Lancet Regional Health-Americas最新文献

{"title":"Inequalities in paediatric hospitalisations for costly and prevalent conditions in Ontario, Canada: a population-based cohort study","authors":"Peter J. Gill ,&nbsp;Thaksha Thavam ,&nbsp;Jingqin Zhu ,&nbsp;Cornelia M. Borkhoff ,&nbsp;Patricia C. Parkin ,&nbsp;Eyal Cohen ,&nbsp;Teresa To ,&nbsp;Sanjay Mahant","doi":"10.1016/j.lana.2025.101056","DOIUrl":"10.1016/j.lana.2025.101056","url":null,"abstract":"<div><h3>Background</h3><div>Identifying inequalities is important for informing research, and policy efforts to reduce health disparities. This study measured the inequalities in hospitalisations for the costly and prevalent conditions in hospitalised children using association estimates.</div></div><div><h3>Methods</h3><div>Population-based cohort study using health administrative databases in Ontario, Canada between 2014 and 2019. The hospitalisation rate was determined for the costly and prevalent conditions in children. Hospitalisation inequalities by four equity stratifiers (material resources, rurality, sex, and immigrant status) were quantified using rate difference (RD), rate ratio (RR), and ratio of excess to total hospitalisation rate. Multivariable logistic regression analyses were also conducted.</div></div><div><h3>Findings</h3><div>In a population of 3·7 million children (median age 7·0 years, Interquartile range: 1·0–12·0), there were 612,597 hospitalisations. Large inequalities comparing children among least versus most resourced quintile was observed in low birth weight (RD: 1,823·3 hospitalisations per 100,000 children, 95% CI: 1,662·7, 1,983·9). Conditions with large inequalities comparing rural versus urban areas included low birth weight (RD: −1,833·2 hospitalisations per 100,000, 95% CI: −2,012·8, −1,653·6); and drug withdrawal syndrome in newborn (RR: 1·9, 95% CI: 1·7, 2·1; adjusted odds ratio (aOR): 1·4, 95% CI: 1·2, 1·5). Conditions with large inequalities comparing males versus females included low birth weight (RD: −888·3 hospitalisations per 100,000, 95% CI: −992·5, −784·02); and anorexia nervosa (RR: 0·08, 95% CI: 0·07, 0·10; aOR: 0·1, 95% CI: 0.1, 0.1). Conditions with large inequalities comparing non-refugee immigrants versus non-immigrants included major depressive disorder (RR: 2·8, 95% CI: 2·7, 2·9), and comparing refugees versus non-immigrants included drug withdrawal syndrome in newborn (RR: 0·09, 95% CI: 0·05, 0·15). Results from multivariable analyses were similar.</div></div><div><h3>Interpretation</h3><div>Newborn and mental health conditions had the largest inequalities in hospitalisations by the equity stratifiers. Findings from this study can be used to prioritise future health equity research to reduce health inequalities.</div></div><div><h3>Funding</h3><div><span>PSI Foundation</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101056"},"PeriodicalIF":7.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, prevalence, and mortality of localized scleroderma in Quebec, Canada: a population-based study","authors":"Stephanie Ghazal ,&nbsp;Anastasiya Muntyanu ,&nbsp;Katherine Aw ,&nbsp;Mohammed Kaouache ,&nbsp;Lauren Khoury ,&nbsp;Maryam Piram ,&nbsp;Catherine McCuaig ,&nbsp;Gaëlle Chédeville ,&nbsp;Elham Rahme ,&nbsp;Mohammed Osman ,&nbsp;Jordana Schachter ,&nbsp;Janie Bertrand ,&nbsp;Elena Netchiporouk","doi":"10.1016/j.lana.2025.101044","DOIUrl":"10.1016/j.lana.2025.101044","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Localized scleroderma is an understudied autoimmune disease characterized by fibrosis of the skin and/or subcutaneous tissue. To date, only 6 articles reported on the incidence and/or prevalence estimates globally, with significant design limitations and risk of bias. None of the studies originated from Canada or investigated mortality/geospatial epidemiology. We aimed to study the incidence, prevalence, mortality and spatiotemporal trends of localized scleroderma in Quebec, Canada, stratified by sex and age.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Quebec populational health administrative databases were used to identify localized scleroderma cases from 1989 to 2019. Crude incidence rate, age-standardized incidence rate, prevalence and mortality analyses were conducted using negative binomial random walk models. Spatial analyses were conducted using a Poisson Besag-York-Mollié regression model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;There were 6063 incident localized scleroderma cases identified over the total period of the study (mean age 53.0, standard deviation [SD] 20.2 years at diagnosis). The overall age and sex-standardized incidence rate was 3.25/100,000 person-years [95% Confidence Interval (CI) 3.17–3.33]. Among 6063 incident cases, 4510 (74.4%) were female and 1553 (25.6%) were male, yielding a female-to-male ratio of approximately 3:1. In females, we noted an initial increase in age-standardized incidence rate followed by a plateau and a decrease after 2013 (average annual percent change −2.0 [95% CI −3.7 to −0.2]%). In males, a steady decrease in age-standardized incidence rate was observed (average annual percent change −3.3 [95% CI −5.0 to −1.8]%). The highest incidence rate was observed in the 60–79 year-old age group for females and the 80+ group for males. Age-standardized incidence rate varied geographically with hotspots identified in the south of Quebec. The average prevalence was 24.5/100,000 [95% CI 24.3–24.8]. The overall standardized mortality ratio was comparable for females (1.04 [95% CI 0.95–1.14]) and males (1.14 [95% CI 0.98–1.33]) and decreased steadily over time for both sexes (from 1.31 [95% CI 1.06–1.58] in 1996 to 0.81 [95% CI 0.66–0.98] in 2019). Standardized mortality ratio analysis revealed excess death only in females aged 40–59 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;From 1989 onward, we report an initial increase in the age and sex-standardized incidence rate of localized scleroderma in Quebec followed by a recent decrease after 2013, as well as a generally increasing prevalence from 1996 to 2019. Standardized mortality ratio analysis confirmed the clinical observation that localized scleroderma is a morbid rather than life-threatening disease. We demonstrate an uneven geographic distribution of localized scleroderma incidence in Quebec.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This project was funded by &lt;span&gt;Canadian Dermatology Foundation&lt;/span&gt;, &lt;span&gt;National Scleroderm","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101044"},"PeriodicalIF":7.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian advancements in alcohol consumption monitoring in the age of disinformation","authors":"Raquel B. De Boni,&nbsp;Ana Paula da Cunha,&nbsp;Norhan Sumar,&nbsp;Roberta Raupp","doi":"10.1016/j.lana.2025.101060","DOIUrl":"10.1016/j.lana.2025.101060","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101060"},"PeriodicalIF":7.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and solutions in women’s health research and clinical care: a call to action","authors":"Judith G. Regensteiner ,&nbsp;Melissa McNeil ,&nbsp;Stephanie S. Faubion ,&nbsp;C. Noel Bairey-Merz ,&nbsp;Martha Gulati ,&nbsp;Hadine Joffe ,&nbsp;Rita F. Redberg ,&nbsp;Stacey E. Rosen ,&nbsp;Jane EB. Reusch ,&nbsp;Wendy Klein ,&nbsp;LEADERS Steering Committee","doi":"10.1016/j.lana.2025.101037","DOIUrl":"10.1016/j.lana.2025.101037","url":null,"abstract":"<div><div>It is now recognized that there are significant differences between the sexes affecting prevalence, incidence, and severity over a broad range of diseases, although the extent of the differences is not fully elucidated. Until the early 1990s, women were excluded from most clinical trials and the limited research including women focused primarily on diseases affecting fertility and reproduction. For these reasons, the prevention, diagnosis, and treatment of chronic diseases in women continue to be based primarily on historical findings in men, and sex-specific clinical guidelines are often lacking. Many illnesses, ranging from cardiovascular disease to cancer to mental health issues, for example, differ by sex in terms of prevalence and adverse effects. Research is needed to understand how medically relevant biological sex differences optimally inform sex-specific prevention, diagnosis, and treatment strategies for women and men. In this way, sex-specific clinical guidelines can be developed where warranted, using evidence-based data.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101037"},"PeriodicalIF":7.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersectionality, racism, and mental health of migrants arriving at borders in Latin America: a qualitative study based on in-depth interviews with key informants of the cases of Ecuador and Chile","authors":"Teresita Rocha-Jiménez ,&nbsp;Irene Torres ,&nbsp;Báltica Cabieses ,&nbsp;Daniel F. López-Cevallos ,&nbsp;Mercedes Mercado-Órdenes","doi":"10.1016/j.lana.2025.101040","DOIUrl":"10.1016/j.lana.2025.101040","url":null,"abstract":"<div><h3>Background</h3><div>Migration is a social determinant of health, as human mobility is associated with the health outcomes of those who move. Social sciences research on migration and health needs to transition from an individual approach to models that reveal how place, processes of racialization, and structural elements impact immigrant health. We aim to describe, from the key informant's perspective in depth, the case of intersectionality, racism, and gender and related perceived effects on Venezuelan migrants' mental health at two relevant Latin American borders.</div></div><div><h3>Methods</h3><div>The present study is a multisite observational cross-sectional qualitative project on two selected borders, the northern borders of Chile (Antofagasta, Iquique, Arica) and Ecuador (Tulcán, Nueva Loja). In-depth semi-structured interviews with key informants were collected in (n = 30) Chile from May to December 2022 and in Ecuador (n = 30) from October to December 2022. 22 participants were men, and 38 were women, and in-depth interviews were analysed using an inductive thematic approach.</div></div><div><h3>Findings</h3><div>We found structural axes (i.e., socioeconomic, migration status, gender) of power that intersect in migrants' and refugees’ conditions and experiences in their access to health and mental health care.</div></div><div><h3>Interpretation</h3><div>We proposed the notions of intersectionality and racism to deliberately connect complex and dynamic concepts relevant to migrant and refugee health research, such as the racism faced by historically racialized populations based on their phenotypes, social class, and/or nationality and socioeconomic and gender inequalities.</div></div><div><h3>Funding</h3><div><span>Deutsche Forschungsgemeinschaft</span>—468252559. TRJ: ANID 11200486, Fondecyt Regular 1231102, ANILLO ATE230065, MILENIO—N° NCS2021_013. BC: ANID Fondecyt Regular 1201461.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101040"},"PeriodicalIF":7.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity fragmentation—a new frontier in physical health?","authors":"Ahmed Sayed ,&nbsp;Leandro Slipczuk ,&nbsp;Carl J. Lavie","doi":"10.1016/j.lana.2025.101051","DOIUrl":"10.1016/j.lana.2025.101051","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101051"},"PeriodicalIF":7.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, incidence, and outcome of childhood cancers in the Afro-descendant population of the French West Indies and French Guiana: a population-based study","authors":"Claire Dichamp ,&nbsp;Brigitte Lacour ,&nbsp;Jacqueline Clavel ,&nbsp;Jean-Hugues Dalle ,&nbsp;Christelle Dufour ,&nbsp;Katell Michaux ,&nbsp;Stephanie Puget ,&nbsp;Benjamin Faivre ,&nbsp;Frederique Delion ,&nbsp;Nadjia Aigoun ,&nbsp;Yves Hatchuel ,&nbsp;Julie Mascle ,&nbsp;Hélène Denailly ,&nbsp;Arnaud Petit ,&nbsp;Guy Leverger ,&nbsp;Daniel Orbach ,&nbsp;Juliette Berry ,&nbsp;Nicolas Boissel ,&nbsp;Graziella Raimondo ,&nbsp;Sabine Sarnacki ,&nbsp;Arthur Felix","doi":"10.1016/j.lana.2025.101050","DOIUrl":"10.1016/j.lana.2025.101050","url":null,"abstract":"<div><h3>Background</h3><div>The epidemiology of childhood cancer in Afro-descendant (AD) populations is poorly described. We performed a descriptive study of the distribution, incidence, and survival of children with cancer in the French West Indies (FWI) and French Guiana (FG).</div></div><div><h3>Methods</h3><div>We included all patients aged 0–17 diagnosed with cancer or benign intracranial tumor between January 2011 and December 2021 and living in the FWI/FG area at time of diagnosis. The cases were identified from the French national registry of childhood cancer and cross-referenced with local sources. Incidence rates were calculated, and compared to that of mainland France by standardized incidence ratios (SIR). Vital status was completed up to the 31st of December 2023 (date of point). Relapses were identified and documented in pediatric reference centers in mainland France and local centers. The 5-year overall survival (5yOS) and event-free survival (5yEFS) were estimated using Kaplan–Meier method.</div></div><div><h3>Findings</h3><div>We identified 368 patients (26% leukemias, 21% central nervous system tumors, 12% lymphomas, and 41% others). The average age at diagnosis was 8.8 years (Range: 0.1–17.8), with 52% boys. The median follow-up was 4.4 years (Range: 0.1–12.3). The age standardized rates for all cancers was lower than in mainland France (124.9 vs 162.6 per million-year for children under 18 years old, SIR = 0.77 [95% CI: 0.69–0.85]). The 5yOS was 78.9% [95% CI: 73.9–83.0] and 5yEFS was 69.3% [95% CI: 63.9–74.0]. The 5yOS for the 0–14 age group was 81.2% [95% CI: 76.9–85.5].</div></div><div><h3>Interpretation</h3><div>This first registry-based study of childhood cancer in the FWI and FG shows that our patients with childhood cancer, treated in a country with a high standard of health care, has resulted in overall survival comparable to that of European and North American children.</div></div><div><h3>Funding</h3><div>The authors received no financial support.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101050"},"PeriodicalIF":7.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responding to medetomidine: clinical and public health needs","authors":"David T. Zhu ,&nbsp;Joseph J. Palamar","doi":"10.1016/j.lana.2025.101053","DOIUrl":"10.1016/j.lana.2025.101053","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101053"},"PeriodicalIF":7.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of COVID-19 vaccination with risks for post-infectious cardiovascular complications: an international cohort study in cancer patients with SARS-CoV-2 infection","authors":"Emily Pei-Ying Lin ,&nbsp;Chih-Yuan Hsu ,&nbsp;Sanjay Mishra ,&nbsp;Elizabeth A. Griffiths ,&nbsp;Brahm H. Segal ,&nbsp;Clara Hwang ,&nbsp;Sunny R.K. Singh ,&nbsp;Nino Balanchivadze ,&nbsp;Chinmay Jani ,&nbsp;Melissa G. Mariano ,&nbsp;Padmanabh S. Bhatt ,&nbsp;Kendra Vieira ,&nbsp;Peter Paul Yu ,&nbsp;Eric J. Oligino ,&nbsp;Trisha Wise-Draper ,&nbsp;Elizabeth K. Ferrara ,&nbsp;Rana R. McKay ,&nbsp;Taylor K. Nonato ,&nbsp;Chris Labaki ,&nbsp;Eddy Saad ,&nbsp;Yu Shyr","doi":"10.1016/j.lana.2025.101038","DOIUrl":"10.1016/j.lana.2025.101038","url":null,"abstract":"<div><h3>Background</h3><div>Whether COVID-19 vaccination is associated with risks for cardiovascular complications after SARS-CoV-2 infection in patients with cancer is unknown. The objective of this study was to investigate the associations between the two.</div></div><div><h3>Methods</h3><div>This registry (COVID-19 and Cancer Consortium)-based retrospective cohort study included patients with laboratory-confirmed SARS-CoV-2 infection from the United States, Canada, and Mexico between April 2021 and December 2022. Patients without COVID-19 vaccination were assigned to the unvaccinated group and patients with ≥2 doses of COVID-19 vaccination were assigned to the fully-vaccinated group. The primary outcome was a composite of post-infectious cardiac complications, including acute myocardial infarction, other ischemic heart disease, atrial fibrillation, ventricular fibrillation, other arrhythmias, cardiomyopathy, and congestive heart failure. The secondary outcome was a composite measure of post-infectious cardiovascular events, comprising of the cardiac complications along with pulmonary embolism, deep vein thrombosis, superficial vein thrombosis, other thrombosis, and cerebrovascular stroke. Multivariable logistic regression was used for data analysis.</div></div><div><h3>Findings</h3><div>A total of 2729 patients were included for analyses, with 1382 in the unvaccinated group and 1347 in the fully-vaccinated group. The median age of the study population was 65 (interquartile range (IQR), 55–74) years. Overall, 1534 (56.0%) were women; 1272 (47%) were never smokers; 1639 (60%) were not obese; 2043 (75%) had stable cancer, and 446 (16%) took anticoagulants at baseline. The primary and secondary analyses showed lower risks of cardiac complications and cardiovascular events in the fully-vaccinated group, with adjusted odds ratios (aOR) of 0.66 (95% confidence interval (CI), 0.48–0.89) and 0.76 (95% CI, 0.59–0.99), respectively. The protective trend with COVID-19 vaccination was observed across infections with different dominant SARS-CoV-2 strains and in patients with or without anticoagulant use.</div></div><div><h3>Interpretation</h3><div>COVID-19 vaccination was associated with a reduced risk of cardiac complications and cardiovascular events by 34% and 24%, respectively, after SARS-CoV-2 infection in patients with cancer.</div></div><div><h3>Funding</h3><div><span>National Institutes of Health USA</span>; <span>National Science and Technology Council of Taiwan</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101038"},"PeriodicalIF":7.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“The end TB strategy” pathway in South America: out of track for 2025 milestones and 2035 eradication","authors":"Miguel Angel Garcia-Bereguiain ,&nbsp;Angel Sebastian Rodriguez-Pazmiño ,&nbsp;Greta Franco-Sotomayor ,&nbsp;Solon Alberto Orlando ,&nbsp;Manuel González ,&nbsp;Cesar Ugarte-Gil","doi":"10.1016/j.lana.2025.101045","DOIUrl":"10.1016/j.lana.2025.101045","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101045"},"PeriodicalIF":7.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}