Timely Access to Essential Surgery, Surgical Workforce, and Surgical Volume: Global Surgery Indicators in Mexico.

INTRODUCTION: The Lancet Commission on Global Surgery seeks to improve surgical care outcomes and equity for the world population through 6 indicators outlined in its 2030 Global Surgery Report. Our study aimed to estimate the percentage of the Mexican population with access to surgical care within the 2-hour distance range (indicator 1), the surgical workforce density (indicator 2), and the number of surgical procedures performed per 100,000 inhabitants (indicator 3) during the year 2020. Knowing these indicators can help to design and implement policies to increase surgical care access coverage and equity in our country. METHODS: Data related to population distribution, local referral hospitals, and surgical volume were obtained from the 2020 Mexican National Census. Information relating to hospital characteristics and surgical specialists was collected from the Secretariat of Health's public records. We calculated travel time between health care facilities and municipalities using the TrueWay Matrix API and R Studio. RESULTS: Taking into consideration the health care system affiliation, the proportion of the Mexican population with timely access to essential surgery was 81.7%, with 29.3 specialists per 100,000 inhabitants and 726.9 annual procedures performed per 100,000 inhabitants. We identified clusters of municipalities where a low proportion of the population has timely access to essential surgery. CONCLUSION: These findings illustrate that changes in Mexican policy are required to facilitate more equitable and timely access to essential surgical care among the population.

Patterns of Lignocellulosic Sugar Assimilation and Lipid Production by Newly Isolated Yeast Strains From Chilean Valdivian Forest.

Three yeast strains were isolated from decaying wood of Chilean Valdivian forest and identified as Meyerozyma guilliermondii, Scheffersomyces coipomensis, and Sugiyamaella paludigena. These strains were able to efficiently grow on the major monomers contained in Pinus spp. and Eucalyptus spp. wood that includes glucose (Glc), xylose (Xyl), and mannose (Man), showing at 28 °C higher uptake rates for Man, and in some cases for Glc, than for Xyl, used as single carbon sources. Nevertheless, in cultures performed on sugar mixtures, the strains displayed a notable preference for Glc. Additionally, in sugar mixtures, the absence of regulatory mechanisms in sugar assimilation (e.g., catabolic repression) was observed and documented when the activities of several enzymes involved in sugar assimilation (i.e., phosphoglucose isomerase, phosphomannose isomerase, and xylulokinase) were determined. The activity of the key enzymes involved in the onset of lipid accumulation (i.e., NAD+-ICDH) and in fatty acid (FA) biosynthesis (i.e., ATP:CL) indicated a significant accumulation of storage lipids (i.e., up to 24%, w/w) containing oleic and palmitic acids as the major components. The present paper is the first report on the potential of M. guilliermondii, S. coipomensis, and S. paludigena as oleaginous yeasts. We conclude that the new isolates, being able to simultaneously assimilate the major lignocellulosic sugars and efficiently convert them into oily biomass, present a biotechnological potential which deserve further investigation.

Short and long-term exposure to diclofenac alter oxidative stress status in common carp Cyprinus carpio.

Diclofenac (DCF) has been detected in significant amounts in municipal treated wastewater effluent. Diverse studies report that trace concentrations of DCF may induce toxic effects on different aquatic organisms as well as developmental, reproductive and renal damage. This study aimed to determine whether short and long-term exposure to DCF alter the oxidative stress (OS) status in blood, muscle, gills, brain and liver of common carp Cyprinus carpio. The median lethal concentration of DCF at 96 h (96-h LC50) and subsequently the lowest observed adverse effect level were determined. Carp were exposed (short and long-term) to the latter value for different exposure times (4 and 24 days) and the following biomarkers were evaluated in gill, brain, liver and blood: hydroperoxides content (HPC), lipid peroxidation (LPX), protein carbonyl content (PCC) and the activity of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Also, the DCF was determined by LC-MS/MS. Significant increases in HPC, LPX and PCC were observed respect to control (P < 0.05) particularly in blood, muscle, gill, brain and liver. SOD, CAT and GPx activity also increased in these organs, with respect to controls (P < 0.05). DCF concentrations decreased and increased in water system and carp, respectively. Cyprinus carpio exposed to DCF was affected in OS status during the initial days of the study (at 4 days), exhibiting an increased response at 24 days in blood and liver. In contrast, a decrease was observed in muscle, gills and brain at 24 days with respect to 4 days. In conclusion, DCF induces OS on blood, muscle, gills, brain and liver in the carp C. carpio in short and long-term exposure. The biomarkers employed in this study are useful in the assessment of the environmental impact of this agent on aquatic species.

M-CHAT Mexican Version Validity and Reliability and Some Cultural Considerations.

The Modified Checklist for Autism in Toddlers (M-CHAT) questionnaire is a brief measure available in Spanish which needs to be validated for the Mexican population. Parents of children from (1) community with typical development (TD) and (2) psychiatric outpatient unit completed the CBCL/1.5-5 and the Mexican/MM-CHAT-version. The study sample consisted of 456 children (age M = 4.46, SD = 1.12), 74.34% TD children and 26.65% with Autism Spectrum Disorders (ASD). The MM-CHAT mean score for failed key items was higher for the ASD group compared with the TD group. Internal consistency for the Mexican/M-CHAT version was .76 for total score and .70 for the 6 critical items. Correlations between the MM-CHAT and the CBCL/1.5: PDD and Withdrawn subscales and with ADI-R dimensions: B non verbal) and A were high, and were moderate with ADI-R dimensions B1 (verbal) and C The failure rate of the MM-CHAT between the groups did not reproduce all the critical items found in other studies. Although the instrument has good psychometric properties and can be used for screening purposes in primary settings or busy specialized psychiatric clinics, these results support evidence for cultural differences in item responses, making it difficult to compare M-CHAT results internationally.