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Background Cervical cancer continues to show a high burden among young women worldwide, particularly in low- and middle-income countries. Limited data is available describing cervical cancer mortality among young women in Latin America and the Caribbean (LAC). The purpose of this study was to examine the mortality trends of cervical cancer among young women in LAC and predict mortality rates to 2030. Methods Deaths from cervical cancer were obtained from the World Health Organization mortality database. Age-standardized mortality rates per 100,000 women-years were estimated in women aged 20–44 years using the world standard population for 16 countries (and territories) in LAC from 1997 to 2017. We estimated the average mortality rates for the last 4 years (2014–2017). Joinpoint regression models were used to identify significant changes in mortality trends. Nordpred method was used for the prediction of the mortality rates to 2030. Results Between 2014 and 2017, Paraguay and Venezuela had the highest mortality rates of cervical cancer, whereas Puerto Rico had the lowest rates. Overall, most of the LAC countries showed downward trends of cervical cancer mortality over the entire period. Significant decreases were observed in Chile (Average annual percent change [AAPC]: − 2.4%), Colombia (AAPC: − 2.0%), Cuba (AAPC: − 3.6%), El Salvador (AAPC: − 3.1%), Mexico (AAPC: − 3.9%), Nicaragua (AAPC: − 1.7%), Panama (AAPC: − 1.7%), and Peru (AAPC: − 2.2%). In contrast, Brazil (AAPC: + 0.8%) and Paraguay (AAPC: + 3.7%) showed significant upward trends. By 2030, mortality rates are not predicted to further decrease in some LAC countries, including Argentina, Paraguay, and Venezuela. Conclusions Mortality trends of cervical cancer among young women have large variability in LAC countries. Cervical cancer screening programs have a high priority for the region. Primary and secondary prevention in the community are necessary to accelerate a reduction of cervical cancer mortality by 2030.

Complex ventral hernias are a surgical challenge associated with high morbidity and healthcare costs. Component separation techniques have improved throughout the years with better outcomes, although the optimal approach remains debated. Robotic surgery has shown promising outcomes as an alternative to open repair, although data in large multicenter studies is still limited. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Adult patients undergoing component separation for ventral hernia repair were identified using CPT and ICD codes. Outcomes included 30-day surgical, wound, medical, and overall complications, as well as length of stay and readmission. Multivariable logistic regression and propensity score matching were applied to adjust for baseline differences. A total of 6,207 patients were included, from those 4,443 (71.6%) underwent open technique and 1,764 (28.4%) robotic. After propensity matching (n = 5,259), robotic repair was independently associated with significantly lower overall complication rates (4.8% vs. 19.6%, aOR 0.193, 95% CI 0.140-0.265, p < 0.001), including wound (2.2% vs. 10.2%, aOR 0.164, p < 0.001), surgical (2.9% vs. 10.0%, aOR 0.271, p < 0.001), and medical complications (2.0% vs. 7.0%, aOR 0.229, p < 0.001). Robotic surgery was also associated with shorter length of stay (1.34 vs. 3.86 days, p < 0.001) and lower readmission rates (4.4% vs. 9.1%, p < 0.001). Robotic component separation for ventral hernia repair is associated with lower postoperative complication rates, shorter length of stay, and fewer readmissions compared to the open approach. These benefits remained significant after multivariate analysis and propensity score matching, supporting the robotic technique as an effective strategy. Prospective studies are warranted to evaluate long-term outcomes, including recurrence, and to assess cost-effectiveness to optimize evidence-based surgical decision-making.

Hypertension is the most prevalent cardiovascular condition and a leading contributor to premature mortality in Latin America and the Caribbean (LAC). Despite its public health relevance, few studies have examined long-term trends in hypertensive disease mortality across the region. The objective was to analyze trends in mortality due to hypertensive diseases from 1997 to 2020 in LAC countries, disaggregated by sex and type of hypertension, and to project mortality rates to 2035. We conducted an ecological time-series study using age-standardized mortality rates (ASMRs) extracted from the World Health Organization Mortality Database. Mortality from hypertensive diseases was defined by ICD-10 codes I10-I13 and further stratified into primary hypertension (I10) and hypertension-mediated organ damage (HMOD, I11-I13). Trends were assessed using Joinpoint regression to estimate average annual percent change (AAPC) and 95% confidence intervals (95%CI). Projections to 2035 were calculated using Norpred based on age - period - cohort analysis. Between 1997 and 2020, mortality from hypertensive diseases increased in most LAC countries. Among men, significant increases were observed in Brazil (AAPC: 2.6%), El Salvador (6.6%), and Panama (6.1%), while Trinidad and Tobago was the only country showing a significant decline (AAPC: -5.7%). Among women, the most marked increase was seen in El Salvador (7.6%). By 2035, the Dominican Republic, Venezuela, and Paraguay are projected to have the highest ASMRs for hypertensive diseases among men, while for women, the Dominican Republic and Venezuela will remain among the most affected. Mortality from primary hypertension represented the greatest burden across countries, while HMOD exhibited lower but variable rates. Hypertensive disease mortality is projected to rise in LAC, with notable disparities by sex, country, and type of hypertension. These findings underscore the urgent need for regionally tailored prevention, screening, and control strategies.

Few studies have evaluated the real-world outcomes of patients with medulloblastoma with contradictory results. Therefore, we aimed to compare the characteristics, survival outcomes, and prognostic factors between children and adults with medulloblastoma. We conducted a retrospective cohort study in a single academic center between 2000 and 2016. Patients were categorized into children and adolescents (≤19 years) and adults (>19 years). Overall survival (OS) and disease-free survival (DFS) were estimated with the Kaplan-Meier method. Prognostic factors were determined using Cox models. In total, 173 patients were included (79 adults and 94 children). No differences were observed in clinical characteristics according to age groups. At 5 years, DFS was 36.88% in children and 50.99% in adults (p = 0.476). Prognostic factors of DFS in adults were radiotherapy (adjusted Hazard ratio [aHR]: 0.22; 95% confidence interval [CI]: 0.07-0.67) and performance status 2-4 (aHR: 3.60; 95% CI: 1.48-8.77); while in children was radiotherapy (aHR: 0.33; 95% CI: 0.11-0.96) and chemotherapy (aHR: 0.34; 95% CI: 0.14-0.84). The 5-year OS rate was 64.25% in children and 60.87% in adults (p = 0.447). In adults, prognostic factors of OS were histologic type (aHR: 6.11, 95% CI: 1.19-31.48, for anaplastic) and radiotherapy (aHR: 0.22, 95% CI: 0.07-0.71), while in children and adolescents, lower performance status (aHR: 2.43, 95% CI: 1.09-5.39, for performance status 2-4) was the only prognostic factor. Subgroup analyses revealed a trend toward improved DFS and significantly better OS among adults who completed chemotherapy, highlighting the importance of treatment adherence. Both populations demonstrated similar survival rates that were comparable to or lower than those reported in previous studies. In adults, performance status and radiotherapy were prognostic factors for DFS, while histologic type and radiotherapy for OS. In children, chemotherapy and radiotherapy were prognostic factors for DFS, and performance status was the only OS prognostic factor. These findings underscore the importance of optimizing treatment adherence and completing standard therapies, as well as improving staging practices, to enhance outcomes in real-world settings.

Background Cervical cancer is the third leading cause of cancer-related death among Latin American women. Peru has the sixth highest mortality rate for cervical cancer in the region with regional variations. We aimed to determine overall and regional cervical cancer mortality rates and trends in Peru between 2008 and 2017. Methods We performed an ecological study on the number of deaths by cervical cancer in Peru. Deaths were extracted from the Peruvian Ministry of Health mortality database. Age-standardized mortality rates (ASMR) were estimated per 100,000 women-years using the world standard Segi population. We computed mortality trends using the Joinpoint regression program, estimating the annual percent change (APC). For spatial analysis, GeoDA software was used. Results Peru showed downward trends in the last decade (from 11.62 in 2008 to 9.69 in 2017 (APC = − 2.2, 95% CI: − 4.3, − 0.1, p  < 0.05). According to regional-specific analysis, the highest ASMR was in the rainforest region, although this declined from 34.16 in 2008 to 17.98 in 2017 (APC = − 4.3, 95% CI: − 7.2, − 1.3, p  < 0.01). Concerning spatial analysis and clustering, the mortality rates from 2008 to 2017 showed a positive spatial autocorrelation and significant clustering (Moran’s I: 0.35, p  < 0.001) predominantly in the neighboring North-East departments (Loreto, Ucayali, and San Martin). Conclusions Although mortality trends in the entire population are decreasing, mortality rates remain very high, mainly in the rainforest region. Our results encourage a need for further development and improvement of the current health care delivery system in Peru.

The aim of this study was to determine the utility of the neutrophil-to-lymphocyte ratio (NLR) as a biomarker for predicting early-mortality (<2 years) among females with metastatic triple-negative breast cancer (mTNBC). We reviewed 118 medical records of females with mTNBC. The cut-off value for the NLR (<2.5 and ≥2.5) was determined with receiver operating characteristic curves (area under the curve: 0.73; 95% CI: 0.62-0.85). Survival curves were estimated using the Kaplan-Meier method and compared with the Log-rank test. Multivariate Cox regression was used to identify the risk of mortality at two years. Moreover, we performed sensitivity analyses with different cut-off values and a subgroup analysis in females that only received chemotherapy. The median follow-up was 24 months. Females with NLR ≥2.5 had a poor overall survival compared to females with NLR <2.5 (6% vs. 28%, p<0.001) at two years. This outcome remained when we stratified for females that only received chemotherapy (8% vs. 36%, p = 0.001). Multivariate analyses identified NLR ≥2.5 as a poor prognostic risk factor for mortality in the entire population (HR: 2.12, 95% CI: 1.32-3.39) and among females that received chemotherapy (HR: 2.68, 95% CI: 1.46-4.92). The NLR is an accessible and reliable biomarker that predicts early mortality among females with mTNBC. Our results suggest that females with high NLR values have poor prognosis despite receiving standard chemotherapy. Health providers should evaluate the possibility to enroll these patients in novel immunotherapy trials.

Background Childhood obesity is emerging as a major public health problem worldwide. To date, most studies of obesity and overweight in Peru are focused on adults, with few of them involving children, a population at a critical stage of development. The trend in overweight and obesity prevalence in Peruvian children under the age of five has not yet been determined. Thus, the objective of the present study is to evaluate the prevalence rates of overweight and obesity between 2010 and 2015 in children under the age of five, stratified by geographical areas in Peru. Methods Data were obtained from the Nutritional Status Information System of Peru. The total number of children evaluated was 14,155,914. For the Geographic Information Systems (GIS), the program Geo Da 1.8® was used to ascertain the spatial distribution of prevalence rates and was mapped for children under five. To assess the degree of spatial dependence, exploratory spatial data analysis was performed using the Moran’s I statistic and was assessed with the Local Indicators of Spatial Association (LISA) analysis to identify geographic concentrations of high and low of obesity and overweight levels. Results Between 2010 and 2015, the national prevalence of childhood overweight and obesity ranged from 6.2%- 6.8% and 1.5%–2.7%, respectively. The highest prevalence of childhood overweight and obesity was found in 2014 and 2013, respectively. During these years, we observed that obesity decreased, but overweight remained stable. The highest prevalence of overweight and obesity was found in the departments located on the coast. Significant positive spatial autocorrelation was found for both overweight and obesity. The departments with the highest prevalence of overweight and obesity were concentrated in Lima, Callao, Ica, Moquegua and Tacna. The lowest were found in Loreto, Cusco and San Martin. Conclusion The decrease in obesity and the stabilisation of overweight are positive results for the Peruvian childhood. However, in comparison with other Latin American countries, Peru still lags in obesity prevention.

Since multi-view learning leverages complementary information from multiple feature sets to improve model performance, a tensor-based data fusion layer for neural networks, called Multi-View Data Tensor Fusion (MV-DTF), is used. It fuses M feature spaces X1,⋯,XM, referred to as views, in a new latent tensor space, S, of order P and dimension J1×⋯×JP, defined in the space of affine mappings composed of a multilinear map T:X1×⋯×XM→S—represented as the Einstein product between a (P+M)-order tensor A anda rank-one tensor, X=x(1)⊗⋯⊗x(M), where x(m)∈Xm is the m-th view—and a translation. Unfortunately, as the number of views increases, the number of parameters that determine the MV-DTF layer grows exponentially, and consequently, so does its computational complexity. To address this issue, we enforce low-rank constraints on certain subtensors of tensor A using canonical polyadic decomposition, from which M other tensors U(1),⋯,U(M), called here Hadamard factor tensors, are obtained. We found that the Einstein product A⊛MX can be approximated using a sum of R Hadamard products of M Einstein products encoded as U(m)⊛1x(m), where R is related to the decomposition rank of subtensors of A. For this relationship, the lower the rank values, the more computationally efficient the approximation. To the best of our knowledge, this relationship has not previously been reported in the literature. As a case study, we present a multitask model of vehicle traffic surveillance for occlusion detection and vehicle-size classification tasks, with a low-rank MV-DTF layer, achieving up to 92.81% and 95.10% in the normalized weighted Matthews correlation coefficient metric in individual tasks, representing a significant 6% and 7% improvement compared to the single-task single-view models.

Black–Latina/o and White–Latina/o bachelor's degree gaps persist in the United States despite substantial increases in Latina/o educational attainment since the late 1950s. The Latina/o population has grown rapidly in recent decades and currently comprises more than 20% of the U.S. population; however, barriers to citizenship have grown in tandem and have limited access to higher education. Using data from the U.S. Census (1950–2010) and the American Community Survey (2015–2017), we examine trends in Black–Latina/o and White–Latina/o college completion gaps and factors that may explain them. We find that college enrollment differences explain the majority of the bachelor's degree gaps. We then decompose enrollment gaps by differences in enrollment by citizenship and find that if the Latina/o population had the same citizenship rate as the White and Black populations, the Black–Latina/o enrollment gaps would effectively disappear and the White–Latina/o enrollment gaps would be reduced by up to 75%. Our findings indicate that the Latina/o population's relatively low college completion rates are partially explained by restricted access to citizenship. The high proportion of Latina/o noncitizens has also masked the considerable educational progress Latina/o citizens have made in recent decades.

Targeted metabolomics has been widely used in pheromone research but may miss pheromone components in study organisms that produce pheromones in trace amount and/or lack bio-detectors (e.g., antennae) to readily locate them in complex samples. Here, we used non -targeted metabolomics—together with high-performance liquid chromatography–mass spectrometry (HPLC–MS), gas chromatography-MS, and behavioral bioassays—to unravel the sex pheromone of the triangulate cobweb spider, Steatoda triangulosa . A ternary blend of three contact pheromone components [ N -4-methylvaleroyl- O -isobutyroyl- l -serine ( 5 ), N -3-methylbutyryl- O -isobutyroyl- l -serine ( 11 ), and N -3-methylbutyryl- O -butyroyl- l -serine ( 12 )] elicited courtship by S. triangulosa males as effectively as female web extract. Hydrolysis of 5 , 11 and 12 at the ester bond gave rise to two mate-attractant pheromone components [butyric acid ( 7 ) and isobutyric acid ( 8 )] which attracted S. triangulosa males as effectively as female webs. Pheromone components 11 and 12 are reported in spiders for the first time, and were discovered only through the use of non -targeted metabolomics and GC–MS. All compounds resemble pheromone components previously identified in widow spiders. Our study provides impetus to apply non -targeted metabolomics for pheromone research in a wide range of animal taxa.