Yamixa Delgado

Weapon carrying and violent behaviors during adolescence are associated with increased risk of injuries and have been linked to suicidal ideation. However, little is known about these associations among Puerto Rican high school students. This cross-sectional study analyzed 2019 Puerto Rico Youth Risk Behavior Surveillance System (YRBSS) data from students in grades 9–12. Survey-weighted descriptive statistics summarized prevalence, and multivariable logistic regression examined associations between suicidal ideation and sociodemographic, violent behavior, and psychosocial variables. Among Puerto Rican high school students, 52% were female, and 12% reported suicidal ideation. Bivariate analyses showed significant associations between suicidal ideation and sex, age, weapon carrying, bullying victimization, persistent sadness/hopelessness, and cigarette use (p < 0.05). In the fully adjusted model, persistent sadness/hopelessness was the strongest factor associated with suicidal ideation (AOR = 8.88, 95% CI: 4.91–16.03). Bullying victimization and cigarette use also remained independently associated with higher odds of suicidal ideation. Weapon carrying was not independently associated with suicidal ideation after adjustment for psychosocial factors. Persistent sadness/hopelessness, bullying victimization, and cigarette use were independently associated with suicidal ideation, highlighting the multifactorial nature of adolescent suicide risk. These findings underscore the importance of comprehensive mental health screening and interventions that address emotional distress, social stressors, and behavioral risk factors among Puerto Rican adolescents.

Background/Objectives: In Puerto Rico (PR), lung cancer mortality remains high because diagnoses frequently occur at advanced stages. Although low-dose computed tomography (LDCT) lowers lung cancer–specific mortality, this screening is difficult to operationalize locally due to high false-positive rates, radiology capacity constraints, payer limitations, and geographic barriers affecting rural populations. Methods: We performed a narrative review on the literature from 2001–2026 of established and emerging detection strategies—LDCT; serum biomarkers (CEA, CYFRA-21-1, NSE, ProGRP, SCC-Ag, HE4, Hp, TAAb); breath analysis (FeNO and VOCs); and liquid biopsy (ctDNAs/CTCs/miRNAs). We assessed technical performance, feasibility, and health-system fit in PR and then synthesized these findings into an implementable biomarker-first triage workflow for are. Results: Multiplex serum panels analyzed with machine learning outperform single markers and TAAb provide high specificity with biological lead time, supporting their use as a triage gateway before LDCT. Breathomics is also feasible at the point of care. Liquid biopsy has modest sensitivity in very-early disease yet provides molecular adjudication for indeterminate nodules. A stepwise pathway—expanded risk assessment, integrated multi-panel testing in primary care, LDCT reserved for biomarker-positive individuals, and liquid biopsy when imaging is inconclusive—can enrich pre-test probability, reduce unnecessary scans, align with capitation, and protect limited radiology capacity. Conclusions: An integrated, non-invasive, biomarker-first triage model offers a pragmatic, equitable route to earlier lung cancer detection in PR and resource stewardship, while reducing disparities.

The integration of artificial intelligence (AI), particularly large language models (LLMs), into education, marks a profound shift in how knowledge is accessed, processed, and applied. These tools offer clear advantages—including improved efficiency, immediate support, and high productivity—but it may simultaneously weaken foundational skills. This Perspective examines the dual impact of AI on education, arguing that over-reliance on AI may displace essential cognitive processes that reinforce professional competence. Emerging evidence points to troubling associations between frequent AI use and diminished critical reasoning. We propose a model of critical alliance, in which AI augments but does not replace core intellectual processes. Unlike existing AI competency or digital literacy, this model centers on preserving human cognitive agency, judgment, reflection, and intellectual ownership, as primary educational outcomes. This framework not only emphasizes cognitive independence, but also equitable access, ethical vigilance, and faculty development as cornerstones of AI literacy. Addressing these questions is essential to safeguard both intellectual growth and educational equity in an AI-augmented era. Unlike existing digital literacy or AI competency frameworks, the critical alliance explicitly centers on preserving human cognitive agency and intellectual ownership as educational priorities, particularly in environments increasingly shaped by high-performing generative systems.

Air pollutants pose a growing public health concern in Puerto Rico (PR), particularly from rapid industrialization, military activities, environmental changes and natural disasters. A total of 193 pollutants, comprising the 187 hazardous air pollutants and the 6 criteria air pollutants—including particulate matter (PM), carbon monoxide (CO), volatile organic compounds (VOC), and heavy metals—coincide with rising respiratory disease rates (e.g., lung cancer) documented in national and regional health registries. This study aimed to review major air pollutants in PR, their molecular carcinogenic mechanisms (mostly focused on respiratory-related cancers), and the geographic areas impacted significantly. We conducted an extensive literature search utilizing peer-reviewed scientific articles (PubMed and Web of Science), governmental reports (EPA, WHO, State of Global Air), public health registries, (Puerto Rico Central Cancer Registry and International Agency for Research on Cancer) and local reports. Data on pollutant type, source, molecular pathways, and carcinogenic properties were extracted and synthesized. Our analysis identified ethylene oxide (EtO), polycyclic aromatic hydrocarbons, and PM from industrial sites as key pollutants. The municipalities of Salinas and Vieques, hubs of industrial activity and military exercises, respectively, emerged as critical hotspots where high concentrations of monitored pollutants (e.g., EtO, formaldehyde, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and diesel PM) are associated with a significant prevalence of cancer and respiratory diseases. These agents, known to induce genomic instability and chromosomal aberrations, were correlated with elevated local cancer incidence. Our findings underscore the urgent need for targeted public health interventions and support a multi-pronged strategy that includes: (1) enhanced regulatory oversight of EtO and other hazardous air pollutant emissions; (2) community-based biomonitoring of high-risk populations; and (3) investment in public health infrastructure and a transition to cleaner energy sources. Integrating rigorous environmental science with public health advocacy is essential to strengthen PR’s cancer-control continuum and foster resilience in its most vulnerable communities.

Air Pollutants pose a growing public health concern in Puerto Rico (PR), particularly from rapid industrialization, military activities, environmental changes and natural disasters. Criteria and hazardous air pollutants (HAPs) emissions from these sources include 193 chemicals— e.g., particulate matter (PM), carbon monoxide, volatile organic compounds, and heavy metals —coincide with rising respiratory disease rates (e.g. lung cancer) documented in national and regional health registries. This study aimed to review major air pollutants in PR, their molecular carcinogenic mechanisms (mostly focused on respiratory-related cancers), and the geographic areas impacted significantly. We conducted an extensive literature search utilizing peer-reviewed scientific articles (PubMed and Web of Science), governmental reports (EPA, WHO, State of Global Air), public health registries (Puerto Rico Central Cancer Registry and International Agency for Research on Cancer) and local reports. Data on pollutant type, source, molecular pathways, and carcinogenic properties were extracted and synthesized. Our analysis identified ethylene oxide (EtO), polycyclic aromatic hydrocarbons, and particulate matter (PM) from industrial sites as key pollutants. The municipalities of Salinas and Vieques, hubs of industrial activity and military exercises, respectively, emerged as critical hotspots where high concentrations of monitored pollutants (e.g., EtO, formaldehyde, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and diesel PM) are associated with a significant prevalence of cancer and respiratory diseases. These agents, known to induce genomic instability and chromosomal aberrations, were correlated with elevated local cancer incidence. Our findings underscore the urgent need for targeted public health interventions and support a multi-pronged strategy that includes: 1) enhanced regulatory oversight of EtO and other hazardous air pollutant emissions; 2) community-based biomonitoring of high-risk populations; and 3) investment in public health infrastructure and a transition to cleaner energy sources. Integrating rigorous environmental science with public health advocacy is essential to strengthen PR’s cancer-control continuum and foster resilience in its most vulnerable communities.

Objective: Currently, in Puerto Rico (PR) there is no study for HPV vaccination rates after implementing mandatory HPV vaccination school-entry policy in 2018. This study aims to (a) explore HPV vaccination status in adults (>= 18 years) residing in PR., particularly those who fall within the age range approved for vaccination; (b) describe participants' gender and sexual identities and behavior risk factors; and (c) determine how the willingness to vaccinate against HPV is influenced by sociodemographic factors such as age, gender, education level, and health insurance. Methods: We conducted a cross-sectional study to understand HPV vaccination status, sexual health and behavior risk factors, and sociodemographic factors in adults residing in PR. Surveys were distributed using various strategies over six months to collect data. Informed consent was obtained, and participants were assured anonymity and data utilization. We performed descriptive and logistic regression analyses using STATA. Results: From a sample of 314 individuals, 47% were vaccinated, and 82% were familiar with the HPV vaccine. Among the unvaccinated, 49% were open to vaccination. Age and gender significantly predicted vaccination status, with older individuals 65% less likely and females 60% more likely to be vaccinated than males and other genders. Conclusion: This study identifies age, gender identity, education, and health insurance as pivotal determinants of HPV vaccination status in PR. It also found interest in vaccine information among nonvaccinated people, revealing significant coverage disparities crucial for enhancing vaccination rates and sexual health education.

Clinically approved iron chelators, originally designed to address iron overload disorders, have emerged as potential anticancer agents. Deferasirox (Def), a tridentate iron chelator, has demonstrated antiproliferative effects in cancer. Background/Objectives: This study aims to elucidate the mechanism of action of Def and its impact on non-small cell lung carcinoma (NSCLC). Methods: NSCLC A549 cells were treated with Def to assess cytotoxicity, the effect on nuclear and mitochondrial pathways, and iron-containing proteins and genes to evaluate anti-metastasis and chemoresistance. A lung carcinoma mouse model was used for in vivo studies. Results: Our findings revealed that Def induced cytotoxicity, effectively chelated intracellular iron, and triggered apoptosis through the increase in phosphatidylserine externalization and caspase 3 activity. Additionally, Def caused G0/G1 cell cycle arrest by downregulating the ribonucleotide reductase catalytic subunit. Furthermore, Def perturbed mitochondrial function by promoting the production of reactive oxygen species and the inhibition of glutathione as a measurement of ferroptosis activation. Def demonstrated inhibitory effects on cell migration in scratch assays, which was supported by the upregulation of n-myc downstream-regulated gene 1 and downregulation of the epidermal growth factor receptor protein. Also, Def downregulated one of the main markers of chemoresistance, the ABCB1 gene. In vivo experiments using a lung carcinoma mouse model showed that Def treatment did not affect the animal’s body weight and showed a significant decrease in tumor growth. Conclusions: This investigation lays the groundwork for unraveling Def action’s molecular targets and mechanisms in lung carcinoma, particularly within iron-related pathways, pointing out its anti-metastasis and anti-chemoresistance effect.

Recently, there has been great interest in plant-derived compounds known as phytochemicals. The pentacyclic oleanane-, ursane-, and lupane-type triterpenes are phytochemicals that exert significant activity against diseases like cancer. Lung cancer is the leading cause of cancer-related death worldwide. Although chemotherapy is the treatment of choice for lung cancer, its effectiveness is hampered by the dose-limiting toxic effects and chemoresistance. Herein, we investigated six pentacyclic triterpenes, oleanolic acid, ursolic acid, asiatic acid, betulinic acid, betulin, and lupeol, on NSCLC A549 cells. These triterpenes have several structural variations that can influence the activation/inactivation of key cellular pathways. From our results, we determined that most of these triterpenes induced apoptosis, S-phase and G2/M-phase cycle arrest, the downregulation of ribonucleotide reductase (RR), reactive oxygen species, and caspase 3 activation. For chemoresistance markers, we found that most triterpenes downregulated the expression of MAPK/PI3K, STAT3, and PDL1. In contrast, UrA and AsA also induced DNA damage and autophagy. Then, we theoretically determined other possible molecular targets of these triterpenes using the online database ChEMBL. The results showed that even slight structural changes in these triterpenes can influence the cellular response. This study opens up promising perspectives for further research on the pharmaceutical role of phytochemical triterpenoids.

In recent times, a great interest has been motivated in plant-derived compounds known as phytochemicals. The pentacyclic oleanane-, ursane-, lupane-type triterpenes are phytochemicals that exert significant activities against diseases like cancer. Lung cancer is the leading cause of cancer-related death worldwide. Although chemotherapy is the treatment of choice for lung cancer, its effectiveness is hampered by the dose‐limiting toxic effects and chemoresistance. Herein, we investigated the structure-activity relationship of six pentacyclic triterpenes: oleanolic acid (OleA), ursolic acid (UrA), asiatic acid (AsA), betulinic acid (BeA), betulin (Betu), lupeol (Lupe), on NSCLC A549 cells. From our studies, we confirmed that all these triterpenes showed cytotoxicity in the mid µM range, where BeA showed the strongest effect. Then, we determined that most of these triterpenes induced S-phase and G2/M phase cycle arrest, reactive oxygen species, mitochondrial depolarization, and caspase 3 activation. For chemoresistance markers, we elucidated that most triterpenes downregulated STAT3 and PDL1 genes. In contrast, ursane-type UrA and AsA also induced DNA damage, reactive nitrogen species and autophagy. These results showed that even slight structural changes in these triterpenes can influence the cellular response and mechanistic pathways. This study opens promising perspectives for further research on the pharmaceutical role of phytochemical triterpenoids.