A simple assay for measuring tannin-protein precipitation capacity offers insights into the diet and food choice of black howler monkeys (Alouatta pigra).

Phenolics, like tannins, are plant-specialized metabolites that play a protective role against herbivory. Tannins can reduce palatability and bind with proteins to reduce digestibility, acting as deterrents to feeding and impacting nutrient extraction by herbivores. Some assays measure tannin and total phenolics content in plants but lack determination of their biological effects, hindering the interpretation of tannin function in herbivory and its impacts on animal behavior and ecology. In this study, we successfully applied the radial diffusion assay to assess tannin protein precipitation (PP) capacity and evaluate the anti-nutritional effects of tannins in food plants (n = 24) consumed by free-ranging black howler monkeys (Alouatta pigra) in Tabasco, Mexico. We found PP rings in five plant species consumed by the monkeys. The mature fruit of Inga edulis was the most consumed food plant, despite having a high tannin PP capacity (56.66 mg tannic acid equivalent/g dry matter). These findings highlight the presence of tannins in the black howler diet and provide insight into the primates' resilience and potential strategies for coping with anti-nutritional aspects of the diet.

Lead exposure and its relationship with fecal cortisol levels in black howler monkeys (Alouatta pigra).

Efficiently detecting early environmental threats to wildlife is vital for conservation. Beyond obvious dangers like habitat loss or deforestation, our study focuses on one of the most hazardous toxic metals for wildlife: lead (Pb). Pb is a widespread, cumulative, and insidious environmental pollutant that can trigger a wide range of physiological, biochemical, and behavioral disorders. In fact, Pb can cause permanent dysfunction of the major stress system, the hypothalamic pituitary adrenal (HPA) axis. We analyzed Pb and cortisol concentrations in fecal samples from Alouatta pigra in southern Mexico. Fecal samples were collected across six sites categorized as free-ranging (n = 65; conserved and disturbed) and from captive animals (n = 58). Additionally, we collected soil samples (n = 35). We found that Pb was present in 28% of fecal samples and 83% of soil samples. There was a positive relation between fecal and soil Pb levels, and fecal Pb concentration was negatively associated with cortisol levels. However, the claim of Pb being a direct interference with HPA axis requires further investigation. Given our findings, assessing wildlife exposure can be a valuable tool for understanding potential Pb exposure levels in the environment and its possible implications for human health. It can also serve as an early warning system of these consequences.

Estimating the impact of the illegal trade of primates in Mexico: a potential threat to wildlife.

The primates of Mexico, Ateles geoffroyi, Alouatta palliata, and Alouatta pigra, are seriously threatened by habitat loss, fragmentation, and illegal hunting and trade. Very little is known about the extent of illegal trade and its impacts on declining primate populations. Our study proposes a potential method based on estimating the number of individuals that die in the trade before being detected and those that probably cannot be detected. This facilitates estimating the number of animals extracted and allows an assessment of how trafficking impacts their populations. We derive estimates from seizure data of primates in Mexico between 2010 and 2019. To do this, we created wildlife detection rates and mortality rates from the existing literature (scientific articles, journalistic articles, and notes) to estimate the number of primates that die during capture, transport, and sale and the number of trafficked primates that were not detected by Mexican authorities. We estimate that 946 primates were removed from the wild for the pet trade each year (spider monkey Ateles geoffroyi = 854; black howler monkeys Alouatta pigra = 38, mantled howler monkey Alouatta palliata = 54). The annual reduction in population size caused by trafficking was greatest for Ateles geoffroyi (2.2%), followed by Alouatta pigra (1.3%), and Alouatta palliata (0.4%). Our estimates show the percentage of impacts that trafficking has on Mexican primate populations. Nevertheless, trade has the potential to impact declining populations and still must be addressed.

Primates Can Be a Rallying Symbol to Promote Tropical Forest Restoration.

With 60% of all primate species now threatened with extinction and many species only persisting in small populations in forest fragments, conservation action is urgently needed. But what type of action? Here we argue that restoration of primate habitat will be an essential component of strategies aimed at conserving primates and preventing the extinctions that may occur before the end of the century and propose that primates can act as flagship species for restoration efforts. To do this we gathered a team of academics from around the world with experience in restoration so that we could provide examples of why primate restoration ecology is needed, outline how primates can act as flagship species for restoration efforts of tropical forest, review what little is known about how primate populations respond to restoration efforts, and make specific recommendations of the next steps needed to make restoration of primate populations successful. We set four priorities: (1) academics must effectively communicate both the value of primates and the need for restoration; (2) more research is needed on how primates contribute to forest restoration; (3) more effort must be put into Masters and PhD level training for tropical country nationals; and finally (4) more emphasis is needed to monitor the responses of regenerating forest and primate populations where restoration efforts are initiated. We are optimistic that populations of many threatened species can recover, and extinctions can be prevented, but only if concerted large-scale efforts are made soon and if these efforts include primate habitat restoration.

Blunt abdominal trauma due to handlebar injury. / Trauma abdominal contuso por golpe con manubrio de bicicleta: Evaluación y tratamiento.

INTRODUCTION: Bicycle accidents are a frequent cause of blunt abdominal trauma in children. In Chile, there are no scientific articles about such accidents, their presentation and management. OBJECTIVE: The aim of this study is to describe three cases of blunt abdominal trauma due to handlebar injury in children, in order to illustrate the different kinds of lesions, their presentation, and management. CLINICAL CASES: 1) 11-year-old boy presented to Emergency Department (ED) after falling on a bi cycle handlebar, hitting his epigastric region. A CT scan showed signs of duodenal perforation. A la parotomy was performed and the duodenal perforation repaired. 2) 14-year-old boy seen at ED after a bicycle accident in which the handlebar hit him in the abdomen area. A CT scan showed a splenic injury with multiple lacerations and active bleeding that was treated with angioembolization. After 6 weeks of follow-up, he presented resolution of the lesion and viability of the spleen. 3) 9-year-old boy admitted due to a hit with the bicycle handlebar on the abdomen area. A CT scan showed a he patic injury that was managed with non-surgical procedures, achieving resolution of the lesion after 8 weeks of follow-up. CONCLUSION: Blunt abdominal trauma caused by handlebar can be potentially serious in pediatric patients, since it may affect solid and hollow abdominal viscera. Non-surgical ma nagement is becoming more used for stable patients, achieving high success rates. Unstable patients or those with suspicion of hollow viscera perforation will require surgery as first approach.

Games academics play and their consequences: how authorship, h-index and journal impact factors are shaping the future of academia.

Research is a highly competitive profession where evaluation plays a central role; journals are ranked and individuals are evaluated based on their publication number, the number of times they are cited and their h-index. Yet such evaluations are often done in inappropriate ways that are damaging to individual careers, particularly for young scholars, and to the profession. Furthermore, as with all indices, people can play games to better their scores. This has resulted in the incentive structure of science increasingly mimicking economic principles, but rather than a monetary gain, the incentive is a higher score. To ensure a diversity of cultural perspectives and individual experiences, we gathered a team of academics in the fields of ecology and evolution from around the world and at different career stages. We first examine how authorship, h-index of individuals and journal impact factors are being used and abused. Second, we speculate on the consequences of the continued use of these metrics with the hope of sparking discussions that will help our fields move in a positive direction. We would like to see changes in the incentive systems, rewarding quality research and guaranteeing transparency. Senior faculty should establish the ethical standards, mentoring practices and institutional evaluation criteria to create the needed changes.

Molecular detection of Bifidobacterium spp. in faeces of black howler monkeys (Alouatta pigra).

BACKGROUND: Bifidobacterium genus are considered to be beneficial bacteria for their hosts; however, knowledge about the specific species that are part of the gut microbiome of howler monkeys is scarce. Polymerase chain reaction (PCR) is a useful technique for the identification of non-cultivable or difficult to grow bacterial species. With the goal of detecting species of the genus Bifidobacterium in black howler monkeys, we used PCR on DNA derived from faecal samples. METHODS: We collected and extracted DNA from 40 faecal samples. Using specific primers, we performed PCR and nested PCR to detect members of the Bifidobacterium genus and a subset of species: Bifidobacterium adolescentis, Bifidobacterium bifidum, Bifidobacterium infantis, Bifidobacterium longum and Bifidobacterium animalis subsp. animalis. RESULTS: 97.5% (39/40) of the samples were positive for Bifidobacterium spp. We found B longum in 100% of the analysed samples. CONCLUSIONS: This is the first report of B longum in black howler monkey faeces.

Prevalence of Refractive Error, Presbyopia, and Spectacle Coverage in Bogotá, Colombia: A Rapid Assessment of Refractive Error.

SIGNIFICANCE: Uncorrected refractive error is the leading cause of visual impairment; therefore, reducing its prevalence is important worldwide. For two decades, there has not been a comprehensive assessment of refractive error in Latin America. PURPOSE: The purpose of this study was to determine the current prevalence of refractive error, presbyopia, spectacle coverage, barriers to uptake refractive services, and spectacle correction in people 15 years and older in Bogotá, Colombia. METHODS: A cross-sectional community-based survey was conducted using 50 randomly selected clusters from 10 districts of Bogotá reflecting the socioeconomic status of the city. Respondents 15 years and older were interviewed and underwent standardized clinical eye examinations. Prevalence of uncorrected refractive error, spectacle coverage, and visual impairment were standardized to 2015 age-sex population distribution of Bogotá and further analyzed. RESULTS: A total of 2886 subjects (90% of 3206 eligible subjects) participated in the study; 39.1% were male and 60.9% were female in the age range of 15 to 96 years, with a median age of 46 years (interquartile range, 45 to 54 years). Age- and sex-standardized prevalence of visual impairment was 19.3% (95% confidence interval [CI], 17.8 to 20.8%). Prevalence of uncorrected refractive error was 12.5% (95% CI, 11.3 to 13.7%). Prevalence of presbyopia among participants 35 years and older was 55.2% (95% CI, 52.9 to 57.4%). Spectacle coverage was 50.9% for distance vision, and it was 33.9% for presbyopia. Main barrier to spectacle uptake was a limitation in affording spectacles because of economic factors (29.5%). CONCLUSIONS: This study provides a current estimate of refractive error using the Rapid Assessment of Refractive Error for Colombia and the Latin American region. The prevalence of uncorrected refractive error and presbyopia was high, and the barriers to spectacle uptake were higher in the lowest socioeconomic strata. The results obtained in the present study will help in making evidence-based decisions related to eye care service delivery in Colombia.

[Differential diagnosis and minimally invasive surgery of an antenatal adrenal mass]. / Diagnóstico diferencial y cirugía mínimamente invasiva de un tumor suprarrenal de hallazgo antenatal.

INTRODUCTION: Adrenal masses are uncommon in newborns. The differential diagnosis includes be nign masses (adrenal hemorrhage, extralobar pulmonary sequestration) and malignant ones (neuro blastoma) that may be a finding during an obstetric ultrasound. The use of complementary imaging methods allows a better diagnosis approach during the postnatal period, with implications for the management of these patients. OBJECTIVE: To report the case of a female newborn with diagnosis of an adrenal mass, and to discuss differential diagnoses and management alternatives of adrenal lesions in newborns. CASE REPORT: Two-month-old female infant, referred for adrenal tumor study diagnosed at 22 weeks gestational age. Postnatal ultrasound showed a tumor compatible with neuroblastoma. The patient was asymptomatic, and the laboratory studies showed no relevant findings. The lesion was excised by laparoscopy. A histological study confirmed pulmonary sequestration. CONCLUSIONS: Extralobar pulmonary sequestration should be considered in the differential diagnosis of an adrenal mass in the newborn. Minimally invasive surgery should be the preferred surgical technique choice in these cases, given the technical feasibility and benefits in the recovery and cosmetic issues of the patient.

Evidence for national universal eye health plans.

Many low- and middle-income countries use national eye-care plans to guide efforts to strengthen eye-care services. The World Health Organization recognizes that evidence is essential to inform these plans. We assessed how evidence was incorporated in a sample of 28 national eye-care plans generated since the Universal eye health: a global action plan 2014-2019 was endorsed by the World Health Assembly in 2013. Most countries (26, 93%) cited estimates of the prevalence of blindness and 18 countries (64%) had set targets for the cataract surgical rate in their plan. Other evidence was rarely cited or used to set measurable targets. No country cited evidence from systematic reviews or solution-based research. This limited use of evidence reflects its low availability, but also highlights incomplete use of existing evidence. For example, despite sex-disaggregated data and cataract surgical coverage being available from surveys in 20 countries (71%), these data were reported in the eye health plans of only nine countries (32%). Only three countries established sex-disaggregated indicators and only one country had set a target for cataract surgical coverage for future monitoring. Countries almost universally recognized the need to strengthen health information systems and almost one-third planned to undertake operational or intervention research. Realistic strategies need to be identified and supported to translate these intentions into action. To gain insights into how a country can strengthen its evidence-informed approach to eye-care planning, we reflect on the process underway to develop Kenya's seventh national plan (2019-2023).

De nombreux pays à revenu faible et intermédiaire ont recours à des plans nationaux de santé oculaire pour guider les actions visant à renforcer les services d'ophtalmologie. L'Organisation mondiale de la Santé reconnaît qu'il est essentiel de disposer de données factuelles pour orienter ces plans. Nous avons évalué la manière dont ces données factuelles ont été intégrées à un échantillon de 28 plans nationaux de santé oculaire, élaborés depuis l'adoption par l'Assemblée Mondiale de la Santé, en 2013, du document Santé oculaire universelle: plan d'action mondial 2014­2019. La plupart des pays (26, soit 93%) ont indiqué utiliser des estimations de la prévalence de la cécité et 18 pays (64%) avaient fixé des objectifs relatifs au taux de chirurgie de la cataracte dans leur plan. D'autres types de données factuelles ont rarement été mentionnés ou utilisés pour définir des objectifs mesurables. Aucun pays n'a mentionné de données issues de revues systématiques ou de recherches fondées sur des solutions. Cette utilisation limitée des données factuelles reflète leur faible accessibilité, mais aussi l'usage incomplet des données existantes. Par exemple, bien que des enquêtes menées dans 20 pays (71%) donnent accès à des données ventilées par sexe et au taux de couverture de la chirurgie de la cataracte, seuls neuf pays (32%) ont reporté ces données dans leur plan de santé oculaire. Seuls trois pays ont mis en place des indicateurs ventilés par sexe et un seul a défini un objectif de couverture de la chirurgie de la cataracte pour en suivre l'évolution. La quasi-totalité des pays a reconnu qu'il était nécessaire de renforcer les systèmes d'information sanitaire et près d'un tiers prévoyait d'entreprendre des recherches opérationnelles ou interventionnelles. Il faudra définir et mettre en œuvre des stratégies réalistes pour passer de l'intention à l'action. Pour en savoir plus sur la manière dont un pays peut renforcer son approche d'élaboration de plans de santé oculaire à partir de données factuelles, nous nous intéressons à l'élaboration, en cours, du septième plan national du Kenya (2019­2023).

Muchos países con ingresos entre bajos y medios utilizan planes nacionales de atención oftalmológica para orientar los esfuerzos a fortalecer los servicios de atención oftalmológica. La Organización Mundial de la Salud reconoce que las pruebas son esenciales para informar a estos planes. Se evaluó cómo se incorporaron las pruebas en una muestra de 28 planes nacionales de atención oftalmológica generados desde que la Asamblea Mundial de la Salud aprobó Universal eye health: a global action plan 2014­2019 (Atención oftalmológica universal: un plan de acción mundial para 2014-2019) en 2013. La mayoría de los países (26, 93 %) citaron estimaciones de la prevalencia de la ceguera y 18 países (64 %) habían establecido metas para la tasa quirúrgica de cataratas en sus planes. Rara vez se citaron o utilizaron otras pruebas para establecer objetivos mensurables. Ningún país citó pruebas de revisiones sistemáticas o investigaciones basadas en soluciones. Este uso limitado de las pruebas refleja su baja disponibilidad, pero también destaca el uso incompleto de las pruebas existentes. Por ejemplo, a pesar de que los datos desglosados por sexo y la cobertura quirúrgica de cataratas están disponibles en las encuestas de 20 países (71 %), estos datos solo se reflejaron en los planes de atención oftalmológica de nueve países (32 %). Solo tres países establecieron indicadores desglosados por sexo y solo un país había establecido una meta para la cobertura quirúrgica de cataratas para el seguimiento futuro. Los países reconocieron casi universalmente la necesidad de fortalecer los sistemas de información sanitaria y casi un tercio tenía previsto realizar investigaciones operacionales o de intervención. Es necesario identificar y apoyar estrategias realistas para convertir estas intenciones en acciones. Para comprender mejor cómo un país puede fortalecer su enfoque basado en pruebas para la planificación de la atención oftalmológica, se ha analizado el proceso en curso para desarrollar el séptimo plan nacional en Kenia (2019-2023).

Salivary tannin-binding proteins are a pervasive strategy used by the folivorous/frugivorous black howler monkey.

Dietary tannins can affect protein digestion and absorption, be toxic, and influence food selection by being astringent and bitter tasting. Animals that usually ingest tannins may regularly secrete tannin-binding salivary proteins (TBSPs) to counteract the negative effects of tannins or TBSPs production can be induced by a tannin-rich diet. In the wild, many primates regularly eat a diet that contains tannin-rich leaves and unripe fruit and it has been speculated that they have the physiological ability to cope with dietary tannins; however, details of their strategy remains unclear. Our research details the salivary protein composition of wild and zoo-living black howler monkeys (Alouatta pigra) feeding on natural versus manufactured low-tannin diets, and examines differences in TBSPs, mainly proline-rich proteins (PRPs), to determine whether production of these proteins is dependent on the tannin content of their food. We measured the pH, flow rate, and concentration of total protein and trichloroacetic acid soluble proteins (an index of PRPs) in saliva. Howler monkeys produced slightly alkaline saliva that may aid in the binding interaction between tannin and salivary proteins. We used gel electrophoresis to describe the salivary protein profile and this analysis along with a tannin-binding assay allowed us to detect several TBSPs in all individuals. We found no differences in the characteristics of saliva between wild and zoo-living monkeys. Our results suggest that black howler monkeys always secrete TBSPs even when fed on foods low in tannins. This strategy of constantly using this salivary anti-tannin defense enables them to obtain nutrients from plants that sometimes contain high levels of tannins and may help immediately to overcome the astringent sensation of their food allowing howler monkeys to eat tanniferous plants.

Prevalence of refractive error and spectacle coverage in schoolchildren in two urban areas of Chile.

OBJECTIVE: To assess the impact of efforts to reduce visual impairment by detecting and treating refractive errors (REs) among schoolchildren in two urban areas of Chile. METHODS: In 2013, in the communities of Concepción and La Florida, we conducted a multicenter, multistage-sampling, cross-sectional study employing methods used by the Refractive Error Study in Children (RESC) survey. Best-corrected visual acuity was assessed using pinhole, with and without glasses. The coverage for correcting visual impairment due to refractive error was estimated. RESULTS: We examined 5 412 schoolchildren, in the communities of Concepción (n = 3 049) and La Florida (n = 2 363). Uncorrected visual acuity (VA) of > 0.63 in at least one eye was found in 4 721 children (87.23%; 95% confidence interval (CI): 86.58%-88.30%). Of the remaining children, 1 017 of them (18.79%; 95% CI: 17.78%-19.80%) had a VA of < 0.5 in at least one eye. Of the 691 children with uncorrected visual impairment with both eyes open (12.77%; 95% CI: 11.9%-13.64%), 476 of them (8.76%; 95% CI: 8.03%-9.49%) achieved normal vision using best possible correction, and with 271 of the 476 (56.93%) having a normal presenting VA in the better eye. CONCLUSIONS: We found an increased coverage of services for RE-associated visual impairment and an increased percentage of children wearing glasses as compared to values reported for La Florida in an article published in 2000. The National Board of School Aid and Scholarships (JUNAEB) in Chile is achieving better results in its schoolchildren eye care program.

Biochemical and hematological evaluations of black howler monkeys (Alouatta pigra) in highly degraded landscapes in Mexico.

BACKGROUND: Loss and fragmentation of Neotropical primates' habitat can alter the health and individual adaptation. Physiological parameters reflect health status and individuals responses to the habitat conditions. METHODS: We captured six wild adult females and six adult males of Alouatta pigra to evaluate their physical condition (body mass, respiratory and heart rate, and rectal temperature), hematology and blood chemistry on fragmentation habitat condition at southeastern Mexico. RESULTS: The males weighed more than females, but the female' temperature, respiratory rate, and heart rate were higher. Low values of hemoglobin, hematocrit, and red blood cells suggest some degree of anemia in these howler monkeys. Low levels of the total protein, albumin, albumin/globulin Ratio, and low levels of blood urea nitrogen suggest that howler monkeys could have protein and carbohydrate deficiencies. CONCLUSIONS: Howler monkeys living under the highly degraded conditions at Balancán, Tabasco, could be showing adaptability by modifying their physiology, hematology, and blood chemistry in response to the conditions of their fragmented landscape.

Through the eyes of children: Drawings as an evaluation tool for children's understanding about endangered Mexican primates.

This study seeks to understand children's perceptions and knowledge of endangered Mexican primates. The black howler monkey (Alouatta pigra) is a charismatic species endemic to Southern Mexico, Northern Belize, and Guatemala and is a symbol of the region that fosters a sense of local pride. Therefore, it can be considered a flagship species for the forests of Southern Mexico. We evaluated the perception and knowledge that 297 Mexican elementary school children (8-10 years old) have about black howler monkeys. Specifically, we analyzed and categorized drawings made by these children based on gender, geographic context (rural or urban), and residence within or outside of Protected Areas (PAs). Student drawings were categorized into three levels of knowledge (no familiarity, basic knowledge, and sophisticated knowledge). Common misconceptions and important landscape elements for black howler conservation were gathered from these visual representations. Children were largely unfamiliar with black howlers, despite sharing the same geographical location. Knowledge was affected by context and residence, with students living within PAs more aware of black howlers than students living outside of PAs. However, overall the children showed a deep understanding of the current forest conservation situation in Southern Mexico; meaning they could be presenting a shifting baseline syndrome. The study highlights the value of assessing children's drawings as a tool that can be used to help policy makers and educational practitioners in fine-tuning educational, environmental, and marketing programs. More importantly, it is a methodology that can be applied in future research for understanding children's perceptions and knowledge about endangered species and environmental change in deciding how to improve the effectiveness of conservation messaging.

Contrasting time-based and weight-based estimates of protein and energy intake of black howler monkeys (Alouatta pigra).

Two methods are commonly used to describe the feeding behavior of wild primates, one based on the proportion of time animals spent feeding on specific plant parts ("time-based" estimates) and one based on estimates of the actual amounts of different plant materials ingested ('"weight-based" estimates). However, studies based on feeding time may not be accurate for making quantitative assessments of animals' nutrient and energy intake. We analyzed the diet of two groups of Alouatta pigra living in forest fragments using two different methods (time- and dry weight-based estimates), to explore how these alternative approaches impact estimates of (a) the contribution of each food type to the diet and (b) the macronutrient composition of the diet, including available protein (AP), non-protein energy (NPE), and total energy (TE) intake. We conducted behavioral observations (N = 658 hr and N = 46 full day focal follows), from August 2012 to March 2013. For each feeding bout, we estimated both time spent feeding and actual fresh- and dry-weight consumption by counting the number of food items ingested during the bout. Using time-based estimates, A. pigra showed a predominantly leaf-based diet. In contrast, weight-based estimates described combined a fruit and leaf-based diet. There were no differences between methods when estimating AP intake; however, we found significant differences while estimating NPE and TE intake. Time-based estimates provide us with important information such as the foraging effort spent on food items, trees, or patches, while weight-based estimates may provide more accurate information concerning nutrient and energy intake. We suggest that quantitative estimates of nutrient intake in a primate's diet be based on observations of wet and/or dry weight actually ingested rather than extrapolated from time spent feeding.

Functional low vision in adults from Latin America: findings from population-based surveys in 15 countries.

OBJECTIVE: To review data on functional low vision (FLV) (low vision-visual acuity (VA) < 6/18 (<20/60) to > perception of light (PL+) in the better eye-that is untreatable and uncorrectable) in adults aged 50 years or older from published population-based surveys from 15 countries in Latin America and the Caribbean. METHODS: Data from 15 cross-sectional, population-based surveys on blindness and visual impairment (10 national and five subnational) covering 55 643 people > 50 years old in 15 countries from 2003 to 2013 were reanalyzed to extract statistics on FLV. Eleven of the studies used the rapid assessment of avoidable blindness (RAAB) method and four used the rapid assessment of cataract surgical services (RACSS) method. For the 10 national surveys, age-and sex-specific prevalence of FLV was extrapolated against the corresponding population to estimate the total number of people > 50 years old with FLV. RESULTS: Age- and sex-adjusted prevalence of FLV in people > 50 years old ranged from 0.9% (Guatemala, Mexico, and Uruguay) to 2.2% (Brazil and Cuba) and increased by age. The weighted average prevalence for the 10 national surveys was 1.6%: 1.4% in men and 1.8% in women. For all 10 national studies, a total of 509 164 people > 50 years old were estimated to have FLV. Based on the 910 individuals affected, the main causes of FLV were age-related macular degeneration (weighted average prevalence of 26%), glaucoma (23%), diabetic retinopathy (19%), other posterior segment disease (15%), non-trachomatous corneal opacities (7%), and complications after cataract surgery (4%). CONCLUSIONS: FLV is expected to rise because of 1) the exponential increase of this condition by age, 2) increased life expectancy, and 3) the increase in people > 50 years old. These data can be helpful in planning and developing low vision services for the region; large countries such as Brazil and Mexico would need more studies. Prevention is a major strategy to reduce FLV, as more than 50% of it is preventable.

A comparative assessment of avoidable blindness and visual impairment in seven Latin American countries: prevalence, coverage, and inequality.

OBJECTIVE: To conduct a comparative analysis of social inequalities in eye health and eye health care and generate baseline evidence for seven Latin American countries as a benchmarking exercise for monitoring progress toward three goals of the regional Plan of Action for the Prevention of Blindness and Visual Impairment: increasing eye health service coverage, minimizing barriers, and reducing eye health-related disease burden. METHODS: Results from cross-sectional eye health surveys conducted in six Latin American countries (Argentina, El Salvador, Honduras, Panama, Peru, and Uruguay) from 2011 to 2013 and recently published national surveys in Paraguay were analyzed. The magnitude of absolute and relative inequalities between countries in five dimensions of eye health across the population gradient defined by three equity stratifiers (educational attainment, literacy, and wealth) were explored using standard exploratory data analysis techniques. RESULTS: Overall prevalence of blindness in people 50 years old and older varied from 0.7% (95% CI: 0.4-1.0) in Argentina to 3.0% (95% CI: 2.3-3.6) in Panama. Overall prevalence of visual impairment (severe plus moderate) varied from 8.0% (95% CI: 6.5-11.0) in Uruguay to 14.3% (95% CI: 13.9-14.7) in El Salvador. The main reported cause of blindness was unoperated cataract and most cases of visual impairment were caused by uncorrected refractive error. Three countries had cataract surgical coverage of more than 90% for blind persons, and two-thirds of cataract-operated patients had good visual acuity. CONCLUSIONS: Blindness and moderate visual impairment prevalence were concentrated among the most socially disadvantaged, and cataract surgical coverage and cataract surgery optimal outcome were concentrated among the wealthiest. There is a need for policy action to increase services coverage and quality to achieve universality.

[National survey of blindness and avoidable visual impairment in Argentina, 2013]. / Encuesta nacional de ceguera y deficiencia visual evitable en Argentina, 2013.

OBJECTIVE: Determine the prevalence of blindness and avoidable visual impairment in Argentina, its causes, the coverage of cataract surgery, and the barriers that hinder access to these services. METHODS: Cross-sectional population study conducted between May and November 2013 using the standard methodology for rapid assessment of avoidable blindness (RAAB), with a random cluster sampling of 50 people aged 50 years or more, -representative of the entire country. Participants' visual acuity (VA) was measured and the lens and posterior pole were examined by direct ophthalmoscopy. An assessment was made of the causes of having VA < 20/60, the coverage and quality of cataract surgery, and the barriers to accessing treatment. RESULTS: 3 770 people were assessed (92.0% of the projected number). The prevalence of blindness was 0.7% (confidence interval of 95%: 0.4-1.0%). Unoperated cataract was the main cause of blindness and severe visual impairment (44.0% and 71.1%, respectively), while the main cause of moderate visual impairment was uncorrected refractive errors (77.8%). Coverage of cataract surgery was of 97.1%, and 82.0% of operated eyes achieved VA ≥ 20/60. The main barriers to receiving this treatment were fear of the surgical procedure or of a poor result (34.9%), the cost (30.2%), and not having access to the treatment (16.3%). CONCLUSIONS: There is a low prevalence of blindness in the studied population and cataract is the main cause of blindness and severe visual impairment. Efforts should continue to extend coverage of cataract surgery, enhance preoperative evaluation, improve calculations of the intraocular lenses that patients need, and correct post-operative refractive errors with greater precision.

Black howler monkey (Alouatta pigra) activity, foraging and seed dispersal patterns in shaded cocoa plantations versus rainforest in southern Mexico.

Recent evidence has shown that primates worldwide use agroecosystems as temporary or permanent habitats. Detailed information on how these primates are using these systems is scant, and yet their role as seed dispersers is often implied. The main objective of this study was to compare the activity, foraging patterns and seed dispersal role of black howler monkeys (Alouatta pigra) inhabiting shaded cocoa plantations and rainforest in southern Chiapas, Mexico. We gathered data on three monkey groups living in shaded cocoa plantations and three groups living in rainforest, using focal sampling, and collecting fecal samples. General activity and foraging patterns were similar in both habitats, with the exception that monkeys in the cocoa habitat spent more time feeding on petioles. Monkeys in shaded cocoa plantations dispersed 51,369 seeds (4% were seeds ≥3 mm width) of 16 plant species. Monkeys in the rainforest dispersed 6,536 seeds (78% were seeds ≥3 mm width) of 13 plant species. Our data suggest that the difference between habitats in the proportion of large versus small seeds dispersed reflects differences in fruit species abundance and availability in cocoa versus forest. Mean seed dispersal distances were statistically similar in both habitats (cocoa = 149 m, forest = 86 m). We conclude that the studied cocoa plantations provide all elements necessary to constitute a long-term permanent habitat for black howler monkeys. In turn, howler monkeys living in these plantations are able to maintain their functional role as seed dispersers for those native tree and liana species present within their areas of activities.

Highly nested diets in intrapopulation monkey-resource food webs.

Recently several studies have focused on the structure of ecological networks to provide insights into ecological and coevolutionary dynamics of interacting species. However, rarely have the tools of ecological networks been used to understand how feeding relationships vary among individuals of the same population. Here we use 7 years of data and network analyzed to examine the intrapopulation diet variation in a group of howler monkeys (Alouatta palliata). We show that individual monkey-resource food webs are nested, but not modular and the stability of these patterns is independent of time of day or season. Our findings indicated that individuals do not forage randomly when compared to null models and that the diets of more selective monkeys represent subsets of the diets of other individuals. Moreover, there are no subgroups that eat a particular set of available plant species more frequently than other sets, suggesting that the spatial strategy of group foraging plays an important role in the feeding ecology of each group given that individuals of the same group tend to share similar resources while the group remains at a feeding site. Since the diets of more selective individuals are a subset of other monkeys, we suggest that more selective monkeys are able to outcompete others for preferred foods. Additionally, we did not observe differences in nutritional content or spatial abundance of more frequently eaten plant species when compared with less frequently eaten species, but in most cases, the more frequently eaten plant species were Ficus (Moraceae). This reinforces the important role that Ficus trees play in howler monkey feeding ecology, likely due to its year-round availability.