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PURPOSEGallbladder cancer (GBC) is a biliary tract malignancy characterized by its high lethality. Although the incidence of GBC is low in most countries, specific areas such as Chile display a high incidence. Our collaborative study sought to compare clinical and molecular features of GBC cohorts from Chile and the United States with a focus on ERBB2 alterations.METHODSPatients were accrued at Memorial Sloan Kettering Cancer Center (MSK) or the Pontificia Universidad Católica de Chile (PUC). Clinical information was retrieved from medical records. Genomic analysis was performed by the next-generation sequencing platform MSK-Integrated Mutation Profiling of Actionable Cancer Targets.RESULTSA total of 260 patients with GBC were included, 237 from MSK and 23 from PUC. There were no significant differences in the clinical characteristics between the patients identified at MSK and at PUC except in terms of lithiasis prevalence which was significantly higher in the PUC cohort (85% v 44%; P = .0003). The prevalence of ERBB2 alterations was comparable between the two cohorts (15% v 9%; P = .42). Overall, ERBB2 alterations were present in 14% of patients (8% with ERBB2 amplification, 4% ERBB2 mutation, 1.5% concurrent amplification and mutation, and 0.4% ERBB2 fusion). Notably, patients with GBC that harbored ERBB2 alterations had better overall survival (OS) versus their ERBB2-wild type counterparts (22.3 months v 11.8 months; P = .024).CONCLUSIONThe prevalence of lithiasis seems to be higher in Chilean versus US patients with GBC. A similar prevalence of ERBB2 alterations of overall 14% and better OS suggests that a proportion of them could benefit from human epidermal growth factor receptor type 2–targeted therapies. The smaller cohort of Chile, where the disease prevalence is higher, is a reminder and invitation for the need of more robust next-generation sequencing analyses globally.

Odontomas are benign tumors characterized by slow and limited growth with a rare recurrence. Odontomas are generally detected by radiographic findings in the radiopaque stage, where calcification of the tissues is observed. This article seeks to report the recurrence of a radiologically diagnosed odontoma to show the importance of radiographic controls after enucleation as a diagnostic and follow-up method. Case report: A female patient, 9 years old, attended dental care in 2020 due to malpositioned teeth. In the intraoral clinical examination, she presented stage II mixed dentition with crowding. A radiographic exam showed no associated lesions. The patient reported a history of odontoma removal and a supernumerary tooth in sextant II in 2016. Subsequently, she was referred to orthodontics, where permanent dentition with moderate anterior crowding in the maxilla and mandible was observed. The radiographic examination showed a radiopaque area compatible with odontoma, palatal to teeth 12 and 13. Conclusions: Although recurrence is rare, complete removal in the case of an odontoma is critical. This study demonstrates the importance of performing radiographic controls 5 years after enucleation of an odontoma, considering the stages of evolution.

Abstract The aim of this study was to develop a Preventive Oral Health Exam for Elderly People (EDePAM), using the e-Delphi technique, to diagnose oral health problems in people 65 or older. The e-Delphi technique was used with experts in multiple stages, and in a final workshop, where an agreement on an examination protocol was reached for diagnosing dental caries, oral mucosa lesions, periodontal diseases, and masticatory function disorders. Quantitative analyses of all the rounds of the e-Delphi method were conducted. It was agreed that the International Caries Detection and Assessment System (ICDAS) should be used together with a modified version of the Nyvad criteria to detect and assess caries lesions. It was also agreed that an assessment was needed of the different factors involved in determining caries risk, namely socioeconomic level, access to fluoride, level of dependence/functionality, salivary flow, history of head and neck cancer treatment, use of medications that decrease salivary flow, diet, use of removable dental prostheses, exposure of root surfaces, and caries history. Furthermore, patients would be required to undergo an examination of the oral mucosa, where any existing lesion should be described in terms of its clinical appearance, location, and risk potential. It was also agreed that an assessment of masticatory function should be performed using the Leake index, together with chewing-gum combined with a color scale to categorize masticatory performance. The number of pairs of occluding antagonist teeth was considered as the best predictor of masticatory function. The 2018 classification by the American Academy of Periodontology (AAP) / European Federation of Periodontology (EFP) was accepted as the standard to assess periodontal status, and it was agreed that this assessment should include an evaluation of clinical attachment loss and bleeding on probing. The novel EDePAM was considered as appropriate for conducting a functional assessment of oral health by providing a comprehensive diagnosis of oral diseases.

This study presents data on the directional flying behaviour of the five most abundant seabird species migrating across the Strait of Gibraltar in relation to the wind, as observed from the north coast, based on radar tracking, and identified to species level by visual observations. A total of 318 seabird trajectories were analysed, illustrating the expected east–west or west–east movements in spring and autumn. We hypothesised that the seabirds that cross the Strait channel during their migrations would behave differently with respect to compensation for wind direction, depending on their flight styles, the migratory period, and the prevailing winds. In this regard, our results showed that flapping birds (Razorbill, Puffin, Northern Gannet, and Balearic shearwater) compensated for wind drift independently of the season and the predominant wind direction. This agrees with the theory that suggests that under moderate winds and whenever visual contact with the coastline is present (as in the case of our study), migrants should compensate for wind drift to avoid being drifted towards the coast, off their main direction of flight. However, Cory’s shearwater, an active gliding seabird with long, slender wings, showed an adaptive directional response to wind, allowing it to be drifted in spring when westerly tailwinds were prevalent, but compensated for wind in autumn, when both easterly and westerly winds were similarly frequent. This adaptive flight behaviour allows it to take advantage of the prevailing tailwinds in spring, gaining ground speed and saving energy during its passage through the Strait, while in autumn, more frequent headwind conditions and a more directional migration to the south may favour compensating for wind drift. Our results support the usefulness of bird radar as a remote tool for describing the pattern of animal movements in the marine environment, as well as their behavioural response to atmospheric conditions. These studies are particularly relevant in the current framework of climate change.

A novel application for conical wire array Z-pinches to surface science is presented. The axial outflows emitted by a tungsten conical wire array in the form of both a dense plasma jet and energetic ions are used to produce morphological modification of substrate surfaces without using any kind of chemical treatment. In particular, surface modifications of (100) oriented Si substrates in the form of micropores and stripes-like formations after a single interaction of the Si to the axial outflows are obtained. It is found that the prevalence of each kind of formation, either micropores or stripes, on the treated substrate depends on the relative position of the target with respect to the wire array. The results indicate that at distances of 11 cm over the array there is still effect of the dense plasma jet outflow since both micropores and stripes are found. On the contrary, solely stripe-like patterns are found at greater distances where the effect of the dense plasma outflow is minimal or null, and only the ion outflow irradiates the surface. The description of the method and future perspectives of this novel application of surface treatment are shown and discussed.

AIM: To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). METHODS: Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. RESULTS: Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D) for sphere. Astigmatism showed better correlation between KR and MR. CONCLUSION: We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected.

El artículo describe la situación actual de la formación de directivos escolares en Chile, a través de una caracterización de los programas de máster especializados en esta área y de su comparación con una observación inicial realizada en el año 2010. Se utilizan como fuente principal los resultados de un cuestionario aplicado a los responsables de una muestra de los programas de formación vigentes en Chile al año 2017. La evidencia recopilada permite concluir que la preparación de directivos en Chile ha experimentado un importante cambio curricular, consistente con las políticas educacionales en este país. Esto se ha traducido en una mayor priorización de conocimientos y habilidades como la teoría y práctica del liderazgo educativo, herramientas para el mejoramiento escolar o la gestión del desarrollo profesional docente. Este interesante cambio convive, sin embargo, con un evidente estancamiento a nivel metodológico: sigue predominando un modelo formativo esencialmente teórico y carente de instancias prácticas de desarrollo profesional, lo que limita las posibilidades de que esta formación logre impactar sustantivamente en el aprendizaje y desempeño de los líderes escolares. El caso chileno entrega, a nivel de la formación misma pero también de las políticas que la promueven, aprendizajes relevantes para el desafío de formar con calidad a los líderes escolares de América Latina.

The Chilean educational system is critical time. From the student mobilization of half-full of 2006 the Chilean Educative Reformation has been put in cuestión. Two questions are emerging: (1) Why, in spite of all the efforts and investments made from 1990 to date, the educative system has not managed to constitute itself in a source of development and equitable distribution of opportunities? and (2) Which is the north that must guide the future Chilean educational policy and, in that context, which are the high-priority challenges that are necessary to face? This article contributes answers to both questions. In his first part reviews the main transformations that have introduced to the Chilean educative system in the last 25 years. In his second part, the article responds to the question on like advancing towards an education of quality for all. Having like north the fundamental keys of the effectiveness and the educative improvement of the schools in Chile, the third part and end of the article, reflects on the policy alternatives that are necessary to consider to advance towards that north.

School managers are often vindicated as executors of educational policies, recognizing a key role for their success or failure in the schools they lead. This article analyzes, from comparable annual surveys, the opinion that the directors of educational centers had regarding the educational policies developed in Chile under the reformist government of President Michelle Bachelet (2014-2017). The results show that the initiative that most marked the opinion of the directors was the law of educational inclusion, approved controversially at the beginning of the period. Around it there was greater initial pessimism regarding the future of national education, as well as a tendency to distance the opinion of managers working in the public sector with respect to the private sector. It can also be seen that the opinion of managers is dynamic, changing in the course of the government, which usually manifests the urgency of certain educational policies (such as improving initial teacher training) above the rest and also provides valuable information on the effects of policies in the educational centers themselves. Therefore, given their quality as qualified informants, decision makers should systematically consider their opinions in the design and implementation of policies.

La pesquería artesanal de cerco multiespecífica que opera en aguas interiores de Chiloé captura sardina común (Strangomera bentincki) y sardina austral (Sprattus fuegensis) al mismo tiempo y en la misma área. Debido a la gran similitud morfológica externa que presentan estas dos especies de peces óseos, la identificación específica en terreno es difícil, aún para observadores científicos experimentados. Por lo tanto, el objetivo de este trabajo es proponer cual o cuales rasgos morfométricos externos debiesen ser considerados para una rápida identificación de estas especies en terreno. Se analizaron 60 ejemplares de sardina común y 79 de sardina austral. Se identificaron los ejemplares a nivel de especie y se registraron las siguientes medidas: longitud total, longitud de la cabeza, preórbita, órbita y posórbita. Todas las medidas morfométricas fueron estandarizadas para evitar colinealidad. Las diferencias en las medidas morfométricas entre especies fueron probadas mediante métodos estadísticos multivariados que incluyen el análisis de componentes principales, análisis de varianza y covarianza (ANOVA y ANCOVA), análisis multivariado de covarianza (MANOVA) y análisis lineal discriminante. La medida posórbita fue el rasgo morfométrico que presentó mayor diferenciación entre especies. Se concluye que la medida de posórbita es por sí sola un carácter morfométrico externo que permitiría una rápida identificación de estas especies en terreno. Los resultados de esta investigación pueden ser tomados como línea base para la generación de guías de campo que apoyen el trabajo de identificación de especies de los observadores científicos.

Editorial

Este trabajo describe la evaluación de las políticas de mejoramiento en Chile y analiza la importancia que han ido adquiriendo en Chile los servicios de Asistencia Técnica Educativa (ATE), como recurso y componente de la reforma educativa en ese país. Se deja en evidencia que la ATE ha ido tomando una relevancia e institucionalización creciente en el sistema educativo chileno, lo que desafía fuertemente a las políticas, que deben ocuparse de la regulación de estos servicios, del desarrollo de una oferta suficiente y efectiva y en la orientación de la demanda que de estos servicios hacen las escuelas y sus sostenedores (administradores). Descriptores: Mejoramiento Educativo, asistencia técnica, agentes externos, rol del estado. The State Role and External Agents in Schools Improvement: Analysis around the Chilean ExperienceThis work describes the evaluation of school improvement policies in Chile and analyzes the importance that has been acquiring in Chile the services of Educative Technical Attendance (ETA), like resource and component of the educative reform in that country. It leaves in evidence that ETA has been taking a relevance and increasing institutionalization in the Chilean educative system, which defies strongly to the policies, that must take care of the regulation of these services, and the development of a sufficient and effective supply in the direction of the demand that these services make the schools and their sostenedores (administrators).Keywords: Educative improvement, technical assistance, external agents, State role.

Raczynski y Muñoz (2007) hicieron un recorrido crítico de la reforma educacional chilena, sus logros y desafíos pendientes, desde la perspectiva de la efectividad y el mejoramiento escolar. El artículo concluía que la reforma no había incidido casi en las prácticas de trabajo asentadas en las escuelas y el aula y que el desafío de la política educativa chilena era combinar medidas y decisiones dirigidas a fortalecer lo que ocurre en el microcosmos de cada escuela, reconociendo y abordando al mismo tiempo las restricciones a su desarrollo que derivan de factores estructurales, fuera del control de la escuela, que ponían techo a sus posibilidades de acercarse a la efectividad escolar. Este artículo analiza la aprobación e implementación, a partir del año 2008, de la Ley de Subvención Escolar Preferencial (SEP) en Chile. Las hipótesis que orientan el trabajo son cuatro: i) la SEP es una nueva forma de entender las políticas de mejoramiento escolar y cambia la relación entre la macropolítica y las escuelas; ii) la fuerza y forma con que esta ley “interviene” en el sistema educativo está modificando la gestión del trabajo educativo en los centros escolares; iii) la Ley SEP crea nuevos “actores” en el sistema escolar y de paso modifica roles y relaciones entre los actores pre-existentes; y iv) la SEP anticipa un nuevo ordenamiento institucional y es preludio a la instalación de un nuevo sistema de rendición de cuentas en la educación escolar chilena que hoy está en curso.

Case: A 44-year-old woman with congenital nystagmus and myopic astigmatism in both eyes who was submitted to phakic intraocular lens (pIOL) implantation. Methods: Full ophthalmologic examination including refractive status, corrected (CDVA) and uncorrected (UCVA) monocular and binocular visual acuities, ocular motility, slit-lamp evaluation, tonometry and fundoscopy before and after implantation of toric pIOLs (Artiflex; Ophtec BV, The Netherlands) in both eyes. Results: Preoperative logMAR CDVA were 0.699 and 0.420 in the right and left eye, respectively. Three months after surgery, logMAR UCVA were 0.398 and 0.182, reaching binocular logMAR UCVA of 0.132. There were no changes in nystagmus characteristics after surgery. Conclusions: pIOL implantation may be a safe and suitable treatment to correct high refractive errors in patients with congenital nystagmus. Significant improvement in CDVA and UCVA can be achieved.

El artículo aborda la pregunta sobre cuáles son las competencias que deben tener los directores escolares para liderar con éxito la mejora educativa en Chile y examina si ellas están siendo desarrolladas por la oferta formativa actual. Mediante la identificación conceptual de competencias críticas, la aplicación de encuestas y entrevistas a encargados de programas y actores del mundo escolar, y la elaboración de un catastro de instancias de formación (de duración igual o superior a un año), la investigación analiza la brecha entre las competencias que los programas intencionan, las que el propio sistema escolar identifica como críticas (a través de la mirada de directores y sostenedores), y las que la evidencia internacional y nacional indica son claves para un liderazgo escolar efectivo. El artículo ofrece una actualización de los modelos nacionales a la luz de nueva literatura y concluye que los programas de formación en Chile tienden a ser homogéneos y a no considerar competencias que son críticas para un liderazgo efectivo.

RESUMEN El denominado énfasis de Fortaleza, Oportunidades, Debilidades y Amenazas, F.O.D.A. Se utiliza principalmente para realizar diagnósticos en organizaciones, lo que permitirá formular una estrategia de acción en instituciones de servicios tales como una entidad universitaria. Sin embargo, esta metodología tiene algunas deficiencias, por ese motivo, este trabajo propone una nueva metodología aplicada a la realización de diagnósticos organizacionales aplicados a instituciones universitarias, con base a un razonamiento de priorización y descarte de aquellas variables en la que no sea posible establecer una clara relación entre: el grado de atractivo o grado de fortaleza, con el grado de importancia que dicha variable representa, en términos de medir su contribución al logro de los objetivos de la institución universitaria en general o una unidad académica estratégica en análisis.