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Ovarian cancer (OC) represents a serious health problem worldwide. In Mexico, most OC patients are detected at late stages, consequently making OC one of the leading causes of death in women after reaching puberty. Personalized medicine (PM) provides an individualized therapeutic opportunity for treating each patient relying on “omic” tools to match the correct drug with the specific pathogenic genomic signature. PM can help predict the best therapeutic option for each affected woman suffering from OC. In recent years, Mexico has made contributions to the PM of OC; however, it still has a long way to go for its full implementation in the country’s health system. World J Oncol. 2021;12(4):85-92 doi: https://doi.org/10.14740/wjon1383

Objective: To investigate factors associated with cognitive impairment (CI) in institutionalized Mexican older adults. Material and methods: Cross-sectional study of residents of three long-term care facilities in the metropolitan area of Monterrey, Mexico. A medical history, Mini-Mental State Examination (MMSE), Barthel index, geriatric depression scale, and a nutritional screening were performed. CI was defined as MMSE ≤24. Results: Of 280 octogenarian residents (72.1% females) 61.1 % had a MMSE ≤24. Older age (OR=1.047), functional dependence (OR=10.309), malnutrition (OR=2.202), urinary incontinence (OR=2.588), and history of fracture (OR=1.764) were directly associated to CI. While higher education level (OR=0.583) and the use of antihypertensives (OR=0.521), antihistamines (OR=0.322), antiprostatic hypertrophy (OR=0.219), and lipid-lowering drugs (OR=0.575) were inversely associated. Conclusions: The evaluation of cognitive performance and its associated factors is essential for institutionalized patients in order to implement a management program aimed at reducing the progression of CI and its possible complications.

Artificial lake expansion and high mercury loading synergistically increase mercury contamination risk from gold mining., Artisanal and small-scale gold mining (ASGM) is the largest global source of anthropogenic mercury emissions. However, little is known about how effectively mercury released from ASGM is converted into the bioavailable form of methylmercury in ASGM-altered landscapes. Through examination of ASGM-impacted river basins in Peru, we show that lake area in heavily mined watersheds has increased by 670% between 1985 and 2018 and that lakes in this area convert mercury into methylmercury at net rates five to seven times greater than rivers. These results suggest that synergistic increases in lake area and mercury loading associated with ASGM are substantially increasing exposure risk for people and wildlife. Similarly, marked increases in lake area in other ASGM hot spots suggest that “hydroscape” (hydrological landscape) alteration is an important and previously unrecognized component of mercury risk from ASGM.

Introduction Human Mesenchymal Stem Cells (hMSCs) are multipotent stem cells capable of renewing themselves and differentiation in vitro into different kinds of tissues. In vivo hMSCs are sources of trophic factors modulating the immune system and inducing intrinsic stem cells to repair damaged tissues. Currently, there are multiple clinical trials (CT) using hMSCs for therapeutic purposes in a large number of clinical settings. Material and Methods The search strategy on clinicaltrials.gov has focused on the key term “Mesenchymal Stem Cells”, and the inclusion and exclusion criteria were separated into two stages. Stage 1, CT on phases 1–4: location, the field of application, phase, and status. For stage 2, CT that have published outcome results: field of application, treatment, intervention model, source, preparation methods, and results. Results By July 2020, there were a total of 1,138 registered CT. Most studies belong to either phase 2 (61.0%) or phase 1 (30.8%); most of them focused in the fields of traumatology, neurology, cardiology, and immunology. Only 18 clinical trials had published results: the most common source of isolation was bone marrow; the treatment varied from 1–200 M hMSCs; all of them have similar preparation methods; all of them have positive results with no serious adverse effects. Conclusions There appears to be a broad potential for the clinical use of hMSCs with no reported serious adverse events. There are many trials in progress, their future results will help to explore the therapeutic potential of these promising cellular sources of medicinal signals.

Chronic liver diseases account for a considerable toll of incapacities, suffering, deaths, and resources of the nation's health systems. They can be prevented, treated or even cured when the diagnosis is made on time. Traditional liver biopsy remains the gold standard to diagnose liver diseases, but it has several limitations. Liquid biopsy is emerging as a superior alternative to surgical biopsy given that it surpasses the limitations: it is more convenient, readily and repeatedly accessible, safe, cheap, and provides a more detailed molecular and cellular representation of the individual patient's disease. Progress in understanding the molecular and cellular bases of diseased tissues and organs that normally release cells and cellular components into the bloodstream is catapulting liquid biopsy as a source of biomarkers for diagnosis, prognosis, and prediction of therapeutic response, thus supporting the realization of the promises of precision medicine. The review aims to summarize the evidence of the usefulness of liquid biopsy in liver diseases, including the presence of different biomarkers as circulating epithelial cells, cell-free nucleic acids, specific species of DNA and RNA, and the content of extracellular vesicles.

Gold shops in artisanal and small-scale gold mining communities represent major point sources of airborne mercury pollution. Concentrations of elemental mercury (Hg0) emitted by these shops can be determined using a portable atomic absorbance spectrometer (AAS) with Zeeman correction. These measured Hg0 concentrations can then be correlated to position as determined by a hand-held GPS unit, and the resulting data mapped using a Geographic Information System (GIS). A detailed method for obtaining and analyzing data collected near gold shops in Mazuko, Peru is provided. Maps generated using this method were employed to identify point sources of Hg0 contamination originating from gold shops in ASGM communities and were shared with local city managers to assist in urban planning.•A detailed method is provided to collect and process data, ultimately generating a map that allows for the screening of a community to identify point sources of Hg0 contamination.•Raw data is provided, as well as a video detailing data processing and mapping using a common spreadsheet program and an open-source GIS.•The generated map can be used for determining areas where people may be exposed to elevated Hg0 concentrations and/or occupational mercury vapor exposure, targeted enforcement, or outreach to limit Hg0 pollution., Graphical abstract Image, graphical abstract

Recent studies from the Madre de Dios region of Peru report elevated mercury exposure among the general population. Our objective was to assess mercury exposure, risk factors, risk perceptions, and knowledge among women of childbearing age, a population of concern due to risks to infant and fetal health. We collected hair samples and administered a survey among 200 women aged 18-49 years residing in Madre de Dios. Hair total mercury (THg) concentrations were analyzed in accordance with EPA Method 7473. Associations between exposures and potential risk factors were analyzed using generalized linear mixed models. Geometric mean hair THg concentration (±standard deviation) for all participants was 1.62 ± 2.54 μg/g (range: 0.01-30.12 μg/g), and 67 participants (33.5%) had concentrations above the 2.2 μg/g reference dose established by the World Health Organization (WHO). Higher exposure was significantly associated with higher fish consumption (p = 0.03) and less mercury knowledge (p 0.0001), but not with age or educational attainment. Most participants (86.2%) expressed concern about mercury contamination, but few (26.2%) had knowledge of the health risks associated with exposure. Many residents consumed fish species previously found to have low mercury concentrations, but more than 25% of participants reported consuming fish species with high mercury concentrations. We did not observe cross-sectional differences in fish intake among women who were pregnant or breastfeeding at the time of data collection.

Gold mining is the largest source of mercury (Hg) pollution worldwide. The discharge of mercury in the environment bears direct human health risks and is likely to increase cascading effects throughout local food chains. In the Peruvian Amazon the mining process consists of slashing and burning trees, followed by extraction of gold-bearing sediment, amalgamation with Hg and gold recovery, leading each year to the degradation of 6,000-10,000 ha and the release of 180 metric tons of Hg per year to the enviroment. The purpose of this study was to determine soil Hg levels in soils of abandoned alluvial gold mine spoils and undisturbed forest in the Madre de Dios region, the epicenter of alluvial gold mining in Peru. We selected gold mine spoils of the two most important technologies locally applied for gold extraction, i.e., Minimally Mechanized Mining (MMM) and Highly Mechanized Mining (HMM), in the native communities of Laberinto and Kotzimba, respectively. We collected 127 and 35 soil samples (0-20cm depth) from potentially contaminated sites and undisturbed forest, respectively. Physicochemical analysis and determination of Hg levels were determined for all soil samples. None of the samples had Hg concentrations above Peruvian, Canadian and British Environmental Quality Standards for Agricultural Soil (6.6mg/kg). Hg levels in MMM and HMM were not significantly different between the two areas. The main variables explaining variation of soil Hg concentrations were the vegetation cover, soil organic matter, soil pH and clay particle content, which explained up to 80% of data set variation. Surprisingly, highest Hg concentrations were found in untouched old-growth forest bordering the mine spoils, but there was also a trend of increasing Hg concentrations with the regenerating vegetation. Our findings suggest that Hg concentrations in old mine spoils are low and shouldn’t stand in the way of efforts to restore soil conditions and develop sustainable land uses. However, it is urgent to end the use of Hg in mining operation to decrease human and environmental risks.

Artisanal gold mining in Amazon forests and rivers has been reported in all Amazonian countries. Amazon mining has a wide range of negative effects and severe environmental and social consequences. Given that the activity in the region is mostly illegal, there are few studies published in the scientific literature on recovery of areas degraded by gold mining. This study conducts an experimental reforestation project aimed to evaluate soil degradation and explore the seedling survivorship and early growth of 51 tropical tree species in gold mined areas at 5 study sites distributed across the Madre de Dios region, in the Peruvian Amazon. The study evaluates the effect of biochar amendments on the survivorship and growth of 51 tropical species. The study also analyzes the influence of species wood density on seedling performance one year after planting. In order to inform further restoration plantation strategies, species were chosen with the end goals of timber production, biodiversity enhancement, and soil restoration. Site degradation, soil properties and mercury levels were analyzed in degraded areas and paired reference forest patches. Soils after gold mining are found to be highly degraded, with soil C being nearly absent, cation content greatly decreased, and loss of fine sediment. Soil mercury levels were found below national and international environmental quality standards. A positive correlation and a statistically significant relationship were found between survivorship and wood density. This reveals that the higher the wood density of the species, the higher the survival percentage. Growth and overall performance of mid, and especially low wood density species were significantly increased by biochar additions, while no effect was recorded on high wood density species growth. The study provides guidance on the post-ASGM restoration potential for 51 common and useful tree species and gives practitioners recommendations for combinations of species and fertilization treatments to optimize restoration designs.

While deforestation rates decline globally they are rising in the Western Amazon. Artisanal-scale gold mining (ASGM) is a large cause of this deforestation and brings with it extensive environmental, social, governance, and public health impacts, including large carbon emissions and mercury pollution. Underlying ASGM is a broad network of factors that influence its growth, distribution, and practices such as poverty, flows of legal and illegal capital, conflicting governance, and global economic trends. Despite its central role in land use and land cover change in the Western Amazon and the severity of its social and environmental impacts, it is relatively poorly studied. While ASGM in Southeastern Peru has been quantified previously, doing so is difficult due to the heterogeneous nature of the resulting landscape. Using a novel approach to classify mining that relies on a fusion of CLASlite and the Global Forest Change dataset, two Landsat-based deforestation detection tools, we sought to quantify ASGM-caused deforestation in the period 1984–2017 in the southern Peruvian Amazon and examine trends in the geography, methods, and impacts of ASGM across that time. We identify nearly 100,000 ha of deforestation due to ASGM in the 34-year study period, an increase of 21% compared to previous estimates. Further, we find that 10% of that deforestation occurred in 2017, the highest annual amount of deforestation in the study period, with 53% occurring since 2011. Finally, we demonstrate that not all mining is created equal by examining key patterns and changes in ASGM activity and techniques through time and space. We discuss their connections with, and impacts on, socio-economic factors, such as land tenure, infrastructure, international markets, governance efforts, and social and environmental impacts.

Objective To describe the characteristics of children less than three years of age with medically intractable epilepsy, who underwent Vagus Nerve Stimulator (VNS) therapy at Children's Hospital of Pittsburgh between 2004 and 2011. Methods: Retrospective chart review. Results: Seventeen patients were identified; adequate follow-up was available for 15. Median follow up duration was 4.3 years (1.4–10.2 years). 12/15 (80%) had a known etiology for their epilepsy. All patients had more than 1 seizure per week prior to VNS and a history of status epilepticus was frequent (40%, 6/15). Five patients (33%) reported improved seizure frequency at one year after VNS. A normal MRI was associated with seizure improvement ( p =0.007). No patient had status epilepticus after VNS at one-year follow-up. At three years after VNS, four patients had experienced status epilepticus with only one patient experiencing multiple episodes. Complications were seen in 2/15 (13%) patients and in 2/21 (9.5%) procedures. Significance: A normal MRI was associated with seizure improvement at one year in children less than three years of age at the time of VNS implant. The degree of overall seizure reduction was modest, but the frequency of status epilepticus was decreased after VNS implant. VNS was tolerated well in this age group.