Health Care Access and Utilization and the Latino Health Paradox.

BACKGROUND: The Latino health paradox is the phenomenon whereby recent Latino immigrants have, on average, better health outcomes on some indicators than Latino immigrants who have lived in the United States longer and US-born Latinos and non-Latino Whites. This study examined whether the paradox holds after accounting for health care access and utilization. METHODS: The 2019-2020 National Health Interview Survey data were used. The main predictors included population groups of foreign-born and US-born Latinos (Mexican or non-Mexican) versus US-born non-Latino Whites. Predicted probabilities of health outcomes (self-reported poor/fair health, overweight/obesity, hypertension, coronary heart disease, diabetes, cancer, and depression) were calculated and stratified by length of residence in the United States (<15 or ≥15 years) among foreign-born Latinos and sex (female or male). Multivariable analyses adjusted for having a usual source of care other than the emergency department, health insurance, a doctor visit in the past 12 months, predisposing and enabling factors, and survey year. RESULTS: After adjusting for health care access, utilization, and predisposing and enabling factors, foreign-born Latinos, including those living in the United States ≥15 years, had lower predicted probabilities for most health outcomes than US-born non-Latino Whites, except overweight/obesity and diabetes. US-born Latinos had higher predicted probabilities of overweight/obesity and diabetes and a lower predicted probability of depression than US-born non-Latino Whites. CONCLUSIONS: In this national survey, the Latino health paradox was observed after adjusting for health care access and utilization and predisposing and enabling factors, suggesting that, although these are important factors for good health, they do not necessarily explain the paradox.

Soil Black Carbon Increases Under Urban Trees with Road Density and Time: Opportunity Hotspots for Carbon Storage in Urban Ecosystems.

Black carbon (BC) can comprise a significant fraction of the soil carbon pool in cities. However, vegetation cover and human activity influence the spatial distribution of urban soil BC. We quantified soil total carbon (TC), soil organic carbon (SOC), BC, and total nitrogen (TN) in a medium-sized city in Dallas-Fort Worth, Texas. Soils were sampled to 20 cm depth from underneath 16 paired Quercus stellata (post oak) trees and open lawns. Effects of vegetation cover, road density, and building age (a proxy for time since development) on soil C and N were analyzed. Soil OC concentrations were higher under post oak trees (5.5%) compared to open lawns (3.6%) at 0-10 cm, but not at 10-20 cm depth. In contrast, soil BC and TN did not differ by vegetation cover. There were significant interaction effects between vegetation cover and road density and vegetation cover and building age on soil BC. At 0-10 cm, soil BC concentrations, stock, and BC/SOC ratios increased more with road density under trees than lawns, indicating enhanced atmospheric BC deposition to tree canopies. Black carbon in tree soils also increased with building age as compared to lawn soils, likely due to higher BC retention under trees, enhanced BC losses under lawns, or both. Our findings show that urban tree soils are localized opportunity hotspots for BC storage in areas with elevated emissions and longer time since development. Conserving and planting urban trees above permeable surfaces and soils could contribute to long-term carbon storage in urban ecosystems.

Shower thoughts: why scientists should spend more time in the rain.

Stormwater is a vital resource and dynamic driver of terrestrial ecosystem processes. However, processes controlling interactions during and shortly after storms are often poorly seen and poorly sensed when direct observations are substituted with technological ones. We discuss how human observations complement technological ones and the benefits of scientists spending more time in the storm. Human observation can reveal ephemeral storm-related phenomena such as biogeochemical hot moments, organismal responses, and sedimentary processes that can then be explored in greater resolution using sensors and virtual experiments. Storm-related phenomena trigger lasting, oversized impacts on hydrologic and biogeochemical processes, organismal traits or functions, and ecosystem services at all scales. We provide examples of phenomena in forests, across disciplines and scales, that have been overlooked in past research to inspire mindful, holistic observation of ecosystems during storms. We conclude that technological observations alone are insufficient to trace the process complexity and unpredictability of fleeting biogeochemical or ecological events without the shower thoughts produced by scientists' human sensory and cognitive systems during storms.

Wet nitrogen (N) deposition to urban Latin America: filling in the gaps with GEOS-Chem.

In Latin America, atmospheric deposition is a major vector of nitrogen (N) input to urban systems. Yet, measurements of N deposition are sparse, precluding analysis of spatial patterns, temporal trends, and ecosystem impacts. Chemical transport models can be used to fill these gaps in the absence of dense measurements. Here, we evaluate the performance of a global 3-D chemical transport model in simulating spatial and interannual variation in wet inorganic N (NH4-N + NO3-N) deposition across urban areas in Latin America. Monthly wet and dry inorganic N deposition to Latin America were simulated for the period 2006-2010 using the GEOS-Chem Chemical Transport Model. Published estimates of observed wet or bulk inorganic N deposition measured between 2006-2010 were compiled for 16 urban areas and then compared with model output from GEOS-Chem. Observed mean annual inorganic N deposition to the urban study sites ranged from 5.7-14.2 kg ha-1 yr-1, with NH4-N comprising 48-90% of the total. Results show that simulated N deposition was highly correlated with observed N deposition across sites (R2 = 0.83, NMB = -50%). However, GEOS-Chem generally underestimated N deposition to urban areas in Latin America compared to observations. Underestimation due to bulk sampler dry deposition artifacts was considered and improved bias without improving correlation. In contrast to spatial variation, the model did not capture year-to-year variation well. Discrepancies between modeled and observed values exist, in part, because of uncertainties in Latin American N emissions inventories. Our findings indicate that even at coarse spatial resolution, GEOS-Chem can be used to simulate N deposition to urban Latin America, improving understanding of regional deposition patterns and potential ecological effects.

Influence of sharpening filters on the detection of root fractures using low-dose cone-beam computed tomography.

OBJECTIVES: To evaluate the influence of sharpening filters in the detection of root fractures using low-dose cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Eighty-four CBCT volumes acquired at three mA levels of 28 teeth inserted in the dental socket of dry human skull were selected from a previous study. The teeth were divided into four groups according to the presence and absence of root fracture and endodontic filling. Five radiologists evaluated all CBCT volumes for the presence of root fracture with and without the application of "Sharpen 1x" and "Sharpen 2x" filters in OnDemand3D software. Area under the ROC curve (AUC), sensitivity, specificity, and inter- and intra-observer concordance were calculated and compared (α = 0.05). RESULTS: Sharpening filters did not lead to significant differences in AUC, sensitivity, and specificity at the three mA levels tested (p > 0.05), regardless of the presence of endodontic filling (p > 0.05). However, the significant reduction of AUC observed in CBCT volumes at 4 mA without filter (p < 0.05) ceased to exist after the application of filters (p > 0.05). Sensitivity and specificity ranged from low and moderate. CONCLUSIONS: The use of sharpening filters can be recommended in CBCT volumes at 4 mA for root fracture detection for leading to the same performance as those at 6.3 and 10 mA. The presence of endodontic filling material did not influence the action of filters in the diagnosis of root fracture. CLINICAL RELEVANCE: Sharpening filters seem to contribute to the diagnosis of root fracture in CBCT volumes acquired with reduced radiation dose.

Bird feathers are potential biomonitors for airborne elemental carbon.

Birds can serve as effective biomonitors of air pollution, yet few studies have quantified external particulate matter accumulation on bird feathers. Biomonitoring of airborne elemental carbon (EC) is of critical significance because EC is a component of particulate matter with adverse effects on air quality and human health. To assess their effectiveness for use in EC monitoring, we compared EC accumulation on bird feathers at two sites that differed in vehicular traffic volume in an urban environment within the Dallas-Fort Worth Metropolitan Area, USA. Moulted flight feathers from domestic chickens were experimentally exposed to ambient EC pollution for 5 days in two urban microenvironments 1.5 km distant from each other that differed in traffic volume--adjacent to an interstate highway and a university campus bus stop. Feathers near the highway accumulated approximately eight times more EC (307 ± 34 µg m-2 day-1), on average, than feathers near the bus stop (40 ± 9 µg m-2 day-1). These findings indicate that EC accumulation on feathers varies over short distances within urban areas and that bird feathers potentially can be used for biomonitoring airborne EC.

Urban Trees Are Sinks for Soot: Elemental Carbon Accumulation by Two Widespread Oak Species.

Urban trees could represent important short- and long-term landscape sinks for elemental carbon (EC). Therefore, we quantified foliar EC accumulation by two widespread oak tree species-Quercus stellata (post oak) and Quercus virginiana (live oak)-as well as leaf litterfall EC flux to soil from April 2017 to March 2018 in the City of Denton, Texas, within the Dallas-Fort Worth metropolitan area. Post oak trees accumulated 1.9-fold more EC (299 ± 45 mg EC m-2 canopy yr-1) compared to live oak trees (160 ± 31 mg EC m-2 canopy yr-1). However, in the fall, these oak species converged in their EC accumulation rates, with ∼70% of annual accumulation occurring during fall and on leaf surfaces. The flux of EC to the ground via leaf litterfall mirrored leaf-fall patterns, with post oaks and live oaks delivering ∼60% of annual leaf litterfall EC in fall and early spring, respectively. We estimate that post oak and live oak trees in this urban ecosystem potentially accumulate 3.5 t EC yr-1, equivalent to ∼32% of annual vehicular EC emissions from the city. Thus, city trees are significant sinks for EC and represent potential avenues for climate and air quality mitigation in urban areas.

Patterns of failure following the excision of in-transit lesions in melanoma and the influence of excisional margins.

BACKGROUND AND OBJECTIVES: To describe the patterns of failure in patients with in-transit (IT) melanoma undergoing surgical excision. METHODS: A retrospective review of patients who underwent their first IT lesion(s) resection between May 2005 and September 2014. Cumulative incidence of local failure (new lesion within 2 cm of IT resection) was estimated. Associations between clinicopathologic characteristics, local failure, and any recurrence were analyzed. RESULTS: One hundred and thirty patients presented to our institution with IT disease over the study period and met the inclusion criteria. The 2-year cumulative incidence of local failure was 19.5%. Twenty-four patients developed disease within 2 cm of the resected IT disease; however, only eight were isolated local events. Cumulative incidence of local failure and of any disease differed with respect to less than 1 year disease-free interval (DFI) from primary melanoma to first IT event, and having greater than 1 IT lesion at presentation. Incidence of local failure was not found to differ with respect to gross margin greater than 5 mm, after adjusting for DFI and greater than 1 IT lesions. CONCLUSIONS: Patients with greater than 1 IT lesion and a DFI less than 1 year are at a higher risk of failure after surgical excision of a first IT event. Very few failures were isolated local disease within 2 cm of the IT resection scar, regardless of IT excision margin.

Neoadjuvant systemic therapy for regionally advanced melanoma.

BACKGROUND: Patients with regionally advanced melanoma are at high risk of distant failure and unlikely to be cured by surgery alone. Neoadjuvant therapy may provide benefit in these patients. OBJECTIVES: To evaluate our experience with neoadjuvant systemic therapy in high-risk stage III patients. METHODS: Retrospective review of patients with advanced stage III disease who received neoadjuvant therapy between August 2009 and August 2016 at Mayo Clinic Rochester. RESULTS: Twenty-three cases met our inclusion criteria, 16 with resectable disease and 7 with unresectable disease. No patients with resectable disease and one patient with borderline resectable disease progressed regionally, prohibiting surgical resection. Five of seven patients with unresectable disease were down-staged to a resectable state. Six of twenty-three (26%) had a CR and five are alive at last follow-up. Fifteen of twenty three patients (65%) progressed with a median progression free survival of 11 months; however, the 5 year overall survival estimate was 84%. CONCLUSIONS: Neoadjuvant systemic therapy is a reasonable approach for patients with advanced but resectable/borderline resectable disease and the risk of losing regional control is low. Our data also suggest some patients with unresectable disease will be converted to resectable and a complete clinical response to treatment can be obtained in approximately one quater of patients.

A Validated Nomogram to Predict Upstaging of Ductal Carcinoma in Situ to Invasive Disease.

BACKGROUND: Approximately 8-56% of patients with a core needle biopsy (CNB) diagnosis of ductal carcinoma in situ (DCIS) will be upstaged to invasive disease at the time of excision. Patients with invasive disease are recommended to undergo axillary nodal staging, most often requiring a second operation. We developed and validated a nomogram to preoperatively predict percentage of risk for upstaging to invasive cancer. METHODS: We reviewed 834 cases of DCIS on CNB between January 2004 and October 2014. Multivariable analysis was used to evaluate CNB and imaging factors to develop a nomogram to predict the risk of upstaging from DCIS to invasive cancer. This nomogram was validated with an external dataset of 579 similar patients between November 1998 and September 2016. An area under the receiver operating characteristic curve was constructed to evaluate nomogram discrimination. RESULTS: The rate of upstaging to invasive disease was 118/834 (14.1%). On multivariable analysis, grade on CNB and imaging factors, including mass lesion, multicentric disease, and largest linear dimension, were associated with upstage to invasive disease, and was used to develop a nomogram (c-statistic 0.71). In the external validation dataset, 62/579 (10.7%) patients were upstaged to invasive disease. Our nomogram was validated in this dataset with a c-statistic of 0.71. CONCLUSION: For patients with a CNB diagnosis of DCIS, our validated nomogram using DCIS grade on biopsy, and imaging factors of mass lesion, multicentric disease, and largest linear dimension, may be used for preoperative assessment of risk of upstaging to invasive disease, allowing patient counseling regarding axillary staging at the time of definitive surgery.

Identifying a subset of patients with DCIS who have a low likelihood of residual disease at surgical excision following a core needle biopsy.

BACKGROUND AND OBJECTIVES: Current randomized controlled trials are investigating the outcomes of non-surgical treatment for patients with ductal carcinoma in situ (DCIS). We sought to evaluate pre-operative factors associated with no residual disease at definitive resection following a core needle biopsy (CNB) diagnosis of DCIS. METHODS: Eight hundred and thirty-four operations for DCIS were performed at our institution between January 2004 and October 2014. We evaluated patient and biopsy tumor characteristics to determine pre-operative factors associated with no residual disease at surgical resection using uni- and multivariable analyses. RESULTS: Sixty-nine patients (8%) had no residual disease on final pathology. On multivariable analysis, low- or intermediate-grade lesions, <1 cm in size on mammography, and lesions where ≥90% of calcifications were removed correlated with finding no residual disease on final pathology, c-statistic 0.84. Of the 14 patients with all three low-risk factors, 36% had no residual disease on final pathology. CONCLUSIONS: Although our multivariable analysis performed well, its clinical utility would be limited as we were unable to identify a subset of patients with DCIS in whom the probability of finding no residual disease is low enough to consider routine use of non-surgical management.

Counterion accumulation effects on a suspension of DNA molecules: Equation of state and pressure-driven denaturation.

The study of the effects associated with the electrostatic properties of DNA is of fundamental importance to understand both its molecular properties at the single molecule level, like the rigidity of the chain, and its interaction with other charged bio-molecules, including other DNA molecules; such interactions are crucial to maintain the thermodynamic stability of the intra-cellular medium. In the present work, we combine the Poisson-Boltzmann mean-field theory with an irreversible thermodynamic approximation to analyze the effects of counterion accumulation inside DNA on both the denaturation profile of the chain and the equation of state of the suspension. To this end, we model the DNA molecule as a porous charged cylinder immersed in an aqueous solution. These thermo-electrostatic effects are explicitly studied in the particular case of some genes for which damage in their sequence is associated with diffuse large B-cell lymphoma.

A novel antagonist anti-cMet antibody with antitumor activities targeting both ligand-dependent and ligand-independent c-Met receptors.

c-Met is a prototypic member of a sub-family of RTKs. Inappropriate c-Met activation plays a crucial role in tumor formation, proliferation and metastasis. Using a key c-Met dimerization assay, a set of 12 murine whole IgG1 monoclonal antibodies was selected and a lead candidate, m224G11, was humanized by CDR-grafting and engineered to generate a divalent full antagonist humanized IgG1 antibody, hz224G11. Neither m224G11 nor hz224G11 bind to the murine c-Met receptor. Their antitumor activity was investigated in vitro in a set of experiments consistent with the reported pleiotropic effects mediated by c-Met and, in vivo, using several human tumor xenograft models. Both m224G11 and hz224G11 exhibited nanomolar affinities for the receptor and inhibited HGF binding, c-Met phosphorylation, and receptor dimerization in a similar fashion, resulting in a profound inhibition of all c-Met functions in vitro. These effects were presumably responsible for the inhibition of c-Met's major functions including cell proliferation, migration, invasion scattering, morphogenesis and angiogenesis. In addition to these in vitro properties, hz224G11 dramatically inhibits the growth of autocrine, partially autophosphorylated and c-Met amplified cell lines in vivo. Pharmacological studies performed on Hs746T gastric cancer xenografts demonstrate that hz224G11 strongly downregulates c-Met expression and phosphorylation. It also decreases the tumor mitotic index (Ki67) and induces apoptosis. Taken together, the in vitro and in vivo data suggest that hz224G11 is a promising candidate for the treatment of tumors. This antibody, now known as ABT-700 and currently in Phase I clinical trials, may provide a novel therapeutic approach to c-Met-expressing cancers.

Anti-c-Met monoclonal antibody ABT-700 breaks oncogene addiction in tumors with MET amplification.

BACKGROUND: c-Met is the receptor tyrosine kinase for hepatocyte growth factor (HGF) encoded by the MET proto-oncogene. Aberrant activation of c-Met resulting from MET amplification and c-Met overexpression is associated with poor clinical outcome in multiple malignancies underscoring the importance of c-Met signaling in cancer progression. Several c-Met inhibitors have advanced to the clinic; however, the development of inhibitory c-Met-directed therapeutic antibodies has been hampered by inherent agonistic activity. METHOD: We generated and tested a bivalent anti-c-Met monoclonal antibody ABT-700 in vitro for binding potency and antagonistic activity and in vivo for antitumor efficacy in human tumor xenografts. Human cancer cell lines and gastric cancer tissue microarrays were examined for MET amplification by fluorescence in situ hybridization (FISH). RESULTS: ABT-700 exhibits a distinctive ability to block both HGF-independent constitutive c-Met signaling and HGF-dependent activation of c-Met. Cancer cells addicted to the constitutively activated c-Met signaling driven by MET amplification undergo apoptosis upon exposure to ABT-700. ABT-700 induces tumor regression and tumor growth delay in preclinical tumor models of gastric and lung cancers harboring amplified MET. ABT-700 in combination with chemotherapeutics also shows additive antitumor effect. Amplification of MET in human cancer tissues can be identified by FISH. CONCLUSIONS: The preclinical attributes of ABT-700 in blocking c-Met signaling, inducing apoptosis and suppressing tumor growth in cancers with amplified MET provide rationale for examining its potential clinical utility for the treatment of cancers harboring MET amplification.

Isolated limb perfusion in Merkel cell carcinoma offers high rate of complete response and durable local-regional control: Systematic review and institutional experience.

INTRODUCTION: Hyperthermic isolated limb perfusion (HILP) has an established role in the management of melanoma, but its role for Merkel cell carcinoma (MCC) is less well defined. METHODS: Retrospective review of our institutional experience with HILP for MCC was conducted (2009-2015). Literature search was performed through 04/2015 and 10 studies met inclusion criteria. RESULTS: Four patients underwent HILP for MCC at our institution. There were no major complications and complete response was achieved in all patients. Early metastatic recurrence developed in two patients. The remaining two had no evidence of disease at last follow-up (36 months) or death (39 months). Systematic review identified an additional 12 pts that underwent HILP for MCC, for a total of 16 cases. Median age was 73 [IQR 69-78] years and 56% were men. Of the patients with reported follow-up, 12 (86%) had complete response, 1 had stable disease, and 1 partial response. Four patients developed local-regional recurrence and six distant metastases, all within 6 months. Overall median follow-up time was 15 [7-36] months. CONCLUSION: Among a highly selective group of patients, regional perfusion for MCC is safe and has a high complete response rate. HILP is an acceptable therapeutic modality for obtaining durable loco-regional control but early distant metastatic disease remains a significant cause of mortality. J. Surg. Oncol. 2016;114:187-192. © 2016 Wiley Periodicals, Inc.

Managing water services in tropical regions: From land cover proxies to hydrologic fluxes.

Watershed investment programs frequently use land cover as a proxy for water-based ecosystem services, an approach based on assumed relationships between land cover and hydrologic outcomes. Water flows are rarely quantified, and unanticipated results are common, suggesting land cover alone is not a reliable proxy for water services. We argue that managing key hydrologic fluxes at the site of intervention is more effective than promoting particular land-cover types. Moving beyond land cover proxies to a focus on hydrologic fluxes requires that programs (1) identify the specific water service of interest and associated hydrologic flux; (2) account for structural and ecological characteristics of the relevant land cover; and, (3) determine key mediators of the target hydrologic flux. Using examples from the tropics, we illustrate how this conceptual framework can clarify interventions with a higher probability of delivering desired water services than with land cover as a proxy.

Ciprofloxacin-resistant Aeromonas infection following leech therapy for digit replantation: report of 2 cases.

Medicinal leeches are commonly used after finger replantation to treat surgically unsalvageable venous congestion. Infection from Aeromonas hydrophila is a recognized complication of leech therapy that can be underestimated by the medical community. Ciprofloxacin and trimethoprim-sulfamethoxazole are the most commonly recommended prophylactic antibiotics used to prevent A. hydrophila infections during leech therapy. Here, we report 2 cases of ciprofloxacin-resistant Aeromonas infections, occurring within 4 months of each other. Both cases developed after leech therapy for unsuccessful digital replantation. These infections were successfully treated with ceftriaxone. Ciprofloxacin-resistant Aeromonas should be recognized when determining prophylactic antibiotic protocols for replant centers when leech therapy is used for finger replantation.

Black carbon in urban soils: land use and climate drive variation at the surface.

BACKGROUND: Black carbon (BC) encompasses a range of carbonaceous materials--including soot, char, and charcoal--derived from the incomplete combustion of fossil fuels and biomass. Urban soils can become enriched in BC due to proximity to these combustion sources. We conducted a literature review of BC in urban soils globally and found 26 studies reporting BC and total organic carbon (TOC) content collected to a maximum of 578 cm depth in urban soils across 35 cities and 10 countries. We recorded data on city, climate, and land use/land cover characteristics to examine drivers of BC content and contribution to TOC in soil. RESULTS: All studies were conducted in the northern hemisphere, with 68% of the data points collected in China and the United States. Surface samples (0-20 cm) accounted for 62% of samples in the dataset. Therefore, we focused our analysis on 0-10 cm and 10-20 cm depths. Urban soil BC content ranged from 0-124 mg/g (median = 3 mg/g) at 0-10 cm and from 0-53 mg/g (median = 2.8 mg/g) at 10-20 cm depth. The median proportional contribution of BC to TOC was 23% and 15% at 0-10 cm and 10-20 cm, respectively. Surface soils sampled in industrial land use and near roads had the highest BC contents and proportions, whereas samples from residential sites had among the lowest. Soil BC content decreased with mean annual soil temperature. CONCLUSIONS: Our review indicates that BC comprises a major fraction (nearly one quarter) of the TOC in urban surface soils, yet sampling bias towards the surface could hide the potential for BC storage at depth. Land use emerged as an importer driver of soil BC contents and proportions, whereas land cover effects remain uncertain. Warmer and wetter soils were found to have lower soil BC than cooler and drier soils, differences that likely reflect soil BC loss mechanisms. Additional research on urban soil BC at depth and from diverse climates is critical to better understand the role of cities in the global carbon cycle.

Prevalence of Chronic Pain by Immigration Status and Latino Ethnicity.

OBJECTIVE: The goal of this study was to evaluate the Latino paradox and healthy migrant hypotheses by estimating the association between the prevalence of chronic pain, immigration status, and Latino ethnicity. METHODS: This cross-sectional study analyzed pooled data from 85,395 adult participants of the 2019-2021 National Health Interview Survey. The dependent variables were any pain and chronic pain in the past 3 months. The independent variables were immigration status (US born, naturalized citizen, non-citizen) and Latino ethnicity. RESULTS: Chronic pain was prevalent for nearly a quarter of US born non-Latino adults (24%) and non-citizen non-Latino adults had the lowest prevalence at 8%. In multivariable adjusted models, US born non-Latino immigration status and ethnicity was associated with a higher probability of reporting chronic pain in the last 3 months compared to US born Latino adults (-3.0%; 95% CI = -4.4%, -1.6%), naturalized citizen non-Latino adults (-4.7%; 95% CI = -5.9%, -3.4%), naturalized citizen Latino adults (-6.7%; 95% CI = -8.5%, -4.9%), non-citizen non-Latino adults (-3.1%; 95% CI = -4.7%, -1.5%), and non-citizen Latino adults (-8.9%; 95% CI = -10.8%, -7.0%). CONCLUSION: US Born non-Latino adults reported the highest prevalence of chronic pain and non-citizen Latino adults reported the lowest prevalence of chronic pain providing support for the Latino paradox and healthy migrant effect hypotheses.

Diabetes current and future translatable therapies.

Diabetes is one of the major diseases and concerns of public health systems that affects over 200 million patients worldwide. It is estimated that 90% of these patients suffer from diabetes type 2, while 10% present diabetes type 1. This type of diabetes and certain types of diabetes type 2, are characterized by dysregulation of blood glycemic levels due to the total or partial depletion of insulin-secreting pancreatic ß-cells. Different approaches have been proposed for long-term treatment of insulin-dependent patients; amongst them, cell-based approaches have been the subject of basic and clinical research since they allow blood glucose level sensing and in situ insulin secretion. The current gold standard for insulin-dependent patients is on-demand exogenous insulin application; cell-based therapies aim to remove this burden from the patient and caregivers. In recent years, protocols to isolate and implant pancreatic islets from diseased donors have been developed and tested in clinical trials. Nevertheless, the shortage of donors, along with the need of immunosuppressive companion therapies, have pushed researchers to focus their attention and efforts to overcome these disadvantages and develop alternative strategies. This review discusses current tested clinical approaches and future potential alternatives for diabetes type 1, and some diabetes type 2, insulin-dependent patients. Additionally, advantages and disadvantages of these discussed methods.