What is behind the success of terrestrial bromeliads as microhabitat for the sylvatic triatomine Mepraia spinolai?

Puya alpestris, P. berteroniana and P. chilensis (Bromeliaceae) are terrestrial plants present in north-central Chile, considered important part of the shrub flora due to their abundance and close interaction with animals. A previous study showed that bromeliad cover positively correlates with the abundance of the sylvatic triatomine vector Mepraia spinolai, only when infected by the protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. Here, we assessed the biological interactions and abiotic conditions provided by these Puya species to M. spinolai. During the austral summers of 2015 and 2016, we sampled 17 sites with presence of M. spinolai colonies. In each site, we estimated the presence of bromeliad and its cover proportion, and placed a camera trap for three months near a M. spinolai colony to record the vertebrates potentially interacting with this triatomine. Three of the camera traps were placed right in front of M. spinolai-colonized bromeliads. At the same time, triatomines present under these bromeliads were collected to assess their blood meal by Next Generation Sequencing. Between July 2017 and January 2018, we examined the abiotic conditions (temperature and humidity) under bromeliad, under rocks and at ground level. We detected 40 vertebrate species associated to Puya spp. (18 birds, 16 mammals, and 6 reptiles). Puya spp. are a resource for keystone species in T. cruzi sylvatic transmission, including small mammals (Octodon degus, Phyllotis darwini) and lizard species (Liolaemus spp.), detecting a positive association between bromeliad presence and availability of reptiles and non-domestic mammals. Native rodents and humans were the most represented vertebrates in the diet of M. spinolai collected under bromeliads. Temperatures were more stable under bromeliad, showing lower amplitude (up to 14.3 °C) compared to under rocks (23.7 °C) or at ground level (49.6 °C). Bromeliads present in the semiarid-Mediterranean ecosystem provide feeding opportunities for triatomines, and act as buffer of abiotic conditions reducing daily thermal amplitude. The presence of bromeliads near human settlements should be carefully monitored, especially because their leaves are consumed by people and browsed by livestock present in endemic areas of Chagas disease.

Socioeconomic disparities in the reopening of schools during the pandemic in Chile.

The COVID-19 pandemic produced the most significant disruption in education in history. More than 190 countries suspended in-person instruction, affecting an estimated 1.6 billion students. The reopening of schools has been unequal. Schools in more affluent areas reopened sooner than poorer ones, exacerbating preexisting inequalities. There is limited research about the reopening processes in Latin America, where schools were closed for extended periods. Using a rich administrative dataset, we investigate the gaps in the resumption of in-person instruction in Chilean schools across socioeconomic groups in the fall of 2021. Schools with lower socioeconomic status were significantly less likely to offer in-person instruction. Disparities in reopening decisions were associated with administrative factors rather than economic or local epidemiological conditions.

A methodology to design, develop, and evaluate machine learning models for predicting dropout in school systems: the case of Chile.

School dropout is a structural problem which permanently penalizes students and society in areas such as low qualification jobs, higher poverty levels and lower life expectancy, lower pensions, and higher economic burden for governments. Given these high consequences and the surge of the problem due to COVID-19 pandemic, in this paper we propose a methodology to design, develop, and evaluate a machine learning model for predicting dropout in school systems. In this methodology, we introduce necessary steps to develop a robust model to estimate the individual risk of each student to drop out of school. As advancement from previous research, this proposal focuses on analyzing individual trajectories of students, incorporating the student situation at school, family, among other levels, changes, and accumulation of events to predict dropout. Following the methodology, we create a model for the Chilean case based on data available mostly through administrative data from the educational system, and according to known factors associated with school dropout. Our results are better than those from previous research with a relevant sample size, with a predictive capability 20% higher for the actual dropout cases. Also, in contrast to previous work, the including non-individual dimensions results in a substantive contribution to the prediction of leaving school. We also illustrate applications of the model for Chilean case to support public policy decision making such as profiling schools for qualitative studies of pedagogic practices, profiling students' dropout trajectories and simulating scenarios.

Using Explicit Thresholds were valuable for judging Benefits and Harms in partially contextualized GRADE Guidelines.

OBJECTIVES: Guideline panels must assess the magnitude of health benefits and harms to develop sensible recommendations. However, they rarely use explicit thresholds. In this paper we report on the piloting and the use thresholds for benefits and harms. STUDY DESIGN AND SETTING: We piloted the use of thresholds in a Chilean COVID-19 living guideline. For each of the critical outcomes, we asked panelists to suggest values of the thresholds for large, moderate, small, or trivial or no effect. We collected this information through a survey and an on-line discussion. RESULTS: Twelve panelists decided on thresholds for three critical outcomes (mortality, need for mechanical ventilation and serious adverse events). For all outcomes, an absolute risk reduction was considered larger with more than 50 events, moderate with less than 50 events, small with less than 25 events, and trivial with less than 10 events. Having these a priori thresholds in place significantly impacted on the development of recommendations. CONCLUSION: Explicit thresholds were a valuable addition to the judgment of the certainty in the evidence, to decide the direction and strength of the recommendation and to evaluate the need for update. We believe this is a line of research worth perusing.

Lost in Translation: Sesgos y la información en la pandemia de COVID-19 / Lost in Translation: Biases and information in the COVID-19 pandemic

The COVID-19 pandemic has produced an endless stream of information in relation to data, analysis and projections of all aspects of this disease. One of the characteristics of scientific information is that it is full of uncertainties, which are not correctly disclosed to the general population. In this essay, we describe the main cognitive biases that cause people to modify their perception of risk, where the most important are memory, novelty, and emotionality or affection. In addition, we review frequent errors that have been made in terms of collection, dissemination and analysis of information by scientific communicators, experts in other areas and the media in general. Ideally, these biases and confounders should be known to all who participate in the flow of information on the health problems of this pandemic, in order to integrate the uncertainty inherent in the data and the critical analysis of the information received.

La pandemia COVID-19 ha producido un caudal interminable de información en relación a datos, análisis y proyecciones de todos los aspectos de esta enfermedad. Una de las características de la información científica es que está llena de incertidumbres, las que no se divulgan correctamente a la población general. En este ensayo, hacemos una descripción de los principales sesgos cognitivos que hacen que las personas modifiquen su percepción de riesgo donde los más importantes son el de memoria, de novedad y emocionalidad o afecto. Además, revisamos errores frecuentes que se pueden cometer en términos de recolección, difusión y análisis de la información de parte de comunicadores científicos, expertos en otras áreas y medios de comunicación en general. Idealmente, estos sesgos y confundentes deben ser conocidos por todos los que participan en el flujo de información de los problemas de salud de esta pandemia, de manera de poder integrar la incertidumbre inherente a los datos y el análisis crítico de la información que se recibe.

Miopericarditis / Myopericarditis

En urgencias el dolor torácico es la segunda causa de consulta después del trauma. Los síntomas en orden de frecuencia son: osteomusculares, cardiovasculares, respiratorios, gastrointestinales y otros. Presentación del caso: hombre de 29 años con dolor precordial opresivo de siete horas de evolución; el ECG reportó una lesión subepicárdica de cara inferior. Se pensó en infarto agudo del miocardio de cara inferior vs pericarditis. Se inició terapia anti-isquémica. El ecocardiograma evidenció discreto aumento de la refringencia del pericardio adyacente a la pared inferior del ventrículo izquierdo y función biventricular conservada. La evolución fue satisfactoria y se dió de alta a las 72 horas. Conclusiones: ante dolor torácico en urgencias hay que considerar la pericarditis y la miopericarditis, cuyos diagnósticos se basan en la historia clínica, el ECG, los biomarcadores y el ecocardiograma transtorácico. El diagnóstico temprano y manejo oportuno reduce las complicaciones...

Chest pain is the second reason for emergency room visits, trauma being number one reason. Musculoskeletal, cardiovascular, respiratory, gastrointestinal and other, are the most common symptoms in order of occurrence. Presentation of the case: 29-year-old man who presented precordial oppressive pain, seven hours after onset; electrocardiography showed a subepicardial lesion of the inferior wall. Acute myocardial infarction of the lower segment and pericarditis were the first diagnostic impressions. Antiischemic therapy was initiated. Echocardiography evidenced mild increase in brightness of the pericardium adjacent to the left ventricle inferior wall, and normal biventricular function. He evolved satisfactorily and was discharged after 72 hours. Conclusions: pericarditis and myopericarditis must be considered in cases of emergency room consultation for chest pain, diagnoses based on clinical history, ECG, biomarkers and transthoracic echocardiography. Early diagnosis and timely management reduces complications...

Dispositivos intrauterinos en atención primaria / Intrauterine contraceptive devices in primary care

Se estudia, en forma retrospectiva, la evolución de 383 mujeres usuarias de dispositivos intrauterinos controlados en el Hospital de Peñaflor. El grupo incluye 280 casadas (73,1%) y 103 solteras (26,9%). Las últimas eran principalmente de paridad baja y usuarias de Tcu. Las casadas eran predominantemente multíparas y usuarias de Lippes. Las complicaciones observadas en orden de frecuencia fueron: expulsiones, metrorragia, procesos inflamatorios pelvianos y dismenorrea, pero con tasas menores a las descritas por otros autores. Las expulsiones fueron más frecuentes en pacientes menores de 29 años y de baja paridad. No existió relación entre los meses de uso del dispositivo y la frecuencia de los procesos inflamatórios pelvianos. La eficacia de los dispositivos para evitar embarazos fue de 2 por 100 años-mujer, valor semejante al señalado por otros estudios. Sin embargo, no se demostró que los dispositivos inertes (Lippes) fueran menos eficientes que los medicamentados (Tcu)

Enteroparasitosis en Peñaflor: análisis del motivo de consulta / Enteroparasitoses in Peñaflor Hospital: analysis of the reasons for consult

Se analizó el resultado del examen coproparasitológico seriado (PSD) y los motivos para solicitarlo en 754 personas atendidas en el Hospital de Peñaflor entre mayo y julio de 1985. Se encontró 46,9% de positividad general, siendo G. lamblia el parásito más frecuente (29,7%). Los motivos para solicitar el examen fueron la edad de los pacientes (72,4% menores de 6 años), el déficit ponderal (34,2%), los PSD de control (11.4%), la anorexia (10,9%) y los cólicos abdominales (9,7%)

Tratamiento de la faringitis catarral en el lactante / Treatment of catarrhal pharyngitis in infants

Se estudia un material de 72 lactantes con clínico de faringitis catarral. Al azar se dividen en dos grupos de acuerdo al esquema de tratamiento utilizado: Grupo A sin antibiótico y Grupo B con una dosis de penicilina benzatina (600.000 U.I. I.M.) más penicilina sódica (100.000 U.I. x Kg. I.M.). Los pacientes se controlaron en días prefijados, consignándose la presencia o ausencia de complicaciones. El porcentaje de complicaciones fue similar en ambos grupos. Se concluye que el tratamiento con antibióticos no modifica la evolución clínica del cuadro y que no se justifica como conducta habitual

Características de las intoxicaciones atentidas en el Servicio de Urgencia del Hospital de Peñaflor durante el año 1982 / Characterístics of intoxications attended at the emergency unit of the Hospital Peñaflor during 1982

Son encuestadas, con respecto al tema de intoxicaciones, 56 madres consultantes del Hospital de Peñaflor. Se analizan 30.209 fichas de atención de urgencia correspondiente al año 1982, encontrándose 45 (0.15%), consultas por intoxicaciones analizándose sus principales características epidemiológicas