Self-Healing Juvenile Cutaneous Mucinosis: A Report of Two Cases With Differing Evolution.

ABSTRACT: Self-healing juvenile cutaneous mucinosis is a rare entity, characterized by the presence of subcutaneous nodules together with frequent nonspecific systemic symptoms, which occurs in the pediatric age and characteristically resolves spontaneously. Although the diagnostic criteria do not require a biopsy to be performed, it is frequently performed, and an abundant dermal mucin deposition will be observed together with other features such as fibroblastic proliferation. Although the prognosis is benign, follow-up is required for the eventual development of a rheumatologic disease.We present 2 clinical cases, describing the clinical findings and their histopathologic correlation. Comparatively, the outcome in both cases was different: in one case, the mucinosis resolved without any related event in the follow-up, and in the other case, the resolution was accompanied by the subsequent development of idiopathic juvenile arthritis.

Clinical, histopathologic, immunohistochemical, and electron microscopic findings in cutaneous monkeypox: A multicenter retrospective case series in Spain.

BACKGROUND: The worldwide outbreak of monkeypox has evidenced the usefulness of the dermatologic manifestations for its diagnosis. OBJECTIVE: To describe the histopathologic and immunohistochemical findings of monkeypox cutaneous lesions. METHODS: This is a retrospective histopathologic and immunohistochemical study of 20 patients with positive Monkeypox virus DNA polymerase chain reaction and immunohistochemical positivity for Vaccinia virus in cutaneous lesions. Four cases were also examined by electron microscopy. RESULTS: The most characteristic histopathologic findings consisted of full-thickness epidermal necrosis with hyperplasia and keratinocytic ballooning at the edges. In some cases, the outer root sheath of the hair follicle and the sebaceous gland epithelium were affected. Intraepithelial cytoplasmic inclusion bodies and scattered multinucleated keratinocytes were occasionally found. Immunohistochemically, strong positivity with anti-Vaccinia virus antibody was seen in the cytoplasm of ballooned keratinocytes. Electron microscopy study demonstrated numerous viral particles of monkeypox in affected keratinocytes. LIMITATIONS: Small sample size. Electron microscopic study was only performed in 4 cases. CONCLUSION: Epidermal necrosis and keratinocytic ballooning are the most constant histopathologic findings. Immunohistochemical positivity for Vaccinia virus was mostly detected in the cytoplasm of the ballooned keratinocytes. These findings support the usefulness of histopathologic and immunohistochemical studies of cutaneous lesions for diagnosis of monkeypox.

Monkeypox outbreak in Spain: clinical and epidemiological findings in a prospective cross-sectional study of 185 cases.

BACKGROUND: Since May 2022, a new outbreak of monkeypox has been reported in several countries, including Spain. The clinical and epidemiological characteristics of the cases in this outbreak may differ from those in earlier reports. OBJECTIVES: To document the clinical and epidemiological characteristics of cases of monkeypox in the current outbreak. METHODS: We conducted a prospective cross-sectional study in multiple medical facilities in Spain to describe the cases of monkeypox in the 2022 outbreak. RESULTS: In total, 185 patients were included. Most cases started with primarily localized homogeneous papules, not pustules, in the probable area of inoculation, which could be cutaneous or mucous, including single lesions. Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms. Less common lesions included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Four patients were hospitalized, none died. Smallpox vaccination and well-controlled HIV disease were not associated with markers of severity. Contact during sex is the most likely mechanism of transmission. In this outbreak, cases have been described in men who have sex with men and are strongly associated with high-risk sexual behaviours. Seventy-six per cent of the patients had other sexually transmitted diseases upon screening. CONCLUSIONS: The clinical findings in this outbreak differ from previous findings and highly suggest contact transmission and initiation at the entry site. The characterization of the epidemiology of this outbreak has implications for control. What is already known about this topic? Monkeypox eruption is described as consisting of pustules. The roles of HIV and previous smallpox vaccination in the prognosis are unknown. The transmission route was initially described as respiratory droplets and was later suggested to be via sexual contact. What does this study add? Initial lesions at the probable inoculation area were homogeneous and papular (pseudopustules). Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms. Less common signs included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Well-controlled HIV and previous smallpox vaccination were not associated with severity. No patient died. The data support the hypothesis of transmission via contact during sex. Although this might change, the outbreak is currently limited mostly to men who have sex with men, with high-risk factors for sexually transmitted diseases.

The Development of Teachers' and Their Students' Social and Emotional Learning During the "Learning to Be Project"-Training Course in Five European Countries.

In recent years, the school curricula in many European countries have introduced social and emotional learning (SEL). This calls for the teachers to have SEL competencies. The present study evaluates teachers' and their students' readiness for SEL during an intervention in five European countries. The participants were teachers (n = 402) in five European countries; Italy, Latvia, Lithuania, Slovenia, and Spain. The pre- and post-measuring points for both the intervention and the comparison group were at approximately the same time before and after the intervention. Comparison data consisted of 159 teachers in the same countries. The training for the intervention group lasted 16 h for the teachers and a maximum of 16 h for the principles and headmasters. An additional 9 h of further monitoring took place. There were two student groups participating in the study: the age group of 8-11 years (pre puberty) and the age group of 12-15-years (adolescents). Students, whose teachers had participated in the intervention, formed the intervention group (n = 2,552). Those students, whose teachers did not participate in the intervention, formed the comparison group (n = 1,730). The questionnaire data were collected at the beginning and at the end of the school year for both age groups. The results indicated that there was a favorable development in the intervention group in some of the measured skills among students, but the effects were different for the two age groups. This study adds to both theoretical and practical development of continuing teacher training about SEL and its possible role in reducing problem behavior among the students.

Arousing the Sound: A Field Study on the Emotional Impact on Children of Arousing Sound Design and 3D Audio Spatialization in an Audio Story.

Sound from media increases the immersion of the audience in the story, adding credibility to the narration but also generating emotions in the spectator. A study on children aged 9-13 years (N = 253), using an audio story, investigated the emotional impact of arousal vs. neutral treatment of sound and 3D vs. stereo mix spatialization. The emotional impact was measured combining three different measures: physiological (Electrodermal activity), self-report (pre-post exposition), and richness of mental images elicited by the story (using Think-aloud technique after exposition). Results showed higher emotional impact of the arousal and 3D audio conditions with different patterns according to the age of the participants and distinctive types of interaction when both variables were combined.

Social and Emotional Competences in Spain: A Comparative Evaluation Between Spanish Needs and an International Framework Based on the Experiences of Researchers, Teachers, and Policymakers.

Critical aspects in the field of education are currently related to low levels of socioemotional competences and high rates of school dropouts. However, there are no standard practices or guidelines for helping countries to assess and train social and emotional competences. To overcome this limitation, the project Learning to be (L2B) aims to propose a comprehensive model of the assessment and development of social and emotional competences that bring together policymakers, researchers, teachers, school authorities and learners from different participating countries: Finland, Italy, Latvia, Lithuania, Portugal, Slovenia, and Spain. The project attempts to create an international framework for regulating activities and supporting teachers working on the social and emotional competences of the students and to provide tools which can be used across countries. The aim of the paper is to describe how L2B has been developed in Spain by analyzing the contributions of the international framework and extracting the specific needs in the Spanish context. Specifically, we describe two products of the project: (a) the process for creating a toolkit, a tool focused on creating activities and materials for helping teachers develop social and emotional competences of students and (b) the results of an exploratory study in Spain in which social and emotional competences are assessed and compared to the international framework. First, we explain the definition of social and emotional competences used for creating the toolkit. Second, we analyze responses of Spanish students to questionnaires administered before applying the toolkit in the schools. The paper describes social and emotional competences in Spain and evaluates the overlap between relevant variables in Spain and those used for developing the toolkit, the international tool. Specific needs in Spain are discussed, as well as the contribution of the project for promoting the improved development of students' social and emotional competences, improving learning outcomes and stronger social cohesion in schools and local communities, as well as the utility of the results for creating new educational policies.