RESUMO
INTRODUCTION: Mexico is one of the countries that is most affected by mortality due to COVID-19. Once infected, the indigenous population living in the lower-income states had worse outcomes. Our objectives were to analyze outcomes by ethnic group, and determine the association between state-level income and the incidence, hospitalizations, outpatients, and death rates per 100,000 population. METHODOLOGY: We analyzed 1,037,567 confirmed COVID-positive cases from February 29 to November 13, 2020 recorded in the Mexican COVID-19 cases database. Sociodemographic characteristics, comorbidities, and outcomes were analyzed. Data was allocated according to the state where the patients were treated. Statistical association between age-adjusted incidence and death rates with state-level GDP per capita (as a measure of income), were ascertained using Spearman correlations. Kruskal-Wallis tests examine the association of cumulative incidence, hospitalizations, outpatients, and death rates, with income quartiles. When significant, a follow-up analysis (Mann-Whitney) was conducted. RESULTS: Respective cumulative incidence rates and death rates were: 900.3 (non-indigenous) and 94.4 (indigenous), and 87.1 (non-indigenous) and 13.9 (indigenous). Spearman correlation coefficients of income with age-standardized incidence and death rates were 0.657 and 0.607 (p < 0.001 for both). Kruskal-Wallis H-Values indicate significant median differences by income in total population rates: cumulative incidence 13.47 (p < 0.01), hospitalizations 11.67 (p < 0.01), outpatients 12.86 (p < 0.01), and deaths 8.92 (p < 0.05). CONCLUSIONS: Cumulative incidence, hospitalizations, outpatients, and mortality rates presented a reversed socioeconomic status health gradient in Mexico. Less adverse outcomes were observed in the lowest-income states compared to higher-income states.
Assuntos
COVID-19 , COVID-19/epidemiologia , Etnicidade , Hospitalização , Humanos , Renda , México/epidemiologia , Pacientes AmbulatoriaisRESUMO
This study aimed to evaluate the effect of incorporating different concentrations (0, 200, 300, and 400 mg L-1) of avocado peel extracts (EE-AP) on the physicochemical properties and antifungal activity of gelatin-carboxymethylcellulose (Gel-CMC) films and their applicability in berry preservation. The results showed that incorporating EE-AP was compatible with the Gel-CMC film and enhanced the mechanical properties without affecting the integrity and thermal properties. The 200 mg L-1 of EE-AP concentration on films offered the best barrier properties against water vapor (2.90 × 10-11 g m-1 s-1 Pa-1). FTIR identified the intramolecular and intermolecular interactions between the functional groups of biopolymers and the EE-AP. The results obtained revealed that EE-AP incorporation into gelatin-carboxymethylcellulose films significantly decreased the moisture content (from 12.48 to 11.02%) and solubility (from 40.13 to 35.39%) of the films. All films incorporated with EE-AP showed higher colorimetric parameters and opacity than the control film (p < 0.05). The DPPH radical scavenging ability of the Gel-CMC films was increased from 24.16 to 41.12, 57.21, and 63.47%, as the extract concentration increased. Active films presented excellent ultraviolet-visible light barrier properties. The antioxidant pigments (flavonoids and chlorophylls) were estimated spectrophotometrically through absorbance. In vitro tests indicated high effectiveness to inhibit the growth of Rhizopus stolonifer and Aspergillus niger. A preservation study indicated the absence of fungal development in berries over six days of storage. In conclusion, gelatin-carboxymethylcellulose films with EE-AP represent a potential option for active packaging and can preserve fresh fruit.