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Introduction Caesarean delivery is a vital procedure to reduce maternal and neonatal mortality. (1) However, in some middle- and high-income settings, caesarean deliveries have increased sharply. (1) Although no clear [...], Caesarean delivery rates in Mexico are among the highest in the world. Given heightened public and professional awareness of this problem and the updated 2014 national guidelines to reduce the frequency of caesarean delivery, we analysed trends in caesarean delivery by type of facility in Mexico from 2008 to 2017. We obtained birth-certificate data from the Mexican General Directorate for Health Information and grouped the total number of vaginal and caesarean deliveries into five categories of facility: health- ministry hospitals; private hospitals; government employment-based insurance hospitals; military hospitals; and other facilities. Delivery rates were calculated for each category nationally and for each state. On average, 2 114 630 (95% confidence interval, CI: 2 061 487-2 167 773) live births occurred nationally each year between 2008 and 2017. Of these births, 53.5% (1 130 570; 95% CI: 1 108 068-1 153 072) were vaginal deliveries, and 45.3% (957 105; 95% CI: 922 936-991 274) were caesarean deliveries, with little variation over time. During the study period, the number of live births increased by 4.4% (from 1 978 380 to 2 064 507). The vaginal delivery rate decreased from 54.8% (1 083 331/1 978 380) to 52.9% (1091 958/2 064 507), giving a relative percentage decrease in the rate of 3.5%. The caesarean delivery rate increased from 43.9% (869 018/1 978 380) to 45.5% (940 206/2 064 507), giving a relative percentage increase in the rate of 3.7%. The biggest change in delivery rates was in private-sector hospitals. Since 2014, rates of caesarean delivery have fallen slightly in all sectors, but they remain high at 45.5%. Policies with appropriate interventions are needed to reduce the caesarean delivery rate in Mexico, particularly in private-sector hospitals. Les taux d'accouchements par cesarienne au Mexique sont parmi les plus eleves au monde. Au vu de la sensibilisation accrue de la population et des professionnels a ce probleme et de la mise a jour des directives nationales de 2014 visant a diminuer la frequence des accouchements par cesarienne, nous avons analyse l'evolution des accouchements par cesarienne selon le type d'etablissement entre 2008 et 2017 au Mexique. Nous avons obtenu des donnees issues d'actes de naissance aupres de la Direction generale mexicaine des informations sur la sante et regroupe le nombre total d'accouchements par voie basse et par cesarienne en cinq categories d'etablissement: hopitaux relevant du ministere de la Sante, hopitaux publics, hopitaux relevant de l'assurance liee a l'emploi public, hopitaux militaires et autres etablissements. Les taux d'accouchements ont ete calcules pour chaque categorie a l'echelle nationale et pour chaque Etat. En moyenne, 2 114 630 (intervalle de confiance, IC, a 95%: 2 061 487-2 167 773) naissances vivantes ont eu lieu chaque annee entre 2008 et 2017 a l'echelle nationale. Parmi ces naissances, 53,5% (1 130 570; IC a 95%: 1 108 068-1 153 072) etaient des accouchements par voie basse, et 45,3% (957 105; IC a 95%: 922 936-991 274) etaient des accouchements par cesarienne, avec peu de variations dans le temps. Au cours de la periode etudiee, le nombre de naissances vivantes a augmente de 4,4% (de 1 978 380 a 2 064 507). Le taux d'accouchements par voie basse est passe de 54,8% (1 083 331/1 978 380) a 52,9% (1 091 958/2 064 507), ce qui correspond a une diminution relative du taux de 3,5%. Le taux d'accouchements par cesarienne est passe de 43,9% (869 018/1 978 380) a 45,5% (940 206/2 064 507), ce qui correspond a une augmentation relative du taux de 3,7%. Le changement le plus important concernant les taux d'accouchements a ete constate dans les hopitaux du secteur prive. Depuis 2014, les taux d'accouchements par cesarienne ont legerement diminue dans tous les secteurs, mais demeurent eleves (45,5%). Des politiques et des interventions appropriees sont necessaires pour reduire le taux d'accouchements par cesarienne aux Mexique, en particulier dans les hopitaux de secteur prive. Las tasas de parto por cesarea en Mexico estan entre las mas altas del mundo. Dada la creciente concienciacion publica y profesional sobre este problema y las directrices nacionales actualizadas de 2014 para reducir la frecuencia de los partos por cesarea, se analizaron las tendencias de los partos por cesarea segun el tipo de establecimiento en Mexico entre 2008 y 2017. Se obtuvieron datos de los certificados de nacimiento de la Direccion General de Informacion Sanitaria de Mexico y se agrupo el numero total de partos vaginales y por cesarea en cinco categorias de establecimientos: hospitales del ministerio de salud publica, hospitales privados, hospitales gubernamentales para asegurados por empleo, hospitales militares y otras instalaciones. Se calcularon los indices de partos para cada categoria a nivel nacional y segun cada estado. De media, 2 114 630 (intervalo de confianza, IC, del 95%: 2 061 487-2 167 773) nacimientos vivos se produjeron a nivel nacional al ano entre 2008 y 2017. De estos nacimientos, el 53,5% (1 130 570; IC del 95%: 1 108 068-1 153 072) fueron partos vaginales y el 45,3% (957 105; IC del 95%: 922 936-991 274) fueron partos por cesarea, con poca variacion a lo largo del tiempo. Durante el periodo de estudio, el numero de nacidos vivos aumento un 4,4% (de 1 978 380 a 2 064 507). La tasa de partos vaginales disminuyo del 54,8% (1 083 331/1 978 380) al 52,9% (1 091 958/2 064 507), lo que supone una disminucion porcentual relativa de la tasa del 3,5%. La tasa de partos por cesarea aumento del 43,9% (869 018/1 978 380) al 45,5% (940 206/2 064 507), lo que representa un aumento porcentual relativo de la tasa del 3,7%. El mayor cambio en las tasas de partos se produjo en los hospitales del sector privado. Desde 2014, las tasas de parto por cesarea se han reducido ligeramente en todos los sectores, pero siguen siendo elevadas (45,5%). Se necesitan politicas con intervenciones apropiadas para reducir la tasa de partos por cesarea en Mexico, especialmente en los hospitales del sector privado.

Acinetobacter baumannii is a relevant bacterium due to its high-resistance profile. It is well known that antimicrobial resistance is primarily linked to mutations and the acquisition of external genomic material, such as plasmids or phages, to which the Clustered Regularly Interspaced Short Palindromic Repeats associated with Cas proteins, or CRISPR–Cas, system is related. It is known that the system can influence the acquisition of foreign genetic material and play a role in various physiological pathways. In this study, we conducted an in-silico analysis using 91 fully assembled genomes of clinical strains obtained from the NCBI database. Among the analyzed genomes, the I-F1 subtype of the CRISPR–Cas system was detected showcasing variations in architecture and phylogeny. Using bioinformatic tools, we determined the presence, distribution, and specific characteristics of the CRISPR–Cas system. We found a possible association of the system with resistance genes but not with virulence determinants. Analysis of the system's components, including spacer sequences, suggests its potential role in protecting against phage infections, highlighting its protective function. [ABSTRACT FROM AUTHOR]

Purpose: Metabolic equivalents for youth (METy) are derived using the estimated basal metabolic rate (BMR). However, is unknown whether this METy can be different when measured resting energy expenditure (REE) is used. The purposes of this article are to: (a) To determine whether there is equivalence between METy values calculated using measured REE (METy-mea) and METy using predicted BMR (METy-est). (b) To determine whether METy values of different activities are dependent on age, sex, and body composition. Methods: A cross-sectional study with a sample of 122 Mexican children (5–11 years old) was conducted. With indirect calorimetry, energy expenditure was measured at rest and during 16 sedentary- to vigorous-intensity physical activities. METy were obtained in two forms: METy-mea and METy-est. Equivalence testing was used to compare METy-mea and METy-est. To examine the individual-level agreement, Bland-Altman plots were graphed, and intra-class correlation coefficients (ICC) were calculated. Linear regression models were estimated having METy as the outcome. Results: For 15 activities, there was equivalence between METy-mea and METy-est (t > 2.05, p < 0.050). However, at the individual-level, for 7 activities the agreement between METy-eREE and METy-mREE was inadequate (ICC<0.75). In the Bland-Altman plots was evident that in 8 activities METy-est was biased compared to METy-mea, METy-est had more correlations with body mass index and body fat. Conclusions: In conclusion, at group-level, for most activities METy-mea and METy-est were equivalent. However, at the individual level, METy-est of many activities is not a valid estimate of METy-mea. METy-est of many physical activities were dependent on adiposity, which could be an artifact introduced when BMR is predicted. [ABSTRACT FROM AUTHOR]

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