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Objective: To estimate survival outcomes in a population living with diabetes, screened for chronic kidney disease (CKD) and to describe characteristics associated with premature mortality using data from an administrative cohort in Jalisco, Mexico., Materials and Methods: Using an administrative cohort design, we investigated the 8-year cumulative mortality associated with CKD. We linked screening with mortality data and described population characteristics by CKD stage, computed years of life lost (YLL), and performed Kaplan-Meier curves and Cox proportional hazard models to analyze survival and mortality risk factors., Results: At screening, 44% of the cohort exhibited impaired renal function. The mortality rate stood at 14%, 2.5% linked to CKD; 8.7% were premature deaths, accumulating 8 036 YLL. Eight-year survival was 93% for individuals with normal renal function at screening, decreasing to 41% for those with glomerular filtration rate below 30 mL/min/1.73m², albumin-creatinine ratio >300 mg/dl, increased years since diabetes diagnosis, hypertension, amputations, retinopathy, and smoking were associated with higher mortality risk; female sex and obesity with a lower risk., Conclusion: The high prevalence of renal impairment in this cohort and its association with high mortality underscores the critical importance of timely detection and protocolized intervention for CKD to mitigate this burden.

HIV infection results in marked alterations in the gut microbiota (GM), such as the loss of microbial diversity and different taxonomic and metabolic profiles. Despite antiretroviral therapy (ART) partially ablating gastrointestinal alterations, the taxonomic profile after successful new ART has shown wide variations. Our objective was to determine the GM composition and functions in people living with HIV (PLWHIV) under ART in comparison to seronegative controls (SC). Fecal samples from 21 subjects (treated with integrase strand-transfer inhibitors, INSTIs) and 18 SC were included. We employed 16S rRNA amplicon sequencing, coupled with PICRUSt2 and fecal short-chain fatty acid (SCFA) quantification by gas chromatography. The INSTI group showed a decreased α-diversity ( p < 0.001) compared to the SC group, at the expense of increased amounts of Pseudomonadota ( Proteobacteria ), Segatella copri , Lactobacillus , and Gram-negative bacteria. Concurrently, we observed an enrichment in Megasphaera and Butyricicoccus , both SCFA-producing bacteria, and significant elevations in fecal butyrate in this group ( p < 0.001). Interestingly, gut dysbiosis in PLWHIV was characterized by a proinflammatory environment orchestrated by Pseudomonadota and elevated levels of butyrate associated with bacterial metabolic pathways, as well as the evident presence of butyrogenic bacteria. The role of this unique GM in PLWHIV should be evaluated, as well as the use of butyrate-based supplements and ART regimens that contain succinate, such as tenofovir disoproxil succinate. This mixed profile is described for the first time in PLWHIV from Mexico.

Competing Interests: We declare no competing interests.

Introduction: Introduction: social or school factors influence the acquisition and selection of foods to be consumed. Objective: identifying the socioeconomic or school level that has the greatest weight in the acquisition of food in Mexican households. Methods: cross-sectional, retrospective and comparative study based on the database of the 2018 National Household Expenditure-Income Survey of Mexico. We worked with the national total of 73,274 Mexican households. The variables considered were: expenditure module of food and beverages, school grade of the head of the family and socioeconomic status to which the household belongs. For the statistical analysis, the following tests were used: linear regression analysis, as well as variance analysis, Snedecor's F test, post-hoc test and Schefé's confirmatory test. Results: socioeconomic status has a greater weight (p < .001) for food acquisition. Sugary drinks were the most widely acquired in all social and school levels. The lowest social level is the one who acquires the most cereals, fats, sugars and legumes, while for high school levels animal foods and processed meats are the ones most frequently acquired. Conclusion: the socioeconomic level has a great weight in the acquisition and variety of foods, although this does not mean that foods obtained are the healthiest. Therefore, public policies are urgently required in favor of nutritional education at all school levels, which promote the purchase of healthy foods and compete with commercial advertising strategies.

Background: Human immunodeficiency virus (HIV) infection is associated with a greater risk of cardiovascular disease (CVD). HIV infection causes a chronic inflammatory state and increases oxidative stress which can cause endothelial dysfunction and arterial stiffness. Aortic stiffness measured by carotid femoral-pulse wave velocity (cfPWV) and central hemodynamics are independent cardiovascular risk factors and have the prognostic ability for CVD. We assessed cfPWV and central hemodynamics in young individuals with recent HIV infection diagnosis and without antiretroviral therapy. We hypothesized that individuals living with HIV would present greater cfPWV and central hemodynamics (central systolic blood pressure and pulse pressure) compared to uninfected controls., Methods: We recruited 51 treatment-naïve individuals living with HIV (HIV(+)) without previous CVD and 51 age- and sex-matched controls (HIV negative (-)). We evaluated traditional CVD risk factors including metabolic profile, blood pressure (BP), smoking, HIV viral load, and CD4 + T-cells count. Arterial stiffness and central hemodynamics were evaluated by cfPWV, central systolic BP, and central pulse pressure (cPP) via applanation tonometry., Results: HIV(+) individuals presented a greater prevalence of smoking, reduced high-density lipoprotein cholesterol, and body mass index. 65.9% of HIV(+) individuals exhibited lymphocyte CD4 + T-cells count < 500 cells/μL. There was no difference in brachial or central BP between groups; however, HIV(+) individuals showed significantly lower cPP. We observed a greater cfPWV (mean difference = 0.5 m/s; p < 0.01) in HIV(+) compared to controls, even after adjusting for heart rate, mean arterial pressure and smoking., Conclusion: In the early stages of infection, non-treated HIV individuals present a greater prevalence of traditional CVD risk factors, arterial stiffness, and normal or in some cases central hemodynamics.

Clostridium difficile B1/NAP1/RT027/ST01 has been responsible for outbreaks of antibiotic-associated diarrhoea in clinical settings worldwide and is associated with severe disease presentations and increased mortality rates. Two fluoroquinolone-resistant (FQR) lineages of the epidemic B1/NAP1/RT027/ST01 strain emerged in the USA in the early 1990s and disseminated trans continentally (FQR1 and FQR2). However, it is unclear when and from where they entered Latin America (LA) and whether isolates from LA exhibit unique genomic features when compared to B1/NAP1/RT027/ST01 isolates from other regions of the world. To answer the first issue we compared whole-genome sequences (WGS) of 25 clinical isolates typed as NAP1, RT027 or ST01 in Costa Rica ( n =16), Chile ( n =5), Honduras ( n =3) and Mexico ( n =1) to WGS of 129 global isolates from the same genotype using Bayesian phylogenomics. The second question was addressed through a detailed analysis of the number and type of mutations of the LA isolates and their mobile resistome. All but two B1/NAP1/RT027/ST01 isolates from LA belong to the FQR2 lineage ( n =23, 92 %), confirming its widespread distribution. As indicated by analysis of a dataset composed of 154 WGS, the B1/NAP1/RT027/ST01 strain was introduced into the four LA countries analysed between 1998 and 2005 from North America (twice) and Europe (at least four times). These events occurred soon after the emergence of the FQR lineages and more than one decade before the first report of the detection of the B1/NAP1/RT027/ST01 in LA. A total of 552 SNPs were identified across all genomes examined (3.8-4.3 Mb) in pairwise comparisons to the R20291 reference genome. Moreover, pairwise SNP distances were among the smallest distances determined in this species so far (0 to 55). Despite this high level of genomic conservation, 39 unique SNPs (7 %) in genes that play roles in the infection process (i.e. slpA ) or antibiotic resistance (i.e. rpoB , fusA ) distinguished the LA isolates. In addition, isolates from Chile, Honduras and Mexico had twice as many antibiotic resistance genes (ARGs, n =4) than related isolates from other regions. Their unique set of ARGs includes a cfr -like gene and tetM , which were found as part of putative mobile genetic elements whose sequences resemble undescribed integrative and conjugative elements. These results show multiple, independent introductions of B1/NAP1/RT027/ST01 isolates from the FQR1 and FQR2 lineages from different geographical sources into LA and a rather rapid accumulation of distinct mutations and acquired ARG by the LA isolates.

The nesting requirements of the Yellow-headed Parrot (Amazona oratrix) are poorly understood, despite their broad historical distribution, high demand for pet trade and current endangered status. Information concerning their nesting requirements is required in order to design specific restoration and conser- vation actions. To assess this, we studied their nesting ecology in the Central Pacific, Michoacan, Mexico during a ten year period. The analyzed variables ranged from local scale nest site characteristics such as nesting tree species, dimensions, geographic positions, diet and nesting forest patches structure, to large scale features such as vegetation use and climatic variables associated to the nesting tree distributions by an ecological niche model using Maxent. We also evaluated the parrot tolerance to land management regimes, and compared the Pacific nest trees with 18 nest trees recorded in an intensively managed private ranch in Tamaulipas, Gulf of Mexico. Parrots nested in tall trees with canopy level cavities in 92 nest-trees recorded from 11 tree species. The 72.8% of nesting occurred in trees of Astronium graveolens, and Enterolobium cyclocarpum which qualified as key- stone trees. The forests where the parrots nested, presented a maximum of 54 tree species, 50% of which were identified as food source; besides, these areas also had a high abundance of trees used as food supply. The lowest number of tree species and trees to forage occurred in an active cattle ranch, whereas the highest species rich- ness was observed in areas with natural recovery. The nesting cavity entrance height from above ground of the Pacific nesting trees resulted higher than those found in the Gulf of Mexico. We hypothesize that the differences may be attributed to Parrot behavioral differences adapting to differential poaching pressure and cavity avail- ability. Nesting trees were found in six vegetation types; however the parrots preferred conserved and riparian semi-deciduous forest for nesting, with fewer nests in deciduous forest, while nesting in transformed agricultural fields was avoided. The main climatic variables associated with the potential distribution of nests were: mean temperature of wettest quarter, mean diurnal temperature range, and precipitation of wettest month. Suitable cli- matic conditions for the potential presence of nesting trees were present in 61% of the region; however, most of the area consisted of tropical deciduous forests (55.8%), while semi-deciduous tropical forests covered only 17% of the region. These results indicated the importance to conserve semi-deciduous forests as breeding habitats for the Yellow-headed Parrot, and revealed the urgent need to implement conservation and restoration actions. These should include a total ban of land use change in tropical semi-deciduous forest areas, and for selective logging of all keystone tree species; besides, we recommend the establishment of wildlife sanctuaries in important nesting areas, and a series of tropical forest restoration programs in the Central Pacific coast.