Glycemic Index, Glycemic Load and Dyslipidemia in Adolescents from Chiapas, Mexico.

Cardiovascular disease risk throughout the life course is increased by abnormal blood lipid levels in youth. The dietary glycemic index (GI) and glycemic load (GL) during adolescence might be related to abnormal blood lipids. This study aimed to analyze the association between dietary GI, GL and dyslipidemia in adolescents from two marginalized regions of Chiapas, Mexico. A cross-sectional study was conducted with 213 adolescents. Food intake was assessed using 24 h recalls. The association between dyslipidemia and dietary GI or GL was tested by using logistic regression models. Low HDL-c was the most prevalent risk factor (47.4%), followed by hypertriglyceridemia (25.4%). In this population, overall dietary GI was not associated with dyslipidemia. A high dietary GL was associated with 2.39 higher odds of low HDL-c (95% CI: 1.21-4.74) when compared to low GL. Female adolescents with high dietary GL had 3.20 higher odds of hypertriglyceridemia (95% CI: 1.03-9.88), whereas no association was found for males. No associations were observed between overall dietary GL and total cholesterol or LDL-c. In adolescents from urban and rural communities in Chiapas, a high dietary GL was associated with a detrimental effect on HDL-c. In female adolescents, high GL was associated with hypertriglyceridemia.

Exploring local perceptions and drivers of engagement in biodiversity monitoring among participants in payments for ecosystem services schemes in southeastern Mexico.

Payments for ecosystem services (PES) are widely applied incentive-based instruments with diverse objectives that increasingly include biodiversity conservation. Yet, there is a gap in understanding of how to best assess and monitor programs' biodiversity outcomes. We examined perceptions and drivers of engagement related to biodiversity monitoring through surveys among current PES participants in 7 communities in Mexico's Selva Lacandona. We conducted workshops among survey participants that included training and field deployment of tools used to monitor biodiversity and land cover, including visual transects, camera traps, acoustic recorders, and forest cover satellite images. We conducted pre- and postworkshop surveys in each community to evaluate changes in respondents' perceptions following exposure to biodiversity monitoring training and related field activities. We also reviewed existing research on participatory environmental management and monitoring approaches. One quarter of current PES participants in the study area participated in our surveys and workshops. The majority stated interest in engaging in diverse activities related to the procedural aspects of biodiversity monitoring (e.g., planning, field data collection, results dissemination) and acknowledged multiple benefits of introducing biodiversity monitoring into PES (e.g., knowledge and capacity building, improved natural resource management, and greater support for conservation). Household economic reliance on PES was positively associated with willingness to engage in monitoring. Technical expertise, time, and monetary constraints were deterrents. Respondents were most interested in monitoring mammals, birds, and plants and using visual transects, camera traps, and forest cover satellite images. Exposure to monitoring enhanced subsequent interest in monitoring by providing respondents with new insights from their communities related to deforestation and species' abundance and diversity. Respondents identified key strengths and weaknesses of applying different monitoring tools, which suggests that deploying multiple tools simultaneously can increase local engagement and produce complementary findings and data. Overall, our findings support the relevance and usefulness of incorporating participatory biodiversity monitoring into PES.

Explorando las percepciones locales y los impulsores de la participación en el monitoreo de la biodiversidad entre participantes de esquemas de pagos por servicios ambientales en el sureste de México Resumen Los pagos por servicios ambientales (PSA) son instrumentos basados en incentivos ampliamente aplicados cuyos diversos objetivos incluyen cada vez más la conservación de la biodiversidad. Sin embargo, existe una brecha en la comprensión de cómo evaluar y monitorear los resultados de los programas en materia de biodiversidad. Examinamos las percepciones y los impulsores de la participación relacionados al monitoreo de la biodiversidad a través de encuestas entre participantes actuales de PSA en siete comunidades de la Selva Lacandona de México. Realizamos talleres entre los participantes de las encuestas que incluyeron capacitación y despliegue en campo de herramientas utilizadas para monitorear la biodiversidad y la cobertura del suelo, incluidos transectos visuales, cámaras trampa, grabadores acústicos e imágenes satelitales de la cobertura forestal. Realizamos encuestas antes y después del taller en cada comunidad para evaluar los cambios en las percepciones de los participantes tras su involucramiento en la capacitación de monitoreo de biodiversidad y las actividades de campo relacionadas. También revisamos la investigación existente sobre enfoques de monitoreo y gestión ambiental participativa. Una cuarta parte de los participantes actuales de PES en el área de estudio participaron en nuestras encuestas y talleres. La mayoría declaró interés en participar en diversas actividades relacionadas con los aspectos procesales del monitoreo de la biodiversidad (por ejemplo, planificación, recopilación de datos de campo, difusión de resultados) y reconoció múltiples beneficios de introducir el monitoreo de la biodiversidad en los PSA (por ejemplo, creación de conocimientos y capacidades, mejora de la gestión de los recursos naturales, y mayor apoyo a la conservación). La dependencia económica de los hogares de los PSA se asoció positivamente con la voluntad de participar en el monitoreo. Los factores inhibidores fueron la experiencia técnica, el tiempo y las limitaciones monetarias. Los encuestados estaban más interesados en monitorear mamíferos, aves y plantas y en utilizar transectos visuales, cámaras trampa e imágenes satelitales de la cubierta forestal. La exposición al monitoreo aumentó el interés posterior en el monitoreo al brindar a los encuestados nuevos conocimientos de sus comunidades relacionados con la deforestación y la abundancia y diversidad de especies. Los encuestados identificaron fortalezas y debilidades clave al aplicar diferentes herramientas de monitoreo, lo que sugiere que implementar múltiples herramientas simultáneamente puede aumentar la participación local y producir hallazgos y datos complementarios. En general, nuestros hallazgos respaldan la relevancia y utilidad de incorporar el monitoreo participativo de la biodiversidad en los PSA.

Analyzing morphometry among extant and extinct species: A case study of genus Agassizia (Spatangoida: Echinoidea) / Análisis de la morfometría entre especies existentes y extintas: Un estudio de caso del género Agassizia (Spatangoida: Echinoidea)

Abstract Introduction: The genus Agassizia in Mexico is represented both in the fossil record by the species Agassizia regia† during the Miocene of Chiapas and by the extant species Agassizia excentrica on the Atlantic coast and Agassizia scrobiculata on the Pacific coast. Qualitative diagnosis and descriptions make it hard to distinguish morphological boundaries between species, especially in groups with fossils and recent representatives, increasing the level of complexity by having samples of disparate qualities and quantities. Objective: We propose the use of little explored statistical methods in the comparison of paleontological and biological populations. This methodology allowed us to resolve issues of missing values in a morphometric data set for the genus Agassizia. Methods: Using samples recently collected and specimens already housed in collections, we explore a routine of recovery of missing data MICE and the numerical and graphic analyses PERMANOVA, PCA, and SIMPER to compare morphometric parameters between these species for recognizing diagnostic characters. Results: Our results show a morphological difference in the length of the ambulacrum II and the length and width of the periproct and peristome structures, these being greater in A. scrobiculata, with a consistent pattern in both population samples not previously described. Conclusions: Quantitative morphometric comparisons can be an assertive and complementary tool to determine distinctive differentiation characteristics in species of the same genus. Comparative morphology reviews should be an ongoing exercise to keep taxonomic knowledge on both extinct and extant species up to date. Our research encourage the scientific community studying fossil populations to utilize quantitative and multivariate methods to strengthen their investigations.

Resumen Introducción: El género Agassizia en México está representado tanto en el registro fósil por la especie Agassizia regia† del Mioceno de Chiapas, como por las especies actuales Agassizia excentrica de la costa del Atlántico y Agassizia scrobiculata de la costa del Pacífico. Las descripciones y diagnosis cualitativas dificultan reconocer los limites morfológicos entre especies, especialmente en grupos con representantes fósiles y recientes, e incrementando el nivel de complejidad al tener muestras de cantidad y calidad desiguales. Objetivo: Proponemos el uso de métodos estadísticos poco explorados en la comparación de poblaciones paleontológicas y biológicas. Esta metodología nos permitió resolver problemas de valores faltantes en un conjunto de datos morfométricos para el género Agassizia. Métodos: Usando muestras recolectadas para este fin, así como provenientes de colecciones científicas, exploramos una rutina de recuperación de datos faltantes MICE, y los análisis numéricos y gráficos PERMANOVA, PCA y SIMPER para comparar parámetros morfométricos entre estas especies y reconocer caracteres de diagnóstico. Además, comparamos cuidadosamente los caracteres morfológicos descritos previamente en la literatura taxonómica y la descripción ambiental del hábitat actual de A. scrobiculata. Resultados: Nuestros resultados muestran una diferencia morfológica en la longitud del ambulacrum II y la longitud y anchura de las estructuras del periprocto y peristoma, siendo estas mayores en A. scrobiculata, con un patrón consistente en ambas muestras poblacionales no descrito previamente. El hábitat actual de las muestras de A. scrobiculata en la costa del Pacífico es un sistema costero poco profundo con sedimentos arenosos y temperaturas tropicales. Bahía Chamela comparte varias similitudes con la fauna y las condiciones ambientales previamente descritas en el Mioceno de Chiapas. Conclusiones: Las comparaciones morfométricas cuantitativas pueden ser una herramienta poderosa y complementaria para determinar caracteres distintivos de diferenciación en especies del mismo género. Las revisiones de morfología comparativa deben ser un ejercicio continuo para mantener actualizado el conocimiento taxonómico sobre las especies existentes y extintas. Nuestro trabajo busca incentivar a la comunidad científica que trabaja con poblaciones fósiles a explorar estos y otros métodos cuantitativos y multivariados para fortalecer sus investigaciones.

[Interventionism in congenital heart disease in Chiapas. The history after thousand cases performed]. / El intervencionismo en cardiopatías congénitas en Chiapas. La historia luego de mil casos realizados.

Background: Congenital heart disease is the most common birth defect and the leading cause of childhood mortality in high-income countries. In these countries, the prognosis for a child born with congenital heart disease is excellent, with over 90% achieving adulthood. However, in the low and lower-middle-income countries, as ours, the outlook is starkly different. In Chiapas, because of the progress of the hemodynamics program, more and more types of congenital heart diseases are susceptible to being treated by cardiac catheterization. Objective: To show the global experience of the interventionism in congenital heart diseases in Chiapas from its inception to recent days. Method: Through a retrospective study from April 2016 to June 2023, we reviewed the electronic files of the total of patients who underwent cardiac catheterism during the same period of time. Results: A total of 1000 procedures were performed, 581 in female patients, with a median age of 4 years (1 day to 77 years). Of the total procedures, 115 (11.5%) were diagnostic catheterizations and 885 (88.5%) were interventional. Conclusions: Cardiac catheterization in pediatrics in Chiapas has displaced cardiac surgery in a large percentage, and the results that have been obtained are undoubtedly encouraging, which already represents a decentralization in the care of congenital heart diseases in our country.

Antecedentes: Las cardiopatías congénitas son el defecto congénito más común y la primera causa de mortalidad infantil en los países de alto ingreso económico. En estos países, el pronóstico de los pacientes nacidos con estos defectos es excelente, llegando el 90% de ellos hasta la edad adulta. Sin embargo, en los países de mediano o bajo ingreso económico, como el nuestro, el pronóstico es completamente distinto. En el Estado de Chiapas, como resultado del avance del programa de hemodinamia, cada vez más tipos de cardiopatías congénitas son susceptibles de ser tratadas por cateterismo cardiaco. Objetivo: Mostrar la experiencia global actual de la hemodinamia en cardiopatías congénitas en Chiapas después de haber alcanzado los primeros 1000 casos realizados desde el inicio de nuestro programa. Método: A través de un estudio retrospectivo que abarcó de abril de 2016 a junio de 2023 revisamos los expedientes electrónicos del total de pacientes que fueron llevados a cateterismo cardiaco durante ese periodo. Resultados: Se realizaron un total de 1000 procedimientos, 581 en pacientes del sexo femenino, con una mediana de edad de 4 años (1 día a 77 años). Del total de los procedimientos, 115 (11.5%) fueron cateterismos diagnósticos y 885 (88.5%) intervencionistas. Conclusiones: El cateterismo cardiaco en cardiopatías congénitas en el Estado de Chiapas ha desplazado a la cirugía cardiaca en un amplio porcentaje, y los resultados obtenidos son sin duda alentadores, lo cual representa ya una descentralización en la atención de las cardiopatías congénitas en nuestro país.

Trophic morphology and diet of the endangered fish Tlaloc hildebrandi (Cyprinodontiformes: Profundulidae) / Morfología trófica y dieta de Tlaloc hildebrandi (Cyprinodontiformes: Profundulidae), especie amenazada de extinción

Abstract Introduction: Tlaloc hildebrandi is a freshwater killifish, endemic to Southern Mexico and under threat of extinction; the knowledge of the trophic morphology and diet is needed by conservation managers. Objective: To analyse and describe the anatomy of the visceral skeleton, visceral musculature, digestive tract and its adjoining glands of T. hildebrandi; as well as its diet. Methods: We performed the trophic anatomy on 20 adult specimens of both sexes, through manual dissection; as well as gut content analysis in 60 individuals to describe the diet. Results: As notable characters of the visceral skeleton of T. hildebrandi we found the posterior notch of the premaxillary, the presence of the "coronoid cartilage", the tricuspid shape of the gill rakers of the first branchial arch, and the presence of the coronomeckelian bone; some outstanding characters of the visceral musculature are the origin of the retractor dorsalis muscle from the first four vertebral centra, and the division of the pharyngoclavicularis externus muscle into two sections. The notable characters of the digestive tube are the absence of stomach and pyloric caeca, and the presence of the "intestinal valve". Insects (IVI = 66.6 %) and ostracods (13 % IVI) were the dominant prey items of the Tlaloc hildebrandi diet; larvae and adults of the family Chironomidae were the most dominant insects in the diet (53 % IVI). Conclusions: The organization of the digestive system of T. hildebrandi corresponds to the general morphologic pattern of the Cyprinodontiformes; however, we register as new information for these fish, the presence of the "coronoid cartilage" and the "intestinal valve". The structures of the trophic morphology and the components of the diet, confirms us that T. hildebrandi is a carnivorous-insectivorous fish.

Resumen Introducción: Tlaloc hildebrandi es un killi de agua dulce, endémico del sur de México y bajo amenaza de extinción; el conocimiento de la morfología trófica y la dieta son necesarios para los administradores de la conservación. Objetivo: Analizar y describir la anatomía del esqueleto visceral, la musculatura visceral, el tracto digestivo y las glándulas adyacentes de T. hildebrandi; así como los componentes de su dieta. Métodos: Mediante la técnica del descarnado manual, realizamos la descripción de la anatomía trófica en 20 especímenes adultos de ambos sexos, y el análisis del contenido estomacal en 60 individuos para describir la dieta. Resultados: Como caracteres sobresalientes del esqueleto visceral de T. hildebrandi está la escotadura posterior del premaxilar, la presencia del "cartílago coronoides", la forma tricúspide de las branquiespinas del primer arco branquial y la presencia del hueso coronomeckeliano; como caracteres de la musculatura visceral sobresalen el origen del músculo retractor dorsalis de los cuatro primeros centros vertebrales, y la división del músculo pharyngoclavicularis externus en dos secciones. Los caracteres notables del tubo digestivo son la ausencia de estómago y de ciegos pilóricos y la presencia de la "válvula intestinal". Los insectos (IVI = 66.6 %) y ostrácodos (13 % IVI) fueron los componentes dominantes de la dieta de T. hildebrandi; particularmente las larvas y adultos de la familia Chironomidae fueron los insectos más abundantes en la dieta (53 % IVI). Conclusiones: La organización del sistema digestivo de T. hildebrandi corresponde al patrón morfológico general de los Cyprinodontiformes, sin embargo, se registra como nueva información para estos peces, la presencia del cartílago coronoides y la válvula intestinal. Las estructuras de la morfología trófica y los componentes de la dieta nos confirman que T. hildebrandi es un pez carnívoro-insectívoro.

Elaphomycescastilloi (Elaphomycetaceae, Ascomycota) and Entolomasecotioides (Entolomataceae, Basidiomycota), two new sequestrate fungi from tropical montane cloud forest from south Mexico.

Two new species of sequestrate fungi are described from south Mexico based on morphological and molecular evidences. Here we describe Elaphomycescastilloi characterized by the yellowish mycelial mat, dull blue gleba and ascospores of 9.7-11.5 µm; Entolomasecotioides is characterized by the secotioid basidiomata, sulcate, pale cream pileus, and basidiospores of 7-13 × 5-9 µm. Both species grow in montane cloud forest under Quercus sp. in the state of Chiapas, Mexico. Descriptions, photographs, and multilocus phylogeny for both species are presented.

Bird species occupancy trends in Southeast Mexico over 1900-2020: Accounting for sighting record absences.

Long-term land-use change impacts tropical bird communities through population-level and functional diversity effects from habitat loss, degradation and fragmentation, leading to land management and conservation challenges. Assessing the temporal impacts of land-use change on occupancy patterns, population change and functional traits of bird species in tropical areas is limited by the treatment of nondetections as true absences or artefacts of low sampling effort during and throughout years. With this in mind, we developed a novel Bayesian species occupancy framework to account for species absences to evaluate bird community changes in Palenque, Chiapas, Mexico, where there is opportunity for study given exceptional records of change across habitats from rainforest to urban centres. We created a novel dataset of population trends for 244 bird species over the years 1900 to 2020 from published short-term field studies, expert field notes and community science pages. Our results show that open area species had higher population increases than forest specialists over time, represented most evidently by the turnover of rainforest specialists for urban species. Modelled influence of functional traits displayed the importance of main habitat types, body mass and habitat and dietary breadth as factors that associated with bird population trends. On average, species with body masses <6.6 and > 948.4 g showed decreasing trends, while all other species showed increasing or stable trends. Our findings illuminate the value of accounting for species absences from several data sources to discover long-term species population trends and affiliated functional traits whose preservation requires conservation and land management action to protect bird ecosystem services. Primary forest conservation is key to maintaining populations of habitat and dietary specialists, such as small understorey insectivorous and large frugivorous species. Protecting rare natural savanna patches from conversion to cattle pasture is vital to prevent further extirpation of native granivores and to slow colonization by exotic and invasive species.

El cambio a largo plazo en el uso de la tierra impacta a las comunidades de aves tropicales a través de los efectos de la diversidad funcional y a nivel de la población debido a la pérdida, degradación y fragmentación del hábitat, lo que lleva a desafíos de gestión y conservación de la tierra. La evaluación de los impactos temporales del cambio de uso de la tierra en los patrones de ocupación, el cambio de población y los rasgos funcionales de las especies de aves en áreas tropicales enfrenta limitaciones al considerar el tratamiento de las no detecciones como ausencias verdaderas o artefactos de bajo esfuerzo de muestreo durante el año y los años. La evaluación de los impactos temporales del cambio de uso de la tierra en los patrones de ocupación, el cambio de población y las características funcionales de las especies de aves en áreas tropicales está limitada por el tratamiento de las no detecciones como verdaderas ausencias o artefactos de bajo esfuerzo de muestreo durante y a lo largo de los años. Con esto en mente, desarrollamos un marco bayesiano novedoso de ocupación de especies para dar cuenta de las ausencias de especies para evaluar los cambios en la comunidad de aves en Palenque, Chiapas, México, donde existe la oportunidad de estudiar dados los registros excepcionales de cambios en los hábitats, desde la selva tropical hasta los centros urbanos. Creamos un nuevo conjunto de datos de tendencias de población para 244 especies de aves durante los años 1900 a 2020 a partir de estudios de campo a corto plazo publicados, notas de campo de expertos y páginas de ciencia comunitaria. Nuestros resultados muestran que las especies de áreas abiertas tuvieron aumentos de población más altos que los especialistas forestales a lo largo del tiempo, representado más evidentemente por la rotación de especialistas de bosques tropicales por especies urbanas. La influencia modelada de los rasgos funcionales mostró la importancia de los principales tipos de hábitat, la masa corporal y el hábitat y la amplitud de la dieta como factores asociados con las tendencias de la población de aves. En promedio, las especies con masas corporales <6,6 g y >948,4 g mostraron tendencias decrecientes, mientras que todas las demás especies mostraron tendencias crecientes o estables. Nuestros hallazgos iluminan el valor de contabilizar las ausencias de especies de varias fuentes de datos para descubrir tendencias de población de especies a largo plazo y rasgos funcionales afiliados cuya preservación requiere acción de conservación y manejo de la tierra para proteger los servicios ecosistémicos de las aves. La conservación de los bosques primarios es clave para mantener las poblaciones de especialistas en hábitat y dieta, como las especies insectívoras pequeñas del sotobosque y las especies frugívoras grandes. Proteger los raros parches naturales de sabana de la conversión en pastos para ganado es vital para evitar una mayor extirpación de los granívoros nativos y para retrasar la colonización por especies invasoras.

Belisario Domínguez: A life and death deserving of a medal.

Belisario Domínguez was a Mexican physician, ophthalmologist, and politician. He traveled abroad to France, where he studied High School, later he entered the School of Medicine at Sorbonne University in Paris. Back in Mexico, Domínguez installed his medical office in his house. Belisario was recognized for his philanthropic attitude, he also often sought the well-being being of Chiapas and Mexico. In 1911 he became Comitán Municipal President, after the overthrown of presidente Porfirio Díaz.He witnessed the coup against President Francisco Madero by General Huerta. Belisario wrote a speech in which he expressed the shame of having a traitor and murderer as President. As consequence of the speech, he was killed. After Belisario's assassination, an outrage was incited, damaging the image of President Huerta. Belisario's civic value was honored with a medal that bears his name " Belisario Domínguez Medal" in 1953 which is the greatest recognition that can be obtained by a Mexican.

Trends in facility-based childbirth and barriers to care at a birth center and community hospital in rural Chiapas, Mexico: A mixed-methods study.

OBJECTIVE: To assess trends in childbirth at a hospital-birth center among women living in Compañeros En Salud (CES)-affiliated communities in Chiapas, Mexico and explore barriers to childbirth care. Our hypothesis was that despite interventions to support and incentivize childbirth at the hospital-birth center, the proportion of births at the hospital-birth center among women from Compañeros En Salud-affiliated communities has not significantly changed after two years. We suspected that this may be due to structural factors impacting access to care and/or perceptions of care impacting desire to deliver at the birth center. DESIGN: This explanatory mixed-methods study included a retrospective Compañeros En Salud maternal health census review followed by quantitative surveys and semi-structured qualitative interviews. PARTICIPANTS AND SETTING: Participants were women living in municipalities in the mountainous Sierra Madre region of Chiapas, Mexico who received prenatal care in one of 10 community clinics served by Compañeros En Salud. Participants were recruited if they gave birth anywhere other than the primary-level rural hospital and adjacent birth center supported by Compañeros En Salud, either at home or at other facilities. MEASUREMENTS: We compared rates of birth at the hospital-birth center, other health facilities, and at home from 2017-2018. We conducted surveys and interviews with women who gave birth between January 2017-July 2018 at home or at facilities other than the hospital-birth center to understand perceptions of care and decision-making surrounding childbirth location. FINDINGS: We found no significant difference in rates of overall number of women birthing at the hospital-birth center from Compañeros En Salud-affiliated communities between 2017 and 2018 (p=0.36). Analysis of 158 surveys revealed distance (30.4%), time (27.8%), and costs (25.9%) as reasons for not birthing at the hospital-birth center. From 27 interviews, negative perceptions and experiences of the hospital included low-quality and disrespectful care, low threshold for medical interventions, and harm and suffering. Partners or family members influenced most decisions about childbirth location. KEY CONCLUSIONS: Interventions to minimize logistical barriers may not be sufficient to overcome distance and perceptions of low-quality, disrespectful care. IMPLICATIONS FOR PRACTICE: Better understanding of complex decision-making around childbirth will guide Compañeros En Salud in developing interventions to further meet the needs and preferences of birthing women in rural Chiapas.

Rethinking referral systems in rural chiapas: A mixed methods study.

Background: Despite the assurance of universal health coverage, large disparities exist in access to surgery in the state of Chiapas. The purpose of this study was to determine the effectiveness of the surgical referral system at hospitals operated by the Ministry of Health in Chiapas. Methods: 13 variables were extracted from surgical referrals data from three public hospitals in Chiapas over a three-year period. Interviews were performed of health care workers involved in the referral system and surgical patients. The quantitative and qualitative data was analyzed convergently and reported using a narrative approach. Findings: In total, only 47.4% of referred patients requiring surgery received an operation. Requiring an elective, gynecological, or orthopedic surgery and each additional surgery cancellation were significantly associated with lower rates of receiving surgery. The impact of gender and surgical specialty, economic fragility of farmers, dependence upon economic resources to access care, pain leading people to seek care, and futility leading patients to abandon the public system were identified as main themes from the mixed methods analysis. Interpretation: Surgical referral patients in Chiapas struggle to navigate an inefficient and expensive system, leading to delayed care and forcing many patients to turn to the private health system. These mixed methods findings provide a detailed view of often overlooked limitations to universal health coverage in Chiapas. Moving forward, this knowledge must be applied to improve referral system coordination and provide hospitals with the necessary workforce, equipment, and protocols to ensure access to guaranteed care. Funding: Harvard University and the Abundance Fund provided funding for this project. Funding sources had no role in the writing of the manuscript or decision to submit it for publication.

Genetic Diversity of Mycobacterium tuberculosis Isolates From an Amerindian Population in Chiapas, México.

This is the first report of the genetic diversity of the Mycobacterium tuberculosis complex isolates found in a Mexican-Amerindian setting. In this study, we analyzed isolates collected from the Highlands region of Chiapas, Mexico, by using spoligotyping and whole-genome sequencing analyses. Seventy-three M. tuberculosis isolates were analyzed initially by spoligotyping; no new spoligotypes were identified. Nineteen percent of the isolates were identified as SIT53 (T1) (n = 14), followed by SIT42 (14%, n = 10, LAM9) and SIT119 (11%; n = 8, X1). SIT53, SIT42, and orphan isolates (16.4%, n = 12) constituted about 50% of the isolates studied and were subjected to whole-genome sequencing (WGS) analysis. Most SIT53 (10/12) isolates belonged to the Euro-American sub-lineage 4.8. Most SIT42 isolates (4/7) as .well as most orphan isolates (5/8) belonged to the lineage 4.3.3 LAM group. By comparing the single-nucleotide polymorphism (SNP) patterns of the SIT53 isolates, we found one clone (<7 SNPs) and four clustered isolates (<15 SNPs). In isolates from the SIT42 and orphan groups, we did not find any clones or clusters. This work demonstrates the success of sub-lineage 4.8 to predominate in Mexico and confirms the dominion of sub-lineage 4.3.3 in Central and South America.

Potential Distribution and Connectivity for Two Plethodontid Salamanders: Conservation Areas and Landscape Corridors for Two Endemic Species of México and Guatemala.

Habitat loss is one of the most important threats to biodiversity; it alters the habitat connectivity of species and is among the main causes of the global amphibian extinction crisis. Identifying the potential areas of distribution and connectivity of species is of the utmost importance so that informed decisions can be made for the conservation of vulnerable amphibian populations. In this study, we performed species distribution models and used circuit theory to model omnidirectional connectivity for two plethodontid salamanders of conservation concern distributed in the forests of Chiapas, Mexico, and Guatemala (Bolitoglossa franklini and Bolitoglossa lincolni). Potential distribution maps show an affinity for well-preserved montane forests for both species. Likewise, we found that the niches of the species are not similar. The connectivity models show that the main areas of connectivity are in the Meseta Central de Chiapas, Sierra Madre de Chiapas, and the Cordillera Volcánica Guatemalense, in this last range, important areas of connectivity were located, as well as least-cost paths and barriers to the movement of both species. We identified that important areas of climatic suitability and connectivity are not within the protected natural areas and may be threatened by the increasing influence of anthropogenic activities. The results of our study show the importance of preserving the regional forests to ensure the persistence of species with arboreal habits and high sensitivity to habitat transformation, as well as to recognize and prioritize potential areas for management and protection in both southern Mexico and Guatemala.

Fungal diversity in shade-coffee plantations in Soconusco, Mexico.

Background: As forested natural habitats disappear in the world, traditional, shade-coffee plantations offer an opportunity to conserve biodiversity and ecosystem services. Traditional coffee plantations maintain a diversity of tree species that provide shade for coffee bushes and, at the same time, are important repositories for plants and animals that inhabited the original cloud forest. However, there is still little information about shade-coffee plantation's fungal diversity despite their relevance for ecosystem functioning as decomposers, symbionts and pathogens. Specifically, it is unknown if and what mycorrhizae-forming fungi can be found on the branches and trunks of coffee bushes and trees, which hold a diversity of epiphytes. Here, we evaluate fungal communities on specific plant microsites on both coffee bushes and shade trees. We investigate the ecological roles played by this diversity, with a special focus on mycorrhizae-forming fungi that may enable the establishment and development of epiphytic plants. Methods: We collected 48 bark samples from coffee bushes and shade trees (coffee; tree), from four plant microsites (upper and lower trunks, branches and twigs), in two shade-coffee plantations in the Soconusco region in southern Mexico, at different altitudes. We obtained ITS amplicon sequences that served to estimate alpha and beta diversity, to assign taxonomy and to infer the potential ecological role played by the detected taxa. Results: The bark of shade trees and coffee bushes supported high fungal diversity (3,783 amplicon sequence variants). There were no strong associations between community species richness and collection site, plant type or microsite. However, we detected differences in beta diversity between collection sites. All trophic modes defined by FUNGuild database were represented in both plant types. However, when looking into guilds that involve mycorrhizae formation, the CLAM test suggests that coffee bushes are more likely to host taxa that may function as mycorrhizae. Discussion: We detected high fungal diversity in shade-coffee plantations in Soconusco, Chiapas, possibly remnants of the original cloud forest ecosystem. Several mycorrhiza forming fungi guilds occur on the bark of coffee bushes and shade trees in this agroecosystem, with the potential of supporting epiphyte establishment and development. Thus, traditional coffee cultivation could be part of an integrated strategy for restoration and conservation of epiphytic populations. This is particularly relevant for conservation of threatened species of Orchidaceae that are highly dependent on mycorrhizae formation.

Biological Activities of Seven Medicinal Plants Used in Chiapas, Mexico.

Seven medicinal plants from Chiapas, Mexico, used by Native Americans were analyzed, aiming to improve the understanding of their medicinal properties through the evaluation of various biological activities, i.e., bactericidal, antioxidant, α-glucosidase inhibition, and toxicity, to provide a scientific basis for the management of infectious and hyperglycemic diseases in the Mexican southeast. Plant extracts were obtained from Cordia dodecandra, Gaultheria odorata, Heliotropium angiospermum, Justicia spicigera, Leucaena collinsii spp. collinsii, Tagetes nelsonii, and Talisia oliviformis through maceration techniques using methanol and chloroform (1:1). Minimum Inhibitory Concentration (MIC) was employed to determine the antibacterial activity against Staphylococcus aureus, Enterobacter faecalis, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeuroginosa. The antiradical/antioxidant activity was determined by the 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays and antihemolytic activity using the 2,2'-Azobis(2-amidinopropane) dihydrochloride radical (APPH). The anti-α-glucosidase activity was evaluated in vitro through the chromogenic PNPG assay. The toxicity was assessed using the brine shrimp lethality assay. The highest antimicrobial activity was displayed by T. nelsonii, mainly against E. faecalis and P. aeuroginosa. The extracts of L. collinsii, J. spicigera, and T. nelsonii possess antioxidant properties with EC50 < 50 µg/mL. J. spicigera and T. nelsonii extracts showed the highest antihemolytic activity with IC50 < 14 µg/mL. T. nelsonii exhibited a remarkable inhibitor effect on the α-glucosidase enzyme and the greatest toxic effect on Artemia salina with IC50 = 193 ± 20 µg/mL and LD50 = 14 ± 1 µg/mL, respectively. According to our results, G. odorata, J. spicigera, T. nelsonii, and T. oliviformis extracts contained active antimicrobial compounds. At the same time, T. nelsonii stands to be a possible source of effective antineoplastic and antihyperglycemic compounds.

Traditions and trust: a qualitative study of barriers to facility-based obstetric and immediate neonatal care in Chiapas, Mexico.

Poor access and quality of intrapartum and postpartum health care contribute to high global maternal and neonatal mortality rates and intracountry inequity. We examined barriers to careseeking and health care utilization for obstetric and immediate neonatal care in Chiapas, a state with one of the largest indigenous populations and poorest health indicators in Mexico. We conducted 74 in-depth interviews with recently delivered women, their male partners, and traditional birth attendants, and 27 interviews with health facility and hospital staff in rural Chiapas. Interviews were conducted and recorded in Tzeltal and Ch'ol; data were transcribed, coded and analyzed in Spanish using thematic analysis techniques. Barriers to utilization of facility delivery that were reported in order of frequency were: (1) economic and geographic barriers; (2) traditions incompatible with facility policies; (3) fear or previous experience of mistreatment or abuse; (4) perceived poor quality care at facilities; (5) language and political barriers. Commonly reported barriers included distance, cost, lack of vehicles, and poor perceived quality of care, as well as linguistic barriers, lack of space, and fears of surgery or mistreatment. Some women reported obstetric violence and rights violations, including two cases of possible forced sterilizations, an unauthorized transfer of a newborn to another facility without consent or accompaniment of a guardian, and one failure to discharge a newborn because the family could not pay. Political conflict in the region contributed to additional barriers such as reduced trust in government facilities, and physical roadblocks during political activities. Improving geographic and economic access to obstetric and neonatal care can contribute to improved service utilization, but uptake of services can only be improved if quality of care, including communication and consent, are addressed. Historical and current relationships between various stakeholder and political groups should be considered when planning programs, which should be created as collaboratively as possible.

Aquatic beetle diversity from Volcán Tacaná, Mexico: altitudinal distribution pattern and biogeographical affinity of the fauna.

Results of an aquatic beetle survey at Volcán Tacaná, Mexico, are presented with five altitudinal levels in a monthly sampling regime, aiming to estimate both diversity and altitudinal distribution patterns of the aquatic beetle fauna. The first list of aquatic beetle species from this mountain is presented, comprising 40 species in 32 genera and nine families, with four species recorded for the first time from Mexico and six recorded for the first time from Chiapas. The aquatic beetle fauna is characterized by Elmidae with 20 species, Dytiscidae with eleven species, Dryopidae with three, and Epimetopidae, Hydraenidae, Hydrophilidae, Gyrinidae, Lutrochidae, and Noteridae with one species each. The species composition through the sampled altitudinal gradient (670-1,776 m) was not homogeneous, with the elmid genera Macrelmis, Heterelmis, Microcylloepus, and Austrolimnius present at all levels, while Hexanchorus, Neoelmis, and Onychelmis were present at levels 1-3 (673-1,214 m); dytiscids were mostly present at levels 4 and 5 (1,619-1,776 m), and dryopids were present only at levels 1-3. A Parsimony Analysis of Endemicity supports a general partition between altitudinal levels 1-3 and levels 4 + 5.

Discovery of a New Genus and Species of Allocreadiidae (Trematoda) in Mexico: Mesoamericatrema Magnisacculus n. Gen. n. Sp.

The trematodes of Allocreadiidae are mainly parasites of freshwater fish and the family contains 18 valid genera. Since 2004, 4 genera have been described in the Americas: Paracreptotrema, Paracreptotrematoides, Pseudoparacreptotrema and Auriculostoma, of which the latter was recently synonymized with Creptotrema by Franceschini et al., (2021). During a study in 2018 on fish parasites of Lacantún River, Chiapas, Mexico, allocreadiids were collected from the intestine of Atherinella alvarezi and morphological differences with other genera of the family were immediately noted. These differences were corroborated with molecular data and phylogenetic analyses, which indicated that it was a new genus and species. The objective of this study is to describe the new taxon, which we name Mesoamericatrema magnisacculus n. gen., n. sp. as well as to clarify its phylogenetic relationships, host specificity, and geographical distribution. For this, we carried out a meticulous study of the morphology and compared the new taxon with its congeners. We also obtained sequences of the 28S and ITS from the ribosomal RNA region that were used in generating molecular phylogenies and in calculating genetic distances with sequences of other species of Allocreadiidae available in the Genbank. The new genus is mainly characterized by having a very large cirrus sac in relation to the length of its body and nests in a clade that groups Creptotrema, Creptotrematina, Paracreptotrema, Paracreptotrematoides, Pseudoparacreptotrema and Wallinia, all of which have a Neotropical affinity in terms of their geographic and host distribution. Mesoamericatrema n. gen. is the fifth genus of Allocreadiidae to be described in the Americas since 2004, the third discovered in Mexico since 2016, and the first to be described as parasitizing Atheriniformes, which indicates that Middle America is a region where important speciation events have occurred in freshwater fish parasites.

Current outlook after 4 years since the beginning of interventional cardiology in congenital heart disease in Chiapas State / Panorama actual a 4 años del inicio de la cardiología intervencionista en cardiopatías congénitas en el Estado de Chiapas.

Introduction: As a result of technological advances, more and more types of congenital heart diseases are susceptible to being treated in the hemodynamic laboratory. The sum of more advanced imaging techniques as well as the development of a diversity of devices specially manufactured for use in children has allowed a better selection of patients and therefore that many of them can be corrected through cardiac catheterization or some patients with more complex congenital heart diseases require fewer surgical procedures or, if they do require them, that these may be of less complexity and risk. Objective: We decided to show the global experience of the interventionism in congenital heart diseases in Chiapas from its inception to recent days. Methods: Through a retrospective study from April 2016 to August 2020, we reviewed the electronic files of the total of patients who underwent cardiac catheterism during the same period of time. Results: A total of 510 procedures were performed, 300 in female patients, with a median age of 4 years (8 days - 77 years). Of the total procedures, 67 (13.1%) were diagnostic catheterizations and 443 (86.9%) were interventional. Conclusions: Cardiac catheterization in congenital heart disease in Chiapas has become a very valuable option with encouraging results which represents a possible decentralization in the care of congenital heart diseases in our country.

Introducción: Como resultado de avances tecnológicos, cada vez más tipos de cardiopatías congénitas son susceptibles a ser tratadas en el laboratorio de hemodinamia. La suma de técnicas de imagen más avanzadas, así como el desarrollo de una diversidad de dispositivos especialmente fabricados para su uso en niños ha permitido una mejor selección de pacientes y, por ende, que muchos de ellos pueden ser corregidos en su totalidad por medio de cateterismo cardiaco o bien que algunos pacientes con enfermedades cardiacas más complejas requieran menos procedimientos quirúrgicos o si los requieren, que estos sean de menor complejidad y riesgo. Objetivo: Decidimos mostrar la experiencia global de la hemodinamia en cardiopatías congénitas en Chiapas desde sus inicios hasta últimas fechas. Método: Mediante un estudio retrospectivo que abarcó de abril de 2016 a agosto de 2020 revisamos los expedientes electrónicos del total de pacientes que fueron llevados a cateterismo cardiaco durante ese periodo de tiempo. Resultados: Un total de 510 procedimientos fueron llevados a cabo, 300 en pacientes del sexo femenino, con una mediana de edad de 4 años (8 días - 77 años). Del total de procedimientos, 67 (13.1%) fueron cateterismos diagnósticos y 443 (86.9%) intervencionistas. Conclusión: El cateterismo cardiaco en cardiopatías congénitas en el Estado de Chiapas se ha convertido en una opción muy valiosa con resultados bastante alentadores, lo cual representa ya una posible descentralización en la atención de las cardiopatías congénitas en nuestro país.

Historical Review and Cost-Effectiveness Assessment of the Programs to Eliminate Onchocerciasis and Trachoma in Mexico.

We present a historical review of two neglected tropical diseases (NTD), namely, onchocerciasis and trachoma, both which were successfully eliminated in Mexico. In addition, we present a cost-effectiveness assessment (CEA) demonstrating that these were worthwhile health interventions. Historically, an estimate of $310.68 and $38.92 per person were spent during the period of time the onchocerciasis and trachoma elimination programs operated, respectively.

Genetic diversity and structure of one of the most endangered freshwater fish species in Mexico: Tlaloc hildebrandi (Miller, 1950) and recognition of its evolutionarily significant units.

The endangered Chiapas killifish Tlaloc hildebrandi is an endemic freshwater species that lives in four subbasins of the Grijalva and Usumacinta basins, and one of the most geographically restricted species of the Produndulidae family. The species was originally described as endemic to springs in the high limestone plateau in San Cristóbal de Las Casas in the Río Amarillo subbasin (upper Grijalva basin). However, it was recently recorded in the Jataté and Tzaconejá subbasins in the upper Usumacinta basin, thereby expanding its known distribution range. The discovery of these populations is relevant not only for the conservation of the species but also for a better understanding of its evolutionary history. Currently, the scarce populations of T. hildebrandi, found in only a few localities in the Grijalva and Usumacinta basins, are fragmented and living under unfavorable conditions. Here, we analyzed three mitochondrial (mt-atp8&6 and mt-nd2) and one nuclear (nuc-s7) marker in order to assess the genetic diversity and population structure of T. hildebrandi. We found that, in comparison with other endangered freshwater fish species from Mexico, T. hildebrandi showed a lower level of genetic diversity (mt-nd2: h = 0.469, π = 0.0009; mt-atp8&6: h = 0.398, π = 0.001; and nuc-S7: h = 0.433, π = 0.001). Moreover, the analyzed populations exhibited a strong genetic structure in accordance with their geographic distribution, and can be placed into three genetic clusters: (1) Amarillo plus Chenhaló in the upper Grijalva basin, (2) Jataté, and (3) Tzaconejá, both in the upper Usumacinta basin. On the basis of our results, we propose the recognition of at least three evolutionarily significant units (ESUs) for the species and the urgent implementation of ex situ and in situ conservation and management efforts that consider the genetic background of the species.