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Significance: The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied., Purpose: This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown., Methods: A retrospective record review of children aged 7 to 18 years who underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico was performed. The spherical equivalent pre- and post-lockdown was compared. The study excluded the best-corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia., Results: In total, 801 records were included in this study. The mean age was 12.7 ± 3.2 years, with 50.3% male and 49.7% female children. The mean spherical equivalent for the right and left eyes was similar ( r = 0.93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre- and post- lockdown (0.22 ± 0.59 D, t800 = 10.44, P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the 7- (0.13 ± 0.79 D, t28 = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t40 = 1.22, P = .23), respectively. No significant change was found between sexes before (0.16 ± 0.12 D; t799 = 1.38, P = .16) and after (0.15 ± 0.13 D; t799 = 1.19, P = .23) confinement., Conclusions: The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2023 American Academy of Optometry.)

The Solve-RD project objectives include solving undiagnosed rare diseases (RD) through collaborative research on shared genome-phenome datasets. The RD-Connect Genome-Phenome Analysis Platform (GPAP), for data collation and analysis, and the European Genome-Phenome Archive (EGA), for file storage, are two key components of the Solve-RD infrastructure. Clinical researchers can identify candidate genetic variants within the RD-Connect GPAP and, thanks to the developments presented here as part of joint ELIXIR activities, are able to remotely visualize the corresponding alignments stored at the EGA. The Global Alliance for Genomics and Health (GA4GH) htsget streaming application programming interface (API) is used to retrieve alignment slices, which are rendered by an integrated genome viewer (IGV) instance embedded in the GPAP. As a result, it is no longer necessary for over 11,000 datasets to download large alignment files to visualize them locally. This work highlights the advantages, from both the user and infrastructure perspectives, of implementing interoperability standards for establishing federated genomics data networks., Competing Interests: The authors declare that they have no conflict of interest., (© 2023 The Authors.)

Objective: To describe a cohort of pediatric patients with encephalitis and their risk factors for admission to the pediatric intensive care unit (PICU)., Study Design: Children (<18 years old), with encephalitis evaluated by conventional microbiology and syndromic, multiplex test in cerebrospinal fluid (CSF) between July 2017 and July 2020, were recruited from 14 hospitals that comprise the Colombian Network of Encephalitis in Pediatrics. Multivariate analyses were used to evaluate risk factors associated with the need for PICU admission., Results: Two hundred two children were included, of which 134 (66.3%) were male. The median age was 23 months (IQR 5.7-73.2). The main etiologies were bacteria (n = 55, 27%), unspecified viral encephalitis (n = 44, 22%) and enteroviruses (n = 27, 13%), with variations according to age group. Seventy-eight patients (38.6%) required management in the PICU. In multivariate analysis, factors associated with admission to the PICU were the presence of generalized seizures (OR 2.73; 95% CI: 1.82-4.11), status epilepticus (OR 3.28; 95% CI: 2.32-4.62) and low leukocyte counts in the CSF (OR 2.86; 95% CI: 1.47-5.57). Compared with enterovirus, bacterial etiology (OR 7.50; 95% CI: 1.0-56.72), herpes simplex encephalitis (OR 11.81; 95% CI: 1.44-96.64), autoimmune encephalitis (OR 22.55; 95% CI: 3.68-138.16) and other viral infections (OR 5.83; 95% CI: 1.09-31.20) increased the risk of PICU admission., Conclusions: Data from this national collaborative network of pediatric patients with encephalitis allow early identification of children at risk of needing advanced care and can guide the risk stratification of admission to the PICU., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Multisystemic inflammatory syndrome in children (MIS-C) is one of the most severe presentations of COVID-19 infection in pediatrics. Currently, we have few studies that describe the characteristics of this condition in Colombian children., Objective: To describe the clinical and epidemiological characteristics of children hospitalized with MIS-C in Neiva, Colombia., Methods: Observational follow-up study of a cohort of children with MIS-C for 12 months (May 15, 2020, to May 30, 2021) in two hospitals in the city of Neiva. Epidemiological data, clinical characteristics, laboratory characteristics, cardiological evaluation, treatment, and clinical outcomes were analyzed., Results: We included 34 patients who met the diagnosis of MIS-C. The median age was 68 months. Some type of nutritional issue was observed by 43.75% of those under 5 years of age and by 27.78% of those over 5 years of age. Gastrointestinal symptoms were the most frequent, with vomiting, diarrhea, and abdominal pain being the most frequent by 79, 70, and 67%, respectively. By 77% of the patients, a history of SARS-COV-2 infection was documented through IgG. In the echocardiogram, 35.4% of the patients had systolic dysfunction, followed by coronary involvement by 35%., Conclusion: This study describes a series of cases of children with MIS-C in Colombia. Gastrointestinal manifestations were predominant. Mortality was high in comparison to other countries but similar to that reported in Colombia. This fact was associated with relevant pathological background. More training is required for physicians in order to have a better understanding of the disease so as to have an early diagnosis and timely treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Pérez López, Carvajal Duque, Salgado García, Vega Vega, Ramos-Castaneda, Ardila Gómez and Romero.)

The European Genome-phenome Archive (EGA - https://ega-archive.org/) is a resource for long term secure archiving of all types of potentially identifiable genetic, phenotypic, and clinical data resulting from biomedical research projects. Its mission is to foster hosted data reuse, enable reproducibility, and accelerate biomedical and translational research in line with the FAIR principles. Launched in 2008, the EGA has grown quickly, currently archiving over 4,500 studies from nearly one thousand institutions. The EGA operates a distributed data access model in which requests are made to the data controller, not to the EGA, therefore, the submitter keeps control on who has access to the data and under which conditions. Given the size and value of data hosted, the EGA is constantly improving its value chain, that is, how the EGA can contribute to enhancing the value of human health data by facilitating its submission, discovery, access, and distribution, as well as leading the design and implementation of standards and methods necessary to deliver the value chain. The EGA has become a key GA4GH Driver Project, leading multiple development efforts and implementing new standards and tools, and has been appointed as an ELIXIR Core Data Resource., (© The Author(s) 2021. Published by Oxford University Press on behalf of Nucleic Acids Research.)

Introduction: Gigantism is a rare pediatric disease characterized by increased production of growth hormone (GH) before epiphyseal closure, that manifests clinically as tall stature, musculoskeletal abnormalities, and multiple comorbidities., Materials and Methods: Case series of 6 male patients with gigantism evaluated at the Endocrinology Service of Hospital de San José (Bogotá, Colombia) between 2010 and 2016., Results: All patients had macroadenomas and their mean final height was 2.01 m. The mean age at diagnosis was 16 years, and the most common symptoms were headache (66%) and hyperhidrosis (66%). All patients had acral changes, and one had visual impairment secondary to compression of the optic chiasm. All patients underwent surgery, and 5 (83%) required additional therapy for biochemical control, including radiotherapy (n = 4, 66%), somatostatin analogues (n = 5, 83%), cabergoline (n = 3, 50%), and pegvisomant (n = 2, 33%). Three patients (50%) achieved complete biochemical control, while 2 patients showed IGF-1 normalization with pegvisomant. Two patients were genetically related and presented a mutation in the aryl hydrocarbon receptor-interacting protein (AIP) gene (pathogenic variant, c.504G>A in exon 4, p.Trp168*), fulfilling the diagnostic criteria of familial isolated pituitary adenoma., Conclusions: This is the largest case series of patients with gigantism described to date in Colombia. Transsphenoidal surgery was the first-choice procedure, but additional pharmacological therapy was usually required. Mutations in the AIP gene should be considered in familial cases of GH-producing adenomas.

Background and Purpose: Spared fibers after spinal cord injury (SCI) tend to consist predominantly of subcortical circuits that are not under volitional (cortical) control. We aim to improve function after SCI by using targeted physical exercises designed to simultaneously stimulate cortical and spared subcortical neural circuits., Methods: Participants with chronic motor-incomplete SCI enrolled in a single-center, prospective interventional crossover study. Participants underwent 48 sessions each of weight-supported robotic-assisted treadmill training and a novel combination of balance and fine hand exercises, in randomized order, with a 6-week washout period. Change post-intervention was measured for lower extremity motor score, soleus H-reflex facilitation; seated balance function; ambulation; spasticity; and pain., Results: Only 9 of 21 enrolled participants completed both interventions. Thirteen participants completed at least one intervention. Although there were no statistically significant differences, multimodal training tended to increase short-interval H-reflex facilitation, whereas treadmill training tended to improve dynamic seated balance., Discussion: The low number of participants who completed both phases of the crossover intervention limited the power of this study to detect significant effects. Other potential explanations for the lack of significant differences with multimodal training could include insufficient engagement of lower extremity motor cortex using skilled upper extremity exercises; and lack of skill transfer from upright postural stability during multimodal training to seated dynamic balance during testing. To our knowledge, this is the first published study to report seated posturography outcomes after rehabilitation interventions in individuals with SCI., Conclusion: In participants with chronic incomplete SCI, a novel mix of multimodal exercises incorporating balance exercises with skilled upper extremity exercises showed no benefit compared to an active control program of body weight-supported treadmill training. To improve participant retention in long-term rehabilitation studies, subsequent trials would benefit from a parallel group rather than crossover study design., Competing Interests: The authors have declared that no competing interests exist.

This study sought to develop a simple index for ranking birds' environmental sensitivity to oil in which birds are used as biological indicators. The study area consisted of both the Santos Estuarine System (SES), and the Laje de Santos Marine State Park (LSMSP), located in Southeastern Brazil. Information on the bird species and their feeding and nesting behaviors were obtained from the literature and were the basis of the sensitivity index created. The SES had a higher number of species, but only about 30% were found to be highly sensitive. The LSMSP presented a much lower number of species, but all of them were considered to be highly sensitive to oil. Due to its simplicity, this index can be employed worldwide as a decision-making tool that may be integrated into other management tools, particularly when robust information on the biology of birds is lacking., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Introduction. Patient safety is an important topic. The purpose of this study is to evaluate the perceived versus observed patient safety measures (PSM) in critically ill patients in a teaching hospital in Latin America. Materials and Methods. The level of perceived patient safety was evaluated with the patient safety hospital survey. Three months later, a qualitative study was conducted, including video recording of procedures, graded according to adherence to PSM. Levels of adherence were scored during patient mobilization (PM), placement of central catheters (PCC), other invasive procedures (OIP), infection control (IC), and endotracheal intubation (ETI). Results. The perceived adherence of PSM in the prestudy survey was considered fair by 89.1% of the ICU staff. After the survey, 829 ICU procedures were video-recorded. Mean observed adherence for fair patient safety measures was 20.8%. Perceived adherence was higher than the real patient safety protocol measures observed in the videos. Conclusion. Perception of PSM was higher than observed in the management of critically ill patients in a teaching hospital in southern Colombia.

Purpose: To determine the prevalence of refractive conditions in the adult population that visited primary care optometry clinics in Puerto Rico., Methods: A retrospective cross-sectional study of patients examined at the Inter American University of Puerto Rico School of Optometry Eye Institute Clinics between 2004 and 2010. Subjects considered had best corrected visual acuity by standardized subjective refraction of 20/40 or better. The refractive errors were classified by the spherical equivalent (SE): sphere+½ cylinder. Myopia was classified as a SE>-0.50D, hyperopia as a SE>+0.50 D, and emmetropia as a SE between -0.50 and +0.50, both included. Astigmatism equal or higher than 0.25 D in minus cylinder form was used. Patients with documented history of cataract extraction (pseudophakia or aphakia), amblyopia, refractive surgery or other corneal/ocular surgery were excluded from the study., Results: A total of 784 randomly selected subjects older than 40 years of age were selected. The estimated prevalence (95%, confidence interval) among all subjects was hyperopia 51.5% (48.0-55.0), emmetropia 33.8% (30.5-37.2), myopia 14.7% (12.1-17.2) and astigmatism 69.6% (68.8-73.3). Hyperopia was more common in females than males although the difference was not statistically significant. The mean spherical equivalent values was hyperopic until 70 y/o and decreased slightly as the population ages., Conclusion: Hyperopia is the most common refractive error and its prevalence and seems to increase among the aging population who visited the clinics. Further programs and studies must be developed to address the refractive errors needs of the adult Puerto Rican population., (Copyright © 2012 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.)

The growth of maritime transport and oil exploitation activities may increase the risk of oil spills. Thus, plans and actions to prevent or mitigate impacts are needed to minimize the effects caused by oil. However, tools used worldwide to support contingency plans have not been integrated, thus leading to failure in establishing priority areas. This investigation aimed to develop indices of environmental vulnerability to oil (IEVO), by combining information about environmental sensibility to oil and results of numerical modeling of spilled oil. To achieve that, a case study concerning to oil spills scenarios in a subtropical coastal area was designed, and IEVOs were calculated and presented in maps, in order to make the information about the areas' vulnerability more easily visualized. For summer, the extension of coastline potentially affected by oil was approximately 150 km, and most of the coastline presented medium to high vulnerability. For winter, 230 km coastline would be affected, from which 75% were classified as medium to high vulnerability. Thus, IEVO maps allowed a rapid and clearer interpretation of the vulnerability of the mapped region, facilitating the planning process and the actions in response to an oil spill., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The article reports on Latina/o high school students who conducted participatory action research (PAR) on problems that circumscribe their possibilities for self-determination. The intention is to legitimize student knowledge to develop effective educational policies and practices for young Latinas/os. PAR is engaged through the Social Justice Education Project, which provides students with all social science requirements for their junior and senior years. The mandated curriculum is supplemented with advanced-level readings from Chicana/o studies, critical race theory, critical pedagogy, and, most important, PAR. The intention is for students to meet the requirements for graduation and to develop sophisticated critical analyses to address problems in their own social contexts.

The authors measured telomerase activity using the telomeric repeat amplification protocol-enzyme-linked immunosorbent assay method in 13 neuroendocrine pulmonary neoplasms and in non-neoplastic frozen lung samples from the same patients. These cases belonged to the complete neuroendocrine neoplastic spectrum: four typical carcinoids, three atypical carcinoids, four large cell neuroendocrine lung carcinomas, and two small cell lung carcinomas. The authors performed the same assay for 52 non-neoplastic lung tissues from the surgical files in their department (negative controls). They verified the presence (or absence) of neoplastic tissue in every case by looking at one frozen section done in the same tissue used for telomerase assay. The telomerase activity level in non-neoplastic tissues (mean, 182 A450nm U) was similar to that obtained in the typical carcinoids (mean, 104.5 A450nm U). All neuroendocrine tumors but the typical carcinoids showed high levels of telomerase activity (mean, 1,750.8 A450nm U). According to the telomerase hypothesis, typical carcinoid cells are mortal pre-M2 stage cells, but atypical carcinoid, large cell neuroendocrine lung carcinoma, and small cell lung carcinoma cells are immortal post-M2 stage cells. This finding may be of important prognostic significance in these kinds of tumors. Measurement of enzyme activity with a good morphologic control could be necessary in telomerase activity assay.