Colorectal cancer outcomes among Hispanic/Latino patients in the United States: a scoping review protocol.

OBJECTIVE: This scoping review will identify the patterns of survival, treatment, and recurrence among Hispanic and/or Latino/a/x (H/L) patients with colorectal cancer (CRC) living in the United States (US) and Puerto Rico. Additionally, population- and individual-level determinants of cancer outcomes among H/L CRC patients will be mapped to highlight under-reported/under-investigated research areas. INTRODUCTION: CRC is the third most common cancer excluding skin cancers in the US. Unlike non-Hispanic White populations, cancer is the number one cause of death in H/L populations and currently represents 21% of total deaths. Despite this, a lack of consensus exists on CRC outcomes for H/L patients. Most research on H/L individuals has examined incidence and screening of CRC, with fewer studies focusing on cancer outcomes. INCLUSION CRITERIA: All epidemiological study designs and systematic reviews will be considered. The review will only include peer-reviewed studies that report on survival, treatment, and/or recurrence patterns for H/L patients with CRC residing in the US and Puerto Rico. METHODS: A 3-step search with a 2-stage study selection process will be followed, as recommended by JBI and Arksey and O'Malley. Databases to be searched will include MEDLINE (PubMed), Embase (Ovid), and Scopus. A data extraction tool will be designed based on JBI recommendations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRSIMA-ScR) will be used, with the results presented in a PRISMA diagram. Publications in English from database inception to the present will be considered.The protocol has been registered in Open Science Framework: https://osf.io/y6qf5.

Continuous A-Mode Ultrasound-Based Prediction of Transfemoral Amputee Prosthesis Kinematics Across Different Ambulation Tasks.

OBJECTIVE: Volitional control systems for powered prostheses require the detection of user intent to operate in real life scenarios. Ambulation mode classification has been proposed to address this issue. However, these approaches introduce discrete labels to the otherwise continuous task that is ambulation. An alternative approach is to provide users with direct, voluntary control of the powered prosthesis motion. Surface electromyography (EMG) sensors have been proposed for this task, but poor signal-to-noise ratios and crosstalk from neighboring muscles limit performance. B-mode ultrasound can address some of these issues at the cost of reduced clinical viability due to the substantial increase in size, weight, and cost. Thus, there is an unmet need for a lightweight, portable neural system that can effectively detect the movement intention of individuals with lower-limb amputation. METHODS: In this study, we show that a small and lightweight A-mode ultrasound system can continuously predict prosthesis joint kinematics in seven individuals with transfemoral amputation across different ambulation tasks. Features from the A-mode ultrasound signals were mapped to the user's prosthesis kinematics via an artificial neural network. RESULTS: Predictions on testing ambulation circuit trials resulted in a mean normalized RMSE across different ambulation modes of 8.7 ± 3.1%, 4.6 ± 2.5%, 7.2 ± 1.8%, and 4.6 ± 2.4% for knee position, knee velocity, ankle position, and ankle velocity, respectively. CONCLUSION AND SIGNIFICANCE: This study lays the foundation for future applications of A-mode ultrasound for volitional control of powered prostheses during a variety of daily ambulation tasks.

Genome-Wide Gene-Environment Interaction Analyses to Understand the Relationship between Red Meat and Processed Meat Intake and Colorectal Cancer Risk.

BACKGROUND: High red meat and/or processed meat consumption are established colorectal cancer risk factors. We conducted a genome-wide gene-environment (GxE) interaction analysis to identify genetic variants that may modify these associations. METHODS: A pooled sample of 29,842 colorectal cancer cases and 39,635 controls of European ancestry from 27 studies were included. Quantiles for red meat and processed meat intake were constructed from harmonized questionnaire data. Genotyping arrays were imputed to the Haplotype Reference Consortium. Two-step EDGE and joint tests of GxE interaction were utilized in our genome-wide scan. RESULTS: Meta-analyses confirmed positive associations between increased consumption of red meat and processed meat with colorectal cancer risk [per quartile red meat OR = 1.30; 95% confidence interval (CI) = 1.21-1.41; processed meat OR = 1.40; 95% CI = 1.20-1.63]. Two significant genome-wide GxE interactions for red meat consumption were found. Joint GxE tests revealed the rs4871179 SNP in chromosome 8 (downstream of HAS2); greater than median of consumption ORs = 1.38 (95% CI = 1.29-1.46), 1.20 (95% CI = 1.12-1.27), and 1.07 (95% CI = 0.95-1.19) for CC, CG, and GG, respectively. The two-step EDGE method identified the rs35352860 SNP in chromosome 18 (SMAD7 intron); greater than median of consumption ORs = 1.18 (95% CI = 1.11-1.24), 1.35 (95% CI = 1.26-1.44), and 1.46 (95% CI = 1.26-1.69) for CC, CT, and TT, respectively. CONCLUSIONS: We propose two novel biomarkers that support the role of meat consumption with an increased risk of colorectal cancer. IMPACT: The reported GxE interactions may explain the increased risk of colorectal cancer in certain population subgroups.

Características epidemiológicas y microbiológicas de los episodios de Neutropenia Febril (NF) en niños con cáncer en el Hospital del Niño - Dr. José Renán Esquivel (HNJRE)

Introducción: La neutropenia febril (NF) constituye una complicación frecuente, considerada una urgencia infectológica en los pacientes con cáncer que reciben tratamiento mielosupresor. Metodología: Se realizó un estudio retrospectivo descriptivo a través de la revisión de los expedientes de todos los episodios de NF secundarios a quimioterapia ingresados en el Hospital del Niño - Dr. José Renán Esquivel durante el periodo de enero a diciembre de 2017. Resultados: El estudio consistió en la evaluación de características epidemiológicas e identificación de agentes infecciosos en 49 casos de NF, y 104 eventos febriles. Se observó que el 51% de los casos eran varones, con una edad promedio de 7 años, y recuperación de NF en los primeros 7 días del 68%. La mayoría de las hospitalizaciones (53,8%) duraron de 1 a 7 días, con una relación directa con los días de fiebre y la presencia de neutropenia. La letalidad registrada fue de 6.1%. Los agentes etiológicos más frecuentes fueron la Pseudomonas aeruginosa, los Estafilococos coagulasa negativos y Staphylococcus aureus meticilino sensible. Conclusión: Los hallazgos permiten conocer la epidemiología actual de los pacientes con NF que se admiten al hospital, con el fin de optimizar el tratamiento para reducir la tasa de letalidad. (provisto por Infomedic International)

Introduction: Febrile neutropenia (NF) constitutes a frequent complication, considered an infectious emergency in cancer patients receiving myelosuppressive treatment. Methodology: A descriptive retrospective study was conducted by reviewing the records of all episodes of NF secondary to chemotherapy admitted to the Hospital del Niño - Dr. José Renán Esquivel during the period from January to December 2017. Results: The study consisted of the evaluation of epidemiological characteristics and identification of infectious agents in 49 cases of NF, and 104 febrile events. It was observed that 51% of the cases were male, with a mean age of 7 years, and recovery from NF in the first 7 days of 68%. Most hospitalizations (53.8%) lasted from 1 to 7 days, with a direct relationship with the number of days of fever and the presence of neutropenia. The case fatality rate was 6.1%. The most frequent etiological agents were Pseudomonas aeruginosa, coagulase-negative Staphylococci and methicillin-sensitive Staphylococcus aureus. Conclusion: The findings provide insight into the current epidemiology of patients with NF admitted to the hospital, in order to optimize treatment to reduce the case-fatality rate. (provided by Infomedic International)

Disparities among Black and Hispanic colorectal cancer patients: Findings from the California Cancer Registry.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in California and second among Hispanic/Latinx (H/L) males. Data from the California Cancer Registry were utilized to investigate the differential impact on CRC outcomes from demographic and clinical characteristics among non-Hispanic white (NHW), non-Hispanic Black (NHB), U.S. born (USB), and non-U.S. born (NUSB) H/L patients diagnosed during 1995-2020. METHODS: We identified 248,238 NHW, 28,433 NHB, and 62,747 H/L cases (32,402 NUSB and 30,345 USB). Disparities across groups were evaluated through case frequencies, odds ratios (OR) from logistic regression, and hazard ratios (HR) from Cox regression models. All statistical tests were two-sided. RESULTS: NHB patients showed a higher proportion of colon tumors (75.8%) than NHW (71.5%), whereas both NUSB (65.9%) and USB (66.9%) H/L cases had less (p < 0.001). In multivariate models, NUSB H/L cases were 15% more likely than NHW to have rectal cancer. Compared to NHW, NHB cases had the greatest proportion of Stage IV diagnoses (26.0%) and were more likely to die of CRC (multivariate HR = 1.12; 95% CI = 1.10-1.15). Instead, NUSB H/L patients were less likely to die of CRC (multivariate HR = 0.87; 95% CI = 0.85-0.89) whereas USB H/L did not differ from NHW. CONCLUSIONS: NHB and H/L cases have more adverse characteristics at diagnosis compared to NHW cases, with NHB cases being more likely to die from CRC. However, NUSB H/Ls cases showed better survival than NHW and US born H/L patients. These findings highlight the importance of considering nativity among H/L populations to understand cancer disparities.

A-Mode Ultrasound-Based Prediction of Transfemoral Amputee Prosthesis Walking Kinematics Via an Artificial Neural Network.

Lower-limb powered prostheses can provide users with volitional control of ambulation. To accomplish this goal, they require a sensing modality that reliably interprets user intention to move. Surface electromyography (EMG) has been previously proposed to measure muscle excitation and provide volitional control to upper- and lower-limb powered prosthesis users. Unfortunately, EMG suffers from a low signal to noise ratio and crosstalk between neighboring muscles, often limiting the performance of EMG-based controllers. Ultrasound has been shown to have better resolution and specificity than surface EMG. However, this technology has yet to be integrated into lower-limb prostheses. Here we show that A-mode ultrasound sensing can reliably predict the prosthesis walking kinematics of individuals with a transfemoral amputation. Ultrasound features from the residual limb of 9 transfemoral amputee subjects were recorded with A-mode ultrasound during walking with their passive prosthesis. The ultrasound features were mapped to joint kinematics through a regression neural network. Testing of the trained model against untrained kinematics from an altered walking speed show accurate predictions of knee position, knee velocity, ankle position, and ankle velocity, with a normalized RMSE of 9.0 ± 3.1%, 7.3 ± 1.6%, 8.3 ± 2.3%, and 10.0 ± 2.5% respectively. This ultrasound-based prediction suggests that A-mode ultrasound is a viable sensing technology for recognizing user intent. This study is the first necessary step towards implementation of volitional prosthesis controller based on A-mode ultrasound for individuals with transfemoral amputation.

Ambulation Mode Classification of Individuals with Transfemoral Amputation through A-Mode Sonomyography and Convolutional Neural Networks.

Many people struggle with mobility impairments due to lower limb amputations. To participate in society, they need to be able to walk on a wide variety of terrains, such as stairs, ramps, and level ground. Current lower limb powered prostheses require different control strategies for varying ambulation modes, and use data from mechanical sensors within the prosthesis to determine which ambulation mode the user is in. However, it can be challenging to distinguish between ambulation modes. Efforts have been made to improve classification accuracy by adding electromyography information, but this requires a large number of sensors, has a low signal-to-noise ratio, and cannot distinguish between superficial and deep muscle activations. An alternative sensing modality, A-mode ultrasound, can detect and distinguish between changes in superficial and deep muscles. It has also shown promising results in upper limb gesture classification. Despite these advantages, A-mode ultrasound has yet to be employed for lower limb activity classification. Here we show that A- mode ultrasound can classify ambulation mode with comparable, and in some cases, superior accuracy to mechanical sensing. In this study, seven transfemoral amputee subjects walked on an ambulation circuit while wearing A-mode ultrasound transducers, IMU sensors, and their passive prosthesis. The circuit consisted of sitting, standing, level-ground walking, ramp ascent, ramp descent, stair ascent, and stair descent, and a spatial-temporal convolutional network was trained to continuously classify these seven activities. Offline continuous classification with A-mode ultrasound alone was able to achieve an accuracy of 91.8±3.4%, compared with 93.8±3.0%, when using kinematic data alone. Combined kinematic and ultrasound produced 95.8±2.3% accuracy. This suggests that A-mode ultrasound provides additional useful information about the user's gait beyond what is provided by mechanical sensors, and that it may be able to improve ambulation mode classification. By incorporating these sensors into powered prostheses, users may enjoy higher reliability for their prostheses, and more seamless transitions between ambulation modes.

Powered knee and ankle prosthesis with indirect volitional swing control enables level-ground walking and crossing over obstacles.

Powered prostheses aim to mimic the missing biological limb with controllers that are finely tuned to replicate the nominal gait pattern of non-amputee individuals. Unfortunately, this control approach poses a problem with real-world ambulation, which includes tasks such as crossing over obstacles, where the prosthesis trajectory must be modified to provide adequate foot clearance and ensure timely foot placement. Here, we show an indirect volitional control approach that enables prosthesis users to walk at different speeds while smoothly and continuously crossing over obstacles of different sizes without explicit classification of the environment. At the high level, the proposed controller relies on a heuristic algorithm to continuously change the maximum knee flexion angle and the swing duration in harmony with the user's residual limb. At the low level, minimum-jerk planning is used to continuously adapt the swing trajectory while maximizing smoothness. Experiments with three individuals with above-knee amputation show that the proposed control approach allows for volitional control of foot clearance, which is necessary to negotiate environmental barriers. Our study suggests that a powered prosthesis controller with intrinsic, volitional adaptability may provide prosthesis users with functionality that is not currently available, facilitating real-world ambulation.

Características clínicas y demográficas de los pacientes con quiste de colédoco atendidos en el Hospital del Niño Dr. José R. Esquivel en Panamá durante los años 2005 a 2018 / Clinical and demographic characteristics of patients with choledochal cysts treated at the Hospital del Niño Dr. José R. Esquivel in Panama during the years 2005 to 2018.

Introducción: El quiste de colédoco es una condición poco frecuente, se caracteriza por una dilatación de la vía biliar intrahepática y extrahepática. La presentación clínica es variable e incluye principalmente la presencia de masa abdominal, vómitos, ictericia y dolor abdominal, Materiales y métodos: El objetivo de este estudio es determinar las características clínicas y epidemiológicas de pacientes con quiste de colédoco atendidos en el Hospital del Niño Dr José Renán Esquivel durante los años 2005 a 2018. Se realizó un estudio descriptivo retrospectivo, con interés en las características demográficas como edad, sexo, lugar de procedencia, grupo étnico y las características clínicas como síntomas, método diagnóstico, tipo de quiste reportado, histopatología, y complicaciones. Resultados: La n fueron 36 pacientes (n=25 femenino y n=11 masculinos). El grupo de edad de 0-4 años representó el 67% de los sujetos del estudio. Las principales manifestaciones clínicas fueron dolor abdominal, vómitos e ictericia. El método diagnóstico principal utilizado fue la ecografía abdominal. Principales complicaciones postquirúrgicas colangitis, pancreatitis y sangrado digestivo. La mayoría de los quistes clasificados son Todani IC Y IV. Conclusiones: El quiste de colédoco es una patología presente en Panamá con una frecuencia de 2.8 casos por año.

Introduction: Choledochal cysts are a rare condition, characterized by dilatation of the intrahepatic and extrahepatic bile ducts. The clinical presentation is variable and includes the presence of an abdominal mass, jaundice, fever, nausea, vomiting and abdominal pain. Materials and methods: The objective of this study is to determine the clinical and epidemiological characteristics of patients with choledochal cyst treated at the Hospital del Niño Dr. José Renán Esquivel during the years 2005 to 2018. A retrospective descriptive study was conducted, with interest in demographic characteristics such as age, sex, place of origin, ethnic group and clinical characteristics such as symptoms, diagnostic method, type of cyst reported, histopathology, complications. Results: The N were 36 patients (n = 25 female and n = 11 male). The age group of 0-4 years represented 67% of the study subjects. The main clinical manifestations were abdominal pain, vomiting and jaundice. The main diagnostic method used was the abdominal ultrasound. Main postsurgical complications cholangitis, pancreatitis and digestive bleeding. The majority of the classified cysts are Todani IC and IV. Conclusions: The choledochal cyst is a pathology present in Panama with 2.8 cases per year.

Interés de estudiantes de la licenciatura en nutrición de universidades latinoamericanas y su formación en el campo de la nutrición comunitaria / Interest of students of the degree in nutrition of latinamerican universities and their training in the field of the community nutrition

Fundamentos: El campo profesional Nutrición Comunitaria es reconocido por su relación con una necesidad social de coadyuvar en la solución de los problemas de alimentación y nutrición, existen evidencias de su escaso desarrollo en la formación y mercado laboral, el objetivo del presente estudio fue conocer su importancia en los planes de estudio de la licenciatura en nutrición, así como el interés de los estudiantes por realizar estudios de posgrado en este campo. Métodos: Estudio transversal, la muestra se conformó de dos universidades, una pública y una privada de: Argentina, Uruguay, Paraguay, Chile, México y Perú. Se encuestó a estudiantes del primero y último año y se entrevistó al director y dos profesores de cada licenciatura. Para el análisis se utilizó Excel y SPSS. Resultados: El campo profesional de mayor interés para realizar estudios de posgrado fue Nutrición Clínica, seguido de Nutrición Comunitaria, situación semejante se presentó en la importancia de cada campo en los planes de estudio. No se encontraron diferencias a valores de P≤0.05, entre los estudiantes del primero y último año. Conclusiones: Aunque la Nutrición Comunitaria se ubicó en segundo nivel de importancia, con base en la situación epidemiológica, se considera conveniente impulsar un mayor desarrollo en la licenciatura y ofertar más oportunidades de estudios de posgrado

Background: Community Nutrition professional field is recognized by its relationby a social need to contributein the solution of food-supply and nutrition problems, there exist evidences of scanty development in the student formation and labor market area, for the aim of the present study was to know about its importance in the study plans of the nutrition degree, as well as the interest of the students to realice postgraduate studies. Methods: Transversal study, the sample was conformed of two universities of each country, a private and a public one from: Argentina, Uruguay, Paraguay, Chile, Mexico and Peru. Students were polled of firstly and last year and one interviewed the director and two teachers of every program, for the analysis we used Excel and SPSS. Results: The professional field of major interest to realize postgraduate studies was Clinic Nutrition, followed by Community Nutrition, a similar situation appeared in the importance of every field in the study plans. There was not differences to values of P≤0.05 among the students of the firstly and last year. Conclusions: Though the Community Nutrition was located in the second level of importance, with base in the epidemiological situation, it is considered suitable to stimulate a major development in the master and to offer more opportunities of postgraduate studies

Fine-scale predictions of distributions of Chagas disease vectors in the state of Guanajuato, Mexico.

One of the most daunting challenges for Chagas disease surveillance and control in Mexico is the lack of community level data on vector distributions. Although many states now have assembled representative domestic triatomine collections, only two triatomine specimens had been collected and reported previously from the state of Guanajuato. Field personnel from the state's Secretaría de Salud conducted health promotion activities in 43 of the 46 counties in the state and received donations of a total of 2,522 triatomine specimens between 1998 and 2002. All specimens were identified, and live insects examined for Trypanosoma cruzi. In an effort to develop fine-scale distributional data for Guanajuato, collection localities were georeferenced and ecological niches were modeled for each species by using evolutionary-computing approaches. Five species were collected: Triatoma mexicana (Herrich-Schaeffer), Triatoma longipennis (Usinger), Triatoma pallidipennis (Stål), Triatoma barberi (Usinger), and Triatoma dimidiata (Latreille) from 201 communities located at elevations of 870-2,200 m. Based on collection success, T. mexicana had the broadest dispersion, although niche mapping indicates that T. barberi represents the greatest risk for transmission of Chagas disease in the state. T. dimidiata was represented in collections by a single adult collected from one village outside the predicted area for all species. For humans, an estimated 3,755,380 individuals are at risk for vector transmission in the state, with an incidence of 3,500 new cases per year; overall seroprevalences of 2.6% indicate that 97,640 individuals are infected with T. cruzi at present, including 29,300 chronic cases.

Carrier detection in Duchenne and Becker muscular dystrophy using dinucleotide repeat polymorphisms: a study in Mexican families

In order to improve carrier detection of Duchenne and Becker muscular dystrophy, denucleotide sequences repeats (CA) of introns 44, 45, 49 and 50 were used as well as two markers located at the 5' and 3' ends of the dystrophin gene. Haplotypes of the unaffected and affected persons of ten DMD/BMD Mexican families were determined. Fifty eight females were studied, 30 of whom were at-risk STR haplotypes. Furthermore, it was possible to identify a recombination event in the dystrophin gene in one family, and a gonadal mosaicism was found in another family

Transplante de epiplón a la corteza cerebral / Omentum transplantation to cerebral cortex

Se realizó trasplante del epiplón a la superficie cortical del cerebro, a un grupo de perros. El estudio experimental demuestra que el omento provoca la neoformación de vasos sanguíneos y de tejido conectivo, en el espacio comprendido entre la corteza cerebral y el omento