Clínica Las Condes

Introducción: La comunicación clínica con personas con demencia implica desafíos complejos, derivados de la progresión del trastorno cognitivo-comu- nicativo. La simulación clínica se ha propuesto como una estrategia formativa efectiva para entrenar habilidades comunicativas en contextos asistenciales, aunque su implementación aún carece de estandarización. El objetivo de esta revisión fue sintetizar la evidencia disponible sobre intervenciones educativas basadas en simulación clínica dirigidas a entrenar habilidades comunicativas en estudiantes y profesionales de la salud que atienden a personas con demencia. Material o Pacientes y Métodos: Se realizó una revisión de alcance en las bases de datos PubMed, Scopus, Web of Science, CINAHL, SciELO y Google Scholar. Se seleccionaron estudios publicados entre 2012 y 2024, en inglés o español, que describieran intervenciones de simulación clínica orientadas a la comunicación con personas con demencia. Tras la depuración de registros, se efectuó un análisis descriptivo y temático de los efectos reportados. Resulta­dos: Se identificaron 12 estudios, realizados mayoritariamente en contextos universitarios con estudiantes de enfermería. Las simulaciones incluyeron pacientes estandarizados, experiencias sensoriales, escenarios estructurados y modelos híbridos. Se reportaron mejoras en autoeficacia comunicativa, actitudes empáticas y habilidades observables. Sin embargo, se evidenció escasa utilización de marcos teóricos, limitada evaluación longitudinal y poca adaptación a los distintos perfiles comunicativos de las personas con demen­cia. Conclusión: La simulación clínica potencia la empatía y las habilidades comunicativas esenciales en la atención a personas con demencia. Su impacto se fortalece cuando se basa en competencias definidas, evaluaciones validadas y debriefings estructurados.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

The evolution of public health surveillance has accelerated in response to digital transformation, expanding from traditional reporting systems toward integrated, data-driven epidemiological frameworks. This review analyzes how digital surveillance systems, big data analytics, and predictive modeling approaches influence population-level decision-making within international contexts, with particular attention to Latin American settings including Mexico, Colombia, and Ecuador. A structured narrative review grounded in the scientific method was conducted, synthesizing peer-reviewed evidence on surveillance modernization, computational forecasting, geospatial analytics, precision public health, and governance frameworks. The results indicate a predominance of digital and hybrid surveillance architectures integrating electronic health records, internet-derived signals, genomic sequencing, and environmental datasets. Machine learning approaches were more frequently reported than traditional statistical models, particularly in outbreak forecasting and real-time anomaly detection. Evaluation metrics most commonly emphasized timeliness and predictive accuracy, reflecting a shift toward anticipatory governance. Decision-support applications were primarily associated with early warning systems and situational awareness dashboards. Governance themes, especially privacy protection and legal interoperability, were consistently identified as critical determinants of sustainability. Regional analysis suggests that while high-income countries demonstrate advanced digital integration, middle-income contexts increasingly adopt hybrid models to balance modernization with infrastructure constraints. Overall, data-driven epidemiology strengthens early detection capacity and operational responsiveness when embedded within interoperable, ethically governed, and institutionally supported systems. The findings underscore that technological innovation must be accompanied by governance alignment and workforce capacity development to ensure equitable and sustainable public health transformation.

ABSTRACT We present photometric and spectroscopic studies of two core-collapse supernovae (SNe) 2008aq and 2019gaf in the optical wavelengths. Light curve and spectral sequence of both the SNe are similar to those of other Type IIb SNe. The pre-maximum spectrum of SN 2008aq showed prominent H $\alpha$ lines, the He lines started appearing in the near maximum spectrum. The near maximum spectrum of SN 2019gaf shows shallow H $\alpha$ absorption and He lines with almost similar strength. Both the SNe show transition from hydrogen-dominated spectra to helium-dominated spectra within a month after maximum brightness. The velocity evolution of SN 2008aq matches well with those of other well-studied Type IIb SNe, while SN 2019gaf shows higher velocities. Close to maximum light, the H $\alpha$ and He i line velocities of SN 2019gaf are $\sim$ 2000 and $\sim$ 4000 km s$^{-1}$ higher than other well-studied Type IIb SNe. Semi-analytical modelling indicates SN 2019gaf to be a more energetic explosion with a smaller ejecta mass than SN 2008aq. The zero-age main-sequence (ZAMS) mass of the progenitor estimated using the nebular spectra of SN 2008aq ranges between 13 and 20 M$_\odot$, while for SN 2019gaf, the inferred ZAMS mass is between 13 and 25 M$_\odot$. The [O i] to [Ca ii] lines flux ratio favours a less massive progenitor star in a binary system for both the SNe.

Small (<5 mm) intracranial aneurysms present a therapeutic challenge due to their low annual rupture risk and uncertainties regarding procedure-related morbidity. Evidence from Latin America remains limited. We conducted a retrospective multicenter observational study including 1,519 patients treated between 2017 and 2023 in eight referral centers across five Latin American countries. Demographic, clinical, morphological, and treatment-related variables were analyzed. Logistic regression was used to identify independent predictors of treatment-related complications. The overall complication rate was 6%. Surgical treatment showed higher crude complication rates (11%) compared with endovascular therapy (6%), largely reflecting a greater proportion of ruptured aneurysms. Independent predictors of treatment-related complications were a history of aneurysmal subarachnoid hemorrhage (odds ratio [OR] = 5.03), intraparenchymal hematoma before treatment (OR = 3.56), and ruptured aneurysm status (OR = 2.13). Complications were associated with higher mortality (31% vs. 7%; P < 0.001) and worse 1-year outcomes (Modified Rankin Scale 3-6: 41% vs. 12%; P < 0.001). In this first regional multicenter series, treatment of small intracranial aneurysms in Latin America demonstrated low complication rates and favorable safety profiles for both surgical and endovascular techniques. The predictors identified may support clinical decision-making and improve prognostic assessment.

High-integrity carbon offset systems require scientifically robust and spatially explicit frameworks to quantify carbon pools and fluxes across ecosystems. We present an integrative methodology that combines eddy covariance measurements, airborne and satellite remote sensing, and modeling to extrapolate near real-time carbon flux monitoring to larger areas, using the old-growth temperate forests of Chilean Patagonia as a case study. Our approach delivers high-resolution aboveground biomass carbon density (30 m) and net ecosystem exchange (NEE, 30 m—30 min) estimates using flux tower data. By integrating ground-based flux measurements with high-resolution remote sensing, the proposed methodology constrains model parameters and spatial extrapolation, thereby reducing uncertainty relative to conventional inventory-based approaches. Our approach offers a replicable framework for informing climate policy, conservation planning, and emerging nature-based finance instruments while meeting operational needs in terms of scalability, technological integration, reproducibility, and traceability.

Aortic surgery carries high risks and complication rates, particularly when extracorporeal life support (ECLS) is required. We compared outcomes of patients receiving post-cardiotomy ECLS after surgeries involving or not involving the thoracic aorta, with a focus on emergency operations. This retrospective multicenter study included adults requiring veno-arterial (V-A) ECLS for post-cardiotomy shock. In-hospital outcomes and long-term survival were analyzed. Among 2,058 patients, 382 (18.6%) underwent aortic and 1,676 (81.4%) non-aortic surgery. Patients undergoing aortic operations were younger (63.0, interquartile range [IQR]: 54.4-70 years; non-aortic: 65.0, IQR: 55-72 years; p = 0.020), with more emergencies (n = 126, 33.1%; non-aortic: n = 402, 24.3%; p < 0.001), longer cross-clamp times (148, IQR: 101-203 mins; non-aortic: 90, IQR: 59-133 mins; p < 0.001) and more postoperative bleeding events (n = 234, 62.4%; non-aortic: n = 922, 56.0%; p = 0.024). Stroke was more frequent after aortic surgery (n = 60, 15.8%; non-aortic: n = 157, 9.4%; p < 0.001), especially in emergency cases (n = 27, 21.6%; p = 0.034). In-hospital mortality was greater after aortic surgery (n = 258, 67.5%; non-aortic: n = 986, 58.8%; p = 0.002), with 49.9% (n = 189) on-ECLS mortality. Neurological injury caused death in 8.9% (n = 22) of patients undergoing aortic and 4.0% (n = 36) non-aortic operations. Post-discharge survival was similar ( p = 0.32), and emergency status did not affect mortality in the aortic group ( p = 0.643). Veno-arterial extracorporeal life support after aortic surgery is associated with higher bleeding, stroke, and in-hospital mortality compared with non-aortic surgery, independent of emergency status.

Peer tutoring through a structured low-cost approach to reading in pairs using the Paired Reading programme has resulted in attainment gains in reading in English (UK) and Spanish (Colombia), using developer-led training in schools. Given the continued issues with poor reading attainment globally, in preparation for the scalability of Paired Reading in the Global South, a train-the-trainer delivery programme was developed, implemented, and assessed using a matched study design including 6 classes and 98 Grade 6 students in a high-poverty region of Chile. The results indicate that the Paired Reading train-the-trainer programme (Latin American Spanish version) is feasible to implement in elementary schools in high-poverty areas in Chile and is capable of improving children’s reading ability as measured by an independently designed standardised reading assessment. Positive results were found (effect size d = +0.67, g = +0.66) for the children who engaged in the technique when assessed against a matched control group. The results indicate that this programme is now ready for assessment using a randomised controlled trial in Chile to test the effectiveness of using this more scalable method of delivery, including with standardised digital resources, for sustainable delivery in the Latin American region.