Abstract: Production of polyhydroxyalkanoates (PHA) has generated great interest as building blocks for bioplastic production. Their production using mixed microbial cultures represents an interesting alternative, since it enables the use of organic wastes as a carbon source. Feast/famine strategy is a common way to promote selection of microorganisms with PHA accumulation capacity. However, when using waste sources, changes in substrate concentration are expected, that may affect performance and efficiency of the process. This study showed how the dissolved oxygen level can be used for online control of the cycle time, ensuring that the desired feast/famine ratio is effectively applied. An operation strategy is presented and validated, using sequential batch reactors fed with acetate as the carbon source. Production of polyhydroxybutyrate (PHB) was studied, which is the expected type of PHA to be synthetized when using acetate as substrate. Two reactors were operated by applying the proposed control strategy, to provide F/F ratios of 0.2 and 0.6, respectively. A third reactor was operated with a fixed cycle time, for comparison purposes. Results showed that the reactor that operated at an F/F ratio of 0.6 promoted higher biomass productivity and PHB content, as a result of a better use of available time, preventing unnecessary long famine times. The application of the tested strategy is a simple a reliable way to promote a better performance of feast/famine-based bioreactors involving mixed microbial cultures for PHB production.

Abstract: Objectives: Birth weight is an important public health indicator that reflects fetal health conditions and predicts future health. Identifying the most important factors related to birth weight would help defining preventive health strategies for both mothers and children. The objectives of this study are i. to describe, using a large birth database from a Chilean hospital, the trend of birth weight during 2002-2015, and ii. to determine factors during prenatal care associated with low and high birth weight.
Study design: This study is a secondary analysis of all single birth records at a Chilean Hospital in the southeast district of Santiago, Chile, during 2002-2015 (N = 78,931).
Methods: Sociodemographic information, clinical and obstetric history, lifestyle, and anthropometric variables were evaluated as potential predictors. Birth weight was categorized into five groups as per percentiles of weight as per gestational age. Data were extracted from clinical records. We used classification and regression tree methodology and logistic regression.
Results: The average birth weight for the period was 3316 g (SD 566), with little variation across time. Preterm births increased from 7% in 2002 to 10% in 2015, and births >40 weeks decreased from 10.7% in 2002 to 4.4% in 2015. The percentages of small and large for gestational age changed from 10.9% and 12.7% in 2002 to 9.9% and 13.9% in 2015, respectively. The predictors included in the optimal tree were body mass index, gestational weight gain, pre-eclampsia, and gestational diabetes. We found that women with a pregestational body mass index <28 kg/m(2), gestational weight gain <17 kg, and pre-eclampsia had a probability of 41% of having a small for gestational age neonate. Conversely, women with a body mass index similar to 28 kg/m(2), gestational weight gain similar to 17 kg, and gestational diabetes had a probability of 44% of having a large for gestational age neonate.
Conclusions: This study showed that the most important variables explaining birth weight are those related to maternal nutritional status. Thus, the strategies to promote a normal birth weight should aim for a normal maternal weight at the beginning of pregnancy, gestational weight gain within the recommendations, and prevention of gestational diabetes and pre-eclampsia. (C) 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Abstract: Objectives: We develop a patient prioritization scheme for treating patients infected with hepatitis C virus (HCV) and study under which scenarios it outperforms the current practices in Spain and Chile.
Study design: We use simulation to evaluate the performance of prioritization rules under two HCV patient cohorts, constructed using secondary data of public records from Chile and Spain, during 2015-2016.
Methods: We use the results of a mathematical model, which determines individual optimal HCV treatment policies as an input for constructing a patient prioritization rule, when limited resources are present. The prioritization is based on marginal analysis on cost increases and health-outcome gains. We construct the Chilean and Spanish case studies and used Monte Carlo simulation to evaluate the performance of our methodology in these two scenarios.
Results: The resulting prioritizations for the Chilean and Spanish patients are similar, despite the significant differences of both countries, in terms of epidemiological profiles and cost structures. Furthermore, when resources are scarce compared with the number of patients in need of the new drug, our prioritization significantly outperforms current practices of treating sicker patients first, both in terms of cost and healthcare indicators: for the Chilean case, we have an increase in the quality-adjusted life years (QALYs) of 0.83 with a cost reduction of 8176 euros per patient, with a budget covering 2.5% of the patients in the cohort. This difference slowly decreases when increasing the available resources, converging to the performance indicators obtained when all patients are treated immediately: for the Spanish case, we have a decrease in the QALYs of 0.17 with a cost reduction of 1134 euros per patient, with a budget covering 20% of the patients in the cohort.
Conclusion: Decision science can provide useful analytical tools for designing efficient public policies that can excel in terms of quantitative health performance indicators.

Abstract: Since the mid-nineteen century, when the first mining companies were established in the region of Antofagasta to extract saltpeter, mining managers and civil authorities have always had to face a number of problems to secure a water supply sufficient for the development of industrial activities and society. The unique features of the region, namely the scarcity of rainfall, the high concentration of arsenic in freshwaters and the increasing pressure of the mining sector, have made the supply of drinking water for local communities a challenge. In the 1950s, the town of Antofagasta experienced a serious drinking water crisis. The 300 km long aqueduct starting from the Toconce catchment, opened in 1958, temporarily ended this shortage of drinking water but created an even more dramatic problem. The concentration of arsenic in the water consumed by the population had grown by approx. ten times, reaching the value of 0.860 mg/L and seriously affecting people's health. The water treatment plants (WTPs) which were installed starting from the 1970s in the region (namely the Old and New Salar del Carmen in Antofagasta and Cerro Topater in Calama, plus the two recent desalination plants in Antofagasta and Tocopilla), have ensured, since 2014, that the drinking water coverage in the urban areas was practically universal (>99.9%). However, the rural areas have continued to experience significant shortcomings regarding their capacity to ensure the quality and continuity of the water supply service in the long run. Presently, approx. 42% of the rural population of the region of Antofagasta does not have a formal supply of drinking water. The recent amendments to the Chilean Water Code (March 2022) and the interventions carried out in the framework of the Agua Potable Rural (APR) program were intended to reduce the socio-ecological inequalities due to the lack of drinking water in the semi-concentrated and isolated rural population.