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Aim/Purpose: This exploratory qualitative case study examines the perceptions of high-school learners of English regarding a pedagogical intervention involving progressive reduction of captions (full, sentence-level, keyword captions, and no-captions) in enhancing language learning. Background: Recognizing the limitations of caption usage in fostering independent listening comprehension in non-captioned environments, this research builds upon and extends the foundational work of Vanderplank (2016), who highlighted the necessity of a comprehensive blend of tasks, strategies, focused viewing, and the need to actively engage language learners in watching captioned materials. Methodology: Using a qualitative research design, the participants were exposed to authentic video texts in a five-week listening course. Participants completed an entry survey, and upon interaction with each captioning type, they wrote individual reflections and participated in focus group sessions. This methodological approach allowed for an in-depth exploration of learners' experiences across different captioning scenarios, providing a nuanced understanding of the pedagogical intervention's impact on their perceived language development process. Contribution: By bridging the research-practice gap, our study offers valuable insights into designing pedagogical interventions that reduce caption dependence, thereby preparing language learners for success in real-world, caption-free listening scenarios. Findings: Our findings show that learners not only appreciate the varied captioning approaches for their role in supporting text comprehension, vocabulary acquisition, pronunciation, and on-task focus but also for facilitating the integration of new linguistic knowledge with existing background knowledge. Crucially, our study uncovers a positive reception towards the gradual shift from fully captioned to uncaptioned materials, highlighting a stepwise reduction of caption dependence as instrumental in boosting learners' confidence and sense of achievement in mastering L2 listening skills. Recommendations for Practitioners: The implications of our findings are threefold: addressing input selection, task design orchestration, and reflective practices. We advocate for a deliberate selection of input that resonates with learners' interests and contextual realities alongside task designs that progressively reduce caption reliance and encourage active learner engagement and collaborative learning opportunities. Furthermore, our study underscores the importance of reflective practices in enabling learners to articulate their learning preferences and strategies, thereby fostering a more personalized and effective language learning experience. Recommendation for Researchers: Listening comprehension is a complex process that can be clearly influenced by the input, the task, and/or the learner characteristics. Comparative studies may struggle to control and account for all these variables, making it challenging to attribute observed differences solely to caption reduction. Impact on Society: This research responds to the call for innovative teaching practices in language education. It sets the stage for future inquiries into the nuanced dynamics of caption usage in language learning, advocating for a more learner-centered and adaptive approach. Future Research: Longitudinal quantitative studies that measure comprehension as captions support is gradually reduced (full, partial, and keyword) are strongly needed. Other studies could examine a range of individual differences (working memory capacity, age, levels of engagement, and language background) when reducing caption support. Future research could also examine captions with students with learning difficulties and/or disabilities.

Using a survey, interviews, and reflections by the teaching-research team, we explored the effects of almost a decade of experimentation, inspired by Freire's pedagogy for liberation, which applied participatory action research in engineering courses and in cities to develop professionals who are more committed to sustainability and more able to interact with 'ordinary' citizens in all their diversity. We found that using a planning-based participatory action research methodology, in the living laboratories of real city neighbourhoods, increased engineers' appreciation of citizenship, sustainability and equity. While this experience does not pretend to universality, it does suggest ways that structuring action research into course activities and critical reflection can improve students' understanding of sustainability and related social justice challenges. Moreover, this innovative pedagogy proved robust during two years of extreme disruption due to social protest and strict COVID-19 quarantines in Chile. The findings may benefit researchers and teachers grappling with similar challenges.

This qualitative case study first examined middle school teacher perceptions of practice regarding L2 listening instruction and, from these, proposes guidelines to favour L2 listening development. Novice middle-school teachers from Chile (n = 14) were guided within semi-structured interviews to reflect on their own L2 listening teaching practices in public and semi-private school classrooms. Verbal reports were transcribed and analysed using thematic analysis techniques and underwent systematic interrogation of qualitative data. The results show an overemphasis on teacher preference for task completion to the detriment of developing listening strategies. We present results and provide guidelines for teachers to integrate features of a metacognitive instruction approach to listening.

This study examined the role of reading motivation in reading comprehension achievement of 1070 Chilean third, fourth, and fifth-grade students enrolled in public and private schools. Students were assessed in Spanish reading comprehension and were administered the Motivation to Read Profile from Gambrell, Palmer, Codling and Mazzoni (1996), at the beginning and end of the school year. Results showed that motivation to read at the beginning of the school year was significantly associated with gains in reading comprehension skills. When disaggregating motivation into self-concept and value of reading, only self-concept of reading significantly predicted gains in reading comprehension. Moderation analyses showed that students that started the year with lower reading comprehension and higher motivation to read, had significantly better reading comprehension at the end of the school year, than their peers who started with lower reading motivation. The pedagogical implications are discussed.

We examined early elementary children's reading motivation in four different countries. Results revealed that reading motivation is a stable construct in countries like Chile, Finland, Greece, and the United States. Motivation to read followed similar patterns across the countries, with increased scores at the end of the school year. This trend differs from what has been reported in the literature for older students. Significant gender differences were observed mainly for Finnish and Greek students. Understanding early reading motivation from a cross-cultural perspective can help identify commonalities in the initial development of reading motivation, and deepen our understanding about how it may differ in different cultural contexts.

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In this study, we examine the social practices related to literacy in classrooms in Chile in order to examine school-based literacy practices. We also examined the constraints and affordances literacy learning offered Chilean students. Through our case study and cross-case analysis, we discovered that although the classrooms contained an assortment of materials, they only offered an "adequate" amount and quality of texts; there were very few local texts. There were differences in the understanding and valuing of texts by students of differing reading abilities. Our research has implications for teacher professional development and teacher education, as well as future research endeavors.

The purpose of this study was to investigate the differences between the amounts of time that U.S. and Chilean students spend on conventional academic reading, extracurricular reading, and Facebook and also to report the types of materials they prefer to read. The study surveyed students in the United States (n = 1,265) and Chile (n = 2,076) across all discipline areas. Descriptive analysis indicated that U.S. students spent 4.94 hours on academic reading, 4.17 hours on extracurricular reading, and 16.40 hours on Facebook weekly. For Chilean students, the figures were 13.17 hours, 3.07 hours, and 14.00 hours, respectively. The results indicated that for both U.S. and Chilean participants, online reading materials were the most popular type of material, followed by magazines/newspapers, graphic novels/comic books, best-selling novels, and nonmajor academic books (books on topics outside the student's major subject in conventional print format). Due to the impact of the Internet on reading resources, students' reading patterns today are different from how they were in the past. College students' reading practices have moved to different venues with the advent of Internet technology, and the modality has migrated to online reading. Specifically, social media sites (e.g., Facebook) provide social accessibility to academic contexts that constitute students' learning experiences and shape their identities.

The current investigation aims at assessing the effectiveness of an intervention program designed to enhance self-regulated learning (SRL) strategies at the university level, with students from different cultural, linguistic, and educational backgrounds. The central tool of the program is a set of letters in which a fictional first-year student describes his experiences as an SRL student. The program was implemented in four universities in different countries and continents (Portugal, Spain, Chile, and Mozambique), with an experimental group and a comparison group at each university (263 students from experimental groups and 247 from comparison groups). Findings display the effectiveness of the program in enhancing a set of motivational variables related to the study process and the use of SRL strategies. Data were consistent across the different cultural and academic contexts in which the program was implemented. The implications of these findings for university administrators and faculty are discussed.

This paper analyses the 2011 Chilean student movement, the most relevant social mobilisation in Chile since the restoration of democracy in 1990. Based on available material and secondary sources, it describes the main features of this student movement, analyses the key components of the students' discourse and its relationship with the Chilean market-oriented educational system, and identifies its impact on the field of higher education. The paper argues that this student movement was a process of expressing accumulated grievances against some neoliberal features of Chilean education. Since this movement is also linked to the emergence of a new generation of higher education students, it identifies relevant characteristics of current students' organisations and protests. Finally, the paper discusses hypotheses for interpreting the recent student movements. This case is informative not only for those concerned with student participation, but also with the potential downsides of market-oriented educational policies.

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At the international level, the progressive recognition of indigenous peoples and their customary rights in legislative tools has established new guidelines for the conservation of natural resources in protected areas (PAs). The indigenous peoples (IPs) in Chile who suffered the dispossession of ancestral areas after the declaration of PAs, have demanded their inclusion and participation based on the legislative tools available. Via the available scientific, institutional and gray literature, we identified seven ways in which IPs contribute to and participate in the protection of biodiversity, conservation and sustainability of natural resources in marine and terrestrial ecosystems in Chile: resistance or defense of ancestral areas, biocultural conservation, sustainable practices, participation in consultation, promotion of area creation, development of management plans, and management, comprising participation in administration, co-administration or co-management. Sixty percent of IPs participate in the management of 7.3% of Chile's PAs. Overall, our results show that the Rapanui and Kawashkar peoples participate mostly in the co-management of 729,439 km2 and 668 km2 of MPAs, respectively. The Aymara and Atacameño peoples lead the management of TPAs in the north of Chile, with 1378 km2 and 872.36 km2, respectively. The Mapuche people, with a higher population density, participate in both environments, leading the administration of maritory with 3475.98 km2 of Marine and Coastal Areas for Indigenous Peoples (MCAIPs). The participation of the remaining peoples is limited. Advancing the recognition and role of IP in the protection of nature via a shared biocultural governance is a challenge for the Chilean State. • The 60% of indigenous people are involved in the management of 7.3% of Chile's Protected Areas. • The Rapanui and Kawésqar peoples lead in their participation in MPAs, while the Atacameños and Aymara peoples lead in TPAs. • The Mapuche people lead the participation in the maritory through the administration of the MCAIPs. • The Rapanui people are the only currently involved in the governance of their entire maritory and ancestral territory. [ABSTRACT FROM AUTHOR]

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Copyright of Magis: Revista Internacional de Investigación en Educación is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: To evaluate and compare the costs and effectiveness of two alternative stent, drug eluting stent (SF) and bare metal stent (SNF). Material and Methods: Cost-utility analysis based on a Markov model using data from a cohort study of Hospital Las Higueras of Talcahuano, Chile. The effectiveness measure was the rate of restenosis and the time of restenosis. The effectiveness outcomes are expressed in quality-adjusted life years (QALY) gained. Costs are expressed in national currency 2011. The evaluation perspective was from the public heath budget. We model a cohort from age 63 to 80 years, life expectancy in Chile. Apply discount rate of 0, 3% and 6% for results and costs. Sensitivity analysis is performed according to the ranges of variability in costs, the utility values of the variables and transition between states. Results: No differences in restenosis rates between the two stents, although there were differences in the time of restenosis. The incremental cost effectiveness ratio (ICER) no discount rate was CH$ 235.749 per QALY gained when using drug-eluting stent, the value below the equivalent of 1 Gross Domestic Product (PIB) per capita for 2011 in Chile. Conclusions: The drug-eluting stent (SF) is cost effective compared to bare metal stent (SNF). The ICER is not affected by the sensitivity analysis (variability of cost, utility ranges used, probability of restenosis). [Copyright &y& Elsevier]

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Copyright of EURE is the property of Pontificia Universidad Catolica de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Disturbed and regenerated forests represent 75% of the world forested area. • Habitat disturbance can alter species behavior besides its composition and abundance. • Camera traps are widely used for wildlife monitoring, but its use on bird is sporadic. • Forest disturbance altered bird daily activity patterns across foraging guilds. • Forest management and restoration should take animal behavior into account. Despite forests are a biodiversity reservoir and a wellbeing source for the humankind, they have been largely disturbed in the past decades. Disturbed and naturally-regenerated forests and forest plantations represent 75% of the world forested area, stressing the need of managing non-pristine forests. While we know that habitat disturbance alters forest structure, reducing species richness and abundances, its effects on animal behavior remain little explored. We used camera traps to test if daily activity patterns of forest birds change along a 450-km disturbance gradient in the Valdivian temperate rainforests of southern Chile. We contrasted bird activity at four conditions: old-growth and second-growth native forests, native forests subject to selective logging, and abandoned exotic plantations with native vegetation. We contrasted habitat structure among conditions and estimated activity kernels to compare bird activity. We also made activity comparisons examining bird foraging guilds (nectarivores, frugivores, and insectivores) and habitat preference (interior vs edge). Habitat structure was different among conditions, being the old-growth native stands the most contrasting habitat. Bird daily activity patterns differed among conditions as well. We observed that bird activity reaches a peak early in the morning at the old-growth native forests, at noon in the plantations, and in the afternoon at the logged forests, while it was more variable in secondary forests. We obtained similar results among bird foraging guilds, but insectivorous birds presented the most contrasting differences. Likewise, we found a similar pattern between forest interior and edge species, which was more evident for forest interior birds. Logged forests presented the largest activity differences, despite being structurally similar to second-growth stands. Forest disturbance not only alters bird species richness and abundance, but also their behavior. Bird daily activity patterns may be directly affected by daily variations in forest microclimate conditions and indirectly affected by chantes in resource availability, which may be affecting their ecological interactions. Therefore, forest management and restoration strategies should take animal behavior into account. [ABSTRACT FROM AUTHOR]

Provides information on the decision of Canadian company Noranda Inc. to withdraw their plans to build the Alumysa aluminum complex among the fjords of Patagonia in Argentina and Chile. Oppositions against the project; Components of the supposed smelter project; Environmental assessment of the Aysen region.

Discusses the efforts of the Chilean Agricultural and Livestock to keep the guanaco, a wild relative of the llama, from disappearing from the Andes mountains in central Chile. Comments by Jurgen Rottman of the Forestry Science Department, University of Chile, on guanacos; Result of the analysis of puma droppings in central Chile; Advantage of the existence of protected open areas near Santiago, according to Cristian Bonacic, director of the wildlife conservation research group Fauna Australis.

Provides information on three marine protected areas to be created in Chile as announced by Gianni Lopez, director of the Chilean Environment Commission, in March 2003. Caldera; Bahia Mansa; Carlos III Island.

Deals with the construction of a highway along Chile's coast in April 2003. Efforts of the Chilean government to avoid the passing of the construction through the Valdivian temperate rainforest; Agreement between the Environmental Agency and the Ministries of Public Works and National Lands; Remarks from botanist Cecilia Smith on temperate rain forests.

Abstract: Pasture is a major component of the diet for dairy cows in Chile, and grain is often used as a supplement to increase milk production. The quantity of grain offered is affected by price and return to the farmer, but 6 kg/day is typical of many situations. However the benefits of feeding grain more frequently than twice daily to cows rotationally grazed on pasture is uncertain. This study was undertaken to measure effects of grain feeding frequency on milk production, intakes and grazing behavior and on blood and urinary metabolites in dairy cows on pasture. The 65 day trial used 28 Black Friesian cows in their second month of lactation. Prior to treatments, milk production averaged 29.7 L/day and mean live-weight was 502 kg. The four treatments included: grazed pasture only (P), pasture plus 6 kg/day of concentrate offered in two equal rations at milking (0600 h, 1500 h) (PC2), grazing plus 6 kg/day of concentrate offered in three equal rations (0600 h, 1200 h, 1500 h) (PC3), and grazing plus 6 kg/day of concentrate offered in four equal rations (0600 h, 1200 h, 1500 h, 2100 h) (PC4). Total feed intakes were determined from controlled-release chromium capsules (CRC) and faecal subsampling and milk composition was analyzed weekly using infrared spectroscopy (Foss 4300 Milko-scan). Milk production was 24.6, 28.7; 29.5 and 28.8 L/day for P, PC2, PC3 and PC4 treatments, respectively. Intake of pasture dry matter pasture (DM) (kg/day) decreased from 16.1 (P) to 12.7, 11.9 and 11.1 with increases in grain feeding frequency (P <0.05). Total DM intakes were higher with grain supplementation but tended to decrease with increased frequency, whilst total chewing time (eating and rumination) declined from 1012 (P) to 966 for the PC4 treatment. Grain supplementation increased milk production, but frequency of grain feeding had no effect (P >0.05) on production, milk fat (3.67%), protein (3.20%) or urea (5.68 mmol/L) concentrations. Live-weight and body condition score did not vary (P >0.05) with treatment. Plasma Beta-hydroxybutyrate (BHBA) and plasma urea–nitrogen (PUN) were not affected by grain feeding frequency averaging 0.51 mmol/l and 14.8 mg/dl respectively (P >0.05). Urinary purine derivatives (allantoin + uric acid)/Creatinine (PD/C) ratio was similar in all treatments, so rumen microbial growth did not appear to be affected by grain feeding or frequency. This trial did not indicate any benefits when supplement was given more than twice daily (at milking) and there appeared to be negative impacts when given 4 times daily. We postulate a disturbance in their behavior when offered small supplements frequently, and a possible reduction in feed intake and time spent chewing. [Copyright &y& Elsevier]

Introduction: Genome-wide association studies (GWAS) are fundamental for identifying loci associated with diseases. However, they require replication in other ethnicities., Methods: We performed GWAS on sporadic Alzheimer's disease (AD) including 539 patients and 854 controls from Argentina and Chile. We combined our results with those from the European Alzheimer and Dementia Biobank (EADB) in a meta-analysis and tested their genetic risk score (GRS) performance in this admixed population., Results: We detected apolipoprotein E ε4 as the single genome-wide significant signal (odds ratio  = 2.93 [2.37-3.63], P = 2.6 × 10 -23 ). The meta-analysis with EADB summary statistics revealed four new loci reaching GWAS significance. Functional annotations of these loci implicated endosome/lysosomal function. Finally, the AD-GRS presented a similar performance in these populations, despite the score diminished when the Native American ancestry rose., Discussion: We report the first GWAS on AD in a population from South America. It shows shared genetics modulating AD risk between the European and these admixed populations., Highlights: This is the first genome-wide association study on Alzheimer's disease (AD) in a population sample from Argentina and Chile. Trans-ethnic meta-analysis reveals four new loci involving lysosomal function in AD. This is the first independent replication for TREM2L, IGH-gene-cluster, and ADAM17 loci. A genetic risk score (GRS) developed in Europeans performed well in this population. The higher the Native American ancestry the lower the GRS values., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Background: Idiopathic Pulmonary Fibrosis (IPF) is a subtype of interstitial lung disease (ILD) that significantly affects people's quality of life, whose prevalence and mortality has increased., Aim: To determine the prevalence and lethality of ILD in the Los Ríos Region between the years 2018 and 2019., Material and Methods: Review of a database of all patients attended at an outpatient clinic of the regional hospital. Those patients with the diagnosis of ILD and seen between 2018 and 2019 were selected. Mortality and its causes were verified with death certificates., Results: In the study period, 339 cases with ILD, aged 71 ± 10 years (64% women) were identified. The calculated ILD prevalence was 84 cases per 100,000 inhabitants, with a higher predominancy in Futrono and Paillaco communes. IPF and Connective Tissue Diseases were the predominant subtypes. Overall lethality was 18%, with more deaths among patients with IPF (n = 31)., Conclusions: In the Los Ríos Region, ILDs have a relevant prevalence and lethality.

Exposure to an adverse prenatal environment can influence fetal development and result in long-lasting changes in the offspring. However, the association between maternal exposure to stressful events during pregnancy and the achievement of pre-reading skills in the offspring is unknown. Here we examined the association between prenatal exposure to the Chilean high-magnitude earthquake that occurred on February 27th, 2010 and the development of early reading precursors skills (listening comprehension, print knowledge, alphabet knowledge, vocabulary, and phonological awareness) in children at kindergarten age. This multilevel retrospective cohort study including 3280 children, of whom 2415 were unexposed and 865 were prenatally exposed to the earthquake shows substantial evidence that maternal exposure to an unambiguously stressful event resulted in impaired pre-reading skills and that a higher detrimental effect was observed in those children who had been exposed to the earthquake during the first trimester of gestation. In addition, females were more significantly affected by the exposure to the earthquake than their male peers in alphabet knowledge; contrarily, males were more affected than females in print knowledge skills. These findings suggest that early intervention programs for pregnant women and/or children exposed to prenatal stress may be effective strategies to overcome impaired pre-reading skills in children.

Background: With the global population aging and life expectancy increasing, dementia has turned a priority in the health care system. In Chile, dementia is one of the most important causes of disability in the elderly and the most rapidly growing cause of death in the last 20 years. Cognitive complaint is considered a predictor for cognitive and functional decline, incident mild cognitive impairment, and incident dementia. The GERO cohort is the Chilean core clinical project of the Geroscience Center for Brain Health and Metabolism (GERO). The objective of the GERO cohort is to analyze the rate of functional decline and progression to clinical dementia and their associated risk factors in a community-dwelling elderly with subjective cognitive complaint, through a population-based study. We also aim to undertake clinical research on brain ageing and dementia disorders, to create data and biobanks with the appropriate infrastructure to conduct other studies and facilitate to the national and international scientific community access to the data and samples for research., Methods: The GERO cohort aims the recruitment of 300 elderly subjects (> 70 years) from Santiago (Chile), following them up for at least 3 years. Eligible people are adults not diagnosed with dementia with subjective cognitive complaint, which are reported either by the participant, a proxy or both. Participants are identified through a household census. The protocol for evaluation is based on a multidimensional approach including socio-demographic, biomedical, psychosocial, neuropsychological, neuropsychiatric and motor assessments. Neuroimaging, blood and stool samples are also obtained. This multidimensional evaluation is carried out in a baseline and 2 follow-ups assessments, at 18 and 36 months. In addition, in months 6, 12, 24, and 30, a telephone interview is performed in order to keep contact with the participants and to assess general well-being., Discussion: Our work will allow us to determine multidimensional risks factors associated with functional decline and conversion to dementia in elderly with subjective cognitive complain. The aim of our GERO group is to establish the capacity to foster cutting edge and multidisciplinary research on aging in Chile including basic and clinical research., Trial Registration: NCT04265482 in ClinicalTrials.gov. Registration Date: February 11, 2020. Retrospectively Registered.

Objective: The objective of this article is to examine whether the levels of empathy fit the concept of empathic decline., Method: This was a non-experimental and cross-sectional study. Two populations of nursing students in two nursing programs were studied: Universidad San Sebastián (Santiago, Chile) and Universidad Mayor (Temuco, Chile). The original data on empathy, assessed by the Jefferson Scale of Empathy, were combined into a single data base. They were then analyzed by means of normality tests and homoscedasticity, Cronbach's alpha, analysis of variance; the standard deviation of the dependent outcome measure (Sy.x) and the coefficient of determination (R2) were estimated., Results: The sample sizes from the two programs were 479 and 277, respectively. It was found that the distributions of the averages over the course of study for empathy (and its components) were constant, and in some cases increased., Conclusion: It was found that the distribution of the means of empathy in the nursing students analyzed did not conform to the classical empathic decline observed in other studies. Therefore, it is inferred that the traditional factors identified as causes of empathic erosion were not operating in the same way in the studied context.

Background: In relapsing-remitting multiple sclerosis (RRMS), no evidence of disease activity-3 (NEDA-3) is defined as the absence of: (1) relapses; (2) disability progression; (3) MRI activity (new/enlarged T2 lesions and/or gadolinium-enhanced T1 lesions). NEDA-4 status is defined as meeting all NEDA-3 criteria plus having an annualized percentage brain volume change (a-PBVC) >-0.4%. In individual patients, brain volume assessment is confounded with normal aging, methodological limitations and fluid-shift related fluctuations in brain volume. Cognitive impairment has been proposed as another component that should be integrated into therapeutic algorithms for RRMS. We aim to determine the proportion of patients failing to meet NEDA-4 criteria and to appraise whether the Symbol Digit Modalities Test (SDMT) is capable of replacing a-PBVC as one of the components of NEDA-4. We hypothesize that NEDA-4 has the potential to capture the impact of DMT therapies in RRMS., Methods: Forty-five patients were prospectively followed 1 and 2 years after their baseline assessment at the University of Chile Hospital. SIENA software was used to assess a-PBVC., Results: At baseline, the patients had a mean age of 33.0 years (range 18-57), disease duration of 1.9 years (0.4-4), Expanded Disability Status Scale score of 1.3 (0-4), and 67% were female. The majority had RRMS (91% while 9% had clinically isolated syndrome (CIS)). Seventy-three percent were on the so-called first line DMTs such as interferons (53%), glatiramer acetate (13%), teriflunomide (9%), and 18% were on fingolimod. There was a serial decline in the proportion of NEDA: after 1 and 2 years of follow-up 60% and 47% met NEDA-3 status, and 38% and 27% met NEDA-4, respectively. At the last follow-up 21% remained on interferons, 47% were now on fingolimod, 4% on alemtuzumab and 2% on natalizumab. At year 1 and year 2, with the replacement of a-PBVC by SDMT, 53% and 40% of patients achieved a putative NEDA-4 status, respectively., Conclusion: Brain volumetric MRI has yet to be translated into clinical practice and SDMT may qualify as the fourth component of NEDA-4 definition. NEDA-4 has the potential to capture the impact of DMT therapies in RRMS earlier in the disease course of RRMS., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Methods: Spinal muscular atrophy (SMA) has gained much attention in the last few years because of the approval of the first intrathecal treatment for this neurodegenerative disease. Latin America needs to develop the demographics of SMA, timely access to diagnosis, and appropriate following of the standards of care recommendations for patients. These are essential steps to guide health policies. This was a descriptive study of a cohort of SMA patients from all over Chile. We analyzed the clinical, motor functional, and social data, as well as the care status of nutritional, respiratory and skeletal conditions. We also measured the SMN2 copy number in this population., Results: We recruited 92 patients: 50 male; 23 SMA type-1, 36 SMA type-2 and 33 SMA type-3. The median age at genetic diagnosis was 5, 24 and 132 months. We evaluated the SMN2 copy number in 57 patients. The SMA type-1 patients were tracheostomized and fed by gastrostomy in a 69.6 % of cases, 65% of SMA type-2 patients received nocturnal noninvasive ventilation, and 37% of the whole cohort underwent scoliosis surgery., Conclusion: Ventilatory care for SMA type-1 is still based mainly on tracheostomy. This Chilean cohort of SMA patients had timely access to genetic diagnosis, ventilatory assistance, nutritional support, and scoliosis surgery. In this series, SMA type-1 is underrepresented, probably due to restrictions in access to early diagnosis and the high and early mortality rate.

Neuroendocrine tumors (NETs) are relatively rare and highly heterogeneous neoplasms. Despite this, recent studies from North America and Central Europe have suggested an increase in incidence. In Latin America, NET data are scarce and scattered with only a few studies reporting registries. Our goal was to establish a NET registry in Chile. Here, we report the establishment and our first 166 NET patients. We observed a slight preponderance of males, a median age at diagnosis of 53 years and a median overall survival of 110 months. As anticipated, most tumors were gastroenteropancreatic (GEP). Survival analyses demonstrated that non-GEP or stage IV tumors presented significantly lower overall survival (OS). Similarly, patients with surgery classified as R0 had better OS compared to R1, R2, or no surgery. Furthermore, patients with elevated chromogranin A (CgA) or high Ki67 showed a trend to poorer OS; however, these differences did not reach statistical significance (log-rank test p = 0.07). To the best of our knowledge, this is the first report of a NET registry in Chile. Median OS in our registry (110 months) is in line with other registries from Argentina and Spain. Other variables including age at diagnosis and gender were similar to previous studies; however, our data indicate a high proportion of small-bowel NETs compared to other cohorts, reflecting the need for NET regional registries. Indeed, these registries may explain regional discrepancies in incidence and distribution, adding to our knowledge on this seemingly rare, highly heterogeneous disease.

α-Linolenic acid (ALA) is the precursor of docosahexaenoic acid (DHA) in humans, which is fundamental for brain and visual function. Western diet provides low ALA and DHA, which is reflected in low DHA in maternal milk. Chia oil extracted from chia (Salvia hispanica L.), a plant native to some Latin American countries, is high in ALA (up to 60%) and thereby is an alternative to provide ALA with the aim to reduce DHA deficits. We evaluated the modification of the fatty acid profile of milk obtained from Chilean mothers who received chia oil during gestation and nursing. Forty healthy pregnant women (22-35 years old) tabulated for food consumption, were randomly separated into two groups: a control group with normal feeding (n = 21) and a chia group (n = 19), which received 16 mL chia oil daily from the third trimester of pregnancy until the first six months of nursing. The fatty acid profile of erythrocyte phospholipids, measured at six months of pregnancy, at time of delivery and at six months of nursing, and the fatty acid profile of the milk collected during the first six months of nursing were assessed by gas-chromatography. The chia group, compared to the control group, showed (i) a significant increase in ALA ingestion and a significant reduction of linoleic acid (LA) ingestion, no showing modification of arachidonic acid (AA), eicosapentaenoic acid (EPA) and DHA; (ii) a significant increase of erythrocyte ALA and EPA and a reduction of LA. AA and DHA were not modified; (iii) a increased milk content of ALA during the six months of nursing, whereas LA showed a decrease. AA and EPA were not modified, however DHA increased only during the first three months of nursing. Consumption of chia oil during the last trimester of pregnancy and the first three months of nursing transiently increases the milk content of DHA.

Introduction: Universally mothers at 35 years or more have had higher maternal and perinatal risks. This study analyzed the trend of this group in maternal population and determined their risk of having premature children, during the demographic transition period in Chile., Materials and Methods: Epidemiological study conducted in the population of simple live births registered in the Chilean National Database Births of 1991-2012. Analyses were performed in three categories of maternal age: 35 or more, under 35, and 20 to 29 years. The risk of prematurity was measured by crude and Adjusted Odds Ratio from logistic regression model., Results: Mothers aged 35 and older increased in population from 10.6% in 1991 to 16.7% in 2012 and presented an overall prevalence of preterm delivery of 6.7%, higher prevalence than 20-29 age group (4.7%). In aging mothers, the Odds Ratio for preterm birth adjusted for education, marital status, and parity was 1.68 (95% CI (1.66-1.70)) compared to mothers aged 20-29. All differences were significant (p < 0.001)., Conclusions: During Chilean demographic transition, mothers aged 35 or older increased steadily and significantly maintaining higher risks of preterm births. Policies to prevent and monitor the late motherhood could contribute to stopping the current trend.

Approximately 25%-40% of ischemic strokes are considered of unknown cause (ie, cryptogenic). The available information on associated risk factors, functional outcome, and recurrence of this subtype of stroke is limited, especially for the Chilean population. We conducted a prospective cohort study of 380 patients aged ≥ 18 years admitted consecutively to a stroke unit with demonstrated ischemic stroke. The stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment criteria. The modified Rankin Scale score and Barthel Index were used to assess functional outcome. The Kaplan-Meier product-limit method and Cox proportional hazards regression analysis were used to identify predictors of recurrent stroke during the follow-up period (mean, 2.1 years). Cryptogenic stroke (CS) was diagnosed in 76 patients (20%), 55.2% of them male, with a mean age of 62 ± 17 years. CS was the third most common stroke subtype after the large-artery disease (29%) and cardioembolic (24.4%) subtypes. After adjustment for age and sex, no vascular risk factors or laboratory parameters assessed at the time of admission were found to be predictive of CS. The CS subtype had the lowest rate of stroke recurrence at the end of the follow-up period (n = 4; 2.5% per year; odds ratio, 0.32; 95% confidence interval, 0.11-0.91; P = .022), a favorable functional outcome (mean modified Rankin Scale score, 2; mean Barthel Index, 77), and no increase in mortality risk (odds ratio, 0.73; 95% confidence interval, 0.29-1.77; P = .48). Our findings demonstrate that patients with no definite etiology identified after an extensive workup are at lower risk of recurrence and more likely to have a favorable outcome. No risk factors distinguish CS from other stroke subtypes in our study population., (Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

We report the clinical features of the original Chilean family with Kufor-Rakeb syndrome (KRS) that led to the discovery of the ATP13A2 gene at the PARK9 locus. KRS is a rare juvenile-onset autosomal recessive disease characterized by progressive Parkinsonism, pyramidal signs, and cognitive decline in addition to vertical gaze palsy and facial-faucial-finger minimyoclonus. Neurological and neuropsychological examination during a 10-year period, videotaping, neuroimaging, and measurement of DNA methylation of the ATP13A2 promoter region were performed. The youngest 5 of 17 children of nonconsanguineous parents, carrying compound-heterozygous ATP13A2 mutations, had normal development until ages ∼10 to 12 years, when school performance deteriorated and slowness, rigidity, and frequent falls developed. Examination revealed bradykinesia, subtle postural/action tremor, cogwheel rigidity, spasticity, upward gaze palsy, smooth pursuit with saccadic intrusions, and dementia. Additional signs included facial-faucial-finger minimyoclonus, absent postural reflexes, visual/auditory hallucinations, and insomnia. Levodopa response could not be fully judged in this family. T2* magnetic resonance imaging sequences revealed marked diffuse hypointensity of the caudate (head and body) and lenticular nucleus bilaterally. Disease progression was slow including epilepsy, cachexia, and anarthria. Four affected members died after 28.5 ± 5.5 (mean ± SD) years of disease. Two heterozygous carriers, the mother and eldest sibling, showed jerky perioral muscle contractions and clumsiness of hand movements. There was no significant correlation between DNA methylation of the ATP13A2 promoter region and disease progression. The marked caudate and lenticular nucleus T2*-hypointensity suggests that KRS might belong to the family of neurodegenerative diseases associated with brain iron accumulation., (© 2010 Movement Disorder Society.)

Background: A higher risk of poststroke cognitive impairment (CI) has been reported in Hispanics in a US cohort but has not been systematically studied in Latin America., Objectives: Our purpose was to investigate the frequencies and determinants of poststroke CI in the hispano-mestizo population of Santiago, Chile., Methods: A prospective study of hospitalized patients aged >60 years admitted with an ischemic or hemorrhagic stroke was conducted. The cognitive status was determined at 3 and 12 months after the stroke by informant questionnaires, neuropsychological testing and clinical diagnosis. Cardiovascular risk factors, brain imaging and stroke features were analyzed using regression models to establish determinants for poststroke CI., Results: A total of 164 patients (mean age = 72 +/- 7.5 years) were recruited. Out of 122 patients (74%) evaluated at 3 months, 81 (66%) had CI. Out of 101 patients (62%) evaluated at 12 months, 39 (39%) had CI no dementia, and 22 (22%) were demented. The new-onset dementia frequency at 1 year was 16%. Independent determinants for dementia were higher functional impairment at hospital egress (OR = 4.0), left-hemisphere large-vessel infarction (OR = 6.9) and a larger amount of white matter changes (OR = 1.3)., Conclusions: In this first study on poststroke CI in Latin America, the frequencies and determinants of poststroke CI were similar to those in other cohorts of different ethnic origin.

During the winter of 1994, a survey of productive and reproductive parameters was undertaken in the south-central part of Chile (8th Region) on 71 cows provided by four small farms with low production (< 3000 l/year). A low food intake was recorded (8.6 +/- 0.2-12.4 +/- 0.2 kg DM/day) and, as a result, the cows calved with poor body condition score (1.9 +/- 0.04 points on the scale of one-to-five, had milk production between 10.5 +/- 0.4 and 12.8 +/- 0.6 l/day, had a delayed start of ovulatory activity (78.2 +/- 4.6 days) and an interval between calving and conception of 120.3 +/- 4.6 days. In addition, low levels of packed cell volume (PCV) and hemoglobin (HEM) were found, which were considered to be a combined effect of low feed ingestion and parastic infection by Fasciola hepatica. To improve the productive and reproductive parameters, treatments were undertaken in three of the four small farms; a parasiticide treatment was used against the F. hepatica at the beginning of the winter and the availability of forage was increased via the use of supplementary green oats. Spring crops were also cultivated: corn for silage and oats with peas to make hay. The antiparasite treatment and supplementation of forage was associated with better body condition score at calving, improved hematological parameters, increased milk production (17%), reduced number of days to conception (120 vs. 91) and increased conception rate at first service (36 vs. 60%). In the fourth small farm where no interventions were undertaken, the parameters obtained during 1994 remained unchanged.