Myopia Prevalence in Latin American Children and Adolescents: A Systematic Review and Meta-Analysis.

Although myopia is a growing global concern, comprehensive studies on its prevalence among Latin American (LATAM) children and adolescents are still lacking. Thus, we conducted a systematic review and meta-analysis to determine the prevalence of myopia in LATAM children and adolescents aged three to 20. The study conducted a thorough literature search from January 1, 1975, to February 28, 2023, identifying 24 studies on the prevalence of myopia in LATAM that met the inclusion criteria. Quality assessment and standardized data collection were performed. The meta-analysis used a random-effects model due to heterogeneity and calculated prevalence rates. Finally, the analysis of data from 24 eligible studies revealed a myopia prevalence of 8.61% (range 0.80-47.36%, 95% confidence interval (CI): 5.22-13.87%, p < 0.05) among 165,721 LATAM children and adolescents. No significant age-based associations or temporal trends were observed in this study. Studies with non-cycloplegic or objective assessment exhibited a numerically higher, although statistically non-significant, myopia prevalence (10.62%, 95% CI: 4.9-21.6%) compared to studies using cycloplegia (7.17%, 95% CI: 3.40-14.50%). In conclusion, myopia affects approximately one in 11 LATAM children and adolescents. Given the increasing exposure of LATAM youth to known myopia risk factors, such as extensive near-work, online learning, and limited outdoor activities, it is crucial to monitor myopia trends in this region. Further research is imperative to address and prevent myopia in LATAM.

A Morphometric Study of the Pars Plana of the Ciliary Body in Human Cadaver Eyes.

This study aimed to determine the pars plana length in postmortem human eyes using advanced morphometric techniques and correlate demographics to ocular metrics such as age, sex, ethnicity, and axial length. Between February and July 2005, we conducted a cross-sectional observational study on 46 human cadaver eyes deemed unsuitable for transplant by the SBO Eye Bank. The morphometric analysis was performed on projected images using a surgical microscope and a video-microscopy system with a 20.5:1 correction factor. The pars plana length was measured three times per quadrant, with the final value being the mean of these measurements. Of the 46 eyes collected, 9 were unsuitable for the study due to technical constraints in conducting intraocular measurements. Overall, the average axial length was 25.20 mm. The average pars plana length was 3.8 mm in all quadrants, with no measurements below 2.8 mm or above 4.9 mm. There were no statistically significant variations across quadrants or with age, sex, axial length, or laterality. Accurately defining the pars plana dimensions is crucial for safely accessing the posterior segment of the eye and minimizing complications during intraocular procedures, such as intravitreal injections and vitreoretinal surgeries.

Optimized Artificial Intelligence for Enhanced Ectasia Detection Using Scheimpflug-Based Corneal Tomography and Biomechanical Data.

PURPOSE: To optimize artificial intelligence (AI) algorithms to integrate Scheimpflug-based corneal tomography and biomechanics to enhance ectasia detection. DESIGN: Multicenter cross-sectional case-control retrospective study. METHODS: A total of 3886 unoperated eyes from 3412 patients had Pentacam and Corvis ST (Oculus Optikgeräte GmbH) examinations. The database included 1 eye randomly selected from 1680 normal patients (N) and from 1181 "bilateral" keratoconus (KC) patients, along with 551 normal topography eyes from patients with very asymmetric ectasia (VAE-NT), and their 474 unoperated ectatic (VAE-E) eyes. The current TBIv1 (tomographic-biomechanical index) was tested, and an optimized AI algorithm was developed for augmenting accuracy. RESULTS: The area under the receiver operating characteristic curve (AUC) of the TBIv1 for discriminating clinical ectasia (KC and VAE-E) was 0.999 (98.5% sensitivity; 98.6% specificity [cutoff: 0.5]), and for VAE-NT, 0.899 (76% sensitivity; 89.1% specificity [cutoff: 0.29]). A novel random forest algorithm (TBIv2), developed with 18 features in 156 trees using 10-fold cross-validation, had a significantly higher AUC (0.945; DeLong, P < .0001) for detecting VAE-NT (84.4% sensitivity and 90.1% specificity; cutoff: 0.43; DeLong, P < .0001) and a similar AUC for clinical ectasia (0.999; DeLong, P = .818; 98.7% sensitivity; 99.2% specificity [cutoff: 0.8]). Considering all cases, the TBIv2 had a higher AUC (0.985) than TBIv1 (0.974; DeLong, P < .0001). CONCLUSIONS: AI optimization to integrate Scheimpflug-based corneal tomography and biomechanical assessments augments accuracy for ectasia detection, characterizing ectasia susceptibility in the diverse VAE-NT group. Some patients with VAE may have true unilateral ectasia. Machine learning considering additional data, including epithelial thickness or other parameters from multimodal refractive imaging, will continuously enhance accuracy. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

A Extensão Universitária como Dispositivo para Formação do Psicólogo em Saúde Mental / The Community Outreach as a Device for Psychologist Training in Mental Health / La Extensión Universitaria como Dispositivo para Formación del Psicólogo en Salud Mental

Este trabalho tem como objetivo analisar criticamente a formação em psicologia no Brasil e demonstrar que a extensão universitária pode ser usada como um dispositivo formativo. Para tanto, é feita uma contextualização das limitações relativas à formação em psicologia no que se refere à atuação em saúde mental em uma lógica psicossocial. Considera-se paradigma de atuação profissional a atualidade das práticas preconizadas pelo modelo de assistência adotado pelo Sistema Único de Saúde (SUS). Sugere-se o dispositivo da extensão como uma ferramenta capaz de contribuir para a superação de algumas dessas limitações com base na descrição de uma experiência de projeto de extensão de uma universidade brasileira. Essa experiência permitiu encontrar na extensão universitária um dispositivo capaz de contribuir para a superação de limitações relativas à estrutura de curso e de formação em psicologia na universidade na qual o projeto é sediado. Sugere-se que a extensão como dispositivo formativo em psicologia contribui para o treinamento de profissionais articulados com a realidade do serviço prestado e da comunidade que os cerca.

The aim of this paper is a critical review of the training in psychology in Brazil and also demonstrate how community outreach can be used as an educational device. Therefore, it was made a contextualization of the limitations related to the training in psychology regarding the mental health performance in a psychosocial perspective. It is considered as paradigm of professional practice the current practices recommended by the care model adopted by the Unified Health System (SUS). It is suggested that the community outreach device is a tool that can contribute to overcome some of these limitations, based on an experience of a community outreach project from a Brazilian university. This experience could show a device capable of contributing to overcome limitations related to the undergraduate course structure in psychology at the university in which the project is based. It is suggested that community outreach as a formative device in psychology contributes to the training of professionals committed to the reality of the service and to their surrounding community.

Este artículo tiene como objetivo analizar críticamente la capacitación en psicología en Brasil y demostrar cómo la extensión universitaria puede ser utilizada como un dispositivo formativo. Por lo tanto, se realiza una contex-tualización de las limitaciones relacionadas con la capacitación en psicología con respecto al desempeño de la salud mental en una lógica psicosocial. Se considera como paradigma de la práctica profesional las prácticas actuales recomendadas por el modelo de atención adoptado por el Sistema Único de Salud (SUS). El dispositivo de extensión se sugiere como una herramienta que puede contribuir a superar algunas de estas limitaciones al describir una experiencia de proyecto de extensión de una universidad brasileña. En esta experiencia se encontró en la extensión universitaria un dispositivo capaz de contribuir a superar las limitaciones relacionadas con la estructura del curso y la formación en psicología en la universidad en la que se basa el proyecto. Se sugiere que la extensión con dispositivo formativo en psicología contribuya a la formación de profesionales articulados con la realidad del servicio y la comunidad circundante.

S-nitrosocaptopril nanoparticles as nitric oxide-liberating and transnitrosylating anti-infective technology.

Nitric oxide (NO), an essential agent of the innate immune system, exhibits multi-mechanistic antimicrobial activity. Previously, NO-releasing nanoparticles (NO-np) demonstrated increased antimicrobial activity when combined with glutathione (GSH) due to formation of S-nitrosoglutathione (GSNO), a transnitrosylating agent. To capitalize on this finding, we incorporated the thiol-containing ACE-inhibitor, captopril, with NO-np to form SNO-CAP-np, nanoparticles that both release NO and form S-nitrosocaptopril. In the presence of GSH, SNO-CAP-np demonstrated increased transnitrosylation activity compared to NO-np, as exhibited by increased GSNO formation. Escherichia coli and methicillin-resistant Staphylococcus aureus were highly susceptible to SNO-CAP-np in a dose-dependent fashion, with E. coli being most susceptible, and SNO-CAP-np were nontoxic in zebrafish embryos at translatable concentrations. Given SNO-CAP-np's increased transnitrosylation activity and increased E. coli susceptibility compared to NO-np, transnitrosylation rather than free NO is likely responsible for overcoming E. coli's resistance mechanisms and ultimately killing the pathogen. FROM THE CLINICAL EDITOR: This team of authors incorporated the thiol-containing ACE-inhibitor, captopril, into a nitric oxide releasing nanoparticle system, generating nanoparticles that both release NO and form S-nitrosocaptopril, with pronounced toxic effects on MRSA and E. coli in the presented model system.