The interrelationship between obesity and race in breast cancer prognosis: a prospective cohort study.

BACKGROUND: Obesity is associated with an increased breast cancer risk in postmenopausal women and may contribute to worse outcomes. Black women experience higher obesity and breast cancer mortality rates than non-Black women. We examined associations between race, obesity, and clinical tumor stage with breast cancer prognosis. METHODS: We conducted a prospective cohort study in 1,110 breast cancer patients, using univariable and multivariable Cox regression analyses to evaluate the effects of obesity, race/ethnicity, and clinical tumor stage on progression-free and overall survival (PFS and OS). RESULTS: 22% of participants were Black, 64% were Hispanic White, and 14% were non-Hispanic White or another race. 39% of participants were obese (body mass index [BMI] ≥ 30 kg/m2). In univariable analyses, tumor stage III-IV was associated with worse PFS and OS compared to tumor stage 0-II (hazard ratio [HR] = 4.68, 95% confidence interval [CI] = 3.52-6.22 for PFS and HR = 5.92, 95% CI = 4.00-8.77 for OS). Multivariable analysis revealed an association between Black race and worse PFS in obese (HR = 2.19, 95% CI = 1.06-4.51) and non-obese (HR = 2.11, 95% CI = 1.05-4.21) women with tumors staged 0-II. Obesity alone was not associated with worse PFS or OS. CONCLUSIONS: Results suggest a complex interrelationship between obesity and race in breast cancer prognosis. The association between the Black race and worse PFS in tumor stages 0-II underscores the importance of early intervention in this group. Future studies are warranted to evaluate whether alternative measures of body composition and biomarkers are better prognostic indicators than BMI among Black breast cancer survivors.

Investigating the Potential Double-Edged Score of Immigration-Related Stress, Discrimination, and Mental Health Access.

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly post-traumatic stress disorder (PTSD) and depression. Both symptoms may, in turn, prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest, assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate that further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.

The Interrelationship between Obesity and Race in Breast Cancer Prognosis: A Prospective Cohort Study.

Purpose: Obesity is associated with an increased breast cancer risk in postmenopausal women and may contribute to worse outcomes. Black women experience higher obesity and breast cancer mortality rates than non-Black women. We examined associations between race, obesity, and clinical tumor stage with breast cancer prognosis. Methods: We conducted a prospective cohort study in 1,110 breast cancer patients, using univariable and multivariable Cox regression analyses to evaluate the effects of obesity, race/ethnicity, and clinical tumor stage on progression-free and overall survival (PFS and OS). Results: 22% of participants were Black, 64% were Hispanic White, and 14% were non-Hispanic White or another race. 39% of participants were obese (body mass index [BMI] ≥ 30 kg/m2). In univariable analyses, tumor stage III-IV was associated with worse PFS and OS compared to tumor stage 0-II (hazard ratio [HR] = 4.68, 95% confidence interval [CI] = 3.52-6.22 for PFS and HR = 5.92, 95% CI = 4.00-8.77 for OS). Multivariable analysis revealed an association between Black race and worse PFS in obese (HR = 2.19, 95% CI = 1.06-4.51) and non-obese (HR = 2.11, 95% CI = 1.05-4.21) women with tumors staged 0-II. Obesity alone was not associated with worse PFS or OS. Conclusion: Results suggest a complex interrelationship between obesity and race in breast cancer prognosis. The association between Black race and worse PFS in tumor stages 0-II underscores the importance of early intervention in this group. Future studies are warranted to evaluate whether alternative measures of body composition and biomarkers are better prognostic indicators than BMI among Black breast cancer survivors.

Generation of Tamm Plasmon Resonances for Light Confinement Applications in Narrowband Gradient-Index Filters Based on Nanoporous Anodic Alumina.

Gold-coated gradient-index filters based on nanoporous anodic alumina (Au-coated NAA-GIFs) were used as model platforms to elucidate how Tamm plasmons can be tailored by engineering the geometric features of the plasmonic and photonic components of these hybrid structures. NAA-GIFs with well-resolved, intense photonic stopbands at two positions of the visible spectrum were fabricated through sinusoidal pulse anodization. These model photonic crystals were used to assess how the quality of Tamm plasmon resonances can be enhanced by tuning the features of the dielectric mirror and the thickness of the porous gold coating layer. It is found that the highest value of the quality factor of Tamm resonance (Q Tamm = 237) is obtained for 11 nm of gold on a dielectric mirror with low porosity corresponding to the resonant spectral position of λTamm of ∼698 nm. Our analysis indicates that Tamm resonances in as-produced Au-coated NAA-GIFs are weak due to the constrained range of wavelengths (narrow bands) at which these photonic crystal structures reflect light. However, after broadening of their photonic stopband upon pore widening, Tamm resonances become better resolved, with higher intensity. It is also observed that the quality of light confinement worsens progressively with the thickness of the porous gold coating layer after a critical value. In contrast to conventional surface plasmon resonance systems, this hybrid Tamm porous system does not require complex coupling systems and provides a nanoporous structure that can be readily tailored for a range of photonic technologies such as sensing and lasing.

A Distinction Without a Difference? A Multi-Method Approach to Understanding PTSD and Depression Symptom Overlap Among Disaster-Exposed Adolescents.

Among adolescents exposed to trauma, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur. Despite the prevalence of comorbidity, the question of how PTSD and MDD are related and appropriate conceptual models for understanding their linkage in adolescence remains unclear. This study applies a multi-methodological approach to advance conceptual and theoretical understanding of the overlap between PTSD and MDD diagnoses/symptoms. We tested three methodological approaches with three distinct theoretical underpinnings on the structure of each disorder proposed in the literature: confirmatory factor analysis (CFA) with dimensional constructs, latent class analysis (LCA) with person-based categorical constructs, and network analysis with symptom-to-symptom associations. Across the three different analytical approaches, there was a significant overlap between PTSD and MDD. Overall, there was no compelling evidence for distinct boundaries between disorders among trauma-exposed adolescents. Instead, we found considerable evidence that the typical latent-construct-based conceptualizations, whether categorical or dimensional, may need revision.

Hepatotoxicity with High-Dose Green Tea Extract: Effect of Catechol-O-Methyltransferase and Uridine 5'-Diphospho-glucuronosyltransferase 1A4 Genotypes.

The predominant catechin in green tea, epigallocatechin gallate (EGCG), may be hepatotoxic in high doses. Our objective was to investigate the influence of catechol-O-methyltransferase (COMT) and uridine 5'-diphospho-glucuronosyltransferase 1A4 (UGT1A4) genotypes on changes in liver injury biomarkers in response to long-term, high-dose green tea extract (GTE) supplementation among postmenopausal women. A secondary analysis was conducted using data from the Minnesota Green Tea Trial (N = 1,075), in which participants were randomized to consume high-dose GTE (843 mg/day EGCG) or placebo capsules for 12 months. Analysis of covariance adjusting for potential confounders was performed to examine changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST: ALT ratio, and alkaline phosphatase from baseline to months 3, 6, 9, and 12 across COMT and UGT1A4 genotypes. Mean age and BMI within the GTE group (n = 400) were 59.8 yrs and 25.1 kg/m2, respectively, and 98% of subjects were white. From baseline to month 3, mean AST: ALT ratio change was +1.0% in the COMT (rs4680) A/G genotype versus -4.8% in the A/A genotype (p = 0.03). From baseline to months 6 and 9, respectively, mean ALT change was +78.1% and +82.1% in the UGT1A4 (rs6755571) A/C genotype versus +28.0% and +30.1% in the C/C genotype (p < 0.001 and p = 0.004, respectively). The UGT1A4 (rs6755571) A/C genotype may be an important risk factor for clinically-relevant serum transaminase elevations with 6-9 months of high-dose GTE supplementation among postmenopausal women. Understanding the genetic underpinnings of GTE-related hepatotoxicity may allow for a genetically-informed paradigm for therapeutic use of GTE.

Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants.

Latinx immigrants experience substantial disparities in mental health treatment access, particularly for posttraumatic stress disorder (PTSD). The availability of brief, flexible interventions in Spanish may assist in reducing these disparities. Written Exposure Therapy (WET) is a five-session PTSD intervention that appears as effective as longer, gold-standard interventions, but has yet to be tested among Latinx immigrants. To test the acceptability and preliminary effectiveness of WET, 20 Spanish-speaking, Latinx immigrants conducted structured interviews at pretreatment, were offered WET, and completed posttreatment structured interviews. Open thematic coding of pre- and posttreatment interview questions examined perceived barriers and benefits of WET. Quantitative components examined symptom change across PTSD (PCL-IV-C) and depression (PHQ-9). Quantitative results indicated clinically meaningful and statistically significant change in PTSD symptoms using intent-to-treat analyses (Mdiff = 17.06, SDdiff = 9.97, range = 0-29, t(15) = 6.84, p < .001). Open thematic coding identified four barrier-related themes and three benefit-related themes at pretreatment. At posttreatment, three barrier-related themes and two benefit-related themes were identified. Qualitative results largely suggested that perceived barriers were common to other PTSD interventions (e.g., exposure components). Only one participant identified barriers specific to WET. Results suggested WET may reduce PTSD symptoms among Latinx immigrants. WET also appeared to be acceptable and primarily viewed as beneficial among this population. WET is a promising intervention with Latinx immigrants and warrants further testing larger trials, including testing implementation strategies that may improve access to care.

Immigrant and U.S.-born migrant farmworkers: Dual paths to discrimination-related health outcomes.

Research with immigrant Latino populations often point to findings that immigrants tend to evidence better health outcomes than nonimmigrants. When exploring differences based on nativity, comparisons often end with just comparing these two groups. Exploring these variables alone may oversimplify the shared and unique paths of risk and resilience between these groups. Experimental research shows that discrimination is often directed toward immigrants, but U.S.-born Latinos report more frequent exposure. We sought to address this by examining two distinct pathways by which discrimination leads to negative health. A sample of 240 Latino migrant farmworkers completed questionnaires regarding immigration-related fears, discrimination, physical and mental health, demographics, and other outcomes. While U.S.-born participants reported similar or worse outcomes across health measures, the pathways to these outcomes appeared to differ between the two groups, with immigration-related fears accounting for substantial portions of these health outcomes, especially in the dual paths with discrimination (p values < .05). Simply comparing Latino groups across U.S. nativity may paper over important differences in how they arrive at those health outcomes, including that immigration-related concerns may exacerbate exposure to and severity of discrimination, which in turn leads to negative health outcomes. On the other hand, discrimination itself may account for numerous negative health outcomes more directly for U.S.-born Latinos. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social Vulnerability and Appendicitis: Single-Institution Study in a High Insurance State.

INTRODUCTION: Multiple factors signifying higher social vulnerability, including lower socioeconomic status and minority race, have been associated with presentation with complicated appendicitis (CA). In this study, we compared the Social Vulnerability Index (SVI) of our population by appendicitis severity (uncomplicated appendicitis [UA] versus CA). We hypothesized that SVI would be similar between patients with UA and CA presenting to our institution, a safety-net hospital in a state with high healthcare insurance coverage. METHODS: We included all patients at our hospital aged 18 y and older who underwent appendectomy for acute appendicitis between 2012 and 2016. SVI values were determined based on the 2010 census data using ArcMap software. We used nonparametric univariate statistics to compare the SVI of patients with CA versus UA and multivariable regression to model the likelihood of operative CA. RESULTS: A total of 997 patients met inclusion criteria, of which 177 had CA. The median composite SVI score for patients with CA was lower than for patients with UA (80% versus 83%, P = 0.004). UA was associated with higher socioeconomic (83% versus 80%, P = 0.007), household/disability (68% versus 55%, P = 0.037), and minority/language SVI scores (91% versus 89%, P = 0.037). On multivariable analysis controlling for age, sex, ethnicity, insurance status, relevant comorbidities, and chronicity of symptoms, there was an inverse association between SVI and the likelihood of CA (odds ratio 0.59, 95% confidence interval 0.4-0.87, P = 0.008). CONCLUSIONS: In the setting of high healthcare insurance and a medical center experienced in caring for vulnerable populations, patients presenting with UA have a higher composite SVI, and thus greater social vulnerability, than patients presenting with CA.

Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Treatments of Posttraumatic Stress Disorder (PTSD) often evidence high rates of dropout, ranging from 25% to 40%, among English-speaking samples. Written Exposure Therapy (WET), a novel manualized treatment for PTSD, evidences lower dropout rates and noninferiority to CPT, one of the most efficacious interventions for PTSD. Spanish-speaking Latinxs often experience greater dropout and barriers to care. WET appears promising for this population, but acceptability and perceived barriers to WET have not been examined among Spanish-speaking Latinxs. The present study assessed perceptions and acceptability of a Spanish-language version of WET among Spanish-speaking Latinxs who scored greater than 45 on the Spanish-language version of the PCL-IV, indicating likely PTSD (n = 20) and providers (n = 12). Participants completed a mixed-methods interview regarding reasons they/clients would not want to receive the treatment, why they/clients would want to receive the treatment, potential solutions for any identified barriers, and reasons for not seeking mental health services generally. Providers, but not potential recipients, identified low literacy as a barrier for WET. Providers and potential recipients identified time as a barrier to WET and other mental health services, but the time reduction was perceived as a potential facilitator of WET. Results also suggest no specific cultural barriers were identified for WET (e.g., provider cultural competency) and that Spanish WET may reduce time-related barriers and is perceived as effective and acceptable among Spanish-speaking Latinxs. Additional work is needed to expand the reach of the intervention, given that mental health services were often perceived as untrustworthy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

BRCAR: herramienta de soporte en la evaluación del riesgo para cáncer de mama / BRCAR: Support Tools for Risk Evaluation of Breast Cancer

Introducción: El cáncer de mama es el tumor maligno más frecuente en el mundo, en Cuba, es la segunda causa de muerte en mujeres. La insuficiencia en el diagnóstico precoz y la existencia de novedosas estrategias de tratamiento plantean la necesidad de establecer formas eficaces para identificar el riesgo en personas sanas, sin embargo en nuestro país no se cuenta con un método eficaz para predecir el riesgo y direccionar las acciones preventivas y terapéuticas. Objetivo: Crear un estándar nacional orientado a la identificación del cáncer de mama como soporte a la práctica médica y como herramienta de apoyo en la evaluación del riesgo. Método: Se combinaron 28 variables (determinadas por los factores de riesgo de cáncer de mama) a las cuales se les atribuyeron parámetros de ponderación asociados al nivel de incidencia registrado en la literatura médica, utilizando un algoritmo de votación como elemento matemático central. Resultados: Se desarrolló un sistema computarizado para la evaluación del riesgo de cáncer de mama en personas sanas. Conclusiones: BRCAR es una herramienta de soporte para objetivar el riesgo del cáncer de mama, al determinar el impacto de determinados factores de riesgo, con el fin de direccionar los métodos de estudio para la detección precoz(AU)

Introduction: Breast cancer is the most frequent malignant tumour in the world; it is the second cause of women death in Cuba. The insufficiency in early diagnosis and the existence of novel treatment strategies raise the need to establish effective ways to identify risk in healthy people, however in our country there is no effective method to predict risk and direct preventive actions and therapeutic. Objective: To create a national standard aimed at identifying breast cancer as a support to medical practice and support tool in risk assessment. Method: 28 variables (determined by risk factors for breast cancer) were combined; assigning to those variables weighting parameters associated with the level of incidence recorded in the medical literature, using a voting algorithm as the central mathematical element. Results: A computerized system was developed to assess the risk of breast cancer in healthy people. Conclusions: BRCAR is a support tool to objectify the risk of breast cancer, by determining the impact of certain risk factors, in order to direct study methods for early detection(AU)

Physiological response to warming in intertidal macroalgae with different thermal affinity.

Changes in the abundance and distribution of seaweeds have been reported worldwide. In Northwest Iberia, cold and warm affinity seaweeds have respectively decreased and increased their abundance. To improve our understanding of their vulnerability to future warming scenarios, the effects of warming on the photosynthetic and respiratory performance of seaweeds with cold-water (Fucus serratus and Vertebrata lanosa) and warm-water (Padina pavonica and Gigartina pistillata) affinities were compared in a highly resolved temperature gradient (7-31 °C) under controlled laboratory conditions. While neither the optimum temperature nor the photosynthetic rate at the optimum temperature showed consistent differences between water affinity groups, the temperature dependence of net photosynthesis was significantly higher in the warm-affinity group. Photosynthesis was less responsive than respiration to warming in cold-affinity seaweeds while both rates showed similar responsiveness in warm-affinity ones, suggesting that the relative responsiveness of respiration and photosynthesis to temperature may be indicative of warming susceptibility.

Optical Platform to Analyze a Model Drug-Loading and Releasing Profile Based on Nanoporous Anodic Alumina Gradient Index Filters.

In this work, a methodology that exploits the optical properties of the nanoporous anodic alumina gradient index filters (NAA-GIFs) has been developed and applied to evaluate in real time the release dynamics of a cargo molecule, acting as a model drug, filling the pores. NAA-GIFs with two photonic stopbands (PSBs) were prepared with one of its stop bands in the same absorption wavelength range of the cargo molecule, whereas the second stopband away from this absorption range. Numerical simulation and experiments confirm that the relative height of the high reflectance bands in the reflectance spectra of NAA-GIFs filled with the drug can be related to the relative amount of drug filling the pores. This property has been applied in a flow cell setup to measure in real-time the release dynamics of NAA-GIFs with the inner pore surface modified by layer-by-layer deposition of polyelectrolytes and loaded with the cargo molecule. The methodology developed in this work acts as a tool for the study of drug delivery from porous nanostructures.

Role of Spectral Resonance Features and Surface Chemistry in the Optical Sensitivity of Light-Confining Nanoporous Photonic Crystals.

Nanoporous anodic alumina optical microcavities (NAA-µQVs) with spectrally tunable resonance band and surface chemistry are used as model light-confining photonic crystal (PC) platforms to elucidate the combined effect of spectral light confinement features and surface chemistry on optical sensitivity. These model nanoporous PCs show well-resolved, spectrally tunable resonance bands (RBs), the central wavelength of which is engineered from ∼400 to 800 nm by the period of the input anodization profile. The optical sensitivity of the as-produced (hydrophilic) and dichlorodimethylsilane-functionalized (hydrophobic) NAA-µQVs is studied by monitoring dynamic spectral shifts of their RB upon infiltration with organic- and aqueous-based analytical solutions of equally varying refractive index, from 1.333 to 1.345 RIU. Our findings demonstrate that hydrophilic NAA-µQVs show ∼81 and 35% superior sensitivity to their hydrophobic counterparts for organic- and aqueous-based analytical solutions, respectively. Interestingly, the sensitivity of hydrophilic NAA-µQVs per unit of spectral shift is more than 3-fold higher in organic than in aqueous matrices upon equal change of refractive index, with values of 0.347 ± 0.002 and 0.109 ± 0.001 (nm RIU-1) nm-1, respectively. Conversely, hydrophobic NAA-µQVs are found to be slightly more sensitive toward changes of refractive index in aqueous medium, with sensitivities of 0.072 ± 0.002 and 0.066 ± 0.006 (nm RIU-1) nm-1 in water- and organic-based analytical solutions, respectively. Our advances provide insights into critical factors determining optical sensitivity in light-confining nanoporous PC structures, with implications across optical sensing applications, and other photonic technologies.

Exposure to ethnic discrimination in social media and symptoms of anxiety and depression among Hispanic emerging adults: Examining the moderating role of gender.

METHOD: Two hundred Hispanic emerging adults from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey, and data were analyzed using hierarchical multiple regression and moderation analyses. RESULTS: Higher social media discrimination was associated with higher symptoms of depression and generalized anxiety. Moderation analyses indicated that higher social media discrimination was only associated with symptoms of depression and generalized anxiety among men, but not women. CONCLUSION: This is likely the first study on social media discrimination and mental health among emerging adults; thus, expanding this emerging field of research to a distinct developmental period.

Análisis regional del proceso de compresión de la mortalidad en Argentina / Análise regional do processo de compressão da mortalidade na Argentina / Regional analysis of the mortality compression process in Argentina

El objetivo de este trabajo es analizar las características de la evolución de la mortalidad en los últimos veinte años en Argentina, a partir del estudio del proceso de compresión de la mortalidad, según sexo y región geográfica. Se analizó la compresión de la mortalidad, según la metodología propuesta por Kannisto (2000), a través del análisis de las curvas de sobrevivencia y de las muertes en tablas de vida. Se construyeron tablas de vida para los últimos tres períodos censales disponibles. Para suavizarlas, se elaboraron a partir del promedio de defunciones trianuales: 1990-1992, 2000-2002, 2009-2011. Los resultados indican que, tanto en hombres como en mujeres de las diversas regiones de Argentina, existe una tendencia a la convergencia en la compresión de la mortalidad, aunque todavía es atrasada en la región Noreste. Estos datos indicarían una tendencia a la convergencia en el proceso de compresión de la mortalidad al interior del país, aunque persisten diferencias en algunas regiones.

O objetivo deste trabalho é analisar as características da evolução da mortalidade nos últimos 20 anos na Argentina, a partir de um estudo do processo de compressão da mortalidade, segundo sexo e região geográfica. A compressão da mortalidade foi analisada de acordo com a metodologia proposta por Kannisto (2000), por meio da análise de curvas de sobrevivência e óbitos por tábuas de vida. As tábuas de vida foram construídas para os três últimos períodos censitários disponíveis. Para suavizá-las, elas foram produzidas com base na média de mortes em três anos: 1990-1992, 2000-2002, 2009-2011. Os resultados indicam que, tanto para homens quanto para mulheres das diversas regiões da Argentina, há uma tendência de convergência na compressão da mortalidade, embora ainda defasada na região Nordeste. Esses dados indicariam que existe uma tendência de convergência no processo de compressão da mortalidade no país, embora as diferenças persistam em algumas regiões.

The aim of this work is to analyze the characteristics of the evolution of mortality in the last 20 years in Argentina, based on the study of the process of compression of mortality, according to sex and geographic region. Compression of mortality was analyzed, according to the methodology proposed by Kannisto (2000) through the analysis of survival curves and deaths from life tables. Life tables were constructed for the last three census periods available. To soften them, they were based on the average of three-year deaths: 1990-1992, 2000-2002, 2009-2011. The results indicate that, in men and women in the various regions of Argentina, there is a trend to convergence in compression of mortality, although it is still late in the Northeast region. These data would indicate that there is a tendency towards convergence in the process of compression of mortality inside the country, although differences persist in some regions.

[Response capacity to the COVID-19 pandemic in Latin America and the Caribbean]. / Capacidad de respuesta frente a la pandemia de COVID-19 en América Latina y el Caribe.

OBJECTIVE: To analyze the evolution of the COVID-19 pandemic in Latin American and Caribbean countries in its first 90 days and its association with variables related to public health measures, and demographic, health and social characteristics. METHODS: he trend in new daily cases and the crude mortality rate (CMR) from COVID-19 were analyzed through the Joinpoint regression analysis methodology, using the Joinpoint Regression Program 4.8.0.1. Data was obtained from the Our World in Data registry. A multiple correspondence analysis was performed between the public health measures adopted in each country to face the COVID-19 pandemic (measured through the stringency index, Oxford University) and sanitary, demographic and social conditions, and the results of the evolution of the pandemic. SPSS software was used. RESULTS: The Joinpoint regression analysis showed that the highest increase in the number of cases was observed in Brazil (11.3%) and the highest increase in CMR in Mexico (16.2%). The multiple correspondence analysis showed that CMR was associated with the total population, the stringency index, the level of urbanization, the proportion of the population living on less than one dollar a day, the prevalence of diabetes and the number of hospital beds. CONCLUSIONS: The countries of the region show a heterogeneous evolution in the incidence of COVID-19. This heterogeneity is associated with both the public health measures adopted, as well as with the population size, poverty levels and pre-existing health systems.

Capacidad de respuesta frente a la pandemia de COVID-19 en América Latina y el Caribe

Objetivo. Analizar la evolución de la pandemia de COVID-19 en países de América Latina y el Caribe en sus primeros 90 días y su asociación con variables relacionadas con las medidas de salud pública y características demográficas, sanitarias y sociales. Métodos. Se analizó la tendencia de nuevos casos diarios y la tasa cruda de mortalidad por COVID-19 (TCM) través de la metodología de análisis de regresión Joinpoint, utilizando el Programa de Regresión de Joinpoint 4.8.0.1. Los datos se obtuvieron del registro Our World in Data. Se realizó un análisis de correspondencias múltiple entre las medidas de salud pública adoptadas en cada país frente a la pandemia de COVID-19 (medido a través del índice de rigor de la Universidad de Oxford), las condiciones sanitarias, demográficas y sociales y los resultados de la evolución de la pandemia. Se utilizó el programa SPSS. Resultados. El análisis de regresión Joinpoint indica que el mayor crecimiento en el número de casos se observa en Brasil (11,3%) y la mayor velocidad de crecimiento en la TCM en México (16,2%). El análisis de correspondencia múltiple identificó que la TCM se asocia con la población total, el índice de rigor, el nivel de urbanización, la proporción de la población que vive con menos de un dólar al día, la prevalencia de diabetes y el número de camas hospitalarias. Conclusiones. Los países de la región muestran una evolución heterogénea en la incidencia de COVID-19. Esta heterogeneidad se asocia tanto con las medidas de salud pública adoptadas, así como con el tamaño de la población, los niveles de pobreza y los sistemas de salud preexistentes.

Objective. To analyze the evolution of the COVID-19 pandemic in Latin American and Caribbean countries in its first 90 days and its association with variables related to public health measures, and demographic, health and social characteristics. Methods. The trend in new daily cases and the crude mortality rate (CMR) from COVID-19 were analyzed through the Joinpoint regression analysis methodology, using the Joinpoint Regression Program 4.8.0.1. Data was obtained from the Our World in Data registry. A multiple correspondence analysis was performed between the public health measures adopted in each country to face the COVID-19 pandemic (measured through the stringency index, Oxford University) and sanitary, demographic and social conditions, and the results of the evolution of the pandemic. SPSS software was used. Results. The Joinpoint regression analysis showed that the highest increase in the number of cases was observed in Brazil (11.3%) and the highest increase in CMR in Mexico (16.2%). The multiple correspondence analysis showed that CMR was associated with the total population, the stringency index, the level of urbanization, the proportion of the population living on less than one dollar a day, the prevalence of diabetes and the number of hospital beds. Conclusions. The countries of the region show a heterogeneous evolution in the incidence of COVID-19. This heterogeneity is associated with both the public health measures adopted, as well as with the population size, poverty levels and pre-existing health systems.

Tunable Nanoporous Anodic Alumina Photonic Crystals by Gaussian Pulse Anodization.

This study presents a Gaussian pulse anodization approach to generate nanoporous photonic crystals with highly tunable and controllable optical properties across the visible-NIR spectrum. Nanoporous anodic alumina Gaussian photonic crystals (NAA-GPCs) are fabricated in oxalic acid electrolyte by Gaussian pulse anodization, a novel form of pulse-like anodization. The effect of the Gaussian pulse width in the anodization profile on the optical properties of these photonic crystals is assessed by systematically varying this fabrication parameter from 5 to 60 s. The optical features of the characteristic photonic stopband (PSB) of NAA-GPCs-the position of the central wavelength, full width at half-maximum, and intensity-are found to be highly dependent on the Gaussian pulse width, the angle of incidence of incoming photons, and the nanopore diameter of NAA-GPCs. The effective medium of NAA-GPCs is assessed by monitoring spectral shifts in their characteristic PSB upon infiltration of their nanoporous structure with analytical solutions of d-glucose of varying concentration (0.0125-1 M). Experimental results are validated and mechanistically described by theoretical simulations, using the Looyenga-Landau-Lifshitz effective medium approximation model. Our findings demonstrate that Gaussian pulse anodization is an effective nanofabrication approach to producing highly sensitive NAA-based PC structures with versatile and tunable PSBs across the spectral regions. The findings provide new exiting opportunities to integrate these unique PC structures into photonic sensors and other platform materials for light-based technologies.