Search Results (130)

This study presents and discusses evidence on the value of biomarker testing and precision medicine in Latin America through a health equity lens. It is essential to explore how to harness the benefits of precision medicine to narrow the health equity gap, ensuring all patients have access to the best cancer treatment. The methodology employed to develop this document consists of a non-systematic literature review, followed by a process of validation and feedback with a group of experts in relevant fields. Precision medicine could help reduce health inequities in Latin America by providing better diagnosis and treatment for everyone with cancer. However, its success in achieving this depends on the implementation of policies that promote equitable access. Findings indicate that the current policy landscape in the Latin American region is not conducive to improving access, reach, quality, or outcome-related problems in cancer care, nor to realizing the full potential of precision medicine. The study explores how precision medicine can advance health equity, concluding with an analysis of the challenges and recommendations for overcoming them. Full article

Introduction: Breakfast has emerged as a critical factor in preventing cardiovascular diseases, driven not only by its nutritional content but also by its alignment with circadian rhythms. However, gaps remain in the literature regarding its clinical impact and thematic evolution. Objective: To characterize the global scientific output on the relationship between breakfast quality and cardiovascular health through a systematic bibliometric analysis. Methodology: The PRISMA 2020 protocol was applied to select 1436 original articles indexed in Scopus and Web of Science (1957–2025). Bibliometric tools, including R (v4.4.2) and VOSviewer (v1.6.19) were used to map productivity, impact, collaboration networks, and emerging thematic areas. Results: Scientific output has grown exponentially since 2000. The most influential journals are the American Journal of Clinical Nutrition, Nutrients, and Diabetes Care. The United States, United Kingdom, and Japan lead in publication volume and citations, with increasing participation from Latin American countries. Thematic trends have shifted from traditional clinical markers to innovative approaches such as chrononutrition, digital health, and personalized nutrition. However, methodological gaps persist, including a predominance of observational studies and an underrepresentation of vulnerable populations. Conclusions: Breakfast is a dietary practice with profound implications for cardiometabolic health. This study provides a comprehensive overview of scientific literature, highlighting both advancements and challenges. Strengthening international collaboration networks, standardizing definitions of a healthy breakfast, and promoting evidence-based interventions in school, clinical, and community settings are recommended. Full article

This study examines the relationship between fear of failure, entrepreneurial passion, and entrepreneurial self-efficacy among university business students from four emerging Latin American economies: Mexico, Colombia, Peru, and Ecuador. This research addresses the need to understand the psychological factors that influence entrepreneurship, particularly in developing economies. Using non-probability convenience sampling, surveys were distributed between June 2021 and August 2022, and 961 valid responses were obtained. Scales from renowned researchers were used, which were translated and semantically validated in Spanish to measure the three variables. The data were analyzed using structural equation modeling with PLS. The overall results reveal that fear of failure negatively affects entrepreneurial passion, while entrepreneurial passion has a positive and significant relationship with entrepreneurial self-efficacy. Furthermore, entrepreneurial passion has a positive and significant relationship with fear of failure and entrepreneurial self-efficacy, with substantial differences between countries. Gender differences were also identified: in women, all relationships in the model were significant, while in men, the direct effect of fear of failure on entrepreneurial self-efficacy did not reach statistical significance. These findings contribute to the entrepreneurship literature by demonstrating that the relationship between these psychological variables varies by context (country) and gender, contradicting the notion of a universal effect. Full article

Background/Objectives: Congenital microcephaly is a clinical manifestation with a heterogeneous etiology, and its epidemiological surveillance relies on the systematic identification of cases and investigation of their underlying causes to inform preventive strategies and improve prognostic assessments. In Latin America, despite the existence of congenital anomaly reporting programs since 1967, the surveillance of microcephaly only gained substantial attention following the Zika virus (ZIKV) epidemic in 2015. Since then, efforts have predominantly concentrated on cases of infectious origin, often at the expense of recognizing endogenous etiologies, particularly those of genetic nature. This review aims to examine the role of genetic alterations in microcephaly pathogenesis and evaluates the limitations of current surveillance systems. Methods: A literature review centered on syndromic and non-syndromic genetic etiologies, alongside an analysis of Latin American surveillance frameworks (ECLAMC, RyVEMCE, ICBDSR, ReLAMC) was performed. Results: The findings reveal improved case detection and increased reported prevalence; however, the proportion of genetically attributed cases has remained stable. No systematic studies were found identifying the most common genetic causes; instead, genetic investigations were limited to isolated cases with a family history. Conclusions: While epidemiological surveillance systems in Latin America have advanced in the reporting of congenital microcephaly cases, substantial gaps remain in case ascertainment and etiological investigation, particularly concerning genetic contributions Full article

In recent years, the intense urbanisation processes in Latin American cities have generated fragmented landscapes in the transition zones between urban and rural areas. There is growing interest among urban planners in the delimitation and management of the urban fringe due to the challenges these areas face, including the accelerated conversion of agricultural land, the loss of biodiversity, ecosystem fragmentation, and increasing socioeconomic inequalities resulting from limited regulation in Latin American cities. This study aims to identify criteria for the delimitation of the urban fringe in Latin American cities, oriented toward policy development and the creation of new management tools. A three-stage mixed-method approach was used, i.e., (1) a structured literature review following the PRISMA protocol, identifying 58 criteria from Global South studies, grouped into seven thematic categories; (2) a qualitative analysis using the SMART methodology to identify feasible criteria; and (3) a survey of 19 Latin American experts to prioritise criteria based on data availability and spatial comparability in the region’s cities. The results reveal a growing concern regarding the conceptual development of the urban fringe in Latin America. Methodological gaps persist in the delimitation of these areas. The final catalogue of criteria shows a trend toward measurable and comparable criteria and highlights the need to approach the urban fringe from a multidimensional perspective, which could facilitate its integration into comparative studies at the regional scale. Full article

Background: Disparities in neuro-oncological care between high-income and low- and middle-income countries (LMICs) are well documented, yet region-specific data from Latin America remain limited. This review evaluates epidemiologic trends, access to care, and systemic challenges in brain tumor management across Latin American LMICs, using Argentina as a case study. Methods: A systematic review of peer-reviewed literature was conducted focusing on brain tumor incidence, mortality, risk factors, and availability of diagnostics and treatments in Latin America. Socioeconomic, cultural, and systemic barriers were also analyzed. Results: Latin America exhibits some of the highest global brain tumor mortality rates, with Brazil reporting age-standardized rates exceeding 4.5 per 100,000. Glioblastomas are frequently diagnosed at younger ages, often in the fifth decade of life, compared to the global average. Meningioma incidence has increased by 15–20% over the last decade, yet region-wide data remain fragmented. Access to neuroimaging, neurosurgery, radiotherapy, and chemotherapy is limited, with up to 60% of patients relying solely on under-resourced public health systems. Less than 30% of hospitals in rural areas have MRI availability, and continuous professional training is infrequent. Innovative adaptations, such as awake craniotomy, are used in some LMIC centers in response to equipment scarcity. Conclusions: Brain tumor care in Latin America is hindered by limited epidemiological data, restricted access to diagnostics and treatment, and insufficient workforce training. Targeted investments in healthcare infrastructure, international educational collaborations, and policy-level reforms are critical to reducing disparities and improving outcomes in neuro-oncology across the region. Full article

This study explores the use of Life Cycle Assessments (LCAs), Total Sustainability Assessment, and Life Cycle Sustainability Assessment (LCSA) as tools to evaluate the environmental, social, and economic impacts in Agri-industry. It highlights the unique trajectory of LCA and LCSA implementation in Latin America, shaped by the region’s distinct environmental, social, and economic contexts, contrasted with global research trends. Evidence shows the importance of biodiversity, conservation, and deforestation mitigation in Latin American LCA applications, which differ from the urban-focused impacts seen in regions like Europe or North America. Furthermore, it emphasizes the significant role of LCSA in addressing socio-economic challenges unique to Latin America, such as inequality and labor conditions. The research reveals the benefits of LCA and LCSA methodologies in the agro-industrial sector, particularly in addressing social issues like land use rights and rural community welfare. Despite challenges such as limited access to high-quality data and the need for capacity building, the innovative application of these methodologies in Latin America offers valuable insights for the global community. Our work relies on Latent Dirichlet Allocation (LDA) to analyze the LCSA literature from 1990 to 2024, identifying evolving trends and research focal areas in sustainability. The analysis herein presented highlights the need for a multi-dimensional and holistic approach to sustainability research and practice. Our findings also emphasize the importance of developing comprehensive models and integrated methodologies to effectively address complex sustainability challenges. Environmental information remains crucial for policy processes, acknowledging uncertainties in estimations and the connection between land use change, agriculture, and emissions from the global food economy and bioenergy sectors. The research underscores the dynamic nature of LCSA and the importance of continually reassessing sustainability efforts to address pressing challenges. Full article

This study identifies key drivers for ERP implementation in small- and medium-sized enterprises (SMEs) in Austro–Ecuador and examines their impact on operational efficiency, strategic adaptability, and digital transformation. Motivated by the limited empirical evidence on ERP adoption in Latin American SMEs, this research aims to provide Austro–Ecuadorian insights that contribute to innovation management practices in emerging economies. To identify the critical success factors (CSFs) influencing ERP implementation, a four-phase methodology was employed, encompassing a CSF literature review, data collection and case analysis from 55 SMEs, multiple correspondence analysis (MCA), and descriptive ERP analysis. Statistical analysis of the surveyed SMEs, primarily from manufacturing sectors, revealed that while a significant portion (37%) lacked ERP experience, 22.9% were in the process of implementing or actively using systems such as Oracle’s J.D. Edwards Enterprise One and SAP. The MCA highlighted ERP system configuration, vendor relationships, and user training as significant factors for successful ERP implementation, reported by 54.5% of the companies. Quadrant analysis further emphasized the influence of IT structure and legacy systems on implementation characteristics, with cluster analysis identifying three distinct groups of companies based on their ERP strategies. The findings underscore the importance of top management support, business process re-engineering, and external consultants for successful ERP adoption in SMEs, providing practical insights for optimizing innovation management in the digital era. Future research should investigate the long-term impacts of ERP systems on organizational performance and innovation sustainability. Full article

Advances in primary healthcare coverage for the improvement in health outcomes at the population level comprise a major goal of public policies of health, particularly considering increases in hospitalization costs linked to chronic diseases in recent decades. Previous evidence shows the positive effects of access to primary healthcare on hospitalization indicators in high-income countries; however, there is a lack of literature on the subject in Latin American countries. Thus, the present study proposes a quantitative investigation on connections between primary healthcare quality and effectiveness in relation to hospitalization indicators, in addition to the identification of its effects on inequalities in hospitalizations in Brazil. The study was based on an empirical analysis of data from five cross-sectional surveys representative at the population level conducted by the Brazilian Institute for Geography and Statistics (IBGE) in 1998, 2003, 2008, 2013, and 2019. Information on the demographic, socioeconomic, and health characteristics of individuals compatible across surveys were included in the analyses, in addition to data on household and survey characteristics. The statistical analyses were based on the estimation of logistic regression models for the exploration of effects of primary healthcare quality and effectiveness on hospitalizations, inpatient days, and perception of quality of hospital care. Furthermore, the estimation of concentration indexes and their disaggregation allowed to verify trends and determinants of inequalities in hospitalization indicators in Brazil throughout the period. The results indicate that primary healthcare effectiveness is associated with the lower occurrence and frequency of hospitalizations, and a lower length of stay in hospitals. Primary healthcare quality was associated with the perception of higher quality of hospital care. Trends in hospitalization indicators showed reduction in inequalities towards low-income individuals from 1998 to 2013, and primary healthcare quality presented minor influence on inequalities in hospitalizations, inpatient days, and perception of quality of hospital care. Full article

The COVID-19 pandemic imposed a substantial burden on healthcare systems worldwide, yet reliable data on COVID-19 morbidity, mortality, and healthcare costs in Latin America remain limited. This study explored the disease and economic burden of COVID-19 in Argentina, Brazil, Chile, Colombia, Mexico, and Peru during the pre-vaccination period. Using national databases and a systematic review of the literature, we analyzed data on adults aged 18 and older, reporting cases, death rates, years of life lost, excess mortality, and direct medical costs. Before vaccination programs began, the average COVID-19 incidence rate was 6741 per 100,000 adults. Of these, 91% were mild cases, 7% moderate/severe, and 2% critical. Among 2,201,816 hospitalizations, 27.8% required intensive care, and 17.5% required mechanical ventilation. Excess mortality ranged from 76 to 557 per 100,000, and years of life lost spanned 241,089 to 3,312,346. Direct medical costs ranged from USD 258 million to USD 10,437 million, representing 2–5% of national health expenditures. The findings highlight significant variability across countries and provide crucial insights to help policymakers to make informed decisions and allocate resources effectively to improve national strategies around surveillance, preventive and treatment strategies to control the spread of COVID-19 disease in the future. Full article

Background and Objectives: The pancreas receives blood through a complex network of multiple branches, primarily originating from the celiac trunk (CeT) and the superior mesenteric artery (SMA). This blood supply is structured into three main arterial groups, each serving different regions of the pancreas to effectively support its endocrine and exocrine functions. Materials and Methods: The databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and the Caribbean Literature in Health Sciences (LILACS) were searched until January 2025. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of sixteen studies met the established selection criteria in this study for meta-analysis. Pancreatic irrigation variants presented a prevalence of 11.2% (CI: 7–14%) and a heterogeneity of 88.2%. The other studies were analyzed by subgroups, showing statistically significant differences in the following subgroups: (1) sample type—a larger sample of images analyzed in the included studies (p = 0.312), which did not show statistically significant differences; (2) geographical region (p = 0.041), which showed a greater presence in the Asian population studied, and this was statistically significant; and (3) sex (male or female) (p = 0.12), where there were no statistically significant differences. Conclusions: The discovery of variations in pancreatic irrigation is common due to the numerous blood vessels involved in supplying this vital organ. Understanding different vascular patterns (such as those from the splenic and mesenteric arteries) is crucial for surgical interventions on the pancreas. For transplant patients, a thorough vascular analysis of both the donor and recipient is essential. Variations can impact blood flow and compatibility, potentially leading to transplant rejection if not addressed. To enhance outcomes, it is recommended to develop more accurate imaging tools for pre-surgical analysis, necessitating ongoing research in this area. Full article

The protozoan parasite Trypanosoma cruzi, causative agent of Chagas disease, affects millions of people in endemic Latin American countries and beyond. In Latin America, Chagas disease is an important cause of death and disability, for which vaccines are lacking and improved treatment options are required. Additionally, the factors governing the development of a variety of clinical manifestations during Chagas disease, ranging from complete lack of symptoms to severe irreversible chronic organ damage (mainly cardiac or digestive), remain largely unknown. Much remains to be learned regarding the biology of T. cruzi in order to enhance our understanding of these lines of inquiry. In this context, proteomic methods have been leveraged to investigate different parasite strains, life-cycle forms, subcellular compartments, macromolecular complexes, signaling events and secreted molecules. The factors driving morphological transformation during the life cycle, the composition and functions of the parasite’s organelles and secreted molecules as well as the determinants of pathogenicity have been explored via proteomic methods, yielding insights into the fundamental processes behind the parasite biology and informing drug design and vaccine development. Importantly, the correlation between the wide genetic and phenotypic variability displayed by T. cruzi has been examined through proteomic methods as well. Here, we review the literature on T. cruzi proteomics and discuss it in the light of its limitations and in the context of the parasite’s genetic diversity. Full article

This study explored how volunteer management is adapted to the specific context of a nonprofit organization (NPO). Through a participatory autoethnographic approach in Huellas Foundation, a Colombian NPO that supports its mission operation in volunteer action, it examined how management practices evolve and adjust according to the particular needs of the context. The analysis revealed two fundamental principles that emerge and guide volunteer management: self-realization and institutional recognition. It also identified four key components that shape the management process: the conversation between roles, profiles, times, and interests; the understanding of volunteering as a cultural reference; the balance between legal shielding and emotional construction; and the contribution of volunteer action to the social organization. The findings suggest that effective volunteer management requires continuous adaptation of practices according to the specific context, considering both the needs of the organization and the motivations of volunteers. This study contributes to the existing literature by providing empirical evidence on how the contingent approach to volunteer management manifests itself in a Latin American context and offers valuable insights for the adaptation of practices in different organizational contexts. Full article

The World Health Organization (WHO) defines vaccine hesitancy as reluctance or refusal to vaccinate despite availability. Contributing factors in visible minority populations include vaccine safety, effectiveness, mistrust, socioeconomic characteristics, vaccine development, information circulation, knowledge, perceived risk of COVID-19, and perceived benefit. Objectives: This study aimed to examine vaccine hesitancy in visible minority populations across Canadian regions. Methods: A survey was conducted among visible minority populations in Canadian regions, using 21 questions from the available literature via the Delphi method. The Canadian Hub for Applied and Social Research (CHASR) administered the survey to individuals 18 years or older who resided in Canada at the time of the survey and identified as visible minorities such as Asian, Black, and Latin American. After recruiting 511 participants, data analysis used Chi-square tests of association and 95% confidence intervals (CIs) to identify regional differences in vaccine choices, side effects, information sources, and reasons for vaccination. A weighted analysis extended the results to represent the visible minorities across provinces. Results: Higher rates of Pfizer were administered to participants in Ontario (73%), the Prairies (72%), British Columbia (71%), and Quebec (70%). British Columbia had the highest Moderna rate (59%). The most common side effect was pain at the injection site in Quebec (62%), Ontario (62%), BC (62%), and in the Atlantic (61%). Healthcare professionals and government sources were the most trusted information sources, with healthcare professionals trusted particularly in the Prairies (70%) and government sources similarly trusted in Quebec (65%) and Ontario (65%). In the Atlantic, 86% of refusals were due to side effects and 69% were due to prior negative vaccine experiences. Conclusions: Leveraging healthcare professionals’ trust, community engagement, and flexible policies can help policymakers improve pandemic preparedness and boost vaccine acceptance. Full article

Doce de leite is a caramel-like confection, mainly produced in several Latin American countries, with increasing popularity worldwide. This overview outlines nine distinct industrial technologies for the production of doce de leite: (1) total batch manufacturing process; (2) batch manufacturing system with fractionated mix addition; (3) manufacturing with pre-concentration in a vacuum evaporator and finishing in an open pan; (4) manufacturing with pre-concentration in a vacuum evaporator, finishing in an open pan, and lactose micro-crystallization; (5) continuous flow manufacturing with total concentration in a vacuum evaporator and a viscosity control holding tank (hot well); (6) manufacturing with total concentration in a vacuum evaporator and sterilization in an autoclave system; (7) manufacturing with sucrose pre-caramelization and a total batch system; (8) manufacturing in colloidal mill without an evaporation process; and (9) manufacturing based of doce de leite bars with a sucrose crystallization stage. We conducted a literature review to gather data on the discussed processes and their principal characteristics, which may be pertinent to doce de leite manufacturers. The choice of a specific process will depend on the desired doce de leite characteristics, the type of doce de leite to be produced, and the manufacturing company’s requirements. When properly integrated, these technologies contribute to efficient and profitable production, yielding high-quality products with appropriate chemical, microbiological, and sensory characteristics at an industrial scale. Full article