Diabetic foot complications among Indigenous peoples in Canada: A scoping review through the PROGRESS-PLUS equity lens

Introduction Indigenous peoples in Canada face a disproportionate burden of diabetes-related foot complications (DRFC), such as foot ulcers, lower extremity amputations (LEA), and peripheral arterial disease. This scoping review aimed to provide a comprehensive understanding of DRFC among First Nations, Métis, and Inuit peoples in Canada, incorporating an equity lens Methods A scoping review was conducted based on Arksey and O’Malley refined by the Joanna Briggs Institute. The PROGRESS-Plus framework was utilized to extract data and incorporate an equity lens. A critical appraisal was performed, and Indigenous stakeholders were consulted for feedback. We identified the incorporation of patient-oriented/centered research (POR). Results Of 5,323 records identified, 40 studies were included in the review. The majority of studies focused on First Nations (92%), while representation of the Inuit population was very limited populations (< 3% of studies). LEA was the most studied outcome (76%). Age, gender, ethnicity, and place of residence were the most commonly included variables. Patient-oriented/centered research was mainly included in recent studies (16%). The overall quality of the studies was average. Data synthesis showed a high burden of DRFC among Indigenous populations compared to non-Indigenous populations. Indigenous identity and rural/remote communities were associated with the worse outcomes, particularly major LEA. Discussion This study provides a comprehensive understanding of DRFC in Indigenous peoples in Canada of published studies in database. It not only incorporates an equity lens and patient-oriented/centered research but also demonstrates that we need to change our approach. More data is needed to fully understand the burden of DRFC among Indigenous peoples, particularly in the Northern region in Canada where no data are previously available. Western research methods are insufficient to understand the unique situation of Indigenous peoples and it is essential to promote culturally safe and quality healthcare. Conclusion Efforts have been made to manage DRFC, but continued attention and support are necessary to address this population’s needs and ensure equitable prevention, access and care that embraces their ways of knowing, being and acting

Changes in the firmness and other quality parameters of fresh-cut ‘Maradol’ papaya treated with additives and 1-methylcyclopropene

This study aimed to evaluate the effect of 1-methylcyclopropene (1-MCP) applied as pre-cutting, post-cutting, and double application (before and after cutting) on the changes in the firmness and quality parameters of fresh-cut ripe ‘Maradol’ papaya. Four treatments (T1 T4) were used. T1 (Control treatment): Fresh-cut ‘Maradol’ papaya slices (Control treatment or T1) dipped in 1% CaCl2 for 2 min, then sprayed with 0.1% iso-ascorbic acid and 0.05% sorbic acid. One part of the T1 slices were treated with 1000 nL/L of 1-MCP for 12 h at 10 °C (T2). T3: Fresh-cut papaya slices treated with the same additives from the whole papaya treated 1000 nL/L of 1-MCP for 12 h at 20°C. T4: Fresh-cut papaya with additives treated with 1-MCP before and after cutting. All slices were packed in polypropylene trays with a perforated cover and stored at 4 ºC. T3 and T4 slices exhibited lower firmness loss and decreased activity of pectin methylesterase, polygalacturonase, and beta-galactosidase compared to T1 and T2 slices. Moreover, T3 and T4 slices had low translucency and microbial load, complying with the European Union limit (3 log CFU/g). No significant variations in acidity, pH, and total soluble solids were noted between treatments, but higher color values were obtained in T3 and T4 slices. To the best of our knowledge, this is the first study where the combining effects of additives and 1-MCP application before and after cutting extended the shelf-life of fresh-cut ‘Maradol’ papaya for up to 13 days at 4 °C, twice the duration reported by others.Keywords: Carica papaya, Postharvest, Translucency, Quality, Shelf-lif

Changes in the firmness and other quality parameters of fresh-cut ‘Maradol’ papaya treated with additives and 1-methylcyclopropene

This study aimed to evaluate the effect of 1-methylcyclopropene (1-MCP) applied as pre-cutting, post-cutting, and double application (before and after cutting) on the changes in the firmness and quality parameters of fresh-cut ripe ‘Maradol’ papaya. Four treatments (T1 T4) were used. T1 (Control treatment): Fresh-cut ‘Maradol’ papaya slices (Control treatment or T1) dipped in 1% CaCl2 for 2 min, then sprayed with 0.1% iso-ascorbic acid and 0.05% sorbic acid. One part of the T1 slices were treated with 1000 nL/L of 1-MCP for 12 h at 10 °C (T2). T3: Fresh-cut papaya slices treated with the same additives from the whole papaya treated 1000 nL/L of 1-MCP for 12 h at 20°C. T4: Fresh-cut papaya with additives treated with 1-MCP before and after cutting. All slices were packed in polypropylene trays with a perforated cover and stored at 4 ºC. T3 and T4 slices exhibited lower firmness loss and decreased activity of pectin methylesterase, polygalacturonase, and beta-galactosidase compared to T1 and T2 slices. Moreover, T3 and T4 slices had low translucency and microbial load, complying with the European Union limit (3 log CFU/g). No significant variations in acidity, pH, and total soluble solids were noted between treatments, but higher color values were obtained in T3 and T4 slices. To the best of our knowledge, this is the first study where the combining effects of additives and 1-MCP application before and after cutting extended the shelf-life of fresh-cut ‘Maradol’ papaya for up to 13 days at 4 °C, twice the duration reported by others.Keywords: Carica papaya, Postharvest, Translucency, Quality, Shelf-lif

Persistent neuropathic pain after inguinal herniorrhaphy depending on the procedure (open mesh v. laparoscopy): a propensity-matched analysis.

International audienc

A Novel 8-Predictors Signature to Predict Complicated Disease Course in Pediatric-onset Crohn’s Disease: A Population-based Study

International audienceBackground The identification of patients at high risk of a disabling disease course would be invaluable in guiding initial therapy in Crohn’s disease (CD). Our objective was to evaluate a combination of clinical, serological, and genetic factors to predict complicated disease course in pediatric-onset CD. Methods Data for pediatric-onset CD patients, diagnosed before 17 years of age between 1988 and 2004 and followed more than 5 years, were extracted from the population-based EPIMAD registry. The main outcome was defined by the occurrence of complicated behavior (stricturing or penetrating) and/or intestinal resection within the 5 years following diagnosis. Lasso logistic regression models were used to build a predictive model based on clinical data at diagnosis, serological data (ASCA, pANCA, anti-OmpC, anti-Cbir1, anti-Fla2, anti-Flax), and 369 candidate single nucleotide polymorphisms. Results In total, 156 children with an inflammatory (B1) disease at diagnosis were included. Among them, 35% (n = 54) progressed to a complicated behavior or an intestinal resection within the 5 years following diagnosis. The best predictive model (PREDICT-EPIMAD) included the location at diagnosis, pANCA, and 6 single nucleotide polymorphisms. This model showed good discrimination and good calibration, with an area under the curve of 0.80 after correction for optimism bias (sensitivity, 79%, specificity, 74%, positive predictive value, 61%, negative predictive value, 87%). Decision curve analysis confirmed the clinical utility of the model. Conclusions A combination of clinical, serotypic, and genotypic variables can predict disease progression in this population-based pediatric-onset CD cohort. Independent validation is needed before it can be used in clinical practice