Invarianza factorial por sexo y puntos de corte del cuestionario de control de la imagen corporal en fotografías en población mexicana / Factorial invariance by sex and cut-off points of the body image control questionnaire in photographs in Mexican population

RESUMEN La imagen corporal varía a lo largo de la vida. Los cambios físicos que conlleva la adolescencia, pueden influir en el desarrollo de conductas de riesgo para trastornos alimentarios. Aunque los factores sociales y culturales afectan la imagen corporal, las formas de interacción modernas, mediante el uso de tecnología, en particular las redes sociales, permiten controlar la autopresentación de la imagen corporal en las fotografías que son publicadas, lo que podría servir como indicador de conductas de riesgo alimentarias. El objetivo de este trabajo fue establecer la asociación de conductas alimentarias de riesgo con el control de la imagen corporal en fotografías, para analizar su invarianza factorial por sexo y proponer puntos de corte en población mexicana. La muestra estuvo conformada por 1 155 adolescentes (51.3 % hombres y 48.7 % mujeres), con una media de edad de 15.18 años. Se utilizó el cuestionario en español sobre el control de la imagen corporal en fotografías denominado BICP-S, además del cuestionario de conductas alimentarias de riesgo (CAR). Los resultados evidenciaron una relación entre las conductas alimentarias de riesgo y el control de la imagen en fotografías. La estructura factorial del BICP-S varía en función del sexo, por lo que se proponen diferentes puntos de corte del cuestionario, en donde aquellas ubicadas en el percentil 85 indican riesgo acerca de las preocupaciones por la imagen corporal en mujeres, mientras que en hombres se establece en el percentil 92, con una alta confiabilidad en el control de la imagen en ambos sexos (α > 0.90). El cuestionario tiene utilidad clínica para la detección de jóvenes con serias preocupaciones en torno a la imagen corporal que, de continuar, pueden constituirse en un factor de riesgo para trastornos de la conducta alimentaria.

ABSTRACT Body varies throughout life. Physical changes that take place during teenage years may influence the development of risky behaviors related to eating disorders. Although social and cultural factors affect body image, modern forms of interaction with technology, particularly social networks, allow controlling the self-presentation of body image in the photographs that are published, which could serve as an indicator of risky eating behaviors. The aim of this study was to establish the association of risky eating behaviors with the body image control in photographies, to analyze the factorial invariance by sex and to propose cut-off points in the Mexican population. The sample consisted of 1 155 adolescents (51.3 % males and 48.7 % females), with a mean age of 15.18 years. The BICP-S was used, in addition to the risky eating behaviors questionnaire (CAR). The results showed a relationship between risky eating behaviors and image control in photographs. The factorial structure of the BICP-S varies according to sex, so different cut-off points of the questionnaire are proposed, where those located at the 85th percentile indicate risk about body image concerns in women, while in men it is established at the 92nd percentile, with a high reliability in image control in both groups (α > 0.90). It is concluded that the questionnaire has clinical utility for the detection of at-risk youth who may have serious body image concerns, which if continued can be a risk factor for eating disorders.

Intervención psicoeducativa para el control de peso en mujeres embarazadas / Psychoeducational intervention for weight control in pregnant women

Introducción: Para controlar la obesidad gestacional es necesario diseñar e implementar intervenciones para mejorar la calidad de la alimentación y actividad física. El objetivo del estudio fue evaluar la eficacia de una intervención psicoeducativa de enfermería para el control del peso gestacional en mujeres embarazadas mexicanas.Métodos: Estudio cuasi-experimetal. La muestra final fue de 34 participantes; n1=17 y n2=17. La intervención psicoeducativa consistió en 12 sesiones, que incluyó técnicas educativas, cognitivo conductuales y yoga prenatal, durante ocho semanas. El grupo control recibió atención rutinaria y adicional un folleto informativo de nutrición saludable. Se realizaron mediciones antropométricas antes y después de la intervención, así como la tasa de retención en la intervención y la satisfacción de los participantes.Resultados: Las mujeres embarazadas que participaron en la intervención presentaron menor aumento de peso gestacional que las del grupo control (D ̅_1 = 5.17 ± 3.01 vs. (D ̅_2= 8.03 ± 4.06; t = -2.32, gl = 32, p = .026). La intervención resultó factible, dado que el 80% cumplió con las sesiones programadas y una aceptabilidad satisfactoria, el 76.5% de las participantes mencionó que la calidad del programa era excelente y el 100% mencionó que recibió la ayuda que esperaba.Conclusión: La intervención psicoeducativa favorece el control peso gestacional en el grupo experimental comparado con el grupo control. Las intervenciones psicoeducativas son recomendables para el manejo del aumento del peso durante el embarazo. (AU)

Introduction: To control gestational obesity, it is necessary to design and implement interventions to improve the quality of diet and physical activity. The objective of the study was to evaluate the efficacy of a psychoeducational nursing intervention for the control of gestational weight in Mexican pregnant women. Methods: quasi-experimental study. The sample consisted of 34 participants; n1=17 y n2=17. The psychoeducational intervention consisted of 12 sessions, which included educational, cognitive behavioral techniques and prenatal yoga, for eight weeks. The control group received routine care and a prospectus additional healthy nutrition. We realized anthropometric measurements before and after the intervention, as well as the retention rate in the intervention and the satisfaction of the participants. Results: Pregnant women who participated in the intervention had less gestational weight gain than those in the control group (𝐷ഥଵ = 5.17 ± 3.01 vs. (𝐷ഥଶ= 8.03 ± 4.06; t = -2.32, gl = 32, p = .026). The intervention was feasible, given that 80% complied with the scheduled sessions and satisfactory acceptability, 76.5% of the participants mentioned that the quality of the program was excellent and 100% mentioned that they received the help they expected. Conclusion: The psychoeducational intervention favors gestational weight control in the experimental group compared to the control group. Psychoeducational interventions are recommended for the management of weight gain during pregnancy. (AU)

Active Surveillance of Antimicrobial Resistance and Carbapenemase-Encoding Genes According to Sites of Care and Age Groups in Mexico: Results from the INVIFAR Network.

We analyzed the antimicrobial resistance (AMR) data of 6519 clinical isolates of Escherichia coli (n = 3985), Klebsiella pneumoniae (n = 775), Acinetobacter baumannii (n = 163), Pseudomonas aeruginosa (n = 781), Enterococcus faecium (n = 124), and Staphylococcus aureus (n = 691) from 43 centers in Mexico. AMR assays were performed using commercial microdilution systems (37/43) and the disk diffusion susceptibility method (6/43). The presence of carbapenemase-encoding genes was assessed using PCR. Data from centers regarding site of care, patient age, and clinical specimen were collected. According to the site of care, the highest AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from ICU patients. In contrast, in A. baumannii, higher AMR was observed in isolates from hospitalized non-ICU patients. According to age group, the highest AMR was observed in the ≥60 years age group for E. coli, E. faecium, and S. aureus, and in the 19-59 years age group for A. baumannii and P. aeruginosa. According to clinical specimen type, a higher AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from blood specimens. The most frequently detected carbapenemase-encoding gene in E. coli was blaNDM (84%).

Factores psicosociales y sociodemográficos asociados con el desgaste profesional en médicos residentes de Sonora (México) / Psychosocial and Sociodemographic Factors Associated with Burnout among Medical Residents of Sonora ­ Mexico / Fatores psicossociais e sociodemográficos associados ao burnout em médicos residentes de Sonora, México

Introducción: la simultaneidad de actividades entre las exigencias académicas y el adiestramiento médico durante las residencias provoca un elevado riesgo de desarrollar un desgaste profesional (o síndrome de burnout [SB]) en los médicos residentes. El objetivo fue identificar los factores psicosociales y socio- demográficos asociados al SB en médicos residentes. Materiales y métodos: estudio transversal y correlacional. Participaron 47 médicos residentes de un hospital público. Se aplicaron la Escala de Desgaste Ocupacional (EDO), el Inventario Multifásico de la Personalidad Minnesota-2 Forma Reestructurada (MMPI2-Rf) y un cuestionario sociodemográfico. Los datos se analizaron mediante la prueba de correlación no paramétrica de Spearman. Resultados: el 25.6 % de los participantes mostró burnout alto, y el 51 %, un agotamiento emocional alto. Respecto a los factores de personalidad y sociodemográficos asociados, solo mostraron relación significativa (p < 0.05) la escala de impulsividad (r = 0.341, p = 0.019) y las horas de ejercicio en la semana (r = −0.414, p = 0.004). Al segmentar por sexo, solo en los hombres del estudio existió una relación entre SB y psicoticismo (r = 0.468, p = 0.018), la disminución de la actividad física (r = −0.620, p = 0.001) y primeros años de residencia (r = −0.396, p = 0.050). Conclusiones: el alto agotamiento emocional de los residentes está asociado con problemas en el manejo de impulsos, distorsiones de la realidad (debido al psicoticismo), pertenecer a los primeros años de residencia y falta de ejercicio físico. Se requiere especial atención a la salud física y mental de estos profesionales

Introduction: The simultaneity of activities between academic demands and medical training during residencies is a high risk of developing burnout syndrome (BS) among resident physicians, which decreases their quality of life. This study aimed to identify the psychosocial and sociodemographic factors associated with BS among resident physicians from a public hospital. Materials and methods: This cross-sectional and correlational study involved 47 resident physicians. The Occupational Burnout Scale (EDO), the Minnesota Multiphasic Personality Inventory-2 Restructured Form, and a sociodemographic questionnaire were applied. The data were analyzed by using nonparametric Spearman's correlation test. Results: We found that 25.6% of the participants had a high level of burnout, while 51% showed a high level of emotional exhaustion. Regarding personality and sociodemographic factors associated with BS, only the impulsivity scale (r = 0.341; p = 0.019) and the hours of exercise performed in a week (r = −0.414; p = 0.004) showed a significant relationship (p < 0.05). When segmented by sex, a relationship between BS and psychoticism (r = 0.468; p = 0.018), decreased physical activity (r = −0.620; p = 0.001), and first years of residence (r = −0.396; p = 0.050) were noted only in men. Conclusions: A high level of emotional exhaustion was evidenced among the medical residents in relation to the development of their activities, which were associated with problems in the management of impulses, distortions of reality (due to psychoticism), belonging to the first years of residency, and the lack of physical exercise. Hence, special attention must be given to the physical and mental health of medical residents

Introdução: a simultaneidade de atividades entre as demandas acadêmicas e ao mesmo tempo a formação médica durante as residências acarreta alto risco de desenvolvimento da Síndrome de Burnout (SB) nos médicos residentes, diminuindo sua qualidade de vida. O objetivo da pesquisa foi identificar os fatores psicossociais e sociodemográficos associados à SB em médicos residentes. Materiais e métodos: estudo transversal e correlacional. Participaram 47 médicos residentes de um hospital público. Aplicou-se a Escala de Desgaste Ocupacional (EDO), o Inventário Multifásico da Personalidade Minnesota-2 Forma Reestruturada (MMPI2-Rf) e adicionalmente um questionário sociodemográfico. Os dados foram analisados por meio do teste de correlação não paramétrica de Spearman. Resultados: 25,6% dos participantes apresentaram alto burnout e 51% alto nível de exaustão emocional. Em relação aos fatores de personalidade e sociodemográficos associados à SB, apenas a escala de impulsividade (r = 0,341; p = 0,019) e as horas de exercício por semana (r = −0,414; p = 0.004) apresentaram relação significativa (p < 0,05). Quando segmentado por sexo, apenas nos homens do estudo houve relação entre SB e psicoticismo (r = 0,468; p = 0,018), diminuição da atividade física (r = −0,620; p = 0,001) e primeiros anos de residência (r = −0,396; p = 0,050). Conclusões: destaca-se o elevado desgaste emocional vivenciado pelos residentes no desenvolvimento das suas atividades, que se associa a problemas na gestão dos impulsos, distorções da realidade (devido ao psicoticismo), estar nos primeiros anos de residência e falta de exercício físico. É necessária atenção especial à saúde física e mental desses profissionais

La ansiedad y depresión en época de COVID y el factor resiliencia / Anxiety and depression in times of COVID and the resilience factor

Resumen Objetivo: Analizar los efectos de la pandemia en su fase II en personas de diversas regiones del país, respecto a la posible aparición de sintomatología de ansiedad y depresión; y cómo éstas se relacionaban con la resiliencia. Material y métodos: Diseño correlacional con corte transversal, participaron 7,439 personas de diferentes estados de México con media de edad de 36.99 (DE=14.00). El cuestionario fue construido por el grupo de investigación PSYCOVID tomando indicadores de diversos instrumentos que miden las variables de estudio como son: la ansiedad, depresión y resiliencia. El mismo mostró una confiabilidad de α=0.88. Resultados: Se encontró presencia de ansiedad en el 11.5% de la muestra, el 23.4% con indicadores de depresión; y el 96.9% de la muestra se manifiestan resilientes. Existe una correlación significativa y negativa entre resiliencia con la ansiedad (r=-0.108, p=0.000) y con depresión (r=-0.100, p=0.000). Respecto a la ansiedad las mujeres obtuvieron porcentajes más altos que los hombres (13.3% vs. 7.5%), mientras que en la depresión las mujeres presentaron porcentajes de 25.5% vs. 18.5% en hombres. En el caso de la resiliencia esta es mayor en hombres (97.4% vs. 96.6%). Por grupos de edad son los adultos jóvenes los que muestran mayor sintomatología depresiva, de ansiedad y resiliencia, comparados con los de mediana edad y adultos mayores. Conclusiones: Se discuten estos datos en función de probables estrategias de atención a nivel comunitario y por grupos vulnerables.

Abstract Objective: To analyze the effects of the pandemic in its phase II in people from different regions of the country, with respect to the possible appearance of anxiety and depression symptoms and how these were related to resilience. Material and methods: Cross-sectional correlational design, 7,439 people from different states of Mexico participated with a mean age of 36.99 (SD=14.00). The questionnaire was constructed by the PSYCOVID research group taking indicators from different instruments that measure the study variables such as anxiety, depression, and resilience. It showed a reliability of α=0.88. Results: The presence of anxiety was found in 11.5% of the sample, 23.4% with indicators of depression; and 96.9% of the sample manifested resilience. There is a significant and negative correlation between resilience with anxiety (r=-0.108, p=0.000) and with depression (r=-0.100, p=0.000). Regarding anxiety, women obtained higher percentages than men (13.3% vs. 7.5%), while in depression, women presented percentages of 25.5% vs. 18.5% in men. In the case of resilience, resilience is higher in men (97.4% vs. 96.6%). By age group, young adults show more depressive, anxiety and resilience symptoms, compared to middle-aged and older adults. Conclusions: These data are discussed in terms of probable care strategies at the community level and by vulnerable groups.

Whole genome analysis of Gram-negative bacteria using the EPISEQ CS application and other bioinformatic platforms.

OBJECTIVES: To determine genomic characteristics and molecular epidemiology of carbapenem non-susceptible Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa from medical centres of Mexico using whole genome sequencing data analysed with the EPISEQⓇ CS application and other bioinformatic platforms. METHODS: Clinical isolates collected from 28 centres in Mexico included carbapenem-non-susceptible K. pneumoniae (n = 22), E. coli (n = 24), A. baumannii (n = 16), and P. aeruginosa (n = 13). Isolates were subjected to whole genome sequencing using the Illumina (MiSeq) platform. FASTQ files were uploaded to the EPISEQⓇ CS application for analysis. Additionally, the tools Kleborate v2.0.4 and Pathogenwatch were used as comparators for Klebsiella genomes, and the bacterial whole genome sequence typing database was used for E. coli and A. baumannii. RESULTS: For K. pneumoniae, both bioinformatic approaches detected multiple genes encoding aminoglycoside, quinolone, and phenicol resistance, and the presence of blaNDM-1 explained carbapenem non-susceptibility in 18 strains and blaKPC-3 in four strains. Regarding E. coli, both EPISEQⓇ CS and bacterial whole genome sequence typing database analyses detected multiple virulence and resistance genes: 20 of 24 (83.3%) strains carried blaNDM, 3 of 24 (12.4%) carried blaOXA-232, and 1 carried blaOXA-181. Genes that confer resistance to aminoglycosides, tetracyclines, sulfonamides, phenicols, trimethoprim, and macrolides were also detected by both platforms. Regarding A. baumannii, the most frequent carbapenemase-encoding gene detected by both platforms was blaOXA-72, followed by blaOXA-66. Both approaches detected similar genes for aminoglycosides, carbapenems, tetracyclines, phenicols, and sulfonamides. Regarding P. aeruginosa, blaVIM, blaIMP, and blaGES were the more frequently detected. Multiple virulence genes were detected in all strains. CONCLUSION: Compared to the other available platforms, EPISEQⓇ CS enabled a comprehensive resistance and virulence analysis, providing a reliable method for bacterial strain typing and characterization of the virulome and resistome.

Bacterial incidence and drug resistance from pathogens recovered from blood, cerebrospinal and pleural fluids in 2019-2020. Results of the Invifar network.

Background: Antimicrobial resistance is a global concern. Analysis of sterile fluids is essential because microorganisms are defined as significant in most cases. Blood, cerebrospinal, and pleural fluids are frequently received in the microbiology lab because they are associated with considerable rates of morbi-mortality. Knowledge of epidemiology in these samples is needed to choose proper empirical treatments due to the importance of reducing selection pressure. Methods: We used retrospective laboratory data of blood, CSF, and pleural fluid collected from patients in Mexico between 2019 and 2020. Each laboratory identified the strains and tested susceptibility using its routine methods. For Streptococcus pneumoniae, a comparative analysis was performed with data from the broth microdilution method. Results: Forty-five centers participated in the study, with 30,746 clinical isolates from blood, 2,429 from pleural fluid, and 2,275 from CSF. For blood and CSF, Staphylococcus epidermidis was the most frequent. For blood, among gram negatives, the most frequent was Escherichia coli. Among Enterobacterales, 9.8% of K. pneumoniae were carbapenem-resistant. For S. pneumoniae, similar resistance percentages were observed for levofloxacin, cefotaxime, and vancomycin. For CSF, the most frequent gram-negative was E. coli. In Acinetobacter baumannii, carbapenem resistance was 71.4%. The most frequent species detected for pleural fluid was E. coli; in A. baumannii, carbapenem resistance was 96.3%. Conclusion: Gram-negative bacteria, with E. coli most prevalent, are frequently recovered from CSF, blood, and pleural fluid. In S. pneumoniae, the routine, conventional methods showed good agreement in detecting resistance percentages for erythromycin, levofloxacin, and vancomycin.

Emergence of Fosfomycin Resistance by Plasmid-Mediated fos Genes in Uropathogenic ESBL-Producing E. coli Isolates in Mexico.

Fosfomycin is currently a viable option against urinary tract infections, particularly against extended-spectrum ß-lactamases (ESBL)-producing E. coli, due to its unique mechanism of action and its low resistance among bacteria. The objective of this study was to investigate two of the three most common mechanisms of resistance against this antibiotic among 350 ESBL-producing E. coli strains isolated from the urine of Mexican patients. The prevalence of fosfomycin resistance in our study was 10.9% (38/350). Of all resistant isolates analyzed, 23 (60.5%) were identified as fos-producing organisms, with 14 strains carrying fosA3 and 9, fosA1. Additionally, 11 (28.9%) fosfomycin-resistant isolates presented resistance due to impaired antibiotic transport and 8 (21.0%) both mechanisms. No resistance mechanism investigated in the study was found on 12 strains. All 38 confirmed ESBL-producing isolates carried a blaCTX-M subtype, 36 (94.5%) belonged to the O25b-ST131 clone, and all of them were able to transfer the fosfomycin resistance trait to recipient strains horizontally. This is the first study in Mexico demonstrating a plasmid-mediated fosfomycin resistance mechanism among clinical E. coli strains. Since our results suggest a strong association among fos and blaCTX-M genes and ST131 clones in uropathogenic E. coli, plasmid-mediated fosfomycin resistance should be closely monitored.

Ansiedad y adaptación a la pandemia en México: Un estudio transversal / Anxiety and adaptation to pandemic in Mexico: A cross-sectional study

RESUMEN Introducción: Un aspecto que cobra relevancia en la situación actual de pandemia, es los probables efectos psicológicos que ésta pueda provocar. Una serie de estudios han mostrado cómo resultado, que estas situaciones de crisis tienen efectos como que las personas desarrollen procesos de ansiedad. De ahí el interés de conocer cómo los hábitos de salud ayudan a la adaptación a la pandemia y a mediar en los procesos de ansiedad. Objetivo: analizar la relación de los hábitos de salud con la ansiedad y la adaptación al confinamiento. Método: Participaron 7,439 personas de México, con edades entre 18 y 80 años (M= 36.99, DE=14.00). Resultados: Encontramos que los hábitos de sueño (58%), alimentación (29%) y actividad física (52%) se han visto afectados por el confinamiento; el 11.5% de los participantes mostraron indicadores de ansiedad. El 9% se adaptó mal al confinamiento. La variable que mejor predice la adaptación al confinamiento es la ansiedad, seguido de la alimentación, el sueño y la actividad física. Quienes más se ven afectados en los hábitos son los jóvenes y por género las mujeres. Conclusiones: La pandemia ha provocado modificaciones negativas en los hábitos en un sector amplio de la población, llegando a poder ser considerados como factores de riesgo para la salud física y mental. Además, los hábitos se asocian a la ansiedad y la adaptación, por lo que es necesario dotar a la sociedad de estrategias que permitan un adecuado manejo de los hábitos lo que puede prevenir la manifestación de ansiedad.

ABSTRACT Background: An aspect that becomes relevant in the current pandemic situation is the probable psychological effects that it may cause. A series of studies have shown that these kinds of critical situations have effects such as the development of anxiety processes in people. Hence the interest in knowing how health habits help to adapt to the pandemic and mediate anxiety processes. Objective: to analyze the relationship of healthy habits with anxiety and adaptation to confinement. Method: 7,439 people from Mexico participated, with ages between 18 and 80 years (M= 36.99,SD= 14.00). Results: We found that sleep (58%), eating (29%) and physical activity (52%) habits have been affected by confinement; 11.5% of the participants showed indicators of anxiety. The 9% of participants adapted poorly to confinement. The variable that best predicts adaptation to confinement is anxiety, followed by food, sleep, and physical activity. Those who are most affected by habits are young people and women by gender. Conclusions: The pandemic has led to changes in negative habits in a large sector of the population, which are now considered risk factors for physical and mental health. In addition, habits are associated with anxiety and adaptation, so it is necessary to provide society with strategies that allow proper management of habits, which can prevent the manifestation of anxiety.

Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network.

Aim: This study aims to assess the changes in antimicrobial resistance among some critical and high-priority microorganisms collected previously and during the coronavirus disease 2019 (COVID-19) pandemic in Mexico. Methods: We collected antimicrobial susceptibility data for critical and high-priority microorganisms from blood, urine, respiratory samples, and from all specimens, in which the pathogen may be considered a causative agent. Data were stratified and compared for two periods: 2019 versus 2020 and second semester 2019 (prepandemic) versus the second semester 2020 (pandemic). Results: In the analysis of second semester 2019 versus the second semester 2020, in blood samples, increased resistance to oxacillin (15.2% vs. 36.9%), erythromycin (25.7% vs. 42.8%), and clindamycin (24.8% vs. 43.3%) (p ≤ 0.01) was detected for Staphylococcus aureus, to imipenem (13% vs. 23.4%) and meropenem (11.2% vs. 21.4) (p ≤ 0.01), for Klebsiella pneumoniae. In all specimens, increased ampicillin and tetracycline resistance was detected for Enterococcus faecium (p ≤ 0.01). In cefepime, meropenem, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Escherichia coli; and in piperacillin-tazobactam, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Pseudomonas aeruginosa. Conclusion: Antimicrobial resistance increased in Mexico during the COVID-19 pandemic. The increase in oxacillin resistance for S. aureus and carbapenem resistance for K. pneumoniae recovered from blood specimens deserves special attention. In addition, an increase in erythromycin resistance in S. aureus was detected, which may be associated with high azithromycin use. In general, for Acinetobacter baumannii and P. aeruginosa, increasing resistance rates were detected.

An ontology network for Diabetes Mellitus in Mexico.

BACKGROUND: Medical experts in the domain of Diabetes Mellitus (DM) acquire specific knowledge from diabetic patients through monitoring and interaction. This allows them to know the disease and information about other conditions or comorbidities, treatments, and typical consequences of the Mexican population. This indicates that an expert in a domain knows technical information about the domain and contextual factors that interact with it in the real world, contributing to new knowledge generation. For capturing and managing information about the DM, it is necessary to design and implement techniques and methods that allow: determining the most relevant conceptual dimensions and their correct organization, the integration of existing medical and clinical information from different resources, and the generation of structures that represent the deduction process of the doctor. An Ontology Network is a collection of ontologies of diverse knowledge domains which can be interconnected by meta-relations. This article describes an Ontology Network for representing DM in Mexico, designed by a proposed methodology. The information used for Ontology Network building include the ontological resource reuse and non-ontological resource transformation for ontology design and ontology extending by natural language processing techniques. These are medical information extracted from vocabularies, taxonomies, medical dictionaries, ontologies, among others. Additionally, a set of semantic rules has been defined within the Ontology Network to derive new knowledge. RESULTS: An Ontology Network for DM in Mexico has been built from six well-defined domains, resulting in new classes, using ontological and non-ontological resources to offer a semantic structure for assisting in the medical diagnosis process. The network comprises 1367 classes, 20 object properties, 63 data properties, and 4268 individuals from seven different ontologies. Ontology Network evaluation was carried out by verifying the purpose for its design and some quality criteria. CONCLUSIONS: The composition of the Ontology Network offers a set of well-defined ontological modules facilitating the reuse of one or more of them. The inclusion of international vocabularies as SNOMED CT or ICD-10 reinforces the representation by international standards. It increases the semantic interoperability of the network, providing the opportunity to integrate other ontologies with the same vocabularies. The ontology network design methodology offers a guide for ontology developers about how to use ontological and non-ontological resources in order to exploit the maximum of information and knowledge from a set of domains that share or not information.

Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network.

AIM: This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum ß-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico. MATERIAL AND METHODS: A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes. RESULTS: Among blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each). CONCLUSION: Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.

Estrés percibido y felicidad en adultos mexicanos según estado de salud-enfermedad / Perceived stress and happiness among Mexican adults split by health-illness condition

Resumen El presente estudio tuvo como objetivo analizar la relación entre el estrés percibido y la felicidad en adultos mexicanos, así como comparar ambas variables según el estado de salud-enfermedad. La muestra estuvo conformada por 762 adultos mexicanos con una media de edad de 44.96 años, de los cuales el 70.3 % reportó no padecer ninguna enfermedad. Se utilizó la Escala de Estrés Percibido y el Inventario de Felicidad Auténtica. Adicionalmente, los participantes reportaron si padecían alguna enfermedad y seleccionaron, posteriormente, en una lista de opciones. Mediante el SPSS v.24 se realizaron análisis de frecuencias, descriptivos, análisis de correlación y análisis de varianza de un factor. En los resultados se observó una correlación negativa y estadísticamente significativa entre el estrés percibido y la felicidad. Por su parte, solo se observaron diferencias significativas en la subescala de estrés percibido "sobrepasado por la situación"; fue mayor en el grupo de personas con una enfermedad aguda en comparación con el grupo de personas sanas. Se discuten los principales hallazgos, así como las implicaciones para la práctica psicológica.

Abstract The present study aimed to analyze the relationship between perceived stress and happiness in Mexican adults, and test for differences in both variables according to the health disease condition. The sample consisted of 762 Mexican adults with an average age of 44.96 years, of which 70.3% reported not suffering from any disease. The Perceived Stress Scale and the Authentic Happiness Inventory were used. In addition, participants reported if they suffer from any disease, later selecting from a list of options. Using the SPSS v.24, frequency, descriptive, correlation and analysis of variance of one factor were performed. Negative and statistically significant correlation between perceived stress and happiness was found. On the other hand, only significant differences were observed in the subscale of perceived stress "overwhelmed by the situation" being greater in the group of people with an acute illness, compared to the group of healthy people. The main findings as well as implications for psychological practice are discussed.

The Evolution of Antimicrobial Resistance in Mexico During the Last Decade: Results from the INVIFAR Group.

Background: Surveillance of antimicrobial resistance (AMR) requires an international approach with national and local strategies. Our aim was to summarize a retrospective 10-year report of antibiotic resistance of gram-positive and gram-negative bacteria in Mexico. Methods: A total of 46 centers from 22 states of Mexico participated. Databases of AMR from January 2009 to December 2018 were included for most species. The 10-year period was divided into five 2-year periods. Results: For Staphylococcus aureus, a decrease in resistance in all specimens was observed for erythromycin and oxacillin (p < 0.0001 for each). For Enterobacter spp., resistance to meropenem increased for urine specimens (p = 0.0042). For Klebsiella spp., increased drug resistance in specimens collected from blood was observed for trimethoprim/sulfamethoxazole, gentamicin, tobramycin (p < 0.0001 for each), meropenem (p = 0.0014), and aztreonam (p = 0.0030). For Acinetobacter baumannii complex, high drug resistance was detected for almost all antibiotics, including carbapenems, except for tobramycin, which showed decreased resistance for urine, respiratory, and blood isolates (p < 0.0001 for each), and for amikacin, which showed a decrease in resistance in urine specimens (p = 0.0002). An increase in resistance to cefepime was found for urine, respiratory, and blood specimens (p < 0.0001 for each). For Pseudomonas aeruginosa, aztreonam resistance increased for isolates recovered from blood (p = 0.0001). Conclusion: This laboratory-based surveillance of antibiotic resistance shows that resistance is increasing for some antibiotics in different bacterial species in Mexico and highlights the need for continuous monitoring of antibiotic resistance.

Contraste del Modelo Jerárquico Tetrafactorial para el Test de Actitud Corporal en Mujeres Mexicanas / Testing the 4 Factor Hierarchical Model for the Body Attitude Test in Mexican Women

Resumen El Body Attitude Test (BAT) fue desarrollado para evaluar la experiencia subjetiva hacia el propio cuerpo y las actitudes que se tienen con el mismo en muestra clínica de mujeres con desórdenes alimentarios. Objetivo. Este estudio toma la versión en español del BAT y analiza su estructura, su consistencia interna e invarianza factorial en una muestra de adolescentes mexicanas. Método. Se usó un análisis factorial confirmatorio para evaluar la estructura factorial subyacente e identificar la validez de constructo del modelo de medición, así como se realizó un análisis de la invarianza factorial. Participantes. La muestra se conformó por 571 mujeres con una media de edad de 15.2 (DE=2.51). Resultados. El análisis de consistencia interna mostró una alta confiabilidad para el conjunto de 20 ítems igual a la propuesta original. La estructura tetrafactorial fue confirmada en el total de la muestra mediante una validación cruzada de la misma, dividida en pares y nones obteniendo valores de bondad de ajuste adecuados (x2/gl = 3.615; RMSEA = .068; CFI = .917; TLI = .903; IFI=.917; NFI= .889). La estructura modelada fue estrictamente invariante en los grupos analizados de preadolescentes y adolescentes. Conclusiones. Se concluye que el BAT posee propiedades psicométricas apropiadas para población no clínica de adolescentes, no obstante, se requieren de futuras investigaciones que incluyan población clínica.

Abstract The Body Attitude Test (BAT) was developed to evaluate the subjective experience and the attitudes towards the own body in a clinical sample of women with eating disorders. Objective. This study takes the Spanish version of the BAT and analyzes its factorial structure, internal consistency and invariance in a sample of Mexican women. Method. A confirmatory factorial analysis was used to evaluate the underlying factor structure and identify the construct validity of the measurement model, as well as an analysis of the factorial invariance. Participants. The sample consisted of 571 women with an average age of 15.2 (SD=2.51). Results. The internal consistency analysis showed a high reliability for the set of 20 items equal to the original proposal. The tetrafactorial structure was confirmed in the total of the sample through a cross-validation, dividing the sample into pairs and odds with adequate goodness-of-fit values (x2 / df = 3.615, RMSEA = .068, CFI = .917, TLI = .903, IFI = .917, NFI = .889). The modeled structure was strictly invariant in the analyzed groups of preadolescents and adolescents. Conclusions. It is concluded that the BAT possesses psychometric properties appropriate for the nonclinical population of women, however, future investigations that include a clinical population are required.

Psychometric properties of the Scale of Attitudes towards Pregnancy and Weight Gain in Mexican population / Propiedades psicométricas de la Escala de Actitudes hacia el Embarazo y el Aumento de Peso en población mexicana

Abstract Introduction Physical changes during pregnancy trigger a positive or negative emotional response to the body image of the future mother. Since this response can affect the health of the mother and the fetus, it is necessary to have valid instruments to evaluate body image in pregnant women. Objective To validate in Spanish the Scale of Attitudes towards Pregnancy and Weight Gain in Mexican population. Method The study was conducted in two phases: it was culturally adapted to determine the linguistic validity and then its psychometric properties were verified through confirmatory exploratory factor analysis. Results Participants included 520 pregnant women over 18 attending prenatal consultation, with a mean age of 23.56 ± 5.89 and with a mean of 33.20 ± 6.69 gestation weeks. The exploratory analysis defined five components that explain 56.04% of the total variance of the 18 items with acceptable internal consistency (α = 78). Factor analysis confirmed five factors (negative attitude towards the increase of gestational weight, positive body image, control of gestational weight, concern over gestational weight and restrictive behavior in response to gestational weight) with adequate fit indices (χ2/gl = 2.57, IFI = .90, CFI = .90, RMSEA = .05 (90% CI [.048, .062], p =.12), SRMR = .05) Discussion and conclusion The instrument has good psychometric properties and is recommended as a valid tool for assessing attitudes toward body image in Mexican women during the period of pregnancy.

Resumen Introducción Los cambios físicos del embarazo propician una respuesta emocional positiva o negativa hacia la imagen corporal de la futura madre. Como esta respuesta puede afectar tanto la salud de ella como la del producto, es necesario contar con instrumentos válidos para evaluar la imagen corporal en mujeres embarazadas. Objetivo Validar en español la Escala de Actitudes hacia el Embarazo y el Aumento de Peso en población mexicana. Método El estudio se llevó a cabo en dos fases: una adaptación transcultural para determinar la validez lingüística y después una verificación de las propiedades psicométricas por medio de un análisis factorial exploratorio y confirmatorio. Resultados Participaron 520 mujeres embarazadas mayores de 18 años que asistieron a consulta prenatal, con una media de edad de 23.56 ± 5.89 años y con un promedio de 33.20 ± 6.69 semanas de gestación. El análisis exploratorio definió cinco componentes que explican el 56.04% de la varianza total de los 18 reactivos y una consistencia interna aceptable (α = .78). El análisis factorial confirmó cinco factores (actitud negativa hacia el aumento del peso gestacional, imagen corporal positiva, control de peso gestacional, preocupación por el peso gestacional y conducta restrictiva hacia el peso gestacional) con índices de ajuste adecuados (χ2/gl = 2.57, IFI = .90, CFI = .90, RMSEA = .05 (IC 90% [.048, .062], p =.12), SRMR = .05). Discusión y conclusión El instrumento tiene buenas propiedades psicométricas y se recomienda como herramienta válida para evaluar las actitudes hacia la imagen corporal en mujeres mexicanas durante el periodo del embarazo.