroides: "monito del monte") exhibit a marked latitudinal genetic differentiation. Nevertheless, it is unclear whether this differentiation results from neutral processes or can be explained, to some extent, by local adaptation to different environmental conditions. Here, we used an SNP panel gathered by Rad-seq and searched for footprints of local adaptation (putative loci under selection) by exploring genetic associations with environmental variables in the two species of Dromiciops in Chilean and Argentinean populations. We applied three methods for detecting outlier SNPs and two genotype-environment associations approaches to quantify associations between allelic frequencies and environmental variables. Both species display strong genetic structure. D. bozinovici exhibited three distinct genetic groups, marking the first report of such structuring in this species using SNPs. In contrast, D. gliroides displayed four genetic clusters, consistent with previous studies. Both species exhibited an association of their genetic structure with environmental variables. D. bozinovici exhibited significant associations of allelic frequencies with elevation, precipitation during the warmest periods, and seasonality in the thermal regime. For D. gliroides, genetic variation appeared to be associated with more variables than D. bozinovici, including precipitation and temperature-related variables, isothermality, and elevation. All the outlier SNPs were mapped to the D. gliroides reference genome to explore if they fell within functionally known genes. These results represent a necessary first step toward identifying the genome regions that harbor genes associated with climate adaptations in Dromiciops. Notably, we identified genes involved in various functions, including carbohydrate synthesis (ALG8), muscle and neuronal regulation (MEF2D), and stress responses (PTGES3). Ultimately, this study contributes valuable insights that can inform targeted conservation strategies aimed at preserving the genetic diversity of Dromiciops in the face of environmental challenges.

Physical exercise in Chilean breast cancer survivors: Qualitative study of barriers, facilitators and preferences. / Actividad física en chilenas sobrevivientes de cáncer de mama: estudio cualitativo de barreras, facilitadores y preferencias.

Introduction: Breast cancer survivors often experience pre and post-treatment physical and psychological symptoms, negatively affecting their quality of life. Regular physical exercise is associated with better quality of life and lower recurrence of cancer, and therefore all oncological patients are recommended to practice it in a regular basis. Despite this, breast cancer survivors have low adherence to physical exercise. The purpose of this study is to identify barriers, facilitators and preferences of Chilean breast cancer survivors to practice physical exercise. Methods: Phenomenological qualitative study of 12 in-depth interviews with adjuvant radiation therapy concluded at least three months ago. Results: Breast cancer survivors ignored the benefits of physical exercise during and after treatment. The barriers were physical symptoms, psychological barriers, sociocultural barriers, health system barriers, disinformation and sedentary lifestyle. Facilitators were coping with physical symoptoms, psychological issues, having information and active lifestyle. The preferences were painless and familiar exercises. Preferred exercise was walking. Conclusions: Breast cancer survivors may adhere to physical exercise despite barriers when certain facilitators are present, which may be promoted by the health team when reporting the benefits of the physical exercise, prescribing personalized, safe and painless physical exercise and educating both patient and her family about the role of the physical exercise in cancer recovering process.

Introducción: Las sobrevivientes de cáncer de mama suelen ver afectada negativamente su calidad de vida por síntomas físicos y psicológicos pre y post tratamiento. La práctica regular de ejercicio físico se asocia a mejor calidad de vida y menor recurrencia del cáncer, por esto es recomendado a todos los pacientes oncológicos. Sin embargo, existe baja adherencia a este. El propósito de este artículo es identificar barreras, facilitadores y preferencias de sobrevivientes de cáncer de mama chilenas para realizar ejercicio físico. Métodos: Estudio cualitativo fenomenológico, basado en entrevistas en profundidad a 12 sobrevivientes de cáncer de mama que terminaron la radioterapia adyuvante hace tres o más meses. Resultados: Las sobrevivientes de cáncer de mama desconocían la importancia del ejercicio físico durante y después del tratamiento. Las barreras identificadas fueron síntomas físicos, barreras psicológicas, socioculturales, del sistema de salud; desinformación y sedentarismo. Los facilitadores fueron físicos, psicológicos, contar con información y práctica de ejercicio físico antes del diagnóstico. Las preferencias fueron ejercicios indoloros y familiares. El ejercicio preferido fue caminar. Conclusiones: Es posible que las sobrevivientes de cáncer de mama adhieran al ejercicio físico, a pesar de las barreras cuando hay ciertos facilitadores presentes. Estos pueden ser generados por el equipo médico al informar los beneficios del ejercicio físico, prescribir ejercicio físico personalizado, seguro e indoloro y educar a la paciente y a su familia sobre el rol del ejercicio físico en la recuperación de sobrevivientes de cáncer de mama.

Exploration of barriers to treatment for patients with eating disorders in Chile.

BACKGROUND: Eating disorders (EDs) are associated with high morbidity and mortality, affecting predominantly young people and women. A delay in starting treatment is associated with chronic and more severe clinical courses; however, evidence on barriers and facilitators of access to care in Latin America is scarce. We aimed to identify barriers and facilitators of ED treatment in Chile from the perspective of patients, relatives, and health professionals. METHODS: Qualitative approach through semi-structured interviews with patients, their relatives, and health professionals. Participants were recruited from two ED centers in Santiago, Chile (one public and one private). Analysis was mainly based on Grounded Theory, using MAXQDA software. RESULTS: 40 interviews were conducted (n = 22 patients, 10 relatives, and 8 health professionals). The mean age of patients was 21.8 years, while the mean duration of untreated ED was 91.4 months (median 70 months). Five categories emerged with intersections between them: patient (P), family and social environment (FSE), health professionals (HP), healthcare system (HCS), and social and cultural context (SCC). Relevant barriers appeared within these categories and their intersections, highlighting a lack of professional knowledge or expertise, cultural ignorance or misinformation regarding EDs, and patient's ego-syntonic behaviors. The main facilitators were patients' and relatives' psychoeducation, recognition of symptoms by family members, and parents taking the initiative to seek treatment. CONCLUSIONS: This study provides information regarding access to treatment for patients living with EDs in Chile. A practical public health approach should consider the multi-causality of delay in treatment and promoting early interventions. Eating disorders (EDs) may severely affect the daily functioning of people enduring them. A delay in starting treatment is associated with a disease that is more difficult to treat. To our knowledge, there are no published studies carried out in Latin America exploring factors influencing treatment initiation in EDs patients. This study aimed to identify facilitators of and barriers to treating patients with EDs in Chile. We interviewed patients (n = 22), their relatives (n = 10), and health professionals (n = 8) from a private and a public center in Santiago, Chile. Our analysis showed that the main barriers to starting treatment were the lack of professional knowledge in ED, the monetary cost of illness, and cultural misinformation. Facilitators were related to the role of the family in recognizing and addressing the disease while being educated in EDs by professionals. This study helps to provide data about treatment access in developing countries. While facilitators and barriers were similar to others reported in the literature, the untreated ED's duration was longer. It is essential to address these barriers to provide access to treatment more efficiently and prevent severe and enduring forms of disease.

De Novo Occurrence of Hb Chile [ß28(B10) Leu→Met] in a Korean Boy with Methemoglobinemia.

Hemoglobin (Hb) Chile, a variant of Hb M, is produced by a point mutation of CTG→ATG on codon 29 (legacy codon 28) of the Hb ß locus gene, which results in an amino acid substitution of Leu→Met. It has been identified in two families worldwide and is inherited in an autosomal dominant manner. Here, we report a case of Hb Chile in which a de novo mutation was detected in the proband. A 17-year-old male presented to the outpatient clinic with a pale appearance. There was cyanosis on his lips and fingers. Blood tests indicated the existence of hemolysis, but complete blood counts revealed no anemia. Peripheral arterial oxygen saturation on pulse oximetry was 80% on room air and did not improve with oxygen supplementation. The level of methemoglobin was 15.4%. Targeted next-generation sequencing identified a heterozygous NM_000518.4(HBB):c.85C > A mutation, indicating Hb Chile. The Hb Chile mutation, on the other hand, was not discovered in his parents, implying that it arose as a result of a de novo mutation. This case highlights the necessity of suspecting Hb gene mutations in patients with unexplained chronic methemoglobinemia, even if there is no family history.

Oceanographical-driven dispersal and environmental variation explain genetic structure in an upwelling coastal ecosystem.

The seascape comprises multiple environmental variables that interact with species biology to determine patterns of spatial genetic variation. The environment imposes spatially variable selective forces together with homogenizing and diverging drivers that facilitate or restrict dispersal, which is a complex, time-dependent process. Understanding how the seascape influences spatial patterns of genetic variation remains elusive, particularly in coastal upwelling systems. Here, we combine genome-wide SNP data, Lagrangian larval dispersal simulated over a hydrodynamic model, and ocean environmental information to quantify the relative contribution of ocean circulation and environmental heterogeneity as drivers of the spatial genetic structure of two congeneric intertidal limpets, Scurria scurra and S. araucana, along the central coast of Chile. We find that a genetic break observed in both limpet species coincides with a break in connectivity shown by the Lagrangian dispersal, suggesting that mean ocean circulation is an important seascape feature, in particular for S. scurra. For S. araucana, environmental variation appears as a better predictor of genetic structure than ocean circulation. Overall, our study shows broad patterns of seascape forcing on genetic diversity and contributes to our understanding of the complex ecological and evolutionary interactions along coastal upwelling systems.

Detection of Trypanosoma cruzi DNA in lizards: Using non-lethal sampling techniques in a sylvatic species with zoonotic reservoir potential in Chile.

Several reptile species have been described as hosts of Trypanosoma cruzi, the causative agent of Chagas disease, and therefore, they have become vertebrates of epidemiological interest. In recent decades, there has been a growing interest in animal welfare, especially in populations with small numbers where lethal sampling could have catastrophic consequences, and non-lethal methodologies have been developed for detecting zoonotic parasites. In this study, we compared three non-lethal sampling methodologies for detecting T. cruzi DNA in 21 captured specimens of the native lizard Liolaemus monticola, collected from the semiarid Mediterranean ecosystem of Chile. Specimens were subjected to xenodiagnosis (XD), tail clipping, and living syringe sampling procedures to evaluate whether lizards could serve as sentinel species for T. cruzi in endemic regions. To detect the protozoan, real-time PCR (qPCR) was performed on the DNA extracted from the samples (intestinal contents, tail tissues, and blood from living syringes). Trypanosoma cruzi DNA was detected in 12 of 21 lizards, considering all three methodologies. By XD, 12 specimens showed infection (57.1 %), and both living syringe and tail sampling methodologies detected only one infected lizard (4.8 %). Therefore, T. cruzi can be detected in lizards by qPCR using the three methodologies but XD is by far the most effective non-lethal detection methodology. The use of tail and living syringe methodologies showed a large underestimation; however, they might be options for monitoring the presence of T. cruzi in lizard populations when large sample sizes are available.

Factors associated with gingival recession prevalence in undergraduate students of the Faculty of Dentistry of the Universidad de los Andes in the year 2022. / Factores asociados a prevalencia de recesiones gingivales en alumnos de pregrado de la Facultad de Odontología de la Universidad de Los Andes en 2022.

Objective: To determine the prevalence of gingival recessions in students of the faculty of odontology at Universidad de Los Andes and the factor associated with its presence. Methods: In this cross-sectional study, a randomized stratified sampling was used to select the students. The sample included 311 undergraduate students evaluated between March and December 2022. The year spectrum was from 17 to 29 years old. Two calibrated examiners intra e interoperator completed a clinical evaluation with a periodontal probe, where the purpose was to diagnose gingival recessions and identify if there were any related factors such as smoking, braces, bruxism, marginal insertion frenulum, fine phenotype, and malposition. The total prevalence was described with each trust interval of 95%. The association between categorical variables was analyzed with the chi-square test, and the t-student test of the Mann-Whitney test analyzed the difference between continuous variables and recession prevalence. Results: 93,56% of the students presented at least one gingival recession. The highest prevalence related to teeth occurred in pieces 1.6, 3.4, 2.6, and 4.1, and the most severe were 3.3, 4.3, and 1.3. The most associated factor related to recessions was orthodontics, with a prevalence of 75,2%. Bruxism showed a positive association with the number of recessions, with a prevalence of 60,7%. Conclusions: Buccal gingival recessions were very prevalent in undergraduate students at the dental school of Universidad de los Andes during 2022, and they were strongly associated with the history of orthodontics.

Objetivo: Determinar la prevalencia de recesiones gingivales en alumnos de pregrado de la Facultad de Odontología de la Universidad de Los Andes, y los factores asociados a su presencia. Métodos: En este estudio transversal para la selección de los participantes, se utilizó el muestreo aleatorio estratificado. La muestra incluyó a 311 alumnos de pregrado evaluados entre marzo y diciembre del año 2022. Las edades fluctuaron entre los 17 y los 29 años. Dos examinadores calibrados intra e interoperador, realizaron una evaluación clínica con una sonda periodontal, para diagnosticar recesiones gingivales, También se buscó determinar si existían factores asociados a estas, como tabaquismo, ortodoncia, bruxismo, frenillos marginales, fenotipo fino, malposiciones. La prevalencia total fue descrita con sus respectivos intervalos de confianza al 95%. La asociación entre variables categóricas fue analizada con la prueba Chi-cuadrado y la diferencia de medias entre variables continuas y prevalencias de recesiones, fueron analizadas a través de la prueba t Student o prueba de Mann-Whitney. Resultados: Un 93,56% de los alumnos presentó al menos una recesión gingival. Los dientes con mayor prevalencia de recesiones gingivales fueron 1,6; 3,4; 2,6 y 4,1; los con mayor severidad fueron el 3,3, 4,3 y 1,3. El factor con mayor asociación a la ocurrencia de recesiones fue el historial de tratamiento ortodóncico con una prevalencia del 75,2%. El bruxismo presentó asociación positiva con respecto al número de recesiones gingivales con una prevalencia de 60,7%. Conclusiones: Las recesiones gingivales vestibulares son una condición muy prevalente en estudiantes de odontología de la Universidad de Los Andes durante el año 2022, con una fuerte asociación a la historia de tratamiento ortodóncico.

Using Household Dietary Diversity Score and Spatial Analysis to Inform Food Governance in Chile.

This study explores how the Household Dietary Diversity Score (HDDS) and spatial visualization can inform food governance in Chile, focusing on socio-demographic and geographical determinants affecting food consumption patterns. A national household database (n = 4047), including households from 2019 (n = 3967; 98.02%) and 2020 (n = 80; 1.98%), provided by the "Family Support Program of Food Self-Sufficiency" (FSPFS) of the Ministry of Social Development and Family, was analyzed. The findings revealed that Chilean vulnerable households were led mostly by women (86.6%), with an age average of 55.9 ± 15.6 years old, versus 68.9 ± 12.9 years in the case of men. The intake frequency analysis showed that dairy, fruits, and vegetables were below the recommended values in at least half of the households, and that fats and sugars were above recommended levels. Regarding the HDDS (0-189), the national average was 91.4 ± 20.6 and was significantly influenced by the number of minors in the households, water access, food access issues, and residing in the Zona Sur. Finally, the spatial visualization showed that the Zona Central had higher consumption of fruits and vegetables, while the extreme zones Norte Grande and Zona Austral showed higher intakes of fats and sugars. These findings emphasize the importance of leveraging data insights like the HDDS and spatial visualization to enhance food security and inform food governance strategies.

Exposure Practices to Animal-Origin Influenza A Virus at the Animal-Human Interface in Poultry and Swine Backyard Farms.

AIM: Backyard production systems (BPS) represent an interface of contact between people, domestic and wild animals. Studies conducted in Chile during the last decade have provided extensive evidence of influenza A virus (IAV) circulation in backyard poultry and swine. The aim of this study was to investigate exposure practices of humans to animal-origin IAV within backyards. METHODS AND RESULTS: Backyard farmers and household members of a total of 101 BPS in the proximity of wetlands located throughout Chile were interviewed between 2021 and 2022. Data were collected on the nature of human-animal contacts through participation in productive activities conducted within backyards, which was used to estimate participants' exposure risk to animal-origin IAV. Additionally, RT-qPCR and serologic IAV active surveillance was carried out in backyard animals. Multilinear regression was used to identify factors associated with exposure risk. Overall, IAV prevalence was 10.1% (95% CI: 4.7%-15.5%) and seroprevalence was 43.5% (95% CI: 29.7%-54.2%), both at the BPS level. Of 180 interviewees, 86% reported participating regularly in poultry or swine exposure activities within the backyard. A greater participation of male participants was observed when evaluating swine exposure activities, while female participation was greater for some activities related to poultry handling. Handwashing was a very extended hygiene practice; however, the use of personal protective equipment was uncommon. Different factors related to participants, households and backyards were associated with an increased exposure risk of participants to animal-origin IAV: (i) older age, (ii) less years of education, (iii) no off-farm work, (iv) greater backyard production value and (v) greater household consumption of backyard products. CONCLUSION: These results indicate the circulation of IAV in BPS and the frequent human-animal contact at this interface, highlighting the need for awareness campaigns and educational programmes aimed at backyard farmers on prevention and biosecurity measures in the management of backyard animals.

Educating gender: The economic and spiritual battles over land and Mapuche children in Araucanía, Chile, 1897-1922.

This article examines the role of gender as an embodied site of political control and resistance within Mapuche-Capuchin relations in the early period of Bavarian Capuchin mission-building in Chile (1897-1922). The study frames agricultural science education as a civilizing method employed in the Capuchin mission schools, targeting Mapuche children. The aim was to educate Mapuche children in Christian and Western gender roles, moral behavior, and rural economic occupations. Amid the overarching conflict over land rights and privatization between Mapuche communities and the Chilean government, the state's support for the Capuchin order's evangelizing mission was perceived as a long-term strategy to appropriate Indigenous lands and assimilate the Mapuche into the rural and urban workforce. The article illustrates how the conflict over embodied gender roles disrupted Mapuche socioeconomic relations.

[Using diagnosis-related groups in Chile: lessons and challengesLições e desafios do uso de grupos de diagnósticos relacionados no Chile]. / Lecciones y desafíos del uso de los grupos relacionados por el diagnóstico en Chile.

Objective: Analyze the implementation of diagnosis-related groups (DRGs) in Chile with a view to optimizing the distribution of public resources. Methods: A chronological narrative analysis of the main milestones was complemented by simulated application of DRGs through emulated competition and cluster analysis for evaluative purposes. Results: In 2001, DRGs were introduced in Chile in an academic context. The National Health Fund (FONASA) began using DRGs in the private sector. A public sector pilot was launched in 2015. After nearly two decades of progress, in 2020 FONASA established the DRG program as a payment mechanism for public hospitals. However, the COVID-19 pandemic slowed its development. In 2022, implementation was resumed. After evaluating the program, it was evident that the hospital clusters that had been predefined for differentiated payment did not successfully differentiate homogeneous groups. In 2023, the program was reformed, financing was increased, a single cluster and base rate were defined, and greater hospital complexity was recognized, compared to previous years. Three hospitals were added to the program, for a total of 68. Conclusions: This experience shows that it is possible to sustain a public health financing policy that achieves greater efficiency and equity in the health system, based on the existence of robust institutions that continuously develop and improve.

Objetivo: Analisar a implementação de grupos de diagnósticos relacionados (DRG, na sigla em inglês) no Chile, com o objetivo de otimizar a distribuição de recursos públicos. Método: Foi utilizada uma análise narrativa cronológica dos principais marcos, complementada por simulações da implementação de DRG usando concorrência simulada (yardstick competition) e análise de agrupamento para fins de avaliação. Resultados: O modelo de DRG foi introduzido no Chile em 2001, em um contexto acadêmico. Em 2015, o Fundo Nacional de Saúde (FONASA) começou a utilizá-lo no setor privado e, com um projeto-piloto, no setor público. Após quase duas décadas de progresso, em 2020, o programa de DRG foi implementado como mecanismo de pagamento do FONASA para os hospitais públicos. No entanto, a pandemia de COVID-19 interrompeu seu desenvolvimento. Em 2022, a aplicação foi retomada e, após uma avaliação do programa, ficou claro que os grupos hospitalares predefinidos para o pagamento diferenciado por DRG não formavam grupos homogêneos. Em 2023, o programa foi reformulado, com aumento dos recursos financeiros e a definição de um único agrupamento e de uma taxa básica, reconhecendo-se uma maior complexidade hospitalar do que nos anos anteriores. Além disso, três hospitais foram adicionados ao programa, elevando o total para 68. Conclusões: A experiência mostra que é possível dar continuidade a uma política pública de financiamento da saúde para alcançar maior eficiência e equidade no sistema de saúde com base na existência de instituições sólidas que persistam em seu desenvolvimento e contínuo aprimoramento.

Social-ecological resilience: Knowledge of agrobiodiversity by campesinos and migrants in the face of global changes.

There is concern that agrobiodiversity is being irreversibly eroded in the face of agricultural industrialization. While academic and policy debates stress loss of landraces, little attention has been paid to evaluating how agricultural knowledge systems endure in response to broader social-ecological changes (i.e., "system's resilience"). For being resilient, agricultural knowledge systems should incorporate new information (modern seed varieties) whilst maintaining its traditional components (landraces) and functions. However, the loss or continuing utilization of landraces may be influenced by several social-ecological filters, which are processes that selectively remove varieties according to their phenotype, local uses, or value. We examined the resilience of agricultural knowledge systems in the southern Andes. These systems include the knowledge of landraces and modern varieties by campesinos and lifestyle migrants. We further assessed the association of social-ecological filters with the knowledge of agrobiodiversity. Over four years (2018-2022), we used mixed-methods including semi-structured interviews with gardener experts and conducted knowledge exercises of seed varieties and surveys of gardeners (n = 132). We assessed the association of 'knowledge score on varieties' (general, landraces, and modern) with a priori-defined social-ecological filters. Gardeners with more proficient knowledge of landraces were more knowledgeable of modern varieties too. The general knowledge of agrobiodiversity and the knowledge of landraces, but not of modern varieties, was higher for campesinos than migrants. The main seed source of gardeners, the participation in seed exchanges, gardeners' origin, and gardeners' age were the social-ecological filters that influenced gardeners' knowledge of agrobiodiversity. We highlight that social-ecological, small-scale farming systems, are being resilient when they have the capacity of incorporating new information (knowledge of modern varieties) whilst maintaining their identity (knowledge of landraces) without undergoing a major shift in their basic structures and functions in this Important Agricultural Heritage Site and Global Biodiversity Hotspot, and beyond.

Quantifying antimicrobial consumption in the Chilean salmon industry using standardized metrics and indicators: The case of florfenicol and oxytetracycline.

The adoption of standardized metrics and indicators of antimicrobial use (AMU) in the food animal industry is essential for the success of programs aimed at promoting the responsible and judicious use of antimicrobials in this activity. The objective of this study was to introduce the use of standardized AMU metrics and indicators to quantify the use of florfenicol and oxytetracycline in the Chilean salmon industry, and in this way evaluate the feasibility of their use given the type of health and production information currently managed by the National Fisheries and Aquaculture Service (SERNAPESCA), the Chilean agency responsible for regulating aquaculture in Chile. The data available from SERNAPESCA allowed the construction and evaluation of the most data-demanding AMU metrics and indicators. Consequently, the use of florfenicol and oxytetracycline administered by oral and parenteral routes was quantified using the treatment incidence based on both animal defined daily dose (TIDDDvet) and animal used daily dose (TIUDDA). To that end, the study included information from 1320 closed production cycles from farms rearing Atlantic salmon, coho salmon and rainbow trout that were active between January 2017 and December 2021. By applying standardized AMU metrics and indicators, we were able to determine that the median of TIDDDvet for florfenicol was 75.1 (80 % range, 20.0-158.0) DDDvet per ton-year at risk for oral procedures and 0.36 (80 % range, 0.07-1.19) DDDvet per ton-year at risk for parenteral procedures. For oxytetracycline, the median TIDDDvet was 3.09 (80 % range, 0.74-42.8) and 0.47 (80 % range, 0.09-1.68) DDDvet per ton-year at risk for oral and parenteral procedures, respectively. The median TIUDDA for treatments with florfenicol was 45.6 (80 % range, 10.9-96.5) UDDA per ton-year at risk for oral treatments and 0.28 (80 % range, 0.05-0.80) UDDA per ton-year at risk for parenteral treatments. For oxytetracycline, the median TIUDDA was 2.63 (80 % range, 0.61-28.2) UDDA per ton-year at risk for oral treatments and 0.41 (80 % range, 0.08-1.29) UDDA per ton-year at risk for parenteral treatments. This study demonstrates that it is feasible to move from traditional AMU metrics and indicators to standardized ones in the Chilean salmon industry. This is possible because the competent authority requires salmon farms to report detailed health and production information at a high frequency. The use of standardized AMU metrics and indicators can help the authority to have a more comprehensive view of the antimicrobial use in the Chilean salmon industry.

Simultaneous determination of 11 water-soluble synthetic colorants in foods consumed in Chile by high-performance liquid chromatography with diode Array detection.

In Chile, limited information is available on colorants in commonly consumed foods among vulnerable age groups. We developed and validated a rapid HPLC-DAD method to simultaneously evaluate 11 synthetic colorants in candies, beverages, ice cream, and cereals. The method exhibited excellent analytical performance for all 11 colorants with LOD (0.44 - 1.55 mgL-1), LOQ v(1.32 - 4.70 mgL-1), precision (4.0 and 7.3% RSD), and recovery (80 - 105%) in fortified matrices (10-50-100 mgL-1). The highest detection frequencies were as follows: cereals > candies > beverages > ice cream. Sunset Yellow was the most prevalent colorant in all food matrices, followed by Allura Red and Azorubine. Positive samples contained between 1 and 5 synthetic colorants. With the exception of cereals, the colorant concentrations in the remaining matrices exceeded the Codex Alimentarius regulations and the values reported in other studies worldwide, indicating the Chilean population is at risk.

Comparative analysis of COVID-19 diagnoses and mortality among hospitalized indigenous and non-indigenous populations in Chile: 2020-2021.

BACKGROUND: Current literature presents mixed effects of the COVID-19 pandemic on Indigenous communities. We aim to highlight potential disparities and temporal shifts in both the impact of COVID-19 and vaccine uptake among hospitalized Indigenous populations in Chile. METHODS: We conducted an observational analysis utilizing 1,598,492 hospitalization records from 2020 to 2021 based on publicly accessible hospital discharge data spanning 65 healthcare facilities of medium and high complexity funded through the Diagnosis-Related Groups (DRG) mechanism in Chile, representing roughly 70% of the country's total hospitalizations. This was supplemented with publicly available municipal data on COVID-19 vaccinations and socio-demographic variables. We performed logistic regression analysis at 0.05 level of significance to assess the bivariate and multivariable association of Indigenous status with COVID-19 diagnosis and COVID-19 deaths among hospitalized populations. We also performed univariate and multiple linear regression to assess the association of COVID-19 vaccination rate and Indigenous status at the municipality level. In addition, we report the distribution of top 10 secondary diagnoses among hospitalized COVID-19 cases and deaths separately for Indigenous and non-Indigenous populations. RESULTS: Indigenous populations displayed lower adjusted odds for both COVID-19 diagnosis (OR: 0.76, 95% CI: 0.74, 0.77) and death (OR: 0.91, 95% CI: 0.85, 0.97) when compared to non-Indigenous groups. Notably, the adjusted odds ratio for COVID-19 diagnosis in Indigenous populations rose from 0.59 (95% CI: 0.57, 0.61) in 2020 to 1.17 (95% CI: 1.13, 1.21) in 2021. Factors such as the significantly higher median age and greater number of comorbidities in the non-Indigenous hospitalized groups could account for their increased odds of COVID-19 diagnosis and mortality. Additionally, our data indicates a significantly negative adjusted association between COVID-19 vaccination rates and the proportion of Indigenous individuals. CONCLUSION: Although Indigenous populations initially showed lower odds of COVID-19 diagnosis and mortality, a marked rise in diagnosis odds among these groups in 2021 underscores the urgency of targeted interventions. The observed negative association between the proportion of Indigenous populations and vaccination rates further underscores the necessity to tackle vaccine access barriers and work towards equitable distribution.

Inclusion of people with disabilities in Chilean health policy: a policy analysis.

BACKGROUND: Around 18% of the population in Chile has disabilities. Evidence shows that this population has greater healthcare needs, yet they face barriers to accessing healthcare due to health system failures. This paper aims to assess the inclusion of people with disabilities in health policy documents and to explore the perceptions of key national stakeholders regarding the policy context, policy processes, and actors involved. METHODS: A policy content analysis was conducted of 12 health policy documents using the EquiFrame framework, adapted to assess disability inclusion. Documents were reviewed and rated on their quality of commitment against 21 core concepts of human rights in the framework. Key national stakeholders (n = 15) were interviewed, and data were thematically analysed under the Walt and Gilson Policy Analysis Triangle, using NVivo R1. RESULTS: Core human rights concepts of disability were mentioned at least once in nearly all health policy documents (92%). However, 50% had poor policy commitments for disability. Across policies, Prevention of health conditions was the main human rights concept reflected, while Privacy of information was the least referenced concept. Participants described a fragmented disability movement and health policy, related to a dominant biomedical model of disability. It appeared that disability was not prioritized in the health policy agenda, due to ineffective mainstreaming of disability by the Government and the limited influence and engagement of civil society in policy processes. Moreover, the limited existing policy framework on disability inclusion is not being implemented effectively. This implementation gap was attributed to lack of financing, leadership, and human resources, coupled with low monitoring of disability inclusion. CONCLUSIONS: Improvements are needed in both the development and implementation of disability-inclusive health policies in Chile, to support the achievement of the right to healthcare for people with disabilities and ensuring that the health system truly "leaves no one behind".

INTRODUCCIóN: Alrededor del 18% de la población de Chile tiene discapacidad. Los datos demuestran que esta población tiene mayores necesidades de salud, pero se enfrenta a barreras para acceder a la salud debido a las deficiencias del sistema sanitario. El objetivo de este estudio es evaluar la inclusión de las personas con discapacidad en las políticas sanitarias y explorar las percepciones de actores nacionales en relación al contexto político, los procesos políticos y los actores implicados. MéTODOS: Se realizó un análisis de contenido de 12 políticas sanitarias utilizando el marco EquiFrame, adaptado para discapacidad. Se calificó la calidad de compromiso de las políticas con respecto a 21 conceptos de derechos humanos del EquiFrame. Se entrevistó a 15 actores nacionales, y los datos se analizaron temáticamente según el Triángulo de Políticas de Walt y Gilson, utilizando NVivo R1. RESULTADOS: Los conceptos de derechos humanos en materia de discapacidad se mencionaron al menos una vez en casi todas las políticas sanitarias (92%). Sin embargo, en el 50% de los casos los compromisos políticos en materia de discapacidad eran escasos. En todas las políticas, la Prevención de los problemas de salud fue el principal concepto de derechos humanos reflejado, mientras que la Privacidad de la información fue el concepto menos mencionado. Los participantes describieron un movimiento de la discapacidad y una política sanitaria fragmentados, relacionados con un modelo biomédico dominante de la discapacidad. Pareciera que la discapacidad no es prioritaria en la agenda política sanitaria, debido a su ineficaz integración por parte del Gobierno y a la limitada participación de la sociedad civil en los procesos políticos. Además, el limitado marco político existente sobre salud inclusiva no se está implementando eficazmente. Esta deficiencia en la implementación se atribuyó a la falta de financiamiento, liderazgo y recursos humanos, junto con el escaso monitoreo de la discapacidad. CONCLUSIONES: Se requieren mejoras tanto en el desarrollo como en la implementación de políticas de salud inclusivas de la discapacidad en Chile, para apoyar el alcance del derecho a la salud de las personas con discapacidad y asegurar que el sistema de salud realmente "no deje a nadie atrás".

Performance of vertical and horizontal treatment wetlands planted with ornamental plants in Central Chile: comparative analysis of initial operation stage for effluent reuse in agriculture.

This study comparatively evaluated effluent reuse from two TWs-a horizontal subsurface flow (HF) and a vertical subsurface flow (VF)-used for rural wastewater treatment in Central Chile during the initial operation stage. The two TWs were planted with Zantedeschia aethiopica and were operated for 10 months at a pilot scale. The water quality of the influent and effluents was measured and compared with reuse regulations. The results showed similarities in the behavior of the effluents from the two TWs, presenting differences only in the chemical oxygen demand (COD) and different forms of nitrogen, suggesting the necessity of complementary treatment stages or modifications to the operation. The effluents from the HF better fulfilled the reuse standards for irrigation, as the VF faced problems associated with its size. However, a complementary disinfection system is necessary to improve pathogen removal in the effluents coming from the two TWs, especially to be reused as irrigation water for crops. Finally, this work showed the potential for applying subsurface TWs for wastewater treatment in rural areas and reusing their effluents as irrigation water, practice that can contribute to reducing the pressure on water resources in Chile, and that can be used as an example for other countries facing similar problems.

Analysis of public records of lobbying practices of the ultra-processed sugary food and drink industries in Chile: a qualitative study.

Background: Given the role of commercial determinants on sugar consumption and health, this study aimed to describe lobbying practices of the ultra-processed sugary food and drinks industries in Chile between 2014 and 2022. Methods: Official meetings between ultra-processed sugary food and drinks industries and related commercial actors and Chilean government officials were obtained from the Chilean Lobby Registry. Relevant commercial names were initially identified based on their market share and expanded iteratively based on information from relevant meetings. Qualitative analysis followed a deductive-inductive approach using the Corporate Political Activity Model to identify and classify objectives, framing and action strategies. Findings: From 237 records identified, the Ministries of Health, Social Development, and Economy were the most frequently lobbied. Industry representatives sought to achieve their short- and long-term objectives by targeting a diverse range of authorities, including Ministers and Under-secretaries, using different strategies. Framing strategies focused on presenting sugary food and drinks industries as socially responsible and legitimate policy actors and criticised public health initiatives as 'bad solutions'. Action strategies aimed to influence policymaking and nurture corporate reputations. Interpretation: Extensive lobbying took place by the sugary food and drinks industries between 2014 and 2022, a period when major public health policies were being discussed in Chile. Lobbying strategies varied to meet industry objectives and targeted a diverse range of government institutions including high-ranking officials. Tighter regulations to stop inappropriate industry influence in public health policymaking are urgently required. Funding: Agencia Nacional de Investigación y Desarrollo (Chile)-PhD Scholarship. University College London-Open Access fees.

Booster Vaccination with BNT162b2 Improves Cellular and Humoral Immune Response in the Pediatric Population Immunized with CoronaVac.

The SARS-CoV-2 Omicron variant and its sublineages continue to cause COVID-19-associated pediatric hospitalizations, severe disease, and death globally. BNT162b2 and CoronaVac are the main vaccines used in Chile. Much less is known about the Wuhan-Hu-1 strain-based vaccines in the pediatric population compared to adults. Given the worldwide need for booster vaccinations to stimulate the immune response against new Omicron variants of SARS-CoV-2, we characterized the humoral and cellular immune response against Omicron variant BA.1 in a pediatric cohort aged 10 to 16 years who received heterologous vaccination based on two doses of CoronaVac, two doses of CoronaVac (2x) plus one booster dose of BNT162b2 [CoronaVac(2x) + BNT162b2 (1x)], two doses of CoronaVac plus two booster doses of BNT162b2 [CoronaVac(2x) + BNT162b2 (2x)], and three doses of BNT162b2. We observed that the [CoronaVac(2x) + BNT162b2 (2x)] vaccination showed higher anti-S1 and neutralizing antibody titers and CD4 and CD8 T cell immunity specific to the Omicron variant compared to immunization with two doses of CoronaVac alone. Furthermore, from all groups tested, immunity against Omicron was highest in individuals who received three doses of BNT162b2. We conclude that booster vaccination with BNT162b2, compared to two doses of CoronaVac alone, induces a greater protective immunity.

Critical swimming speed at different temperatures for small-bodied freshwater native riverine fish species.

This study evaluated the effect of fish total length (LT) and three water temperatures (10, 15 and 20 °C) on the critical swimming speed (Ucrit) of the species Percilia irwini (2.9-6.3 cm LT), Cheirodon galusdae (3.4-5.5 cm LT), and Trichomycterus areolatus (4.0-6.3 cm LT). An Ucrit estimation model was constructed for each species as a function of temperature and size. The results showed mean Ucrit for P. irwini of 44.56, 53.83 and 63.2 cm s-1 at 10, 15 and 20 °C, respectively: 55.34, 61.74 and 70.05 cm s-1 for C. galusdae and 56.18, 63.01 and 71.09 cm s-1 for T. areolatus. Critical velocity depended on the interaction between species, body length and water. The swimming performance increased significantly with rising temperature in all three species. The velocity also increased with greater fish total length. After controlling for fish total length, velocity also increased with higher temperature in the three species. This research is relevant to small fish species that require conservation measures.