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To evaluate the accuracy and precision of HemoCue 201 (HemoCue) and Masimo Pronto 7 (Masimo) devices for measuring hemoglobin (Hb) in epidemiological studies, having venous blood samples as a gold standard. We measured Hb concentrations in a field sample of 148 children from one to five years of age. Masimo and HemoCue were used for capillary blood samples and an automatic analyzer for venous blood samples. Regression models with no intercept were constructed to measure precision and predictability, concordance correlations to measure accuracy and precision, and Bland-Altman limits of agreement as well as hierarchical linear models to estimate variance. Both HemoCue and Masimo underestimated Hb concentrations compared to the gold standard. They respectively yielded the following results: regression coefficients of 0.887 and 0.876 with 98.7% and 98.6% predictability; concordance correlation coefficients of 0.183 (p<0.001) and 0.166 (p<0.001); and Bland-Altman variances of -1.51 and -1.62. With regard to Masimo specifically, the three-level Hierarchical Linear Model showed that 57.9% of total variance stemmed from random errors in repeated measures from the same subject. HemoCue and Masimo measure lower Hb concentrations than the gold standard. Their accuracy and precision levels are comparable. It is essential to ensure proper use of devices through enhanced training of field workers.

The performance of manufacturing operations relies heavily on the operators’ performance. When operators begin to exhibit signs of fatigue, both their individual performance and the overall performance of the manufacturing plant tend to decline. This research presents a methodology for analyzing fatigue in assembly operations, considering indicators such as the EAR (Eye Aspect Ratio) indicator, operator pose, and elapsed operating time. To facilitate the analysis, a dataset of assembly operations was generated and recorded from three different perspectives: frontal, lateral, and top views. The top view enables the analysis of the operator’s face and posture to identify hand positions. By labeling the actions in our dataset, we train a deep learning system to recognize the sequence of operator actions required to complete the operation. Additionally, we propose a model for determining the level of fatigue by processing multimodal information acquired from various sources, including eye blink rate, operator pose, and task duration during assembly operations.

Vaginal self-sampling for human papillomavirus (HPV) DNA testing could increase rates of screening participation. In clinic-based settings, vaginal HPV testing is at least as sensitive as cytology for detecting cervical intraepithelial neoplasia (CIN) grade 2 or worse; however, effectiveness in home settings is unknown. We aimed to establish the relative sensitivity and positive predictive value for HPV screening of vaginal samples self-collected at home as compared with clinic-based cervical cytology. We did a community-based, randomised equivalence trial in Mexican women of low socioeconomic status aged 25–65 years. Participants came from 540 medically underserved, predominantly rural communities in Morelos, Guerrero, and the state of Mexico. Our primary endpoint was CIN 2 or worse, detected by colposcopy. We used a computer-generated randomisation sequence to randomly allocate patients to HPV screening or cervical cytology. Eight community nurses who were masked to patient allocation received daily lists of the women's names and addresses, and did the assigned home visits. We referred women with positive results in either test to colposcopy. We did per-protocol and intention-to-screen analyses. This trial was registered with the Instituto Nacional de Salud Pública, Mexico, INSP number 590. 12 330 women were randomly allocated to HPV screening and 12 731 to cervical cytology; 9202 women in the HPV screening group adhered to the protocol, as did 11 054 in the cervical cytology group. HPV prevalence was 9·8% (95% CI 9·1–10·4) and abnormal cytology rate was 0·38% (0·23–0·45). HPV testing identified 117·4 women with CIN 2 or worse per 10 000 (95·2–139·5) compared with 34·4 women with CIN 2 or worse per 10 000 (23·4–45·3) identified by cytology; the relative sensitivity of HPV testing was 3·4 times greater (2·4–4·9). Similarly, HPV testing detected 4·2 times (1·9–9·2) more invasive cancers than did cytology (30·4 per 10 000 [19·1–41·7] vs 7·2 per 10 000 [2·2–12·3]). The positive predictive value of HPV testing for CIN 2 or worse was 12·2% (9·9–14·5) compared with 90·5% (61·7–100) for cytology. Despite the much lower positive predictive value for HPV testing of self-collected vaginal specimens compared with cytology, such testing might be preferred for detecting CIN 2 or worse in low-resource settings where restricted infrastructure reduces the effectiveness of cytology screening programmes. Because women at these sites will be screened only a few times in their lives, the high sensitivity of a HPV screen is of paramount importance. Instituto Nacional de Salud Pública, the Health Ministry of Mexico, QiAGEN Corp

The search for pathological biomarkers in biological fluids that can provide valuable insight into an individual’s health status, is a relevant area of research for multiple pathologies. Currently, the use of proteomics for the identification of differences in protein expression profiles between samples from healthy subjects and patients, has emerged as a powerful strategy to improve the current diagnosis of various pathologies or propose novel therapeutic approaches. Among the biological fluids from which new pathological biomarkers can be identified, tear secretion is highly attractive, since it can be collected non-invasively and could better concentrate proteins that sensitively reflect allergic responses, owing to their exposure to environmental factors and its connection to the respiratory system. Despite its potential, tear fluid remains underexplored, offering significant research opportunities. In this study, we collected human tear samples using the Shirmer Test from healthy and allergic individuals. Our optimized workflow, combining sample preparation and high-throughput proteomics using the data-independent acquisition (DIA) strategy, identified 2542 proteins and enabled the successful differentiation of the two groups. We identified 99 differentially expressed proteins. Our results show the feasibility of protein analysis in human tear samples, highlighting tears as a highly sensitive fluid for detecting health conditions. Data are available via ProteomeXchange with identifier PXD067099.

Therapeutic drugs for Alzheimer's disease have been extensively studied due to its recurrence and abundance among neurodegenerative diseases. It is thought that the accumulation of amyloid precursor protein (APP) products, a consequence of an up-regulation of the β-site APP-cleaving enzyme 1 (BACE1), is the main triggering mechanism during the early stages of the disease. This study aims to explore the ability of a multifunctional conjugate based on magnetite nanoparticles for the cellular delivery of siRNA against the expression of the BACE1 gene. We immobilized the siRNA strand on PEGylated magnetite nanoparticles and investigated the effects on biocompatibility and efficacy of the conjugation. Similarly, we co-immobilized the translocating protein OmpA on PEGylated nanoparticles to enhance cellular uptake and endosomal escape. BACE1 suppression was statistically significant in HFF-1 cells, without any presence of a cytotoxic effect. The delivery of the nanoconjugate was achieved through endocytosis pathways, where endosome formation was likely escaped due to the proton-sponge effect characteristic of PEGylated nanoparticles or mainly by direct translocation in the case of OmpA/PEGylated nanoparticles.

What effect on body mass index, obesity and diabetes can we expect from the 1-peso-per-litre tax to sugar sweetened beverages in Mexico? Using recently published estimates of the reductions in beverage purchases due to the tax, we modelled its expected long-term impacts on body mass index (BMI), obesity and diabetes. Microsimulations based on a nationally representative dataset were used to estimate the impact of the tax on BMI and obesity. A Markov population model, built upon an age-period-cohort model of diabetes incidence, was used to estimate the impact on diagnosed diabetes in Mexico. To analyse the potential of tax increases we also modelled a 2-peso-per-litre tax scenario. Ten years after the implementation of the tax, we expect an average reduction of 0.15 kg/m2 per person, which translates into a 2.54% reduction in obesity prevalence. People in the lowest level of socioeconomic status and those between 20 and 35 years of age showed the largest reductions in BMI and overweight and obesity prevalence. Simulations show that by 2030, under the current implementation of 1-peso-per-litre, the tax would prevent 86 to 134 thousand cases of diabetes. Overall, the 2-peso-per-litre scenario is expected to produce twice as much of a reduction. These estimates assume the tax effect on consumption remains stable over time. Sensitivity analyses were conducted to assess the robustness of findings; similar results were obtained with various parameter assumptions and alternative modelling approaches. The sugar-sweetened beverages tax in Mexico is expected to produce sizable and sustained reductions in obesity and diabetes. Increasing the tax could produce larger benefits. While encouraging, estimates will need to be updated once data on direct changes in consumption becomes available.

Bark beetles are among the primary drivers of tree mortality in coniferous forests worldwide. Individuals belonging to the order Coleoptera were identified across different forest areas in Honduras. Descriptive statistics were used to calculate the number of families, subfamilies, genera, and species collected per department. Moreover, the barcoding approach was used by amplifying and sequencing the mitochondrial COI gene. The intraspecific genetic diversity of Ips apache was also analyzed. 1,131 individuals were examined and 27 genera were identified. Most of the specimens were identified as belonging to the genus Ips , accounting for 53.2% of the total. Xyleborus accounted for 16.5% and Temnoscheila accounted for 10%. Fewer than four individuals were found for fifteen genera. 68% of the specimens were identified to the species level, and all the specimens were identified to the genus level. Ips , Temnoscheila , Xyleborus , Hypothenemus , and Pityophthorus exhibited the most extensive geographic distribution among the sampled sites. At the genus level, Olancho, El Paraíso, and Copán displayed the highest diversity. This study also marks the first report of the genera Xylomeira and Stephanopachys in Honduran pine forests. Within I. apache , evidence of intraspecific genetic diversity was observed, although no population structure was detected. While this research provides an updated inventory of beetle species associated with Honduran coniferous forests, further taxonomic surveys and ecological studies are essential to better understand the spread and impact of bark beetles in pine ecosystems.

This case series describes the first 18 patients hospitalized with infection with novel swine-origin influenza A (H1N1) virus (S-OIV) from March 24 through April 24, 2009, in Mexico City. More than half the patients were between 13 and 47 years of age, and most had been healthy previously. Respiratory distress requiring intubation and mechanical ventilation developed in 10 patients; 7 patients died. There were 22 secondary infections among health care workers, none of which required hospitalization. This case series describes the first 18 patients hospitalized with infection with novel swine-origin influenza A (H1N1) virus (S-OIV) from March 24 through April 24, 2009, in Mexico City. In April 2009, the Mexican Secretariat of Health reported an outbreak of respiratory disease. In the affected patients, a novel swine-origin influenza A (H1N1) virus (S-OIV) with molecular features of North American and Eurasian swine, avian, and human influenza viruses 1 – 4 was found. In the same month, the World Health Organization (WHO) classified the global spread of this virus as a public health event of international concern. After documentation of human-to-human transmission of the virus in at least three countries of two WHO regions, the WHO raised the pandemic level to 6. 5 As of May 29, 2009, Mexico had reported . . .

Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries.

The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico. We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years) with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c) was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear) with combined data files, including survey year as covariate to assess change. Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension) were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94). Age more than 65 years old, the type of health subsystem, gender (males), and high socio-economic status were also significantly associated to glycemic control. Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care.