Dominant contribution of atmospheric nonlinearities to ENSO asymmetry and extreme El Niño events.

Extreme El Niño events have outsized impacts and strongly contribute to the El Niño Southern Oscillation (ENSO) warm/cold phase asymmetries. There is currently no consensus on the respective importance of oceanic and atmospheric nonlinearities for those asymmetries. Here, we use atmospheric and oceanic general circulation models that reproduce ENSO asymmetries well to quantify the atmospheric nonlinearities contribution. The linear and nonlinear components of the wind stress response to Sea Surface Temperature (SST) anomalies are isolated using ensemble atmospheric experiments, and used to force oceanic experiments. The wind stress-SST nonlinearity is dominated by the deep atmospheric convective response to SST. This wind-stress nonlinearity contributes to ~ 40% of the peak amplitude of extreme El Niño events and ~ 55% of the prolonged eastern Pacific warming they generate until the following summer. This large contribution arises because nonlinearities consistently drive equatorial westerly anomalies, while the larger linear component is made less efficient by easterly anomalies in the western Pacific during fall and winter. Overall, wind-stress nonlinearities fully account for the eastern Pacific positive ENSO skewness. Our findings underscore the pivotal role of atmospheric nonlinearities in shaping extreme El Niño events and, more generally, ENSO asymmetry.

Asociación entre los marcadores lipídicos en la infancia/ adolescencia y los eventos cardiovasculares en la adultez: una revisión sistemática / Association between lipid markers in childhood/ adolescence and cardiovascular events in adulthood: A systematic review

Introducción. La asociación entre los marcadores lipídicos en la infancia/adolescencia y la incidencia de eventos clínicos cardiovasculares en la adultez está poco explorada en la literatura. El objetivo de esta revisión sistemática fue analizar la evidencia disponible sobre este tema. Población y métodos. Esta revisión sistemática se realizó de acuerdo con las guías PRISMA. Se realizó una búsqueda bibliográfica para detectar los estudios que evaluaron la asociación entre los niveles lipídicos en la edad pediátrica y la incidencia de eventos cardiovasculares en la edad adulta. No hubo restricciones idiomáticas ni geográficas en la búsqueda. Resultados. En total, cinco estudios observacionales (todas cohortes prospectivas) que incluyeron 43 540 pacientes fueron identificados y considerados elegibles para este estudio. Cuatro estudios evaluaron el nivel de triglicéridos; todos reportaron una asociación significativa entre este marcador en la edad pediátrica y los eventos cardiovasculares en la adultez. Un estudio reportó la misma asociación con el nivel de colesterol total, mientras que otro evidenció el valor predictivo de la lipoproteína (a) para el mismo desenlace clínico. Un solo estudio evaluó el colesterol asociado a lipoproteínas de alta densidad (C-HDL), sin encontrar una relación con el punto final de interés. El análisis del colesterol asociado a lipoproteínas de baja densidad (C-LDL) arrojó resultados contradictorios, aunque la asociación fue significativa en los estudios con un tamaño muestral más grande y con un mayor número de eventos durante el seguimiento. Conclusión. Los datos de esta revisión sugieren que las alteraciones de los marcadores lipídicos en la infancia y la adolescencia se asocian con un mayor riesgo cardiovascular en la adultez temprana y media.

Introduction. The association between lipid markers in childhood/adolescence and the incidence of clinical cardiovascular events in adulthood has been little explored in the bibliography. The objective of this systematic review was to analyze available evidence on this topic. Population and methods. This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive bibliographic search was done to find studies assessing the association between lipid levels in childhood and the incidence of cardiovascular events in adulthood. There were no language or geographic restrictions. Results. A total of 5 observational studies (all prospective cohorts) including 43 540 patients were identified and considered eligible for this study. Four studies assessed triglyceride levels; all reported a significant association between this lipid marker in childhood and cardiovascular events in adulthood. A study reported the same association with total cholesterol level, while another showed the predictive value of lipoprotein (a) for the same clinical outcome. Only one study assessed high-density lipoprotein cholesterol (HDL-C), but it did not find an association with the endpoint of interest. The analysis of lowdensity lipoprotein cholesterol (LDL-C) showed contradictory results, although the association was significant in the studies with a larger sample size and a higher number of events during follow-up. Conclusion. According to this review, alterations in lipid markers in childhood and adolescence are associated with a higher cardiovascular risk in early and middle adulthood.

Versión argentina de la herramienta de evaluación de la alimentación pediátrica PediEAT / Argentine version of the PediEAT, a pediatric eating assessment tool

Introducción. Durante la infancia, los niños pueden experimentar algún grado de dificultad al comer. Existe una herramienta, desarrollada en Estados Unidos, de evaluación de la alimentación pediátrica (PediEAT), que permite identificar síntomas problemáticos. Objetivo. Realizar una adaptación transcultural para una versión argentina, con adecuación cultural y equivalencia semántica respecto a su versión original. Población y métodos. Se utilizó una versión autoadministrada del PediEAT que fue respondida por familias y/o cuidadores de niños de 6 meses a 7 años. Se realizó una primera fase de evaluación de validez del contenido con un grupo de expertos. Luego, una fase de pretest con familias mediante entrevistas cognitivas para comprobar la comprensión de las palabras y frases. Se realizaron las modificaciones necesarias para que quedara adaptada al contexto. Resultados. En la fase de evaluación de validez del contenido con el grupo de 8 expertos, de los 80 ítems se modificaron 36. En el pretest, se realizaron entrevistas cognitivas a 18 cuidadores; se realizaron cambios en 11 ítems para mejorar la comprensión por parte de la población argentina. La versión argentina fue aprobada por los autores originales. Conclusiones. El instrumento PediEAT versión argentina resulta lingüísticamente equivalente a su versión original, lo que permite su uso para la detección de problemáticas alimentarias en niños.

Introduction. During childhood, children may experience some degree of difficulty eating. A tool (PediEAT) has been developed in the United States and is available to assess pediatric eating and to identify problematic symptoms. Objective. To obtain an Argentine version that is transculturally adapted, culturally adequate, and semantically equivalent to the original version. Population and methods. A self-administered version of the PediEAT was used and completed by families and/or caregivers of children aged 6 months to 7 years. In the first phase, content validity was assessed by a group of experts. This was followed by a pre-test phase with families using cognitive interviews to test word and phrase comprehension. The necessary changes were made to obtain a version adapted to the context. Results. The tool's content validity was assessed by a group of 8 experts; as a result, 36 of the 80 items were changed. During the pre-test phase, cognitive interviews were conducted with 18 caregivers; 11 items were changed to improve comprehension by the Argentine population. The Argentine version was approved by the original authors. Conclusions. The Argentine version of the PediEAT tool is linguistically equivalent to the original version, and this allows its use to screen for feeding problems in children.

Alcohol use among children and adolescents with chronic pain. Scoping review.

AIM: To examine and map alcohol consumption in children and adolescents with chronic pain (CP). METHOD: A scoping review of international databases (CINAHL, WOS, PubMed, PsycINFO, Scopus, Embase, and MEDLINE) and grey literature was conducted between September 2022 and February 2023. Documents addressing the relationship between alcohol consumption and CP in children and adolescents, published in English and Spanish between 2012 and 2023, were included. Those papers with a population suffering from CP derived from neurodegenerative diseases, chronic infectious diseases or cognitive impairment were excluded. We assessed the level of evidence (LE) and the degree of recommendation (DR) of the studies included in accordance with the Scottish Intercollegiate Guidelines Network. Finally, 11 documents were considered out of the 479 reviewed. RESULTS: The relationship between substance consumption and CP in adolescents is a scarcely investigated topic. While there is a trend towards lower rates of alcohol consumption in youth with pain, there is evidence suggesting an association, particularly in cases of intense pain. The use of various substances, both legal and illegal, for pain management underscores the importance of comprehensively addressing this phenomenon in this population. CONCLUSIONS: Further research is needed to assess the relationship between alcohol consumption in children and adolescents with CP.

Investigation of the Correlation between Enterovirus Infection and the Climate Factor Complex Including the Ping-Year Factor and El Niño-Southern Oscillation in Taiwan.

Enterovirus infection and enterovirus infection with severe complications (EVSC) are critical issues in several aspects. However, there is no suitable predictive tool for these infections. A climate factor complex (CFC) containing several climate factors could provide more effective predictions. The ping-year factor (PYF) and El Niño-Southern Oscillation (ENSO) are possible CFCs. This study aimed to determine the relationship between these two CFCs and the incidence of enterovirus infection. Children aged 15 years and younger with enterovirus infection and/or EVSC were enrolled between 2007 and 2022. Each year was categorized into a ping-year or non-ping-year according to the PYF. Poisson regression was used to evaluate the associations between the PYF, ENSO, and the incidence of enterovirus infection. Compared to the ping-year group, the incidence rate of enterovirus infection, the incidence rate of EVSC, and the ratio of EVSC in the non-ping-year group were 1.24, 3.38, and 2.73 times higher, respectively (p < 0.001). For every one-unit increase in La Niña, the incidence rate of enterovirus infection decreased to 0.96 times (p < 0.001). Our study indicated that CFCs could be potential predictors for enterovirus infection, and the PYF was more suitable than ENSO. Further research is needed to improve the predictive model.

Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: results of the ALADINO study.

INTRODUCTION: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6-9 years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics. METHODOLOGY: The analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6-9 years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization and the International Obesity Task Force) and of central obesity, in addition to associated demographic and socioeconomic variables. RESULTS: Between 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8 years (by -5.4%, -5.7% and -5.3%, respectively) and boys whose parents had a higher educational attainment (by -5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable. CONCLUSIONS: The prevalence of overweight and the prevalence of obesity in schoolchildren aged 6-9 years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6-8 years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable.

Climate change reduces long-term population benefits from no-take marine protected areas through selective pressures on species movement.

Marine protected areas (MPAs) are important conservation tools that confer ecosystem benefits by removing fishing within their borders to allow stocks to rebuild. Fishing mortality outside a traditionally fixed MPA can exert selective pressure for low movement alleles, resulting in enhanced protection. While evolving to move less may be useful for conservation presently, it could be detrimental in the face of climate change for species that need to move to track their thermal optimum. Here, we build a spatially explicit simulation model to assess the impact of movement evolution in and around static MPAs resulting from both fishing mortality and temperature-dependent natural mortality on conservation benefits across five climate scenarios: (i) linear mean temperature shift, (ii) El Niño/La Niña conditions, (iii) heat waves, (iv) heatwaves with a mean temperature shift, and (v) no climate change. While movement evolution allows populations within MPAs to survive longer, we find that over time, climate change degrades the benefits by selecting for higher movement genotypes. Resulting population declines within MPAs are faster than expected based on climate mortality alone, even within the largest MPAs. Our findings suggest that while static MPAs may conserve species for a time, other strategies, such as dynamic MPA networks or assisted migration, may also be required to effectively incorporate climate change into conservation planning.

Changes in dinoflagellate and diatom blooms in the East China Sea over the last two decades, under different spatial and temporal scale scenarios.

Frequent algal blooms in the nearshore area of the East China Sea (ECS) pose a serious threat to both the marine environment and human health. Climate and environmental changes play an important role in the occurrence of diatoms and dinoflagellates blooms. Using the MODIS-Aqua 1-km satellite observations, the outbreaks of dinoflagellate and diatom blooms in the ECS coast in summer during 2003-2022 were mapped. Our results found that although the bloom frequency of dinoflagellate was consistently higher than diatoms, its bloom intensity showed a slightly decline trend in recent decades. The driving factors analysis showed that river runoff and sediments discharge played different effect on the formation of diatom and dinoflagellate blooms. Besides, our results compared the effect of El Niño and La Niña on bloom occurrences. This study was supposed to provide detailed insights into algal blooms, with important implications for relevant meteorological and climate changes in coastal regions.

The relationship between parental awareness of sexual abuse and children's skills to say "no".

INTRODUCTION: Child sexual abuse is a global and multidimensional social problem and causes devastating and permanent psychological, emotional, cognitive, behavioural, physical, sexual and interpersonal sequelae. This study examines the relationship between the ability to say "no" and parental awareness of sexual abuse in 4th grade primary school students. METHODS: The study was conducted between April 2022 and June 2022 in primary schools in the central district of a province in north-eastern Turkey. The sample consisted of 310 students enrolled in 4th grade and their parents. We collected the data through a personal information form, the Ability to Say "No" Scale for Children and the Sexual Abuse Awareness Scale for Parents. RESULTS: There was a weak positive correlation between the mean maternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P < .05), as well as a weak positive correlation between the mean paternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P < .05). CONCLUSION: As mothers' and fathers' awareness of sexual abuse myths and of teachings and actions to combat sexual abuse increased, the refusal of children also increased. Also, as fathers' awareness of the signs of sexual abuse increased, children's refusal increased.

Evaluación de la condición física y salud escolar en niños y niñas de la provincia de San Luis, Argentina / Assessment of children's physical fitness and school health in the province of San Luis, Argentina

Introducción. La evaluación de la condición física (CF), junto con otros indicadores de salud, es una estrategia utilizada para conocer el estado actual de los escolares. El principal objetivo fue medir en escolares sanluiseños el estado de salud actual, los niveles de CF y construir tablas de referencias de CF. Población y métodos. Escolares entre 9 y 12 años de edad (ambos sexos) fueron evaluados con dos indicadores de salud: índice de masa corporal y presión arterial. La CF fue medida con la batería ALPHA-Fitness. El orden de las pruebas fue el siguiente: tensión arterial, masa corporal, estatura, longitud de pie y mano, salto en longitud, velocidad en 30 metros, agilidad 4 × 10 m y la prueba de ida y vuelta en 20 metros. Se calculó el índice de masa corporal (IMC) y la maduración biológica. Resultados. Fueron evaluados 15548 escolares. Los valores promedios fueron presión arterial sistólica 101 ± 10 mmHg y diastólica 66 ± 7 mmHg; IMC 20,2 ± 4,3 kg/m2. Para la CF fueron las siguientes: componente cardiorrespiratorio VO2 máx. 39,87 ± 3,2 ml/kg/min y velocidad alcanzada en la prueba de ida y vuelta en 20 m 8,9 ± 0,6 km/h; componente neuromuscular; salto en longitud: 120,6 ± 23,9 cm, velocidad 30 m: 6,56 ± 0,85 s, agilidad 4 × 10 m: 15,17 ± 1,82 s. El rendimiento siempre fue superior en el grupo masculino (p <0,001). Conclusión. Los escolares mostraron niveles saludables de presión arterial. El 50 % de la muestra fue clasificada con sobrepeso u obesidad según el IMC. En ambos sexos, se observaron bajos niveles de CF. Por primera vez, se elaboraron tablas de referencia de CF en escolares sanluiseños

Introduction. The assessment of physical fitness (PF), is useful strategy to know the current status of schoolchildren. Our primary objective was to measure the current health status and PF levels of schoolchildren in San Luis and to develop PF reference tables. Population and methods. Schoolchildren aged 9 to 12 years (boys and girls) were assessed based on 2 health indicators: body mass index and blood pressure. PF was measured using the ALPHA-Fitness test battery. Blood pressure, body mass, height, foot and hand length, standing long jump, 30 m sprint, 4 × 10 m agility test, and 20 m shuttle run test were assessed. The body mass index (BMI) and biological maturation were estimated. Results. A total of 15 548 schoolchildren were assessed. Average systolic blood pressure was 101 ± 10 mmHg and diastolic blood pressure, 66 ± 7 mmHg; BMI: 20.2 ± 4.3 kg/m2. Average PF was, in the cardiorespiratory component, VO2 max.: 39.87 ± 3.2 mL/kg/min and speed reached during the 20 m shuttle run test: 8.9 ± 0.6 km/h; in the musculoskeletal component, standing long jump: 120.6 ± 23.9 cm, 30 m sprint: 6.56 ± 0.85 s, 4 × 10 m agility test: 15.17 ± 1.82 s. The performance was better in the boys group (p < 0.001). Conclusion. Blood pressure was normal. Fifty percent of the sample was overweight or obese as per their BMI. Both boys and girls showed low PF levels. PF reference tables for schoolchildren from San Luis were developed for the first time.

Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia.

Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015-2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012-2014 episode, the episodes of El Niño 2015-2016 and La Niña 2010-2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015-2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015-2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015-2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.

Maternal postnatal depressive symptoms and early achievement of developmental milestones in infants and young children: A meta-analysis.

Screening for social determinants of health, including maternal depression, is a recommended pediatric practice. However, the magnitude of association between maternal and child screening tools remains to be determined. The current study evaluated the association between maternal postnatal depressive symptoms and child developmental milestones, as well as moderators of these associations. A comprehensive search strategy was carried out in four databases (MEDLINE, EMBASE, APA PsycINFO, and Cochrane Central Register of Controlled Trials) from database inception to September 2022. Studies that examine postnatal depressive symptoms and associations with infant and early child (<6 years) achievement of developmental milestones were included. Data were extracted by two independent coders and a random-effects meta-analysis was used to estimate pooled effect sizes and test for moderators. A total of 38 non-overlapping studies (95,897 participants), all focused on maternal postnatal depression, met inclusion criteria. The pooled effect size for the association between postnatal depressive symptoms and early achievement of infant and child developmental milestones (N = 38; r = -.12; 95% CI = -.18, -.06) was small in magnitude. Child age at maternal depression measurement was a moderator, whereby effect sizes became greater for older children. Despite small effects, maternal postnatal depressive symptoms should be included in screening during routine well-child visits to enhance child development outcomes.

El examinar los determinantes sociales de la salud, incluyendo la depresión materna, es una práctica pediátrica recomendada. Sin embargo, la magnitud de la asociación entre las herramientas de examinación materna y del niño está por ser determinada. El presente estudio evaluó la asociación entre los síntomas depresivos postnatales maternos y los momentos cruciales en el desarrollo del niño, así como su papel de moderadores de estas asociaciones. Una estrategia de investigación comprensiva se llevó a cabo en cuatro bancos de datos (MEDLINE, EMBASE, APA PsycINFO, y el Registro Central Cochrane para Ensayos Controlados) desde el inicio del banco de datos hasta septiembre de 2022. Se incluyeron los estudios que examinan los síntomas depresivos postnatales y sus asociaciones con el alcance de logros de momentos cruciales del infante y del niño en su temprana niñez (<6 años). Se extrajeron los datos por medio de dos independientes codificadores y se usó un metaanálisis de efectos al azar para estimar los tamaños de efectos agrupados y examinarlos como moderadores. Un total de 38 estudios que no compartían la misma información (95,897 participantes), todos enfocados en la depresión materna postnatal, reunieron los criterios para ser incluidos. El tamaño de los efectos agrupados para la asociación entre los síntomas depresivos postnatales y el logro temprano de los momentos cruciales del infante y el niño (N = 38; r = -.12; 95% CI = -.18, -.06) fue pequeño en magnitud. La edad del niño en la medida de la depresión materna fue un moderador, por lo cual los tamaños de los efectos se hicieron mayores para los niños de mayor edad. A pesar de los pequeños efectos, los síntomas depresivos postnatales maternos deben ser incluidos en la examinación durante las visitas rutinarias de chequeos del bienestar del niño para mejorar los resultados del desarrollo del niño.

Le dépistage de déterminants sociaux de la santé, y compris la dépression maternelle, est une pratique pédiatrique recommandée. Cependant la magnitude du lien entre les outils de dépistage maternelle et de l'enfant reste indéterminée. Cette étude a évalué le lien entre les symptômes dépressifs postnatals maternels et les jalons du développement de l'enfant, ainsi que les modérateurs de ces liens. Une stratégie de recherche exhaustive a été adoptée pour quatre bases de données (MEDLINE, EMBASE, APA PsycINFO, et Cochrane Central Register of Controlled Trials) des débuts de la base de données jusqu'à septembre 2022. Les études examinant les symptômes dépressifs postnatals et les liens avec l'atteinte des jalons de développement du nourrisson et du petit enfant (<6 ans) ont été inclues. Les données ont été extraites par deux codeurs et une méta-analyse à effets aléatoires a été utilisée afin d'estimer les tailles et tests d'effet regroupées pour les modérateurs. Un total de 38 études ne se recoupant pas (95897 participantes), toutes focalisées sur la dépression maternelle postnatale, ont rempli les critères d'inclusion. La taille d'effet regroupé pour le lien entre les symptômes dépressifs postnatales et l'atteinte précoce des jalons de développement du nourrisson et de l'enfant (N = 38; r = -,12; 95% CI = -,18, -,06) était petite en magnitude. L'âge de l'enfant à la mesure de la dépression maternelle était un modérateur, où l'ampleur de l'effet était plus grande pour les enfants plus âgés. En dépit du peu d'ampleur les symptômes dépressifs postnatals maternels devraient être inclus dans le dépistage durant les visites de routine de santé de l'enfant afin d'améliorer les résultats sur le développement de l'enfant.

Pseudotumor cerebri in the paediatric population: clinical features, treatment and prognosis.

INTRODUCTION: Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. PATIENTS AND METHODS: We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. RESULTS: We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. CONCLUSION: Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients.

Results of the REIV-TOXO national survey on prenatal screening for toxoplasmosis in Spain.

INTRODUCTION: Currently, the status of serological screening for toxoplasmosis in pregnant women in Spain is unknown, and there is no official recommendation. The objective of this study is to show the current practice of gestational screening for toxoplasmosis in hospitals belonging to the Spanish Network for Research on Congenital Toxoplasmosis (REIV-TOXO). METHODS: An electronic survey was sent between April 2021 and September 2021 to investigators from 118 hospitals of REIV-TOXO, representing all Spanish regions. Nine items related to gestational screening for toxoplasmosis were collected. This information was compared with cases of congenital toxoplasmosis (CT) identified in REIV-TOXO to determine if these were diagnosed in the presence of gestational screening. RESULTS: During the study period, serological screening was performed in 53.3% (63/118) hospitals, with variations between regions and even among hospitals within the same region. Testing performed in each trimester was the most common practice (57.7%), followed by a single determination (24.4%). 89.4% of CT cases between January 2015 and September 2021 were diagnosed due to gestational screening. CONCLUSION: The decision to perform gestational screening for toxoplasmosis in Spain is highly heterogeneous, with significant local and regional differences. Despite this, screening still allows the diagnosis of most CT cases. It is urgent to have current epidemiological data to inform decision-making in public health.

Immunisation schedule of the Spanish Association of Pediatrics: 2024 recommendations.

The AEP Immunization Calendar for 2024, with its immunization recommendations for pregnant women, children and adolescents residing in Spain, marks the 25th edition since the first one was introduced in 1995, being annual since 2003, as a vaccination calendar, and since 2023 as immunization schedule due to the inclusion of a monoclonal antibody for the prevention of RSV disease. Novelties for this year include the following: The rest of the recommendations from the previous calendar remain unchanged.

Social support buffers the impact of pregnancy stress on perceptions of parent-infant closeness during the COVID-19 pandemic.

Pregnant individuals and parents have experienced elevated mental health problems and stress during COVID-19. Stress during pregnancy can be harmful to the fetus and detrimental to the parent-child relationship. However, social support is known to act as a protective factor, buffering against the adverse effects of stress. The present study examined whether (1) prenatal stress during COVID-19 was associated with parent-infant closeness at 6 months postpartum, and (2) social support moderated the effect of prenatal stress on the parent-infant relationship. In total, 181 participants completed questionnaires during pregnancy and at 6 months postpartum. A hierarchical linear regression analysis was conducted to assess whether social support moderated the effect of stress during pregnancy on parent-infant closeness at 6 months postpartum. Results indicated a significant interaction between prenatal stress and social support on parents' perceptions of closeness with their infants at 6 months postpartum (ß = .805, p = .029); parents who experienced high prenatal stress with high social support reported greater parent-infant closeness, compared to those who reported high levels of stress and low social support. Findings underscore the importance of social support in protecting the parent-infant relationship, particularly in times of high stress, such as during the COVID-19 pandemic.

Individuos y progenitores en estado de embarazo experimentan elevados problemas de salud mental y estrés durante el COVID-19. El estrés durante el embarazo puede ser dañino para el feto y perjudicial para la relación progenitor-niño. Sin embargo, es sabido que el apoyo social actúa como un factor de protección, sirviendo como agente amortiguador contra los adversos efectos del estrés. El presente estudio longitudinal examinó si 1) el estrés prenatal durante el COVID-19 se asociaba con la cercanía madre-infante a los seis meses después del parto, y 2) el apoyo social moderaba el efecto del estrés prenatal en la relación madre-infante. Un total de 181 participantes completaron cuestionarios durante el embarazo y a los seis meses después del parto. Un análisis de regresión lineal jerárquico se llevó a cabo para evaluar si el apoyo social moderaba el efecto del estrés durante el embarazo en cuanto a la cercanía progenitor-infante a los seis meses después del parto. Los resultados indicaron una interacción significativa entre el estrés prenatal y el apoyo social sobre las percepciones que los progenitores tenían de la cercanía con sus infantes a los seis meses después del parto (ß = .805, p = .029); los progenitores que experimentaron un alto estrés prenatal con un alto apoyo social reportaron una mayor cercanía progenitor-infante, comparados con aquellos que reportaron altos niveles de estrés y bajo apoyo social. Los resultados subrayan la importancia del apoyo social para proteger la relación progenitor-infante, particularmente en épocas de alto estés, tal como durante la pandemia del COVID-19.

Les personnes enceintes et les parents font l'expérience de plus grands problèmes de santé mentale et de plus de stress durant la crise du COVID-19. Le stress durant la grossesse peut être néfaste pour le foetus et vient au détriment de la relation parent-enfant. Cependant l'on sait que le soutien social est un facteur de protection, faisant tampon face aux effets adverses du stress. Cette étude longitudinale a examiné si 1) le stress prénatal durant le COVID-19 était lié à la proximité mère-nourrisson à six mois postpartum, et 2) le soutien social a modéré l'effet du stress prénatale sur la relation mère-nourrisson. En tout 181 participants ont rempli des questionnaires durant la grossesse et à sic mois postpartum. Une analyse de régression linéaire hiérarchique a été faite pour évaluer si le soutien social a modéré l'effet du stress durant la grossesse sur la proximité parent-nourrisson à six mois postpartum. Les résultats ont indiqué une interaction importante entre le stress prénatal et le soutien social sur les perceptions des parents de la proximité avec leurs nourrissons à six mois postpartum (ß = ,805, p = ,029); les parents qui ont fait l'expérience d'un stress prénatal élevé avec un soutien social élevé ont signalé une plus grande proximité parent-nourrisson, comparé à ceux ayant signalé des niveaux de stress élevés et un faible soutien social. Les résultats soulignent l'importance du soutien social dans la protection de la relation parent-nourrisson, particulièrement en temps de stress élevé, comme durant la pandémie de COVID-19.

Testing reliability and validity of practitioner-rated parental sensitivity: A novel tool for practice.

Improving parental sensitivity is an important objective of interventions to support families. This study examined reliability and validity of parental sensitivity ratings using a novel package of an e-learning tool and an interactive decision tree provided through a mobile application, called the OK! package. Independent raters assessed parental sensitivity using the OK! package (N = 11 raters) and the NICHD Parental Sensitivity rating scales (N = 22 raters) on the basis of videotaped mother-child interactions at 10- or 12-months-old (N = 294) and at 24-months-old (N = 204) from the Dutch longitudinal cohort study Generation2 . Mothers reported on children's externalizing and internalizing problems and social competence when children were 4 and 7 years old. Results showed excellent single interrater reliability for raters using the OK! package (mean ICC = .79), and strong evidence for convergent validity at 10- or 12-month-old (r = .57) and 24-month-old (r = .65). Prospective associations of neither parental sensitivity rated using the OK! package or the NICHD Parental Sensitivity rating scales with child developmental outcomes were statistically significant (p > .05), with overlapping 95% confidence intervals for both measures. The OK! package provides a promising direction for testing alternatives to current training and instruction modalities.

Mejorar la sensibilidad de progenitores es un objetivo importante de intervenciones para ayudar a las familias. Este estudio examinó la confiabilidad y validez de los puntajes de sensibilidad de progenitores usando un novedoso paquete de una herramienta de e-aprendizaje y un árbol interactivo de decisión, ofrecido a través de una aplicación móvil llamada ¡Paquete OK! Calificadores independientes evaluaron la sensibilidad de progenitores usando el ¡Paquete OK! (N = 11 calificadores) y las escalas de puntajes de Sensibilidad del Progenitor de NICHD (N = 22 calificadores) sobre la base de las interacciones madre-niño grabadas en video a los 10 o 12 meses de edad (N = 294) y a los 24 meses de edad (N = 204) del grupo holandés de estudio longitudinal Generación 2. Las madres reportaron sobre los problemas de externalización e internalización de los niños y la competencia social cuando los niños tenían 4 y 7 años. Los resultados muestran una excelente sola confiabilidad entre calificadores para los calificadores que usaron el ¡Paquete OK! (media ICC = .79), y una fuerte evidencia para la validez convergente a los 10 o 12 meses de edad (r = .57) y a los 24 meses de edad (r = .65). Las asociaciones probables, ni de la sensibilidad del progenitor evaluada usando el ¡Paquete OK! ni de las escalas de puntajes de Sensibilidad del Progenitor NICHD, con los resultados del desarrollo del niño, fueron estadísticamente significativas (p > .05), con intervalos de confiabilidad que coincidían 95% para ambas medidas. El ¡Paquete OK! Ofrece una prometedora directriz para examinar alternativas al entrenamiento y modalidades de instrucción actuales.

L'amélioration de la sensibilité parentale est un objectif important d'interventions pour soutenir les familles. Cette étude a examiné la fiabilité et la validité de la sensibilité parentale utilisant une nouvelle approche combinant un outil de formation en ligne et un arbre de décision interactif offert au travers d'une application mobile, appelée l'approche OK!. Des évaluateurs indépendants ont évalué la sensibilité parentale en utilisant l'approche OK! (N = 11 évaluateurs) et les échelles d'évaluation de le sensibilité parentale NICHD (N = 22 évaluateurs) sur la base d'interactions mère-enfant filmées à la vidéo à 10- ou 12 mois N = 294) et à 24 mois (N-204) de l'étude de cohorte longitudinale hollandaise Generation2. Les mères ont signalé les problèmes d'externalisation et d'internalisation des enfants et leur compétence sociale lorsque les enfants avaient 4 et 7 ans. Les résultats ont démontré une excellente fiabilité entre les évaluateurs pour les évaluateurs utilisant l'approche OK! (moyenne ICC = ,79(, et de fortes preuves d'une validité convergente à 10 ou 12 mois (r = ,57) et à 24 mois (r = ,65). Les associations prospectives d'aucune sensibilité parentale évaluée en utilisant l'approche OK! ou les échelles d'évaluation de la sensibilité parentale NICHD ave des résultats développementaux de l'enfant étaient statistiquement significatives (p . ,05) avec un chevauchement des intervalles de confiance de 95% pour les deux mesures. L'approche OK! offre une direction prometteuse d'alternatives des tests aux modalités de formation et d'instruction actuelles.

Cross-scale assessments of the impacts and resilience of subtropical montane cloud forests to chronic seasonal droughts and episodic typhoons.

Montane cloud forests (MCFs) are ecosystems frequently immersed in fog and are vital for the terrestrial hydrological cycle and biodiversity hotspots. However, the potential impacts of climate change, particularly intensified droughts and typhoons, on the persistence of ecosystems remain unclear. Our study conducted cross-scale assessments using 6-year (2016-2021) ground litterfall and 21-year (2001-2021) satellite greenness data (the Enhanced Vegetation Index [EVI] and the EVI anomaly change [ΔEVI% ]), gross primary productivity anomaly change (ΔGPP% ), and meteorological variables (the standardized precipitation index [SPI] and wind speed). We found a positive correlation between summer EVI and ΔGPP% with the SPI-3 (3-month time scale), while winter litterfall showed a negative correlation. Maximum typhoon daily wind speed was negatively correlated with summer and the monthly ΔEVI% and ΔGPP% . These findings suggest vegetation damage and productivity loss were related to drought and typhoon intensities. Furthermore, our analysis highlighted that chronic seasonal droughts had more pronounced impacts on MCFs than severe typhoons, implying that high precipitation and frequent fog immersion do not necessarily mitigate the ramifications of water deficit on MCFs but might render MCFs more sensitive and vulnerable to drought. A significant negative correlation between the summer and winter ΔEVI% and ΔGPP% of the same year, suggesting disturbance severity during summer may facilitate vegetation regrowth and carbon accumulation in the subsequent winter. This finding may be attributed to the ecological resilience of MCFs, which enables them to recover from the previous summer. In the long-term, our results indicated an increase in vegetation resilience over two decades in MCFs, likely driven by rising temperatures and elevated carbon dioxide levels. However, the enhancement of resilience might be overshadowed by the potential intensified droughts and typhoons in the future, potentially causing severe damage and insufficient recovery times for MCFs, thus raising concerns about uncertainties regarding their sustained resilience.

Gamification and neurological motor rehabilitation in children and adolescents: a systematic review.

INTRODUCTION: Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS: We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS: From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1). CONCLUSION: The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.

Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia

Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015–2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012–2014 episode, the episodes of El Niño 2015–2016 and La Niña 2010–2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015–2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015–2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015–2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.