Underreporting and Underrepresentation of Racial and Ethnic Minority Patients in Lymphedema Clinical Trials: A Systematic Review.

The generalizability of findings from Clinical Trials (CTs) investigating lymphedema treatment modalities requires an accurate representation of the target population. This study aims to evaluate racial and ethnic reporting and representation in lymphedema CTs. A comprehensive systematic literature search was conducted during May 2023 using multiple databases, following the PRISMA guidelines. All CTs published from 2018 to 2023 were included. A total of 84 articles were included in this review, from which 6,546 participants were included in the analysis. Seventy-four (88.1%) articles addressed secondary lymphedema, of which 60 (81.1%) were related to breast cancer. Only 12 (13%) of CTs reported at some extend race or ethnicity. Of these, five (41.6%) reported race and two (16.6%) reported ethnicity according to FDA guidelines. White race had the highest pooled prevalence (80%; 95% CI 72-86%; I2=90%), followed by Black (7%; 95% CI 2- 15%; I2= 94.3%) and Asian (4%; 95% CI 1-8%; I2= 89.9%). In studies reporting ethnicity, participants were predominantly non-Hispanic (92.1%; 95% CI 90 - 94%). There is an underreporting and underrepresentation of racial and ethnic minorities among lymphedema CTs, limiting their generalizability. It is imperative to future development of strategies to enhance diversity in the study sample.

Density dependent diffusional model of an infective population.

In this work, we present a density-dependent diffusional model which, coupled to three different types of growth, permitted us to study the infective potential of a bacteria species. The results show that those species with strong internal competency have the higher colonizing capacity in terms of invasion speed. Here, we also advanced a model for the static spatial inhomogeneous distribution that some species establish after migration. It is proposed that the origin of these patterns is the result of a balance between the dispersal tendency and the attractive behavior. The results obtained were compared with the observed behavior of Rhizobium spp. during infection of leguminous roots. A possible explanation of the observed morphologies of nodule development in different legumes is suggested.

A model for aggregation-dispersion dynamics of a population.

An important feature that distinguishes the movement of living systems from the random motion of inorganic material is a delicate balance between spreading and concentrating. This movement is based on the kind of interactions which a bacterial colony may establish during migration. Namely, the antagonistic effects of dispersal which take place preferentially down the population gradient and the tendency in grouping together. In this work a model is proposed which considers these effects. The phase plane analysis and the numerical calculations reveal the existence of stable sharp wave front solutions. The speed of the wave front is modulated by the compromise between the tendencies of spreading and aggregating. The results obtained were compared with experimental observations in cultures of Escherichia coli and Streptococcus faecalis. The agreement between both types of results supports the hypothesis on which the model was based.