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Introduction: This study aims to assess the cost effectiveness of romosozumab versus teriparatide, both sequenced to denosumab, for the treatment of severe postmenopausal osteoporosis at very high risk of fractures in Mexican women., Methods: A Markov model was used to assess the relative cost effectiveness of 1 year of romosozumab versus 2 years of teriparatide, both sequenced to denosumab for a total treatment duration of 5 years. Outcomes for a cohort of women with a mean age of 74 years, a T-score ≤-2.5 and a previous fragility fracture were simulated over a lifetime horizon. The analysis was conducted from the perspective of the Mexican healthcare system and used a discount rate of 5% per annum. To inform relative fracture incidence, the bone mineral density (BMD) advantage of romosozumab over teriparatide was translated into relative risks of fracture, using relationships provided by a meta-regression of osteoporosis therapy trials. Outcomes were assessed in terms of lifetime costs (2023 Mexican pesos), quality-adjusted life years (QALYs) and life-years gained (LYs)., Results: Base case results showed that, compared with teriparatide/ denosumab, romosozumab/ denosumab reduced costs by $51,363 MXN per patient and yielded 0.03 additional QALYs and 0.01 LYs. Scenario analyses and probabilistic sensitivity analyses confirmed that results are robust to uncertainty in model assumptions and inputs., Conclusions: Results show that romosozumab/ denosumab produces greater health benefits at a lower total cost than teriparatide/ denosumab., Competing Interests: TAM, LG, EY and LMC are employed by Amgen. JPDM has served as a consultant for Amgen and has received research grants from them. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2025 Diaz Martinez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Surface waters function as ecological niches where Salmonella enterica can persist and disseminate to fresh produce production systems. We examined the genomic characteristics of S. enterica serotypes Agona ( n = 86), Braenderup ( n = 47), Muenchen ( n = 53), and Panama ( n = 69) isolates from surface waters in Chile, Mexico, and Brazil between 2019 and 2022. Mexican isolates consistently displayed a higher occurrence of genotypic antimicrobial resistance (AMR) than Chilean and Brazilian isolates. All S . Agona isolates exhibited the presence of fosA7.2 , while qnrB19 emerged as the predominant AMR gene (ARG) among S . Braenderup isolates. S . Muenchen isolates from Chile displayed an absence of any ARGs, while those from Mexico and Brazil predominantly carried qnrB19 . Among S . Panama isolates from Chile, aadA1 , floR , sat2 , and tet(B ) were the most prevalent ARGs, whereas those from Mexico and Brazil harbored tet(A ), and floR and tet(A ) as the leading ARGs, respectively. ARG sharing among isolates and ARG co-occurrence within individual isolates were prevalent across countries and serotypes. All isolates containing integrons exhibited genotypic multidrug resistance. The principal coordinates analysis reveals distinct clustering patterns based on country, serotype, number of ARGs per isolate, and plasmid and integron presence/absence. The whole-genome phylogenetic analysis demonstrates clear clusters, each associated with their respective countries. However, a notable exception was observed with one S . Agona isolate from Brazil closely related to two isolates from Chile, differing by only 18 and 19 single-nucleotide polymorphisms, respectively.IMPORTANCEThis comprehensive study explored the intricate genomic landscapes of S . Agona, Braenderup, Muenchen, and Panama isolates from surface waters across Chile, Mexico, and Brazil. By filling important knowledge gaps related to the genomic characteristics of these serotypes, the research offers a nuanced understanding of these serotypes as potential reservoirs for multidrug resistance. Our findings emphasize the urgency of targeted interventions to mitigate the emergence and dissemination of multidrug-resistant Salmonella enterica . This work underscores the need for informed policies and collaborative efforts to address the risks posed by S. enterica in Latin American surface waters., Competing Interests: The authors declare no conflict of interest.

Objectives: We examined differential item functioning (DIF) of the Center for Epidemiologic Studies Depression Scale (CES-D) items by country and statistically harmonized common cross-national factor scores for the CES-D to aid further cross-national research., Study Design and Setting: Data were from Harmonized Cognitive Assessment Protocol (HCAP) studies in China (N = 9639), England (N = 1262), India (N = 4048), Mexico (N = 1918), South Africa (N = 631), and the United States (N = 3321). Multiple indicators, multiple causes models were estimated to test DIF in the CES-D items by country. DIF items were defined as having an odds ratio (OR) outside the range of 0.75-1.25 in multiple indicators, multiple causes models. We evaluated DIF impact and identified salient DIF by examining whether the difference between DIF-adjusted factor scores and non-DIF-adjusted factor scores exceeded a threshold of 0.30 standard deviation (SD) units. Confirmatory factor analysis was used to create DIF-adjusted, cross-nationally harmonized CES-D factor scores., Results: Controlling for underlying depressive symptoms, HCAP participants in India had higher odds of reporting being not hopeful about future (OR = 1.38, 95% confidence interval [CI]: 1.34-1.42), not enjoying life (OR = 1.43, 95% CI: 1.38-1.48), and being unhappy (OR = 1.29, 95% CI: 1.25-1.34), compared to HCAP participants in the United States. These identified DIF items artificially increased mean harmonized CES-D factor scores by 0.48 SD units in the India HCAP, with over 50% of the factor scores increased by over 0.30 SD units, indicating salient DIF in the India HCAP., Conclusion: Our findings demonstrate cross-national heterogeneity in the expression of depressive symptoms. We provide DIF-adjusted CES-D factor scores to improve the quality of cross-national comparisons in aging research., Competing Interests: Declaration of competing interest There are no competing interests for any author., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Water and food insecurity often co-occur, and have independently been identified as potential risk factors for poor mental health. Their interlinkages are only just beginning to be explored; even less is known about how the relationships vary by gender. Understanding the independent associations of water and food insecurity with mental health, as well as their joint effects, can help identify which interventions might be most appropriate for improving health., Methods: We explored how probable depression covaried with water and food insecurity using nationally representative data from the Mexican National Health and Nutrition Survey 2021 (ENSANUT 2021, n = 13,126). Cross-sectional data were collected on household water, food insecurity, and probable depression amongst adults. We used multivariable logistic regression models to examine the association of water insecurity and food insecurity with moderate-to-severe probable depression, and we stratified the models by sex., Results: Household water insecurity was associated with higher odds of probable depression amongst women (1.37 OR, CI: 1.13-1.66) and men (1.30 OR, CI: 0.92-1.83). When controlling for household food insecurity, the association between probable depression and water insecurity was no longer important, however, household food insecurity was associated with higher odds of probable depression. Those experiencing joint water and food insecurity had the highest odds of probable depression (2.70 OR, CI: 2.13-3.40). The associations between water insecurity, food insecurity and mental health did not differ by sex., Conclusion: Concurrent water and food insecurity increase the likelihood of probable depression amongst both men and women. Strategies to mitigate both resource insecurities could improve mental health., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sera L Young reports financial support was provided by National Institute of Mental Health. Indira Bose reports financial support was provided by UK Research and Innovation Economic and Social Research Council. Sera L Young reports financial support was provided by Leverhulme Trust. Suneetha Kadiyala reports financial support was provided by UK Government Foreign Commonwealth & Development Office. Suneetha Kadiyala reports financial support was provided by Bill and Melinda Gates Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

In Mexico, Neospora caninum and Toxoplasma gondii are major causes of reproductive problems in sheep. Understanding the environmental factors that influence the spread of these parasites is crucial for developing effective control strategies. The objective of this study was to identify the environmental factors associated with N. caninum and T. gondii infections in sheep in western Mexico. Blood samples were collected from 184 sheep and determine seroprevalence using the ELISA test. Based on the seroprevalence data and information about the climatic regions and geographic characteristics, logistic regression analysis was employed to identify the environmental factors associated with N. caninum and T. gondii infections. Antibodies for N. caninum were found in 27 of the 184 blood samples. The environmental risk factors associated with N. caninum were Köppen climate area Ca(w1) with an OR = 6.55 and rainfall (700-800 mm) with an OR = 3.23. For T. gondii, antibodies were detected in 113 of the 184 sheep sampled. The main risk factors were Köppen climate area Cb(w1) with an OR = 10.5 and rainfall (900-1000 mm) with an OR = 4.6. Identifying these factors is crucial for developing more effective control strategies to reduce the incidence of these infections and improve the reproductive health of sheep flocks in the region., Competing Interests: Declarations. Ethical approval: The Committee on the Use and Care of Animals of the Instituto Tecnológico El Llano Aguascalientes and the farm owners approved this project (ITEL-CUCA 011/20). Consent for publication: Authors have permission for publication. Consent to participate: Authors have permission to participate. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s) under exclusive licence to International Society of Biometeorology.)

Introduction: Malnutrition risk (MR) in older adults with neurological disorders is high, but there is little evidence for validated screening tools in this group, as well as for the clinical and socioeconomic factors associated with a high MR., Objectives: To determine the association of MR using the Malnutrition Universal Screening Tool (MUST) with mortality and length of stay (LOS) in older adults with neurological diseases. Secondarily, the association of clinical, and socioeconomic factors with MR and clinical outcomes was sought., Methods: A retrospective cohort study was carried out at a third-level neurological disease referral center in Mexico. All patients older than 60 years admitted from January 2017 to December 2018 were considered. MUST, clinical and socioeconomic factors were assessed at hospital admission. Outcomes were followed up to hospital discharge or a maximum of 6 months., Results: A total of 765 patients were included, of whom 24.7% (n = 189) were at high risk. A high MR was independently associated with mortality (OR 3.09; 95% CI 1.60-5.98, p  = .001) and LOS >14 days (OR 4.38; 95% CI 2.79-6.89, p  = <.001). The only factors independently associated with high MR was economic dependence and unemployment. Patients with high MR and economic dependence (OR 4.0; 95% CI 1.34-11.99, p  = .013) or unemployment (OR 3.43; 95% CI 1.17-10.06, p  = .025) had the highest mortality., Conclusions: In hospitalized older adults with neurological diseases, high MR is independently associated with increased mortality and LOS. Economic dependence or unemployment are associated with worse clinical outcomes in patients with high MR.

People who inject drugs (PWID) face a heightened risk of acquiring/transmitting HIV, enhanced by stigma and limited health care access. In Mexico, studies on PWID have focused on the north of the country. This study aimed to delineate characteristics of PWID living with HIV in Mexico City, identify profiles based on the substance injected, and evaluate variables associated with forming transmission clusters. A cross-sectional study was conducted with data from 2019 to 2023. Participants completed a questionnaire on sociodemographic, clinical, and behavioral variables. Bivariate and multi-variate logistic regression analyses were made. Among PWID, 96.3% were male ( n = 437), of which 90.1% were men who have sex with men, 1.5% were cisgender females ( n = 7), and 2.2% were transgender females ( n = 10). PWID were more likely to use drugs during sex (adjusted odds ratio [aOR] = 3.3, 95% confidence interval [CI]: 1.7-6.4, p < 0.001), have more sexually transmitted diseases (aOR = 1.7, 95% CI: 1.1-2.9, p = 0.035), and have less condom use (aOR = 0.5, 95% CI: 0.3-0.8, p = 0.002). The most frequently injected substance was crystal meth, and those who injected it were more likely to have syphilis (aOR = 2.9, 95% CI: 1.2-7.1, p = 0.021), use Grindr (aOR = 3.6, 95% CI: 1.5-8.9, p < 0.001), and engage in high-risk practices (aOR = 6.9, 95% CI: 2.1-22.7, p < 0.001) in the last 3 months. Those under 25 years ( p = 0.002), recently infected ( p < 0.001), and who practiced insertive anal sex ( p < 0.001) were more likely to be part of a cluster. These findings, and the increasing use of crystal meth, underscore the critical need to implement targeted risk-reduction strategies for PWID living with HIV and to design interventions responsive to specific profiles associated with different substances, taking into account not only their risk practices but also protective behaviors such as HIV testing.

Bats, which play a vital role in maintaining ecosystems, are also known as natural reservoirs of coronaviruses (CoVs), thus have raised concerns about their potential transmission to humans, particularly in light of the emergence of MERS-CoV, SARS-CoV, and SARS-CoV-2. The increasing impact of human activities and ecosystem modifications is reshaping bat community structure and ecology, heightening the risk of the emergence of potential epidemics. Therefore, continuous monitoring of these viruses in bats is necessary. Despite the rich diversity of bats species in México, few studies have been conducted to search for CoVs in these group of mammals. In the present study we conducted CoV surveillance across previously unexplored sites in the state of Yucatán, a state located within the ecologically diverse Yucatán Peninsula, a tropical region undergoing pronounced anthropogenic changes, including deforestation, agricultural expansion and urbanization. We captured 191 bats between 2021 and 2022 in three different habitats: diversified rural (Tzucacab), rural (Tizimín) and urban (Mérida). Molecular analyses had revealed a 5.4% CoV prevalence, with the diversified rural site exhibiting a notably elevated rate (26.3%). Subsequent sequencing and phylogenetic assessment revealed four distinct Alphacoronavirus genotypes, indicating host-specific clustering among Phyllostomidae bats. Notably, one was detected for the first time in a Sturnira species. Our findings suggest a reduced likelihood of transmission of these viruses to humans or other species, evidenced by clustering patterns and sequence dissimilarity with known CoVs. We emphasize that maintaining sustained virus surveillance in bats is crucial to understanding viral diversity and identifying potential risks to human and animal health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Healthcare-associated infections (HCAIs) in neonates are frequent and highly lethal, in particular those caused by extended spectrum beta-lactamase (ESBL) producing bacteria. We evaluated the beneficial effects of ultraviolet C (UV-C) disinfection and copper adhesive plating on HCAIs in the Neonatal Intensive Care Unit (NICU) of a third level paediatric hospital in Mexico City, both in combination of hand-hygiene (HH) and prevention bundles., Methods: All NICU patients were included. There were 4 periods (P): P1: HH monitoring and prevention bundles; P2: P1+UV-C disinfection; P3: P2+Copper adhesive plating on frequent-contact surfaces and P4: Monitoring of P3 actions., Results: 552 neonates were monitored during 15,467 patient days (PD). HCAI rates decreased from 11.03/1000 PD in P1 to 5.35/1000 PD in P4 (p=0.006). HCAIs with bacterial isolates dropped from 5.39/1000 PD in PI to 1.79/1000 PD in P4 (p=0.011). UV-C and copper were associated with significant HCAI prevention (RR 0.49, CI 95% 0.30-0.81, p=0.005) and with lesser HCAIs with bacterial isolates (RR 0.33, CI 95% 0.14-0.77, p=0.011)., Conclusions: Copper adhesive plating combined with UV-C disinfection were associated with a drop in HCAI rates and with the elimination of ESBL-caused HCAIs. Hence, we propose that these strategies be considered in MDRO proliferation preventions., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Purpose: We estimated the 5-year overall, age at diagnosis- and stage-specific colorectal cancer survival in patients treated through their coverage with Seguro Popular., Methods: We conducted a retrospective study using a dataset that included 1418 colorectal cancer patients covered by Seguro Popular (Mexico's public health insurance system covering 60 % of the population) between 2013 and 2016. Deaths were identified using the Epidemiologic Death Statistics Subsystem registry, with a specialized algorithm for record linkage. The Kaplan-Meier method was used to estimate overall survival curves and the proportion of patients alive at various follow-up time points. We compared survival curves across subgroups using the log-rank test., Results: In this study the average age at diagnosis was 56 years with 31.9 % of patients diagnosed before the age of 50. Most cases (78.1 %) were diagnosed in advanced stages (i.e., III and IV), with nearly half of the cases originating in the rectum. The overall 5-year survival was 50 %, with higher survival (74 %) for patients with stage I-II and lower survival for those with stage III (58 %) and IV (33 %). While age at diagnosis was not associated with survival for early-stage colorectal cancer, younger patients with metastatic disease had a worse prognosis compared to older patients., Conclusion: The 5-year overall colorectal cancer survival was 50 %, with variation by clinical stage. Almost 80 % of the population was diagnosed with advanced stages, underscoring the need for screening programs. Younger patients with metastatic disease exhibited a worse prognosis, highlighting the need for targeted interventions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Compare the prevalence and severity of anxiety and depression among people with epilepsy (PWE) evaluated by telemedicine during the initial stages of the COVID-19 pandemic and follow up on their status 15 months later., Methods: We conducted a prospective, observational, and analytical study at the Epilepsy Clinic of the National Institute of Neurology and Neurosurgery (NINN) in Mexico City during the COVID-19 pandemic. HADS-A and HADS-D instruments were administered to adult patients diagnosed with epilepsy, initially through telemedicine and later through in-person visits or phone calls after one year., Results: A sample of 115 patients was obtained, with 62.5% being women. The mean age of the patients was 33.6 years (± 12), and the mean age of epilepsy onset was 16.82 years (± 13.82). The majority of patients had focal epilepsy (78.3%), and only 42% reported being seizure-free. The results from the HADS-A scale showed that 48.69% of the patients had anxiety. On the HADS-D scale, 29.56% of the patients were found to have depression. At follow-up, the HADS-A results indicated that 50.64% of the patients had anxiety, and the HADS-D results showed that 36.36% had depression. An analysis of associations between sociodemographic or clinical variables and the presence of anxiety and/or depression in PWE revealed no statistically significant results, except for the clinical variable of patients taking anxiolytic or antidepressant medications during the assessment. These patients had lower HADS-A and HADS-D scores, with a statistically significant p-value of 0.0001., Significance: Comparing these findings with a previously published paper by our group showed a significant increase in both depression and anxiety, which were already prevalent in the earlier study. In conclusion, PWE exhibited high levels of anxiety and depression during and one year after the pandemic, despite receiving appropriate treatment. These symptoms, present before the pandemic, have been further exacerbated and continue to persist., Plain Language Summary: This study examined anxiety and depression in patients with epilepsy (PWE) during the COVID-19 pandemic at the National Institute of Neurology and Neurosurgery in Mexico. Using the HADS-A and HADS-D scales, 115 patients were assessed over a year. Results showed that 48.69% had anxiety and 29.56% had depression, with both increasing to 50.64% and 36.36%, respectively, after one year. The only significant finding was that patients on anxiolytic or antidepressant medication had lower scores for anxiety and depression. The study concludes that anxiety and depression in PWE worsened during the pandemic and persisted despite treatment., (© 2024 The Author(s). Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Introduction: Rheumatoid arthritis (RA) is a progressive autoimmune inflammatory disease. According to the European League Against Rheumatism (EULAR), the stages of RA progression include pre-RA, preclinical RA, inflammatory arthralgia, arthralgia with positive antibodies, arthralgia suspected of progressing to RA, undifferentiated arthritis and finally established RA. According to the Community Oriented Program for Control of Rheumatic Diseases (COPCORD), the prevalence of RA in Mexico is 1.6% [2], with approximately 10% of health problems addressed at the primary care level., Objective: To assess the implementation of an early referral programme for patients with RA and to reduce the time from symptom onset to specialist referral within the Mexican healthcare system., Materials and Methods: This was a prospective, observational cohort study conducted in family medicine units affiliated with the HGZ #17 of the IMSS, Delegación Nuevo León. A pilot early referral programme was implemented as follows. Phase 1: Patients presenting with hand arthralgia during the initial consultation were referred for a pre-consultation, where they were assessed using the EULAR classification criteria for clinically suspicious arthralgia. Phase 2: Patients meeting more than four of these criteria were scheduled for a direct appointment with a rheumatologist within 3-4 weeks. During the same timeframe, these patients were compared to 200 first-time referrals to rheumatology between April and October 2023 who followed the standard referral process. The following time intervals (measured in months) were evaluated: (A) From symptom onset to the first primary care consultation, (B) To the referral consultation, (C) To internal medicine, and (D) To rheumatology consultation., Results: Patients diagnosed with RA in the early referral group were 14 out of 41 (34.1%) compared to 25 out of 200 (12.5%) in the standard referral group. The total duration from symptom onset to rheumatology consultation was 28.5 months (SD 35.07) in the standard referral group versus 5.4 months (SD 8.9) in the early referral group., Conclusion: The implementation of this early referral programme significantly reduced the time in months for patients to access rheumatologic care., (© 2024 John Wiley & Sons Ltd.)

Purpose: Breast cancer is the most prevalent cancer type in Mexico, with male breast cancer accounting for only 1% of all breast cancer cases. A limited number of studies have described the clinical-pathological profiles of males with breast cancer in low- and middle-income countries. This study presents an analysis of patients with breast cancer seen at three different institutions in México., Methods: A retrospective review of the medical records was performed to analyze the clinical and pathological characteristics of 49 men diagnosed with breast cancer and their overall survival., Results: The mean age at diagnosis was 64.65 years. A significant proportion of patients presented at diagnosis with stage IV disease (n = 11, 22.45%), had triple-negative subtype (n = 6, 12.24%), and nuclear grade III (n = 20, 40.8%). Primary endocrine resistance was observed in 10 patients (31.25%). Genetic analysis was performed on 24 patients (48.9%), revealing a germline BRCA pathogenic variant in 8.33%., Conclusion: Our findings described the clinical and pathological profile of breast cancer in a male cohort in Mexico, with a significantly high proportion of advanced disease, triple-negative subtype, nuclear grade III, and endocrine resistance. Further comprehensive studies, including research into somatic mutations, are needed., Competing Interests: Declarations. Competing interests: The authors have not disclosed any competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To analyze the temporal and territorial relationship between health system financing fragmentation and maternal mortality in the last two decades in Mexico., Methods: We conducted an ecological-longitudinal study of the maternal mortality ratio (MMR) in the 32 states of Mexico during the period 2000-2022. Annual MMRs were estimated at the national and state levels according to health insurance. We compared the distribution of individual attributes and place of residence between deceased women with and without social security to identify overrepresented demographic profiles. Finally, we mapped state disparities in MMR by health insurance for the last four political administrations., Findings: MMR in Mexico decreased from 59.3 maternal deaths per hundred thousand live births in 2000 to 47.3 in 2018. However, from 2019 onwards, MMR increased from 48.7 in 2019 to 72.4 in 2022. Seven out of ten maternal deaths occurred in the population without social security from 2000 to 2018, then decreasing to six out of ten from 2020. Maternal deaths in the population without social security were more frequent among younger women, with less schooling, unmarried, and residing in rural areas, with higher Indigenous presence and greater social marginalization. From 2019 onwards, the MMR was higher in the population with social security., Conclusion: The results of this study confirm the close relationship between maternal mortality and social inequalities, and suggest that affiliation with social security has ceased to be a differentiating factor in recent years. Understanding the evolution of maternal mortality between the population with and without social security in Mexico allows us to quantify the gap in maternal deaths attributed to inequalities in access to maternal health services, which can contribute to the design of policies that mitigate these gaps., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. This study involved no human participants and was approved by the Research, Ethics, and Biosecurity Committees of the National Institute of Public Health of Mexico (ID:2358/1826/S21-2022). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: No study has assessed the impact of flavor capsule cigarettes (FCCs) on smoking cessation. Thus, the purpose of this exploratory study was to assess (1) the sociodemographic and smoking-related characteristics associated with using FCCs, and (2) the preliminary impact of FCCs on smoking cessation., Methods: This study is a secondary data analysis of a single-arm study with 100 individuals living in Mexico who smoked and received a smoking cessation mHealth intervention and pharmacotherapy support. The primary outcomes were self-reported and biochemically verified 7-day smoking abstinence at Month 3., Results: Just over one-third of participants (36%) used FCCs, with a preference for one capsule and menthol/mint flavor. Compared to participants who smoked non-FCCs, participants who smoked FCCs were (1) younger, (2) more likely to be women, and (3) more likely to smoke less than 10 cigarettes per day (CPD; all p's < 0.05). After controlling for all significant associations, age younger than 50 years old (AOR = 3.26, 95% CI 1.25-8.51) and being a woman (AOR = 3.62, 95% CI 1.41-9.35) were positively and independently associated with smoking FCCs. Treating those lost to follow-up as participants who continued smoking, 41.7% (15/36) of participants who smoked FCCs self-reported smoking abstinence at month 3 compared to 42.2% (27/64) of participants who smoked non-FCCs (p = 0.96). Furthermore, 33.3% (12/36) of participants who smoked FCCs were biochemically verified abstinent at Month 3 compared to 18.8% (12/64) of participants who smoked non-FCCs (p = 0.10)., Conclusions: Younger age and being a woman were associated with using FCCs. Self-reported smoking abstinence at Month 3 was comparable between participants who smoke FCCs and non-FCCs. However, biochemically verified abstinent at Month 3 was higher among participants who smoke FCCs compared to participants who smoke non-FCCs, although the difference was not statistically significant. Prospective and adequately powered comparisons must be made between individuals who smoke FCCs and non-FCCs to effectively assess differences in smoking abstinence, and the reasons for these differences., Competing Interests: Declarations. Ethics approval and consent to participate: The Human Subjects Committee of the National Institute of Public Health in Mexico approved and monitored the study procedures (Study identifier: CI:1712-CB:1703). Informed consent was obtained from participants prior to study procedures. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Bacterial pathogens remain poorly characterized in bats, especially in North America. We describe novel (and in some cases panmictic) hemoplasmas (10.1% positivity) and bartonellae (25.6% positivity) across three colonies of Mexican free-tailed bats ( Tadarida brasiliensis ), a partially migratory species that can seasonally travel hundreds of kilometers. Molecular analyses identified three novel Candidatus hemoplasma species most similar to another novel Candidatus species in Neotropical molossid bats. We also detected novel hemoplasmas in sympatric cave myotis ( Myotis velifer ) and pallid bats ( Antrozous pallidus ), with sequences in the latter 96.5% related to Candidatus Mycoplasma haematohominis. We identified nine Bartonella genogroups, including those in cave myotis with 96.1% similarity to Candidatus Bartonella mayotimonensis. We also detected Bartonella rochalimae in migratory Mexican free-tailed bats, representing the first report of this human pathogen in the Chiroptera. Monthly sampling of migratory Mexican free-tailed bats during their North American occupancy period also revealed significant seasonality in infection for both bacterial pathogens, with prevalence increasing following spring migration, peaking in the maternity season, and declining into fall migration. The substantial diversity and seasonality of hemoplasmas and bartonellae observed here suggest that additional longitudinal, genomic, and immunological studies in bats are warranted to inform One Health approaches., Importance: Bats have been intensively sampled for viruses but remain mostly understudied for bacterial pathogens. However, bacterial pathogens can have significant impacts on both human health and bat morbidity and even mortality. Hemoplasmas and bartonellae are facultative intracellular bacteria of special interest in bats, given their high prevalence and substantial genetic diversity. Surveys have also supported plausible zoonotic transmission of these bacteria from bats to humans, including Candidatus Mycoplasma haematohominis and Candidatus Bartonella mayotimonensis. Greater characterization of these bacteria across global bat diversity (over 1,480 species) is therefore warranted to inform infection risks for both bats and humans, although little surveillance has thus far been conducted in North American bats. We here describe novel (and in some cases panmictic) hemoplasmas and bartonellae across three colonies of Mexican free-tailed bats and sympatric bat species. We find high genetic diversity and seasonality of these pathogens, including lineages closely related to human pathogens, such as Bartonella rochalimae ., Competing Interests: The authors declare no conflict of interest.

This study aimed to estimate a socio-spatial vulnerability index for type 2 diabetes mellitus (T2DM) at the municipal level in Mexico for 2020. It incorporated factors such as poverty, social backwardness, marginalization index, and human development index. This retrospective ecological study analyzed 317,011 incident cases of T2DM in 2020. Utilizing multi-criteria decision analysis, weighted values were assigned to each vulnerability criterion. A multiple linear regression model was developed, complemented by cluster and outlier analyses using Moran I's and the high-low clustering method. A clustered spatial autocorrelation of high values was found across 17.65% of Mexico, which was statistically significant (p < 0.001). Conversely, 37.78% of the territory showed a pattern of low values without significant evidence of groupings. The analysis revealed 117 nodes of very high vulnerability forming six focal areas, 172 nodes with high vulnerability across five areas, 168 nodes with medium vulnerability in two areas, 112 nodes with low vulnerability across 16 areas, and 152 nodes with very low vulnerability in 24 focal areas. This method proves to be robust and offers a technical-scientific basis for guiding T2DM prevention strategies and actions using a spatial/epidemiological approach. It is recommended that future strategies take into account factors such as poverty, social backwardness, marginalization index, and human development index to be effective.

Introduction: The methicillin-resistant Staphylococcus aureus (MRSA) genome varies by geographical location. This study aims to determine the genomic characteristics of MRSA using whole-genome sequencing (WGS) data from medical centers in Mexico and to explore the associations between antimicrobial resistance genes and virulence factors., Methods: This study included 27 clinical isolates collected from sterile sites at eight centers in Mexico in 2022 and 2023. Antibiotic susceptibility testing was performed using VITEK 2. In addition, WGS was performed using a NovaSeq platform, and a bioinformatic analysis was conducted using several tools., Results: In this study, 21 strains were CC5, five were CC8, and one was CC93. Moreover, six strains were identified as ST5(CC5)-MRSA-IIa- t895, four strains were found to be ST1011(CC5)-MRSA-IIa-t895, five strains were found to be ST1011(CC5)-MRSA-IIa-t9364, one strain was found to be ST1011(CC5)-MRSA-IIa-t8116, another was found to be ST1011(CC5)-MRSA-IIa-t62, three were found to be ST8(CC8)-MRSA-IVa-t8, one strain was ST5(CC5)-MRSA-IVa-t2, one strain was as ST93(CC93)-MRSA-IVa-t3949, two strains were ST9003(CC8)-MRSA-IVa-t18492, and three strains were ST9034(CC5)-MRSA-V-t2. All SCCmec IIa strains showed resistance to levofloxacin and ciprofloxacin, and all but two strains were resistant to clindamycin. Among the strains that harbored the type IIa cassette, most had the aadD, blaZ, and ermA&#95;SDS genes and the erm A gene. Multiple genes for adhesion, enzymes, immune evasion, and secretion system were detected, regardless of SCCmec type. Of the SCCmec IVa strains, most harbored the Panton-Valentine leukocidin encoding genes., Conclusion: In this study, the most frequently detected CC was CC5, followed by CC8, and CC93, and the most frequently detected MRSA ST was ST1011, followed by ST5. Most SCCmec elements were found to be type IIa, followed by type IVa. High MIC values were observed for ciprofloxacin, erythromycin, and clindamycin, particularly within SCCmec IIa. Of the SCCmec IVa strains, most harbored the lukS-PV and lukF-PV genes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Echaniz-Avilés et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Idiopathic pulmonary fibrosis (IPF) is the most common Interstitial Lung Disease (ILD). It is characterized by dyspnoea and a progressive decline in lung function, which negatively affects life. This study aimed to evaluate Health-Related Quality of Life (HRQoL) in IPF patients in Latin American countries., Methods: Six countries (Argentina, Bolivia, Colombia, Chile, Mexico, and the Dominican Republic) enrolled patients with IPF. They answered the Saint George's Respiratory Questionnaire for Idiopathic Pulmonary Fibrosis (SGRQ-I) and the Hospital Anxiety and Depression Scale (HADS). Demographic characteristics, the Torvan index, and a lung function test were also assessed. IPF was diagnosed according to the ATS/ERS/JRS/ALAT 2018 criteria., Results: We enlisted 75 patients diagnosed with IPF; 81% were male, with an average age of 74 ± 7. The total SGRQ-I score was 49 ± 23, with a higher score in the activity domain of 70 ± 23. Torvan index average was 17 ± 6. We found that 28% presented anxiety and 35% depression. Besides, we observed that patients requiring oxygen had a worse quality of life (total SGRQ-I 62 ± 22 vs. 45 ± 22, p = 0.003) without finding differences in antifibrotic therapy. We did not find differences in HRQoL when dividing groups according to their altitude above sea level, except for a higher frequency of anxiety in patients living at sea level., Conclusions: We found similar data compared to those reported in real-life European populations. We also found that anxiety and depression are prevalent. However, they are often underdiagnosed and, therefore, left untreated., Competing Interests: Declarations. Ethics approval and consent to participate: The research ethics committees of each participating country approved the study: México: Comité de Ética e Investigación Instituto Nacional de Enfermedades Respiratorias. Argentina: Comité de Ética en Investigación Hospital María Ferrer. Colombia: Comité de Ética en Investigación de la Fundación Neumológica Colombiana. República Dominicana: Comité de Bioética Clínica Universitaria Unión Medica del Norte. Bolivia: Comité de Bioética Biomédica. Chile: Comité Ético-cientíco Servicio de la Salud Metropolitano Oriente del Instituto Nacional del Tórax. Informed consent to participate was obtained from all of the participants in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable., (© 2025. The Author(s).)

Background: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and destruction of lung tissue, primarily attributed to tobacco smoking. However, other factors like biomass-burning smoke (BS) exposure are also implicated. COPD has been described as an accelerated aging disease, and telomere length is a biomarker of aging., Methods: This study examined telomere length in 189 Mexican individuals, from which 93 developed COPD secondary to BS exposure (BE-COPD); the rest of the participants were exposed to BS but did not develop the disease. Lung function parameters were measured by spirometry, and relative telomere length (rTL) from peripheral blood DNA was determined using multiplex qPCR., Results: Results showed rTL to inversely correlate with age (R 2 =-0.207, p = 0.006) and with the hours-a-day of BS exposure (R 2 =-0.297, p < 0.001). Within BE-COPD cases, rTL was associated with daily BS exposure, and BE-COPD individuals exhibited a reduced rTL compared to controls (1.39 ± 0.45 vs. 0.89 ± 0.50; p < 0.001). When compared by rTL length in BE-COPD cases, longer telomeres were associated with decreased COPD risk (β = 0.134, 95% CI = 0.053-0.339; p < 0.001). However, no significant relationship was found between rTL and clinical or lung function parameters in the BE-COPD group., Conclusions: This is the first study to document that individuals with COPD secondary to biomass smoke exposure present shorter telomeres than BS-exposed subjects who did not develop the disease., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted following the Declaration of Helsinki and approved by the Ethics Committee of Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (protocol numbers B11–19, C38-19, and B14-17). Written informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Acute lymphoblastic leukemia (ALL) is a malignant neoplasm with the highest incidence in the pediatric population. Although the 5-year overall survival is greater than 85%, in emerging countries such as Mexico, the mortality rate is high. In Mexico, B-ALL is the most common type of childhood cancer; different characteristics suggest the presence of the disease; however, the prognosis is dependent on clinical and laboratory features, and no adverse prognostic molecular marker for B-ALL has yet been identified. The present research aimed to identify the prognostic value of HMMR expression in pediatric patients with B-ALL. The differential expression profile of B-ALL cells was determined via in silico analysis, and HMMR expression was subsequently measured via qRT-PCR and immunocytochemistry. The results were statistically analyzed via the ROUT test, Kolmogorov-Smirnov Z test, and Mann-Whitney U test. ROC curves and the Youden index were constructed, and Kaplan-Meier curves were plotted. We found that HMMR expression was increased in B-ALL patients ( p < 0.0001). We observed that high expression was related to poor prognosis ( p < 0.05). We observed that high expression was related to poor prognosis ( p < 0.05). The increase in HMMR expression could be a potential early molecular prognostic marker and/or a new target in childhood B-ALL patients.

Spinocerebellar ataxia type 10 (SCA10) is an autosomal dominant (AD) neurodegenerative disorder prevalent in the Americas, particularly in Mexico. Clinical manifestations include progressive ataxia and epilepsy. However, it can exhibit wide phenotypic variability and even reduced penetrance. Because the diagnostic overlaps with other ataxias, molecular diagnosis is essential. This cross-sectional study conducted a retrospective review and analysis of 183 DNA samples from a laboratory registry of patients with ataxia who were suspected of having AD ataxia (n = 86; negative for ATXN1, ATXN2, ATXN3, ATXN7, TBP, and ATN1 genes) or sporadic ataxia (n = 97). Triplet repeat-primed PCR (TP-PCR) was performed to identify ATXN10 gene expansions. 19.6% (n = 36) of the samples showed ATXN10 expansions, with a higher proportion of hereditary AD cases (30.2%; n = 26) compared to sporadic cases (10.3%; n = 10). Clinical information was available in only 23 registries, with manifestations predominantly including cerebellar signs, but notably not epilepsy. The frequency of SCA10 in our country underlines the need to change the diagnostic suspicion, as the absence of epilepsy challenges previous diagnostic assumptions. As this is a study from a laboratory registry, we are aware of certain limitations., Competing Interests: Declarations. Study Funding: This research did not receive specific funding from any public, commercial, or not-for-profit funding agency. Competing Interests: Tetsuo Ashizawa received grants from the NIH (U01 NS104326 and R01 NS115002), the National Ataxia Foundation, and the Myotonic Dystrophy Foundation. He discloses participation in Biogen trials NCT03952806 and Biohaven trials NCT03701399, and he received the endowment Harriet and Joe B. Foster Distinguished Chair in Neurosciences., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Detection and quantification of disease-related biomarkers in wastewater samples, denominated Wastewater-based Surveillance (WBS), has proven a valuable strategy for studying the prevalence of infectious diseases within populations in a time- and resource-efficient manner, as wastewater samples are representative of all cases within the catchment area, whether they are clinically reported or not. However, analysis and interpretation of WBS datasets for decision-making during public health emergencies, such as the COVID-19 pandemic, remains an area of opportunity. In this article, a database obtained from wastewater sampling at wastewater treatment plants (WWTPs) and university campuses in Monterrey and Mexico City between 2021 and 2022 was used to train simple clustering- and regression-based risk assessment models to allow for informed prevention and control measures in high-affluence facilities, even if working with low-dimensionality datasets and a limited number of observations. When dividing weekly data points based on whether the seven-day average daily new COVID-19 cases were above a certain threshold, the resulting clustering model could differentiate between weeks with surges in clinical reports and periods between them with an 87.9% accuracy rate. Moreover, the clustering model provided satisfactory forecasts one week (80.4% accuracy) and two weeks (81.8%) into the future. However, the prediction of the weekly average of new daily cases was limited (R 2 = 0.80, MAPE = 72.6%), likely because of insufficient dimensionality in the database. Overall, while simple, WBS-supported models can provide relevant insights for decision-makers during epidemiological outbreaks, regression algorithms for prediction using low-dimensionality datasets can still be improved.

Background: Hereditary predisposition to breast and ovarian cancer syndrome (HBOC) is a pathological condition with increased cancer risk, including breast (BC), ovarian cancer (OC), and others. HBOC pathogenesis is caused mainly by germline pathogenic variants (GPV) in BRCA1 and BRCA2 genes. However, other relevant genes are related to this syndrome diagnosis, prognosis, and treatment, including TP53, PALB2, CHEK2, ATM, etc. This study aimed to identify the prevalence of non-BRCA genes in HBOC patients of Northeast Mexico., Methods: This multicentric study included 1285 patients with HBOC diagnosis from four oncologic centers in northeast Mexico from 2016 to 2023. Genomic and clinical data were analyzed based on multi-gene panel results and electronic records of the medical geneticist consultation. For the data analysis of qualitative and quantitative variants, JASP statistical software (version 0.18.1) was used, taking p < 0.05 as a significant result., Results: We found that 32.7% of the patients had at least one GPV in non-BRCA genes. The five most frequent non-BRCA genes were CHEK2, PALB2, MUTYH, CDKN2A, and ATM. Among the group of non-BRCA genes, six are involved in the homologous repair pathway (HR), and three are related to DNA damage repair (DDR) pathways. In analyzing GPVs in molecular pathways, both have similar frequencies with no statistical difference for BC., Conclusion: Multi-gene testing implementation improves the detection of often overlooked genes related to HBOC pathogenesis and treatment. Non-BRCA GPVs in Northern Mexico correspond to one-third of the HBOC cases, including HR and DDR pathways genes that would be misdiagnosed if not tested. HR patient carriers are potential targets of iPARP therapies. The optimal approach to cancer treatment for non-BRCA mutation carriers warrants further investigation to develop newer therapies., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of the Hospital Universitario” Dr. José Eleuterio González” from the Universidad Autónoma de Nuevo León (protocol code ON18- 00015). Consent for publication: All patients voluntarily consented to participate in this study by signing an informed consent, approved by the ethics committee of our institution. Conflict of Interest: The authors declare no competing interests., (© 2025. The Author(s).)

This study investigates the relationship between SARS-CoV-2 RT-PCR cycle threshold (Ct) values and key COVID-19 transmission and outcome metrics across five years of the pandemic in Jalisco, Mexico. Utilizing a comprehensive time-series analysis, we evaluated weekly median Ct values as proxies for viral load and their temporal associations with positivity rates, reproduction numbers (Rt), hospitalizations, and mortality. Cross-correlation and lagged regression analyses revealed significant lead-lag relationships, with declining Ct values consistently preceding surges in positivity rates and hospitalizations, particularly during the early phases of the pandemic. Granger causality tests and vector autoregressive modeling confirmed the predictive utility of Ct values, highlighting their potential as early warning indicators. The study further observed a weakening association in later pandemic stages, likely influenced by the emergence of new variants, hybrid immunity, changes in human behavior, and diagnostic shifts. These findings underscore the value of Ct values as scalable tools for public health surveillance and highlight the importance of contextualizing their analysis within specific epidemiological and temporal frameworks. Integrating Ct monitoring into surveillance systems could enhance pandemic preparedness, improve outbreak forecasting, and strengthen epidemiological modeling.

Objective: To estimate the effectiveness of several vaccine brands-Pfizer, Astra, and Sinovac-against symptomatic COVID-19 without information on vaccination at the individual level., Methods: We use data of mass vaccination programs-specifically, for sexagenarians and quinquagenarians-in three large municipalities of Mexico (Monterrey, Guadalupe, and San Nicolás) to conduct a two-step time series estimation procedure involving a synthetic control group. The data covers the period between the first week of March 2020 and the first week of October 2021., Results: Vaccine effectiveness is a concave function of time. At the peak, Pfizer reaches 92.6 % effectiveness, Astra 83.6 % and Sinovac 65.6 %. This occurs 9 to 12 weeks after the first shot., Conclusion: The results indicate that the three vaccines protect against symptomatic COVID-19. Nevertheless, they offer different levels of protection. The results also suggest that VE-under a two-shot scheme-reaches its peak 9 to 16 weeks after the first shot. Moreover, there seems to be a trade-off between achieving higher efficiency by administering the 2nd shot earlier or extending the protection period by administering it later., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Central nervous system tumors (CNSTs) represent a significant oncological challenge in pediatric populations, particularly in developing regions where access to diagnostic and therapeutic resources is limited., Methods: This research investigates the epidemiology, histological classifications, and survival outcomes of CNST in a cohort of pediatric patients aged 0 to 19 years within a 25-year retrospective study at the Civil Hospital of Guadalajara, Mexico, from 1999 to 2024., Results: Data was analyzed from 273 patients who met inclusion criteria, revealing a higher incidence in males (51.6%) with a mean age at diagnosis of 8.2 years. Histological analysis revealed gliomas as the most common type (52.7%), followed by embryonal tumors (28.6%). High-grade tumors (WHO grade 4) comprised 49.8% of cases, demonstrating significantly poorer survival outcomes (median overall survival of 13.5 months) compared to lower-grade tumors (up to 57 months). The predominance of tumors in the supratentorial region and the notable differences in survival outcomes by tumor type underscore the varied impact of geographical and socioeconomic factors on pediatric oncology in Mexico., Conclusion: This study highlights the critical need for improved healthcare infrastructure and early diagnosis initiatives, as well as the importance of targeted research to address disparities in treatment and outcomes for pediatric CNST in this region., Competing Interests: Declarations. Ethics approval: Ethical approval was waived by the local Ethics Committee of Civil Hospital “Dr Juan I. Menchaca” (Registration codes: 17CI14039116 and 0483–21 HJCIM/2021). Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The presence of malnutrition in early life is a determining factor in the onset of metabolic alterations and chronic diseases in adults. Therefore, the objective of this study was to determine the impact of malnutrition in early childhood with the presence of cardiometabolic risk factors in adulthood in marginalized populations from Chiapas, Mexico. The present investigation was based on a prospective cohort study that began in 2002, with young adults aged 18 to 25 years belonging to De Los Bosques region in Chiapas, Mexico. Sociodemographic, anthropometric, clinical and biochemical data were obtained in adulthood. Binary logistic regression models with 95% confidence intervals were fitted to assess the association between nutritional status in childhood (≤5 years of age) and cardiometabolic risk in adulthood. Individuals with overweight/obesity in childhood were more likely to have overweight/obesity (OR = 2.65, 95% CI: 1.09-6.45), high waist circumference (3.78, 95% CI: 1.55-9.24), high waist to height ratio (OR = 5.38, CI 95%: 1.60-18.10), elevated total cholesterol (OR = 3.95, 95% CI: 1.36-11.43) and metabolic syndrome (OR = 4.71, 95% CI: 1.49-14.90) in adulthood. In conclusion, malnutrition presented in early childhood increased the probability of developing cardiometabolic alterations in young adults from southern Mexico.

Acinetobacter baumannii has emerged as a critical global health threat due to its exceptional survival skills in adverse environment and its ability to acquire antibiotic resistance, presenting significant challenges for infection treatment and control. The World Health Organization has classified carbapenem-resistant A. baumannii as a "Critical Priority" pathogen to guide research and the development of control and prevention strategies. Epidemiological surveillance methodologies provide the tools necessary for classifying A. baumannii into international clonal lineages, facilitating the analysis of molecular characteristics, global dissemination, and evolution. This study provides a detailed analysis of the molecular epidemiology of A. baumannii in Mexico, focusing on identifying the main international clonal lineages. Genomic analyses of 146 genomes, along with information from previous studies, identified 24 different sequence types according to the Oxford Scheme. The major international clone IC2 (CC208) was identified and harbors β-lactamases OXA-66, ADC-30, OXA-72, and is predicted to possess the OCL1 locus. The international clone IC5 (CC205) carries β-lactamase OXA-65, along with ADC-214 and OXA-239, with OCL10 predicted in 82.2% of the genomes. The international clone IC7 (CC229) harbors β-lactamase OXA-64, as well as ADC-174 and ADC-214, with OCL6 and OCL7 loci predicted. These international clones were identified in different periods and regions of Mexico and are likely to be widely distributed throughout the country. The analysis of each lineage reveals distinct molecular characteristics, including sequence types, capsule typing, outer core loci, and specific antibiotic resistance profiles. Understanding these features is crucial for elucidating their roles in infection dynamics, resistance mechanisms, and their impact on clinical outcomes., Competing Interests: The authors declare the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Humberto, Luis and Josefina.)

Background: Abortion-related complications are difficult to measure due to lack of standardized definitions and limited available data. We describe the proportion of abortive events that result in a documented complication in Mexico's public sector hospitals., Methods: We used ICD-10 codes from Mexico's hospital discharge system (2018-2022), Subsistema Automatizado de Egresos Hospitalarios (SAEH), to describe abortive events admitted to hospitals: complications for excessive bleeding, infection, embolism, and unspecified; patient socio-demographic and clinical characteristics; and municipality-level structural vulnerability. We estimate complications by pregnancy duration, describe types of complications, identify characteristics associated with the presence of a complication using multuvariable regression, and calculate complication rates (proportion of abortive event that result in a complication treated in a public sector hospital per 1,000 women of reproductive age) by state in 2022., Findings: There were 399,405 abortive events that received hospital-based care in Secretaria de Salud (SS) hospitals between 2018-2022. Ninety-two percent had no complication reported. The adjusted predicted probability of a complication was higher among patients at > 13 weeks' gestation (8.9%; 95% CI 8.1-9.7%) compared with ≤ 13 weeks (6.6%; 95% CI 6.0-7.2%). Higher parity, care at a tertiary hospital, and high marginalization at place of residence were positively associated with presence of a complication. States with higher complication rates are primarily in the central and southern regions., Conclusions: In Mexico, 92% of patients who seek care for all abortive events (induced, spontaneous, post-abortion) in SS hospitals have no complications. Marginalized patients are more likely to have a complication and to seek care at later pregnancy durations. Routinely conflating care-seeking and complications leads to overestimates of the risk of abortion., Competing Interests: Declarations. Ethics approval and consent to participate: This analysis was deemed non-human subjects by the Oregon Health and Science University Institutional Review Board. Consent for publication: Not applicable. Competing interests: Blair Darney is a member of the Board of Directors of the Society of Family Planning (SFP) and CISIDAT (Health Research Consortium, Mexico). She is a Deputy Editor at Contraception and a committee member at the American College of Obstetrics and Gynecology (ACOG), activities for which she receives honoraria. Dr. Darney is also supported by a Garcia-Robles COMEXUS-Fulbright award, Mexico, 2023-2024. All other authors have nothing to disclose. All other authors have nothing to disclose., (© 2025. The Author(s).)

Since 1996, the incidence of rickettsiosis has been increasing in Yucatán, Mexico, but recent prevalence data are lacking. This study aimed to determine exposure to the Spotted Fever Group (SFG) and Typhus Group (TG) in human serum samples suspected of tick-borne diseases (TBD) between 2015 and 2022. A total of 620 samples were analysed using indirect immunofluorescence assay (IFA) to detect IgG antibodies against SFG ( Rickettsia rickettsii ) and TG ( Rickettsia typhi ), considering a titer of ≥64 as positive. Results showed that 103 samples (17%) were positive for R. rickettsii and 145 (24%) for R. typhi , while 256 (41%) and 229 (37%) were negative, respectively. There was a cross-reaction in 244 samples (39%). Individuals with contact with vectors, such as ticks, showed significant exposure to fleas (p = 0.0010). The study suggests a high prevalence of rickettsiosis and recommends prospective studies to assess the disease burden and strengthen surveillance and prevention in Yucatán, considering factors like temperature and ecological changes.

Background: The 2022 mpox outbreak marked a significant shift in the epidemiology of this zoonotic disease, traditionally confined to Central and West Africa. With over 80 countries reporting cases, this outbreak was characterized by a rapid spread in non-endemic regions, leading to more than 70,000 confirmed cases globally., Objective: To quantify the cumulative incidence of mpox and identify associated factors of mpox among the Mexican population affiliated by the Mexican Social Security Institute during the 2022-2023 outbreak., Material and Methods: A retrospective observational study using a cross-sectional survey to assess the cumulative incidence and factors associated with mpox. The cumulative incidence of laboratory confirmed mpox cases was calculated by dividing the number of confirmed cases by the insured population in the Mexican Social Security Institute as of mid-2022, per 100,000 individuals, this was analyzed by sex, age group, sexual orientation and people living with HIV. Logistic regression analyses were conducted to identify sociodemographic and clinical factors associated with mpox infection., Results: A total of 2,956 probable cases were reported, with 1,744 (59%) laboratory-confirmed mpox cases. Most confirmed cases were male, with a median age of 32 years. The overall cumulative incidence was 4.05 per 100,000 persons, significantly higher in men and men who have sex with men. Logistic regression revealed that male sex was significantly associated with higher odds of laboratory-confirmed mpox. Age groups 30-34, 35-39, and 40-44 had an elevated risk of infection. Men who have sex with men showed a substantially increased likelihood of mpox, while individuals living with HIV were at higher risk compared to those without HIV. Key clinical predictors included fever, arm rash, and inguinal lymphadenopathy., Conclusion: The 2022 mpox outbreak revealed significant disparities in infection risk, particularly among men, men who have sex with men, and individuals living with HIV., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Vallejos Parás et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction : Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) stems from disrupted lipid metabolism in the liver, often linked to obesity, type 2 diabetes, and dyslipidemia. In Mexico, where obesity affects 36.9% of adults, MASLD prevalence has risen, especially with metabolic syndrome affecting 56.31% by 2018. MASLD can progress to Metabolic Dysfunction-Associated Steatohepatitis (MASH), affecting 5.27% globally, leading to severe complications like cirrhosis and hepatocellular carcinoma. Background : Visceral fat distribution varies by gender, impacting MASLD development due to hormonal influences. Insulin resistance plays a central role in MASLD pathogenesis, exacerbated by high-fat diets and specific fatty acids, leading to hepatic steatosis. Lipotoxicity from saturated fatty acids further damages hepatocytes, triggering inflammation and fibrosis progression in MASH. Diagnosing MASLD traditionally involves invasive liver biopsy, but non-invasive methods like ultrasound and transient elastography are preferred due to their safety and availability. These methods detect liver steatosis and fibrosis with reasonable accuracy, offering alternatives to biopsy despite varying sensitivity and specificity. Conclusions : MASLD as a metabolic disorder underscores its impact on public health, necessitating improved awareness and early management strategies to mitigate its progression to severe liver diseases.

Background: Mexico has one of the highest global incidences of paediatric overweight and obesity. Public health interventions have shown only moderate success, possibly from relying on knowledge extracted using limited types of statistical data analysis methods., Purpose: To explore if multimodal machine learning can enhance identifying predictive features from obesogenic environments and investigating complex disease or social patterns, using the Mexican National Health and Nutrition Survey., Methods: We grouped features into five data modalities corresponding to paediatric population exogenous factors, in two multimodal machine learning pipelines, against a unimodal early fusion baseline. The supervised pipeline employed four methods: Linear classifier with Elastic Net regularisation, k-Nearest Neighbour, Decision Tree, and Random Forest. The unsupervised pipeline used traditional methods with k-Means and hierarchical clustering, with the optimal number of clusters calculated to be k = 2., Results: The decision tree classifier in the supervised early fusion approach produced the best quantitative results. The top five most important features for classifying child or adolescent health were measures of an adult in the household, selected at random: BMI, obesity diagnosis, being single, seeking care at private healthcare, and having paid TV in the home. Unsupervised learning approaches varied in the optimal number of clusters but agreed on the importance of home environment features when analysing inter-cluster patterns. Main findings from this study differed from previous studies using only traditional statistical methods on the same database. Notably, the BMI of a randomised adult within the household emerged as the most important feature, rather than maternal BMI, as reported in previous literature where unwanted cultural bias went undetected., Conclusion: Our general conclusion is that multimodal machine learning is a promising approach for comprehensively analysing obesogenic environments. The modalities allowed for a multimodal approach designed to critically analyse data signal strength and reveal sources of unwanted bias. In particular, it may aid in developing more effective public health policies to address the ongoing paediatric obesity epidemic in Mexico., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Silva Sepulveda and Boman.)

Background: Psoriasis requires a comprehensive assessment of concomitant diseases to make better therapeutic decisions. This study examined the differences in the onset and progression of associated cardiometabolic comorbidities in psoriasis patients based on their treatments., Methods: A retrospective longitudinal study was conducted on patients aged over 13 years with psoriasis seen at a Northern Mexican Hospital between 2012 and 2023. Patients were categorized into three groups according on the type of treatment received: topical, systemic, and biologic. A logistic regression analysis was performed to identify predictors of comorbidity development., Results: 197 patients were included; 52.8% were women, with a mean (SD) age of 54.45 (16.91) years, divided into topical [n = 90 (45.7%)], systemic [n = 57 (29.1%)], and biologic [n = 50 (25.5%)] groups, metabolic dysfunction-associated steatotic liver disease (MASLD) was significantly more prevalent in the biologic group [22 (44%)], p < 0.001. The logistic regression showed that type 2 diabetes mellitus, biological treatments (OR = 5.798, p = 0.001), and body mass index (OR = 1.144, p = 0.002), predicted the development of MASLD with a Nagelkerke's R 2 of 0.400., Conclusions: Psoriasis patients using biological therapies have a greater predisposition to MASLD. These patients should receive a comprehensive approach to identify metabolic conditions, and screening tests for MASLD are recommended., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This research uses numerical simulations and mathematical theories to simulate and analyze the spread of the influenza virus. The existence, uniqueness, positivity, and boundedness of the solution are established. We investigate the fundamental reproduction number guaranteeing the asymptotic stability of equilibrium points that are endemic and disease-free. We also examine the qualitative behavior of the models. Using the Lyapunov method, Routh-Hurwitz, and other criteria, we explore the local and global stability of these states and present our findings graphically. Our research assesses control policies and proposes alternatives, performing bifurcation analyses to establish prevention strategies. We investigate transcritical, Hopf, and backward bifurcations analytically and numerically to demonstrate disease transmission dynamics, which is novel to our study. Contour plots, box plots, and phase portraits highlight key characteristics for controlling epidemics. The disease's persistence depends on its fundamental reproduction quantity. To validate our outcomes, we fit the model to clinical data from influenza cases in Mexico and Colombia (October 1, 2020, to March 31, 2023), aiming to analyze trends, identify critical factors, and forecast influenza trajectories at national levels. Additionally, we assess the efficacy of implemented control policies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Mohammad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Xylazine is a α2-adrenergic receptor agonist, used for sedation in veterinary contexts. Although it is increasingly found in overdose deaths across North America, the clinical management of xylazine-involved overdoses has not been extensively studied, especially in community-based harm reduction settings. Here we present a clinical series of xylazine-involved overdose and share the clinical approach and lessons learned by a community overdose response team in Tijuana, Mexico amidst the arrival of xylazine., Case Presentation: We present three cases describing the clinical management of patients with xylazine-involved overdoses that occurred in close proximity to the Prevencasa community harm reduction clinic. The long period of post-naloxone sedation in xylazine overdoses is a unique clinical feature. The first case is a 61-year-old man with longstanding opioid and methamphetamine use disorder found hypoxic, who received 4.0 mg of intranasal naloxone, and quickly began respirating well. He remained unconscious for 20 min, and upon awakening, experienced withdrawal symptoms, agitation and confusion, and exposed himself to considerable physical danger by entering a local roadway. The second is a 28-year-old man who primarily uses stimulants, who overdosed while trying "China White". His oxygen saturation improved from 81 to 100% with supplemental oxygen and field management, and he did not require naloxone administration. He recovered consciousness after 40 min. The third patient is a 36-year-old male who was found down, saturating at 20%, who received 0.4 mg intramuscular naloxone, was placed in recovery position, and remained unconscious for 12 min before making a complete recovery. The first and third patients provided urine and drug samples that tested positive for xylazine and fentanyl., Conclusions: We describe insights about the clinical management of combined xylazine-fentanyl involved overdoses in the field, from a community harm reduction context where xylazine arrived suddenly spurring a large number of overdoses. In response to the long period of post-naloxone sedation inherent to xylazine overdoses, the clinical team learned to center oxygenation-not consciousness-as the key parameter of interest for the titration of naloxone, increase emphasis on field airway management, portable oxygen administration, and scene safety, and employ xylazine testing strips for urine and direct substance analysis to educate the patient population about health risks., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics approval is not required for this case study per UCSD and Prevencasa IRB guidelines. Patients provided written consent. Consent for publication: Patients provided written consent. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Tackling the inertia of growing threat of antimicrobial resistance (AMR) requires changes in how antibiotics are prescribed and utilized. The monitoring of antimicrobial prescribing in hospitals is a critical component in optimizing antibiotic use. Point prevalence surveys (PPSs) enable the surveillance of antibiotic prescribing at the patient level in small hospitals that lack the resources to establish antimicrobial stewardship programs (ASP). In this study, we analyzed antibiotic use at two public secondary care hospitals in Mexico using PPSs., Methods: Following WHO methodology, we conducted four cross-sectional PPSs on antibiotic use in two public secondary care facilities in Mexico: two surveys in a women's specialty hospital (H1) and two in a general referral hospital (H2). We collected data from clinical records of all patients with active antibiotic prescriptions (APs) across the medical, surgical, and mixed (MIX) wards, and intensive care units (ICUs). Descriptive statistics were computed to analyze the PPSs data using Stata., Results: The PPSs collected data on 127 patients, and 283 active APs. The prevalence of antibiotic use was 60.4% (H1, n = 29/48) and 70.5% (H2, n = 98/139). Antibiotics were more frequently used among patients in the MIX wards (H1: 87.5%, n = 14/16) and ICUs (H2: 90%, n = 9/10). The most frequent patient indications for antibiotic use were medical prophylaxis (H1: 51.7%, n = 15/29), community-acquired infections (H2: 42.9%, n = 42/98), and preoperative prophylaxis (H1: 27.6%, n = 8/29; H2: 23.5%, n = 23/98). The APs were mostly empirical (H1: 97%, n = 64/66; H2: 98.2%, n = 213/217), and parenterally administered (H1: 90.9%, n = 60/66; H2: 96.8%, n = 210/217). Most clinical records lacked documented post-prescription reviews (H1: 82.8%, n = 24/29; H2: 98%, n = 96/98). Preoperative prophylaxis was predominantly administered as multiple doses for more than one day. Penicillins with extended-spectrum (24.2%, n = 16/66), aminoglycosides (22.7%, n = 15/66), and first-generation cephalosporins (16.7%, n = 11/66) were the most prescribed antibiotic classes in H1, while third-generation cephalosporins (35%, n = 76/217), fluoroquinolones (14.3%, n = 31/217), and carbapenems (13.4%, n = 29/217) were the most prescribed in H2. No hospital had formally established ASP., Conclusions: This study shows high prevalence rates of antibiotic use and variations in commonly prescribed antibiotic classes in public Mexican secondary care hospitals, along with shared practices in broad-spectrum antibiotic prescription. PPS-based surveillance enables the identification of specific targets to optimize antibiotic use according to the healthcare needs of patients in each hospital and facilitates comparative evaluations across hospitals., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Zumaya-Estrada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Unhealthy lifestyles risk factors, such as smoking, alcohol consumption, physical inactivity, poor diet, and obesity, have been associated with a higher risk of all-cause and cause-specific mortality. However, composite score of these unhealthy behaviours has not been considered, particularly in Latin American populations. Herein, we examined the association of lifestyle risk factors score with all-cause and cause-specific mortality in Mexican adults. A total of 159,517 adults from the Mexico City Prospective Study (MCPS) were included. Data on sociodemographic, lifestyle risk factors and medical histories was collected through a self-reported baseline questionnaire in a census-style door-to-door interviews. Lifestyle risk factors assessment was based on five modifiable lifestyle risk factors and their respective cut-off points according to current health recommendations, including obesity, physical inactivity, tobacco, alcohol consumption and fruits and vegetables intake. Multivariable Cox regression models were used to estimate the associations of lifestyle risk factor score (ranging from 0 to 5) with all-cause and cause-specific mortality (cardiovascular disease, renal or hepatobiliary diseases, diabetes, respiratory diseases, cancer and all-cause mortality). We excluded the first 2, 5, 10, and 15 years of follow-up to account for reverse causation bias. We found a high prevalence (77%) of Mexican adults, with two or more lifestyle risk factors. Hazard ratio for respiratory diseases and renal or hepatobiliary diseases were 1.86 (95%CI: 1.45-2.39) and 2.00 (95%CI: 1.60-2.52) comparing participants with 4-5 lifestyle risk factors vs. those with none. For all-cause mortality, participants with 4-5 lifestyle risk factors had a 49% (HR: 1.49; 95%CI: 1.03-2.16) higher risk as compared to participants with none. The magnitude of the associations increased as the exclusion of follow-up time increased after 2, 5, 10 and 15 years. There was a positive association between the number of lifestyle risk factors and all-cause and cause-specific mortality, showing the highest rate of respiratory, renal or hepatobiliary and all-cause mortality among participants with 4-5 lifestyle risk factors. After accounting for reverse causation, associations were stronger., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval and consent to participate: The Mexico City Prospective Study was approved by the Mexican Ministry of Health, the Mexican National Council of Science and Technology (0595 P-M) and the Central Oxford Research Ethics Committee (C99.260). All study participants provided written informed consent., (© 2024. The Author(s).)

This article presents the first systematic review and meta-analysis of the prevalence and correlates of different forms of intimate partner violence (IPV) among women and men in Mexico. To identify studies, a comprehensive search strategy was developed and executed across 11 databases (Academic Search Complete, APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, International Bibliography of the Social Sciences, LILACS, MEDLINE, SciELO, Sociological Abstracts, Web of Science). From the 1,746 studies screened, 155 full-text articles were reviewed, and this systematic review included 27 studies involving 249,557 participants to determine the prevalence of physical, psychological, sexual, threats, and other forms of IPV, according to gender and other sociodemographic characteristics. Overall IPV prevalence was 16.4%, with significant differences across pregnant and non-pregnant women. Physical IPV prevalence was 14.7%, revealing higher rates in men (29.5%) compared to women (14.2%). Psychological IPV prevalence was 27.3% and sexual IPV was at 6.6%, with differences across evaluation periods. Threats and other IPV forms showed a prevalence rate of 14.2% and 21.5%. Meta-regression analyses included gender, education, marital status, rural residency, pregnancy, age, and evaluation period. This study demonstrates that IPV is a critical public health concern in Mexico, impacting both women and men. It shows the vulnerability of rural residents, youth, and pregnant women. However, understanding IPV complexities in Mexico requires nuanced considerations of demographic and situational contexts. Urgent initiatives from municipal, state, and federal governments are needed to combat IPV, focusing on prevention and support for affected individuals., Competing Interests: Author’s NoteSeyed Mohammad Mahdi Moshirian Farahi is now affiliated to University of Ottawa, Ottawa, ON, Canada. Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The American College of Cardiology/American Heart Association introduced the Predicting Risk of Cardiovascular EVENTs (PREVENT™) algorithm to estimate the 10-year risk of developing cardiovascular disease. We aimed to assess the cardiovascular risk (CVR) reclassification among rheumatoid arthritis (RA) patients using traditional CVR algorithms-the 2024 PREVENT™ and the 2013 Atherosclerotic Cardiovascular Disease (ASCVD)-and the presence of carotid plaque (CP). This was a cross-sectional study nested of a RA patients' cohort. A certified radiologist performed a high-resolution B-mode carotid ultrasound to identify the presence of CP. The CVR evaluation was performed by a cardiologist, blinded to carotid ultrasound results, using the PREVENT™ and the ASCVD algorithms. Cohen's kappa (k) coefficient assessed concordance between high-risk classification by CVR algorithms and CP presence. ROC curve analysis evaluated the algorithms' capacity to identify RA patients with CP. The cutoff point was determined by the Youden-Index, with p < 0.05 as statistically significant. A total of 210 RA patients were included. The reclassification of CVR due to CP was 34.3% for the PREVENT™ algorithm and 30.0% for the ASCVD algorithm. Of these, 44.4% and 71.4%, respectively, were initially classified as low risk. Concordance between CVR algorithms and carotid ultrasound showed slight agreement (k = 0.032 and k = 0.130, respectively). The PREVENT™ algorithm did not identify more than one-third of high-CVR RA patients with indication of starting statin therapy based on carotid ultrasound findings. The PREVENT™ and ASCVD algorithms showed poor performance in identifying RA patients with CP. Key Points • The presence of CP was identified in more than a third of the evaluated RA patients (35.7%), classifying them as high CVR. • CVR reclassification by the presence of CP was observed in 34.3% RA patients with the PREVENTTM algorithm and in 30.0% RA patients with the ASCVD algorithm. • Most of the reclassified patients belonged to the low-risk category, 44.4% with the PREVENTTM algorithm and 71.4% with the ASCVD algorithm. • When evaluating the concordance between the ASCVD algorithm and the carotid ultrasound for high-risk classification, a slight agreement was found (k = 0.130)., Competing Interests: Declarations. Ethics approval: All procedures performed in this study were in accordance with the Research Ethics Committee of the University Hospital “Dr. José Eleuterio González” and with the 1964 Helsinki declaration and its later amendments. Registration number of MI14-006. All patients provided written informed consent before inclusion. The study adhered to ethical standards outlined in the 1964 Declaration of Helsinki and its subsequent amendments. Data retrieval occurred from the medical records. Informed consent: All patients provided written informed consent before inclusion. All the data were anonymized and consented to submit the original research article to the journal. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Objective: We aimed to assess physical and psychosomatic manifestations of patients with long COVID and their association with a decreased patient's quality of life (QOL) or different times elapsed since the COVID-19 diagnosis., Methods: This is a cross-sectional study. We retrospectively collected the clinical characteristics of adult patients who had tested positive for SARS-CoV-2 and had symptoms at least as early as 4 weeks after COVID-19 in México City between April 2020 and February 2021. A total of 179 were included. They answered questions to define chronic symptoms. The Sniffin' Sticks Screening 12 test olfactory evaluation was performed. The diminish of QOL was defined by ≥10 points in the EuroQol visual analog scale between pre- and post-COVID-19, and each dimension of EQ-5D-5L test was evaluated. Chi-square test, Fisher's exact test, Student t test, Wilcoxon rank-sum, and signed-rank test were used as required. A backward stepwise logistic regression analysis determined the factors associated with a decrease in QOL. All analyses were performed using R software version 3.6.3 (R Foundation)., Results: In the multivariable analysis, post-COVID-19 pain/discomfort (adjusted odds ratio [aOR] 2.5 [1.66-9.68]; P = .01), anxiety/depression (aOR 13 [1.44-17.23]; P = .03), and persistence of ≥3 symptoms (aOR 2.6 [0.96-7.47]; P = .05) remained statistically significant associated with decreased QOL., Conclusions: Patients with long COVID-19 have decreased QOL mainly associated with pain/discomfort, anxiety/depression, and ≥3 persistent symptoms. Our findings enhanced the notion of a strong psychosomatic factors involved with long COVID-19. Therefore, these patients might benefit from neuropsychological rehabilitation, although the effect of such interventions should be evaluated., Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Members of the subgenus Herpetosoma are specialized parasites of mammals of the order Lagomorpha and Rodentia. It is estimated that around 50 species within this subgenus are transmitted by several flea species. These parasites have recently gained attention from a public health perspective because several species have been reported to infect humans. Several species of the Herpetosoma subgenus have been recognized on the American continent, although there have been no reports from the Mexican Transition Zone. Therefore, the present study aimed to report the presence of a member of the Herpetosoma subgenus in cricetid rodents from Querétaro, Mexico. A total of 17 rodents belonging to three species, Peromyscus boylii, Peromyscus gratus, and Peromyscus melanophrys, were collected. Genetic material was extracted using the Chelex 100 resin, followed by PCR and sequencing of a fragment of 800 bp of the 18S ribosomal gene of the genus Trypanosoma. Out of these hosts, eight individuals of P. gratus (1♀), P. melanophrys (1♂), and P. boylii (3♂, 3♀) tested positive for Trypanosoma microti DNA, previously detected in the England and Japan. The present study, therefore, provides the first discovery of T. microti in Mexico, thereby increasing the known richness of species of the genus Trypanosoma in rodents from this country and the Mexican Transition Zone., Competing Interests: Declaration of competing interest On behalf of all the co-authors, we declare that we have no conflict of interest. Thank you for your consideration of this submission., (Copyright © 2024. Published by Elsevier B.V.)

The COVID-19 pandemic created an unprecedented situation for families worldwide, with its potential impact on child development remaining uncertain, particularly within Latin American communities. This study aimed to analyze child development in children from Costa Rica and Mexico who grew up during COVID-19 pandemic. A cross-sectional study was conducted using a convenience sample of 183 children; a historical control group of Costa Rican children (n = 171) was also included. Child development was assessed using the EDIN-II in Costa Rica and the EDI in Mexico, along with a parental questionnaire. Descriptive statistics, chi-square tests, and logistic regression analysis were performed, with a significance level of 0.05. Significant differences were found when comparing the risk of development delay, particularly in the overall score and the fine motor domain score. The probability of overall delay was associated with the child's sex, age, maternal education level and whether the primary caregiver role was shared by both parents or fulfilled by a single parent. In Costa Rica, the development of children assessed post-pandemic was lower than that of children assessed pre-pandemic. The probability of these delays was associated with growing up during the pandemic, child's sex, and families' Socioeconomic Development Index. These results contribute to understanding child development during the COVID-19 context and provide a foundation for future research., (© 2024 International Congress of Infant Studies.)

Background: Avocado contains numerous vitamins, minerals, and phytochemicals that can contribute to reducing the risk of metabolic syndrome and diabetes. However, limited studies have examined the association between avocados and diabetes risk., Objective: This study aimed to examine the association between avocado consumption and diabetes by sex in Mexican adults., Design: This was a cross-sectional study., Participants/setting: Participants included a subsample of adults (aged 20 years and older) from the 2012, 2016, and 2018 Mexican National Health and Nutrition Survey. Avocado consumption was assessed using a 7-day, semiquantitative food frequency questionnaire, and participants were classified as avocado consumers (consuming any amount of avocado) or nonconsumers., Main Outcome Measures: Participants were considered to have diabetes if they answered "yes" to "Has a doctor ever told that you have diabetes or high blood sugar?", Statistical Analyses Performed: This analysis assessed the association between avocado intake and diabetes using multivariate logistic models by sex and adjusted for relevant covariates., Results: Of 28 239 Mexican National Health and Nutrition Survey 2012, 2016, and 2018 participants, 25 640 met the criteria (ie, have diabetes outcome and plausible energy and avocado intakes) for this study. More than half of the participants were women, and approximately 45% were avocado consumers, with an average (SE) avocado consumption of 34.7 (0.9) among men and 29.8 (0.8) g/day among women. Avocado consumers had lower odds of diabetes in both unadjusted (odds ratio [OR] 0.762, 95% CI 0.639 to 0.907) and adjusted (OR 0.792, 95% CI 0.632 to 0.993) models among women but not men (OR 1.192, 95% CI: 0.907 to 1.566 and OR 0.914, 95% CI 0.675 to 1.239 for unadjusted and adjusted models, respectively)., Conclusions: Avocado consumption was associated with a lower risk of diabetes, which remained significant even when adjusted for relevant covariates. However, this finding was observed in only women, not men, underscoring the importance of personalized nutrition in diabetes care and prevention., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: As a shared external shock, the coronavirus pandemic (COVID-19) impacted health and well-being around the world. Mitigation strategies employed in many locations included school closures and travel restrictions. These strategies directly impacted educational access and opportunities and created economic stressors for families. This study examines how these direct impacts also altered educational aspirations for children and adolescents, an important predictor of educational attainment., Method: We estimate multilevel regression models using two waves of data, collected in 2017-18 and 2020-21, from 1294 children and adolescents (Mean age = 13.1, SD = 2.8; 50.3% female) in Jalisco, Mexico, and 2201 children and adolescents (Mean age = 14.7, SD = 2.6; 49.1% female) in Chitwan Nepal. We examine changes in educational aspirations between the two waves (pre- and post-COVID-19 onset)., Results: Initial aspirations are positively associated with household wealth, caregiver education, and prior commitment to education. Multilevel regression models predicting changes in educational aspirations demonstrate these resources are important for maintaining high educational aspirations. But children and adolescents in households that experienced more economic loss following the external shock of the pandemic had lowered aspirations over time., Conclusions: Disruptions to schooling and economic shocks to households curtailed educational aspirations among children and adolescents in a similar way in two disparate settings. These results raise concerns about the educational attainment of children in the face of external shocks and the possibility that educational progress will stall in low resourced environments among the most vulnerable youth., (© 2024 The Author(s). Journal of Adolescence published by John Wiley & Sons Ltd on behalf of Foundation for Professionals in Services to Adolescents.)

Purpose: Mexico has the second highest incidence of central and peripheral nervous system cancer cases in Latin America, but clinical and research resources to improve oncologic care are biased towards high-income countries. We carried out a retrospective study to identify sociodemographic factors associated with more severe clinical presentation among surgical neuro-oncology who underwent surgery at a major public referral hospital in Mexico City., Methods: The hospital electronic medical record was reviewed to identify all surgical neuro-oncology patients who underwent surgery between January 1 and December 31, 2022. Descriptive statistics were used to characterize the patient population and outcomes; statistical analysis was performed to determine association between sociodemographic variables and advanced clinical presentation., Results: A total of 366 neuro-oncology patients underwent surgery during the study period. The median patient age was 48 (IQR 17-83). The majority of patients were female (60.1, n = 220), single (51.4%, n = 188), and 29.2% (n = 107) endorsed being the primary provider for their family. The median number of dependents per patient was 4 (IQR 2-50), while the median monthly income was 10269 Mexican pesos (MXN) (IQR 2000-13500] and the median travel distance to INNN was 49 km (IQR 22-174). On multivariate analyses, having a higher number of dependents was associated with increased odds of presenting with longer symptom duration (p = 0.01). Divorced/separated status was associated with increased odds of presenting with tumors > 35mL in volume (p = 0.04). Primary provider (p = 0.01) and higher average monthly income (p = 0.03) was associated with decreased odds of presenting with tumors > 35mL., Conclusions: This is the first study to recognize that certain sociodemographic factors are associated with more severe clinical presentation among surgical neuro-oncology patients. Further studies are needed in order to decern specific causes for delayed presentation in this patient population in order to create targeted interventions and decrease delays in care., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Conflict of interest: The authors declare no conflict of interests., (© 2024. The Author(s).)

Background: Accurate identification of Fusarium species requires molecular identification. Treating fusariosis is challenging due to widespread antifungal resistance, high rates of treatment failure, and insufficient information relating antifungal susceptibility to the clinical outcome. Despite recent outbreaks in Mexico, there is limited information on epidemiology and antifungal susceptibility testing (AST)., Objectives: We aimed to analyse the distribution of Fusarium species from a referral centre in Mexico with DNA sequencing and to describe AST to the clinical outcome., Methods: We conducted a retrospective study on clinical isolates of Fusarium. They were identified by translation elongation factor-1α gene amplification and sequencing. AST was performed to determine minimal inhibitory concentrations (MICs)., Results: A total of 35 Fusarium isolates from 26 patients were included. The most common was Fusarium solani species complex (FSSC) in 51.5%, of which Fusarium petroliphilum and Fusarium oxysporum species complex were the most frequent with 37% and 20%, respectively. AST did not show MICs above the epidemiological cut-off value. Fusariosis was diagnosed in 19 patients, mostly with hematologic neoplasm; the overall mortality rate was 32%., Conclusions: Fusarium petroliphilum from the FSSC was found most frequently. Elevated mortality and MICs for all tested antifungals were found, with higher MIC50 among F. solani SC than F. oxysporum SC or F. fujikuroi SC., (© 2025 The Author(s). Mycoses published by Wiley‐VCH GmbH.)

Background: Dating violence is a prevalent issue among Mexican women, as is the incidence and prevalence of Type 2 diabetes mellitus (T2DM). The effects of dating violence can negatively impact lifestyle and, consequently, increase the risk of T2DM., Objective: This study aimed to explore the influence of dating violence on lifestyle and the risk of T2DM in women university students from Mexico., Methods: The study employed a cross-sectional and correlational design. The study population consisted of women university students. The sample size included 255 participants. Women aged 18 to 39 with current dating relationships and residency in Mexicali, Baja California, Mexico, were included. Data collection was conducted from February to May 2023. Correlations and multiple linear regression models were conducted., Results: A total of 255 women participated, with an average age of 21.6 years (SD = 3.2), and 32.2% had a history of intrafamily violence during childhood. 58.8% of the participants exhibited some level of risk of T2DM, and 56.7% of the lifestyle was mostly categorized as poor/fair. Detachment was the most prevalent type of dating violence, followed by coercion. Dating violence was correlated with lifestyle (r = -.430) and the risk of T2DM (r = .321). In the multiple linear regression model, dating violence influenced the risk of T2DM., Conclusion: Women who reported higher levels of dating violence have a less healthy lifestyle and a greater risk of T2DM. It is important to consider dating violence to improve lifestyle and prevent T2DM in Mexican women university students., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Purpose: Metastatic urothelial carcinoma (mUC) poses a challenge to health care systems, given its treatment complexity and mortality. We aimed to describe the characteristics, treatment patterns, and survival outcomes of Mexican patients with mUC., Methods: A retrospective study was conducted across eight centers for adults with mUC from January /2001 to December 2021. We recorded medical history, eligibility for first-line platinum therapy, treatment lines received, and access to novel drugs. Descriptive statistics were used and survival analysis, including Kaplan-Meier curves and Cox proportional hazards model, was performed., Results: We identified 379 patients with mUC; 37 were excluded, and 76% was male, with a median age of 67 years. The median follow-up was 8.4 months. Among those who received a first-line treatment (65%), cisplatin-based chemotherapy (45%) was the most common followed by carboplatin (39%). Causes of cisplatin ineligibility were Eastern Cooperative Oncology Group ≥2 (41%) and glomerular filtration rate <60 mL/min (33%). The overall response rate to up-front platinum therapy was 33%, with a median progression-free survival of 6.1 months (95% CI, 4.9 to 6.9). Second-, third-, and fourth-line treatment was given to 24.6%, 8.8%, and 3.5%, respectively. Chemotherapy was the most common regimen prescribed. Access to novel drugs was limited, 14 patients received avelumab, and 25% received immunotherapy as second-line treatment. The median overall survival was 11.8 months (95% CI, 10.2 to 15.2). Multivariate analysis showed that first-line treatment was independently associated with better survival, whereas poor performance status and visceral disease were associated with worse survival., Conclusion: To our knowledge, these data represent the first effort to delineate treatment trends of mUC in Mexico. First-line treatment prescription and rates of progression to platinum therapy were higher than those described worldwide. Factors affecting survival included performance status, first-line treatment, and visceral disease. Our study highlights unequal access to novel treatments, underscoring the need for equitable care.