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Puerto Rico (PR) has faced environmental and public health challenges that could have significantly affected cancer screening access. Using administrative claims data from PR's Medicaid population, this study assessed trends in colorectal and breast cancer screening from 2016 to 2021, the impact of disasters in screening, and the absolute deficit in screening due to the pandemic. The monthly rates of claims were analyzed using Poisson regression. Significant reductions in breast and colorectal cancer screening utilization were observed. The colorectal cancer screening rate in 2017 was 77% lower a month after Hurricanes Irma and María [RRadj: 0.23; 95% CI: 0.20, 0.25] compared to the same time period in 2016. Breast cancer screening dropped 50% in November 2017 compared to November 2016 [RRadj: 0.50; 95% CI: 0.47, 0.54]. Prospectively, a recovery in utilization has been observed only for breast cancer screening. The results revealed that cancer screening utilization substantially declined after environmental disasters and the pandemic. These findings have potentially severe long-term implications for cancer health disparities and mortality in PR.

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BACKGROUND: Allergy skin prick tests are important tools for the diagnosis of respiratory allergic diseases. Cockroach antigens have been identified as the cause of rhinitis, asthma, and other allergic diseases. OBJECTIVE: To show that the cockroach antigen participates in the cause of allergic diseases. METHODS: A retrolective and cross-sectional study was carried out, for which clinical records and history of atopy were reviewed; the results were obtained from blood biometry, nasal cytology, total IgE, and coproparasitoscopic serial tests. After prior informed consent, skin tests were applied in 3-74 year-old patients. RESULTS: 1,837 patients were studied; the prevalence of cutaneous reactivity to the cockroach antigen was of 17.90%; 56% of the patients had a diagnosis of allergic rhinitis, and only 6% had been diagnosed with asthma and rhinitis. CONCLUSION: The application of the cockroach antigen in skin tests must be considered in the practice of all allergists.

Antecedentes: Las pruebas cutáneas por técnica de punción son herramientas importantes para el diagnóstico de la alergia respiratoria. Se han identificado los antígenos de las cucarachas como responsables del desarrollo de rinitis, asma y otras enfermedades alérgicas. Objetivo: Demostrar la participación del antígeno de cucaracha en enfermedades alérgicas. Métodos: Se llevó a cabo un estudio retrolectivo y transversal, para el cual se revisaron historias clínicas y los antecedentes de atopia; se recolectaron los resultados de biometría hemática, citología nasal, IgE total y estudio coproparasitoscópico seriado. Previo consentimiento informado se aplicaron pruebas cutáneas en pacientes de tres a 74 años. Resultados: Se estudiaron 1837 pacientes, la prevalencia de reactividad cutánea al antígeno de cucaracha fue de 17.90 %; 56 % de los pacientes tenía diagnóstico de rinitis alérgica y solo 6 %, de asma y rinitis. Conclusión: Se debe considerar la aplicación del antígeno de cucaracha en las pruebas cutáneas en la práctica del alergólogo.

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Multilayered microresonators commonly use sensitive coating or piezoelectric layers for detection of mass and gas. Most of these microresonators have a variable cross-section that complicates the prediction of their fundamental resonant frequency (generally of the bending mode) through conventional analytical models. In this paper, we present an analytical model to estimate the first resonant frequency and deflection curve of single-clamped multilayered microresonators with variable cross-section. The analytical model is obtained using the Rayleigh and Macaulay methods, as well as the Euler-Bernoulli beam theory. Our model is applied to two multilayered microresonators with piezoelectric excitation reported in the literature. Both microresonators are composed by layers of seven different materials. The results of our analytical model agree very well with those obtained from finite element models (FEMs) and experimental data. Our analytical model can be used to determine the suitable dimensions of the microresonator's layers in order to obtain a microresonator that operates at a resonant frequency necessary for a particular application.

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Four mononuclear complexes [Cu(HL(1))Cl]PF(6).CH(3)OH (1), [Cu(HSL(1))Cl]PF(6).0.75H(2)O (2), [Cu(HL(2))Cl]PF(6).CH (3)OH (3), [Cu(HSL(2))Cl]PF(6).1.5CH(3)OH (4), and two polynuclear complexes [Cu (2)(SL(2))(2)](PF(6))(2).2CH(3)OH (5) and {Cu[Cu(SL(2))(Cl)](2)}(PF(6))(2) (6) (HL(1): 2-[(bis(2-pyridylmethyl)-amino)methyl]-4-methylphenol; HSL(1): 2-[(bis(2-pyridylmethyl)amino) methyl]-4-methyl-6-(methyl-thio)phenol; HL(2): 2-[(2-pyridylmethyl)(2'-pyridylethyl)-aminomethyl)]-4-methylphenol; HSL(2): 2-[(2-pyridylmethyl)(2'-pyridylethyl)amino-methyl]-4-methyl-6-(methylthio)phenol were obtained and characterized. The crystal structures of the mononuclear complexes 1-4 show the copper centers in a square-base pyramidal environment with the phenolic oxygen coordinated at the axial position. Dinuclear complex 5 has two copper centers with different geometry and bridged by phenoxo oxygens; one of the copper atoms is square pyramidal while the other can be described with a highly distorted octahedral geometry with a long Cu-S distance (2.867 A). Density functional theory calculations were used to obtain the reported structure of 6, since single crystals suitable for X-ray diffraction were not isolated. Magnetic studies done for 5 and 6 show an antiferromagnetic behavior for 5 (J = -134 cm(-1)) and a ferromagnetic behavior for 6 (J = +11.9 cm(-1)). Redox potentials for the mononuclear complexes were measured by cyclic voltammetry; the values show the effect of the chelating ring size (-213 mV and -142 mV for Cu-HL(1) and Cu-HL(2), respectively) and the presence of the thiomethyl substituent (-213 mV and -184 mV for Cu-HL(1) and Cu-HSL(1), respectively).

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Two new ligands, 2-[(bis(2-pyridylmethyl)amino)methyl]-4-methylphenol (HL) and 2-[(bis(2-pyridylmethyl)amino)methyl]-4-methyl-6-(methylthio)phenol (HSL), were synthesized and were used to prepare the trinuclear copper(II) complex {[CuSL(Cl)]2Cu}(PF6)2.H2O (1) and the corresponding binuclear complexes [Cu2(SL)2](PF6)2 (2) and [Cu2L2](PF6)2 (3). The crystal structure of 1 shows two different coordination environments: two square base pyramidal centers (Cu1 and Cu1a, related by a C2 axes), acting as ligands of a distorted square planar copper center (Cu2) by means of the sulfur atom of the SCH3 substituent and the bridging phenoxo oxygen atom of the ligand (Cu2-S = 2.294 A). Compounds 2 and 3 show two equivalent distorted square base pyramidal copper(II) centers, bridged in an axial-equatorial fashion by two phenoxo groups, thus defining an asymmetric Cu2O2 core. A long copper-sulfur distance measured in 2 (2.9261(18) A) suggests a weak bonding interaction. This interaction induces a torsion angle between the methylthio group and the phenoxo plane resulting in a dihedral angle of 41.4(5) degrees. A still larger distortion is observed in 1 with a dihedral angle of 74.0(6) degrees. DFT calculations for 1 gave a ferromagnetic exchange between first neighbors interaction, the calculated J value for this interaction being +11.7 cm-1. In addition, an antiferromagnetic exchange for 1 was obtained for the second neighbor interaction with a J value of -0.05 cm-1. The Bleaney-Bowers equation was used to fit the experimental magnetic susceptibility data for 2 and 3; the best fit was obtained with J values of +3.4 and -16.7 cm-1, respectively. DFT calculations for 2 and 3 confirm the nature and the values of the J constants obtained by the fit of the experimental data. ESR and magnetic studies on the reported compounds show a weak exchange interaction between the copper(II) centers. The low values obtained for the coupling constants can be explained in terms of a poor overlap between the magnetic orbitals, due to the axial-equatorial phenoxo bridging mode observed in these complexes.

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Incidence of electrocardiographic abnormalities in subarachnoid hemorrhage secondary to aneurysm rupture is 50-100%. The most frequent electrocardiographic abnormalities described include acuminated, inverted or flat T waves, inverted T waves associated with prolonged QT interval, positive or negative ST segment levels, prominent U waves, PR segment enlargement, acuminated P waves, and pathologic Q waves. J point is the isoelectric union of QRS complex with ST segment. It represents the end of depolarization and the beginning of repolarization. Prominent and positive J point level is named J wave, considered pathognomonic of severe hypothermia, although it has also been described in other clinical entities not associated with hypothermia, such as hypercalcemia, Brugada syndrome, acute brain injury, cardiac arrest, and dysfunction of cervical sympathetic system. Non-hypothermic J wave is an infrequent electrocardiographic manifestation of subarachnoid hemorrhage. We describe a clinical case of non-hypothermic J wave in a patient with subarachnoid hemorrhage.

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