Presentar los resultados estatales de salud y nutrición obtenidos mediante la Encuesta Nacional de Salud y Nutrición Continua 2020-2024 (Ensanut Continua 2020-2024). Material y métodos. La Ensanut Continua es una serie de encuestas anuales, probabilísticas, estratificadas y por conglomerados, con representatividad nacional, regional, urbana, rural y estatal. Se integraron cinco rondas (2020-2024) con más de 50 000 hogares y 53 600 adultos encuestados. Se unificaron bases mediante ponderadores ajustados y análisis con diseño complejo para estimar 145 indicadores de salud y nutrición.

Se obtuvieron estimaciones estatales válidas y comparables sobre inseguridad alimentaria e hídrica, acceso a servicios de salud, nutrición infantil y adulta, enfermedades crónicas, salud mental, envejecimiento y actividad física. Las prevalencias mostraron heterogeneidad territorial y social, reflejando brechas en cobertura y bienestar. Conclusión. La Ensanut Continua 2020-2024 fortalece el monitoreo nacional y estatal de la salud y nutrición, proporcionando evidencia clave para la planeación, implementación y evaluación de políticas públicas en México.

Postpartum depression (PPD) is a common mental health issue that negatively impacts maternal well-being and infant development. The COVID-19 pandemic has exacerbated depression risk among postpartum women due to added stressors from the crisis. This study aimed to assess PPD prevalence during the pandemic and identify associated factors. The study was conducted at Hanoi Obstetrics and Gynecology Hospital from May 2023 to December 2023. This cross-sectional study selected 223 postpartum women via convenience sampling. Data collection utilized online surveys and phone interviews. The Edinburgh Postnatal Depression Scale (EPDS) gauged depression levels, analyzed using Stata 16.0. Descriptive statistics and logistic regression explored relationships between PPD and contributing factors. Among participants, 22.0% scored 9-11 on EPDS, indicating mild depression; 5.8% were high-risk (EPDS 12-13), and 8.5% had PPD (EPDS > 14). The study identified links between PPD and poor sleep, COVID-19 anxiety, and limited social support. PPD remains a critical concern during COVID-19, with factors like sleep quality, pandemic-related anxiety, and social support influencing depression risk. Early screening and psychological interventions are crucial to mitigate PPD's impact on maternal and infant health post-pandemic.

Synaptic dysfunction is a candidate mechanism in psychotic disorders, yet the precise underlying substrates remain elusive. We investigated how combining in vivo electroencephalography (EEG) and in vitro human cortical spheroid (hCS)-based methods can further our understanding of psychosis pathophysiology during fetal stages of neurodevelopment. Ten individuals with schizophrenia (SZ) or bipolar disorder (BD; 5 males and 5 females) and five controls (CTRL; 3 males and 2 females) underwent EEG assessments, including long-term potentiation (LTP)-like cortical plasticity and mismatch negativity (MMN). hCS were generated from induced pluripotent stem cells of all participants, and immunohistochemistry, Seahorse bioenergetics and patch-clamp recordings were performed. EEG-based LTP-like plasticity was reduced in individuals with SZ and BD. Basal respiration was decreased in BD hCS and VGLUT1 levels were reduced in both SZ and BD hCS. There was a positive association between EEG-based LTP-like plasticity and hCS basal respiration which survived correction. Our data provide further support for roles of mitochondrial and glutamatergic impairments in the synaptic dysfunction of psychosis and demonstrate the potential of combining EEG- and hCS-based methods for early development mechanistic studies of brain disorders.

Chronic pain represents heritable conditions linked to suicide death. It has been suggested that a shared genetic predisposition may contribute to this relationship, but there has not yet been a comprehensive assessment of genetic and clinical overlaps of different types of chronic pain with suicide death. Here, we integrated whole-genome sequencing and electronic health records from 986 unrelated individuals of European ancestry who died by suicide in the Utah Suicide Mortality Research Study and 415 ancestrally-matched population controls selected for absence of disease. Polygenic scores (PGSs) for seven distinct types of chronic pain were calculated and tested in the suicide cohort. We observed significant positive associations of PGSs for multisite chronic pain (PGS_MCP) and chronic widespread pain (PGS_CWP) with suicide mortality. Sex-stratified analyses showed elevations in both males and females. Pain diagnosis-stratified analyses revealed associations with suicide death regardless of chronic pain diagnoses. Follow-up tests of PGSs for more specific pain conditions showed additional associations with suicide death for: 1) monoarticular arthritis, 2) back pain, and 3) chronic inflammatory demyelinating polyneuropathy across all suicide death individuals, and 4) irritable bowel syndrome within males only. In a multiple logistic regression test of all chronic pain PGSs associating suicide death status, four types of pain remained uniquely associated with suicide death, highlighting distinct subgroups within suicide death: some attributed to MCP and CWP, and others associated with monoarticular arthritis or chronic inflammatory demyelinating polyneuropathy. This cohort study reports associations between suicide death and PGSs from various pain conditions, regardless of sex or chronic pain diagnosis, suggesting that combining genetic and clinical risk factors may better identify genetic overlap, causal directions, and/or specific gene pathways.

Ankylosing spondylitis (AS) is strongly associated with the human leukocyte antigen B27 (HLA-B27), yet how this genetic risk factor interacts with the gut microbiome remains unclear. We integrated fecal gut microbiota analysis, untargeted metabolomics, and clinical phenotyping in 88 participants, including HLA-B27-positive patients with AS (n = 28), HLA-B27-positive healthy controls (n = 30), and HLA-B27-negative healthy controls (n = 30). HLA-B27 positivity, particularly in AS, was associated with marked alterations in gut microbial composition and metabolic profiles, with forty bacterial species showing progressive disease-related shifts across cohorts. Integrated pathway and metabolomic analyses identified three amino acid-related pathways consistently disrupted in AS: tryptophan metabolism, cysteine metabolism, and pyruvate-centered biosynthesis of branched-chain amino acids, ornithine, and lysine. Correlation network analyses linking differential taxa, metabolites, and clinical indices revealed previously unrecognized microbial and metabolic signatures that robustly distinguished AS from both control groups. To explore causality, fecal microbiota transplantation (FMT) from clinical donors into antibiotic-treated mice recapitulated key disease-relevant features, including impaired intestinal barrier function, systemic inflammation, trabecular bone loss, and polarization of macrophages toward a proinflammatory M1 phenotype. Mechanistic validation identified cinnabarinic acid as a critical microbial-derived metabolite that suppresses M1 macrophage polarization via activation of the aryl hydrocarbon receptor (AhR) pathway and confers protection in the FMT model. Together, these findings support a model in which HLA-B27-associated gut dysbiosis and metabolic reprogramming promote AS pathogenesis through macrophage-mediated inflammation and osteocatabolic signaling, highlighting microbial-metabolic pathways as potential therapeutic targets.

Dementia is a major global cause of death, with cases projected to rise from 57.4 million in 2019 to 152.8 million by 2050. As the disease progresses, individuals experience growing frailty, complex health needs and multiple comorbidities, requiring comprehensive support to maintain quality of care. Non-pharmacological physical interventions, targeting either the physical body or immediate environment, may help address these needs, especially in advanced dementia nearing end of life.

To map, appraise and synthesise evidence on the effectiveness of physical interventions for people with dementia nearing end of life.

An umbrella review of systematic reviews on physical interventions, part of a broader palliative dementia care series.

MEDLINE, Epistemonikos and ASSIA were searched for systematic reviews from 1980 to May 2024 involving people with dementia, carers or staff in health and social care settings. Physical interventions were defined as non-pharmacological approaches focusing on the body or physical environment.

From 6052 records, 13 reviews met the inclusion criteria. Interventions grouped into two categories: (1) nutrition and hydration (including enteral feeding) and (2) physical activities (including exercise, massage and approaches to reduce care resistance). Evidence quality was generally low, with no conclusive findings on effectiveness. Most interventions addressed well-being and function, with limited evidence for carer support, holistic assessment or medical management.

Research has primarily targeted well-being and functional outcomes, leaving key gaps in carer support and holistic management, warranting further investigation.

PROSPERO CRD42020162887.

Subthreshold depressive symptoms significantly hinder functional recovery in bipolar disorder (BD). While most studies use a global score to assess the impact of these symptoms on functioning, this study examines which specific subthreshold depressive symptoms mostly impede functional recovery in patients with BD in remission.

The sample comprised a total of 413 patients with BD. Subthreshold depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D), and psychosocial functioning was measured with the Functioning Assessment Short Test (FAST). Bivariate analyses were performed to identify items from the HAM-D as well as other clinical and demographic variables associated with functional impairment. Multivariate linear regression analyses were conducted including the variables that demonstrated significant associations in the bivariate analyses.

The linear regression model for the FAST total score demonstrated that "psychomotor retardation" (item 8) had the strongest association on psychosocial functioning (β = 6,9; p < 0,001), followed by "feelings of guilt" (item 2) (β = 5,75; p < 0,001) "work and activities" (item 7) (β = 5,38; p < 0,001) and "somatic anxiety" (item 11) (β = 3,45; p < 0,001). Other significant clinical variables included antipsychotic use, older age, fewer years of education and male sex. This model explained 39,6% of the variance in the FAST total score (R² = 0,396; Adjusted R² = 0,375; F_(399,13) = 20,04; p < 0,001).

Specific subthreshold symptoms, including psychomotor retardation, apathy, guilt and somatic anxiety significantly influence psychosocial functioning. These findings highlight the importance of specifically targeting these symptoms to achieve functional recovery, even when patients are clinically stable.

A wide array of operational and management practices characterizes the dairy farming landscape in Canada. This heterogeneity poses challenges in understanding the full range of dairy farming systems, which can lead to incomplete representations and less effective interventions aimed at improving the well-being of dairy farmers. This study aimed to holistically explore the relationship between dairy farmers' well-being and farm management practices. A multiple factorial analysis was used to group dairy farmers based on various factors, including demographic characteristics, mental and physical health outcomes, farming responsibilities, work-life balance, social environment and support, animal housing and management, and concerns about various dairy-related stressors. The analysis identified 4 distinct clusters of farmers defined by 66 significant variables. Key factors influencing the differences among the surveyed dairy producers included age, concern about finances, drought, public perceptions of the dairy industry, policies and regulations, farm responsibilities, satisfaction with professional relationships (such as those with veterinarians and feed representatives), and mental health outcomes. Despite the variations among the clusters, a common theme emerged: most participants selected finding more time for enjoyable activities and reducing their workload as ways to improve their well-being. The findings suggest that the nature of dairy farming and its associated responsibilities may often hinder farmers from achieving a healthy work-life balance. Furthermore, this study highlights the distinct challenges faced by various groups of dairy farmers. The typologies established in this research offer a promising foundation for providing tailored resources and support.

Cognitive impairment is a key yet understudied component of normal pressure hydrocephalus (NPH). Although gait and radiological markers are routinely assessed, neuropsychological outcomes remain inconsistently reported, and no standardized cognitive battery exists for evaluating patients before and after CSF shunt. This systematic review synthesizes available evidence on the cognitive trajectories of adults with NPH and identifies the neuropsychological tests that are most sensitive and clinically informative for monitoring outcomes following ventriculo-peritoneal (VPS) and lumbo-peritoneal shunt (LPS).

A systematic search of PubMed/MEDLINE and Web of Science identified studies reporting standardized neuropsychological assessments in adult NPH. Ten studies met inclusion criteria. Because statistical reporting varied across studies (means/SD vs medians/IQR), non-parametric data were harmonized into estimated means and SDs using validated transformation methods. Weighted means and pooled SDs were computed for each test and follow-up interval (T0, 3, 6, 12, 24 months), enabling comparison of cognitive trajectories across domains, with values rounded according to appropriate significant digit conventions to enhance clinical interpretability.

Across 537 baseline assessments, the Mini-Mental State Examination (MMSE) was most frequently administered, followed by Trail Making Test A (TMT-A), Trail Making Test B (TMT-B), Digit Span, Verbal Fluency, and the Frontal Assessment Battery (FAB). Aggregated results revealed modest domain-specific and time-dependent postoperative improvements. Global cognition (MMSE) improved steadily up to 12 months, psychomotor speed and attention (TMT-A) improved early, and executive functions (TMT-B, FAB) showed later gains peaking at 12 months. Working memory (Digit Span) and verbal fluency improved more variably and often later. Variability across studies was reflected in pooled SDs. Across measures, MMSE, TMT-A, TMT-B, and Digit Span were the most robust and sensitive indicators of postoperative cognitive change.

Cognitive recovery after shunt in NPH follows a predominantly fronto-subcortical pattern, with the greatest improvements occurring within the first postoperative year. MMSE, TMT-A, TMT-B, and Digit Span represent the most reliable and informative neuropsychological tools for pre- and postoperative evaluation and should constitute the core of a standardized NPH-specific cognitive battery. Establishing uniform testing protocols and improving methodological consistency across studies will enhance diagnostic accuracy, surgical decision-making, and long-term monitoring of this treatable condition.