Food-grade titanium dioxide (E171) and zinc oxide nanoparticles induce mitochondrial permeability and cardiac damage after oral exposure in rats.

Food-grade titanium dioxide (E171) and zinc oxide nanoparticles (ZnO NPs) are found in diverse products for human use. E171 is used as whitening agent in food and cosmetics, and ZnO NPs in food packaging. Their potential multi-organ toxicity has raised concerns on their safety. Since mitochondrial dysfunction is a key aspect of cardio-pathologies, here, we evaluate the effect of chronic exposure to E171 and ZnO NPs in rats on cardiac mitochondria. Changes in cardiac electrophysiology and body weight were measured. E171 reduced body weight more than 10% after 5 weeks. Both E171 and ZnO NPs increased systolic blood pressure (SBP) from 110-120 to 120-140 mmHg after 45 days of treatment. Both NPs altered the mitochondrial permeability transition pore (mPTP), reducing calcium requirement for permeability by 60% and 93% in E171- and ZnO NPs-exposed rats, respectively. Treatments also affected conformational state of adenine nucleotide translocase (ANT). E171 reduced the binding of EMA to Cys 159 in 30% and ZnO NPs in 57%. Mitochondrial aconitase activity was reduced by roughly 50% with both NPs, indicating oxidative stress. Transmission electron microscopy (TEM) revealed changes in mitochondrial morphology including sarcomere discontinuity, edema, and hypertrophy in rats exposed to both NPs. In conclusion, chronic oral exposure to NPs induces functional and morphological damage in cardiac mitochondria, with ZnO NPs being more toxic than E171, possibly due to their dissociation in free Zn2+ ion form. Therefore, chronic intake of these food additives could increase risk of cardiovascular disease.

Retiro de dispositivo de oclusión septal transcateterismo en una paciente con comunicación interventricular / Removal of Transcatheter Septal Occlusion Device in a Patient with Ventricular Septal Defect

Introducción: Las complicaciones asociadas al procedimiento de colocación de un dispositivo de oclusión septal se presentan en menos del 10 por ciento de los casos. La embolización requiere de cirugía cardíaca, por lo que se incrementa el riesgo de la mortalidad. Objetivo: Presentar el caso en una paciente con comunicación interventricular e hipertensión pulmonar severa que se le retiró el dispositivo de oclusión septal transcateterismo. Presentación de caso: Se presentó una mujer de 24 años de edad con comunicación interventricular, insuficiencia cardíaca (New York Heart Association) clase IV e hipertensión pulmonar tipo 2, que se programó para la colocación de dispositivo de oclusión septal, sin embargo, presentó fallo en la colocación del dispositivo y defecto residual de 7 mm, por lo que se realizó el retiro de este 48 h después sin presentar complicaciones. Conclusiones: Aunque el cierre transcateterismo de la comunicación interventricular es una alternativa segura y efectiva a la cirugía, no está exento de complicaciones. En caso de translocación del dispositivo de oclusión septal este debe ser retirado durante el mismo procedimiento, ya que el riesgo de embolización es elevado y en caso de presentarse, el riesgo de muerte se incrementa(AU)

Introduction: Complications associated with the placement procedure of a septal occlusion device occur in less than 10percent of cases. Embolization requires cardiac surgery, which increases the risk of mortality. Objective: To report the case of a patient with ventricular septal defect and severe pulmonary hypertension who had the transcatheter septal occlusion device removed. Case report: We report the case report of a 24-year-old woman with ventricular septal defect, heart failure (New York Heart Association) class IV and type 2 pulmonary hypertension. She was scheduled for placement of a septal occlusion device, however, the placement of the device failed and had a residual defect of 7 mm, so the placement was removed 48 hours later without complications. Conclusions: Although transcatheter closure of the ventricular septal defect is a safe and effective alternative to surgery, it is not free of complications. In case of translocation of the septal occlusion device, it must be removed during the same procedure, since the risk of embolization is high and if it occurs, the risk of death increases(AU)

Relationships between Math Skills, Motor Skills, Physical Activity, and Obesity in Typically Developing Preschool Children.

There is evidence of a relationship between motor and cognitive development. The literature has shown that of all the motor skills, fine motor skills are those that contribute most to mathematical performance in preschool children. As this is a sensitive period in the development of motor skills, low levels of physical activity in this period can compromise their development and contribute to weight gain and obesity. The aim of this study was therefore to analyze the relationship between mathematical and motor skills, physical activity levels, and obesity. The sample consisted of 62 preschool children (32 males) with an average age of 4.63 ± 0.81. The Weschler preschool and primary scale of intelligence-revised arithmetic test was used to assess mathematical skills. The tests to assess fine motor skills were the "Adapted Threading Beads Test" and the "Adapted Visuomotor Integration Test". The movement assessment battery for children-2, band 1, "Aiming & Catching", and "Balance" tests were used to assess gross motor skills. Levels of physical activity were assessed using the "Preschool-age physical activity questionnaire" and obesity using the body mass index. The results indicated that only the fine motor skills of visuomotor integration were included in the multiple linear regression model (F < 0.001; r = 0.464; R2 = 0.215; p < 0.001), with the exclusion of gross motor skills, physical activity levels, and obesity levels. Thus, it was concluded that mathematical skills were only directly and significantly influenced by visuomotor integration. However, visuomotor integration was positively and significantly associated with gross motor skills (r = 0.269; p < 0.05) and not with levels of physical activity and obesity. Thus, gross motor skills could contribute to improving visuomotor integration directly and consequently mathematical skills indirectly. The results of this study suggest that the implementation of structured physical activity programs can contribute to mathematical performance.

Retrospective analysis of outcomes for pediatric acute lymphoblastic leukemia in South American centers.

Introduction: Acute lymphoblastic Leukemia (ALL) is the most common pediatric malignancy. While the survival rate for childhood ALL exceeds 90% in high-income countries, the estimated survival in low-and middle-income countries ranges from 22-79%, depending on the region and local resources. Methods: This study retrospectively reviewed demographic, biological, and clinical parameters of children under 18 years of age with newly diagnosed ALL presenting between 2013-2017 across five pediatric centers in 4 countries in South America. Survival analyses were estimated using the Kaplan-Meier method. Results: Across the five centers, 752 patients were analyzed (Bolivia [N=9], Ecuador [N=221], Paraguay [N=197], Peru [N=325]) and 92.1% (n=690) patients were diagnosed with B-cell and 7.5% (n= 56) with T-cell ALL. The median age was 5.5 years old (IQR 7.29). At diagnosis, 47.8% of patients were categorized as standard and 51.9% as high risk per their institutional regimen. Advanced diagnostics availability varied between modalities. MRD was evaluated in 69.1% of patients; molecular testing was available for ETV6-RUNX, BCR-ABL1, TCF3-PBX1, and KMT2A-rearranged ALL in 75-81% of patients; however, karyotyping and evaluation for iAMP21 were only performed in 42-61% of patients. Central nervous system (CNS) involvement was evaluated at diagnosis in 57.3% (n=429) patients; of these, 93.7% (n=402) were CNS 1, 1.6% (n=7) were CNS 2, 0.7% (n=11) were CNS3, 1.9% (n=8) had cranial nerve palsy, and 2.1% (n=9) results unavailable. Chemotherapy delays >2 weeks were reported in 56.0% (n=421) patients during treatment. Delays were attributed to infection in 63.2% (n=265), drug-related toxicities in 47.3% (n=198), and resource constraints, including lack of bed availability in 23.2% (n=97) of patients. The 3-year Abandonment-sensitive EFS and OS were 61.0±1.9% and 67.2±1.8%, respectively. The 3-year EFS and OS were 71.0±1.8% and 79.6±1.7%, respectively. Discussion: This work reveals opportunities to improve survival, including addressing severe infections, treatment interruptions, and modifications due to drug shortages. In 2018, healthcare professionals across South America established the Pediatric Oncology Latin America (POLA) group in collaboration with St. Jude Children's Research Hospital. POLA collaborators developed an evidence-based, consensus-derived, adapted treatment guideline, informed by preliminary results of this evaluation, to serve as the new standard of care for pediatric ALL in participating institutions.

Multifaceted Shape Memory Polymer Technology for Biomedical Application: Combining Self-Softening and Stretchability Properties.

Thiol-ene polymers are a promising class of biomaterials with a wide range of potential applications, including organs-on-a-chip, microfluidics, drug delivery, and wound healing. These polymers offer flexibility, softening, and shape memory properties. However, they often lack the inherent stretchability required for wearable or implantable devices. This study investigated the incorporation of di-acrylate chain extenders to improve the stretchability and conformability of those flexible thiol-ene polymers. Thiol-ene/acrylate polymers were synthesized using 1,3,5-triallyl-1,3,5-triazine-2,4,6(1H,3H,5H)-trione (TATATO), Trimethylolpropanetris (3-mercaptopropionate) (TMTMP), and Polyethylene Glycol Diacrylate (PEGDA) with different molecular weights (Mn 250 and Mn 575). Fourier Transform Infrared (FTIR) spectroscopy confirmed the complete reaction among the monomers. Uniaxial tensile testing demonstrated the softening and stretching capability of the polymers. The Young's Modulus dropped from 1.12 GPa to 260 MPa upon adding 5 wt% PEGDA 575, indicating that the polymer softened. The Young's Modulus was further reduced to 15 MPa under physiologic conditions. The fracture strain, a measure of stretchability, increased from 55% to 92% with the addition of 5 wt% PEGDA 575. A thermomechanical analysis further confirmed that PEGDA could be used to tune the polymer's glass transition temperature (Tg). Moreover, our polymer exhibited shape memory properties. Our results suggested that thiol-ene/acrylate polymers are a promising new class of materials for biomedical applications requiring flexibility, stretchability, and shape memory properties.

A Deep Learning Neural Network to Classify Obesity Risk in Portuguese Adolescents Based on Physical Fitness Levels and Body Mass Index Percentiles: Insights for National Health Policies.

The increasing prevalence of overweight and obesity among adults is a risk factor for many chronic diseases and death. In addition, obesity among children and adolescents has reached unprecedented levels and studies show that obese children and adolescents are more likely to become obese adults. Therefore, both the prevention and treatment of obesity in adolescents are critical. This study aimed to develop an artificial intelligence (AI) neural network (NNET) model that identifies the risk of obesity in Portuguese adolescents based on their body mass index (BMI) percentiles and levels of physical fitness. Using datasets from the FITescola® project, 654 adolescents aged between 10-19 years old, male: 334 (51%), female: n = 320 (49%), age 13.8 ± 2 years old, were selected to participate in a cross-sectional observational study. Physical fitness variables, age, and sex were used to identify the risk of obesity. The NNET had good accuracy (75%) and performance validation through the Receiver Operating Characteristic using the Area Under the Curve (ROC AUC = 64%) in identifying the risk of obesity in Portuguese adolescents based on the BMI percentiles. Correlations of moderate effect size were perceived for aerobic fitness (AF), upper limbs strength (ULS), and sprint time (ST), showing that some physical fitness variables contributed to the obesity risk of the adolescents. Our NNET presented a good accuracy (75%) and was validated with the K-Folds Cross-Validation (K-Folds CV) with good accuracy (71%) and ROC AUC (66%). According to the NNET, there was an increased risk of obesity linked to low physical fitness in Portuguese teenagers.

Preliminary Adaptation of Motor Tests to Evaluate Fine Motor Skills Associated with Mathematical Skills in Preschoolers.

Mathematics is the subject in which many school-age children reveal difficulties. The literature has shown that fine motor skills, namely fine motor coordination and visuomotor integration, have been more robustly associated with mathematical performance. Studies have shown the importance that instruments have to evaluate these skills, however, the characteristics of these instruments do not fit the reality of kindergartens, they are usually time consuming and expensive and are usually administered by specialists. Thus, the main objective of this study was to identify, select, adapt and validate motor tests to evaluate fine motor skills associated with mathematical skills to allow the kindergarten teachers to apply them simultaneously to the class, with few material resources, in a short period of time and without the need for a lot of training to apply, score and classify. For this purpose, firstly, it was necessary to understand the main difficulties highlighted by kindergarten teachers regarding the use of instruments to evaluate fine motor skills and, thus, elaborate criteria to identify and select the tests that best fit the reality of kindergartens. The test identified, selected and adapted to evaluate fine motor coordination was threading beads from the Movement Evaluation Battery for Children, 2nd Edition. The main adaptation of the test was related to time, that is, instead of counting the time it takes the child to string the total number of cubes on the string, we counted the number of cubes the child strung on the string in a pre-defined time. To evaluate visual-motor integration, the test identified, selected and adapted was the Visual-Motor Integration (6th Edition) test. The main adaptation was related to material resources, that is, it will be possible to apply the test using only one sheet per child instead of the seven suggested by the original test. After the preliminary adaptation of the tests, their validation was performed by means of the degree of reliability (test-retest) and predictive validity. The results indicated that the adapted tests presented an excellent degree of reliability (>0.9) and could therefore be used to administer them simultaneously to the class group. The adapted Visual-Motor Integration test seems to be the most suitable one to be used by kindergarten teachers, in a classroom context, to simultaneously evaluate students' fine motor skills and associate their results with mathematical skills.

Obesity Status and Physical Fitness Levels in Male and Female Portuguese Adolescents: A Two-Way Multivariate Analysis.

Obesity and decreasing fitness levels among the youth are growing concerns in Portugal, similar to other developed countries, with implications for health and psychomotor development. Understanding the influence of health determinants such as sex and age are crucial for developing effective public health strategies. This study aimed to analyze the association between sex and chronological age with obesity status and physical fitness in Portuguese adolescents. A total of 170 adolescents (85 males and 85 females) were evaluated for body mass index, abdominal adiposity, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed in a 40 m sprint using the FITescola® physical fitness battery, a Portuguese government initiative. The general model, analyzed using Pillai's trace, showed a significant effect of age and sex on body mass index, abdominal circumference, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed (V = 0.99, F (7) = 10,916.4, p < 0.001, partial η2, sex = 0.22; age = 0.43, sex and age interaction = 0.10). Boys had higher physical fitness levels than girls in most tests, but both sex groups had a significantly higher proportion of non-fit adolescents, with boys showing the highest number of participants classified as non-fit.

Association between motor and math skills in preschool children with typical development: Systematic review.

Mathematics has been the subject in which many school-age children have revealed many difficulties. Research carried out in an attempt to understand the causes of failure in this area pointed to a positive association between mathematical performance and motor performance. Given the importance of math development in future school outcomes, knowing which specific motor components are most associated with math performance can help educators define better strategies for teaching mathematics. In this sense, the present systematic review study aimed to identify the components of motor skills most positively associated with mathematical performance in children with typical development who attend preschool. The PRISMA methodology (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used in this study. The databases searched were ERIC, PubMED, SciELO, Scopus and Web of Science. A total of 2,909 articles were identified, of which 18 were included in this systematic review. The main results showed positive associations between fine motor skills, namely fine motor coordination and visuomotor integration, and mathematical performance. The math skill of numerical counting was the most associated with FMS. The main characteristics of the instruments used showed that the tasks of copying figures or drawings are the most used to assess visuomotor integration and the tasks of handling objects with pinch-like movements are the most used to assess fine motor coordination. Given the importance of mathematical performance in future school results, identifying early children with difficulties in fine motor skills will help educators to design better strategies for teaching mathematical skills. In this sense, the need to identify instruments to assess fine motor skills in preschool children with characteristics that facilitate their administration by the educator in the classroom context, i.e., requiring little administration time, not requiring much experience or training, the possibility of being administered to the group/class, few material resources, and the results can be easily interpreted, classified, and associated with mathematical performance.

Acute Hepatitis of Unknown Origin in Children: Two Cases in a Portuguese Hospital.

Several cases of paediatric acute hepatitis of an unknown aetiology have been described in these last few months and in several countries worldwide. We present two patients, a 7-month-old girl and an 8-year-old boy, with gastrointestinal symptoms and lethargy, associated with elevation of transaminase levels. Serologies for hepatitis A-E virus and PCR test to SARS-CoV-2 were all negative. In the first case, an adenovirus serotype C could be isolated in a respiratory sample as well as cytomegalovirus (CMV) in the blood (100 copies/mL). In both children, there was a progressive decrease in the hepatic markers and symptomatic resolution, compatible with a good prognosis, also seen globally in most cases. To date, infection remains the most plausible cause to consider, especially when it is presumed to be linked to adenovirus. Other potential agents and causes are still being evaluated, thus emphasizing the importance of continuous epidemiological surveillance, notification, and detailed study of all hepatitis cases.

The Influence of Abdominal Adiposity and Physical Fitness on Obesity Status of Portuguese Adolescents.

The aim of this study was to verify the relationship between abdominal adiposity and physical fitness in the obesity status of Portuguese adolescents. BMI, abdominal adiposity, and physical fitness tests from the FITescola® were evaluated in a total of 654 Portuguese adolescents, aged 10-19 years old-male: n = 334 (51%), female: n = 320 (49%). For the final model, BMI was positively related with age (ß = 0.25), abdominal adiposity (ß = 0.313), horizontal jump (ß = -0.100), 40 m maximal velocity (ß = 0.274), and aerobic fitness (ß = -0.250, R2 = 0.75, F = 382.2, and p = 0.0001). We conclude that higher age and abdominal adiposity are positively related with a higher adolescent BMI. Furthermore, lower horizontal jump distances and worse times on the 40 m maximal velocity were inversely related with a higher adolescent BMI, and lower aerobic fitness was inversely related with a higher adolescent BMI.

"Community engagement via restorative justice to build equity-oriented crisis standards of care".

The COVID-19 (SARS-CoV-2) Pandemic has revealed multiple structural inequities within the United States (US), with high social vulnerability index communities shouldering the brunt of death and disability of this pandemic. BIPOC/Latinx people have undergone hospitalizations and death at magnitudes greater than White people in the US. The untold second casualties are health care workers that are suffering from increased risk of infection, death, and mental health crisis. Many health care workers are abandoning the profession all together. Although Crisis Standards of Care (CSC) mean to guide the ethical allocation of scare resources, they frequently use scoring systems that are inherently biased. This raises concern for the application of equity in CSC. Data examining the impact of these protocols on health equity is scarce. Structural maltreatment in healthcare and inequities have led to cumulative harms, physiologic weathering and structural adversities for residents of the US. We propose the use of Restorative Justice (RJ) practices to develop CSC rooted in inclusion and equity. The RJ framework utilizes capacity building, circle process, and conferences to convene groups in a respectful environment for dialogue, healing, accountability, and action plan creation. A phased, non-faith-based facilitated RJ approach for CSC development (or revision) that fosters ethically equitable resource distribution, authentic community engagement, and accountability is shared. This opportunity for local, inclusive decision making and problem solving will both reflect the needs and give agency to community members while supporting the dismantling of structural racism and oppressive, exclusive policies. The authors are asking legislative and health system policy makers to adopt Restorative Justice practices for Crisis Standards of Care development. The US cannot afford to have additional reductions in inhabitant lifespan or the talent pool within healthcare.

BNT162b2 vaccine-induced humoral and cellular responses against SARS-CoV-2 variants in systemic lupus erythematosus.

OBJECTIVES: Our aim was to evaluate systemic lupus erythematosus (SLE) disease activity and SARS-CoV-2-specific immune responses after BNT162b2 vaccination. METHODS: In this prospective study, disease activity and clinical assessments were recorded from the first dose of vaccine until day 15 after the second dose in 126 patients with SLE. SARS-CoV-2 antibody responses were measured against wild-type spike antigen, while serum-neutralising activity was assessed against the SARS-CoV-2 historical strain and variants of concerns (VOCs). Vaccine-specific T cell responses were quantified by interferon-γ release assay after the second dose. RESULTS: BNT162b2 was well tolerated and no statistically significant variations of BILAG (British Isles Lupus Assessment Group) and SLEDAI (SLE Disease Activity Index) scores were observed throughout the study in patients with SLE with active and inactive disease at baseline. Mycophenolate mofetil (MMF) and methotrexate (MTX) treatments were associated with drastically reduced BNT162b2 antibody response (ß=-78, p=0.007; ß=-122, p<0.001, respectively). Anti-spike antibody response was positively associated with baseline total immunoglobulin G serum levels, naïve B cell frequencies (ß=2, p=0.018; ß=2.5, p=0.003) and SARS-CoV-2-specific T cell response (r=0.462, p=0.003). In responders, serum neutralisation activity decreased against VOCs bearing the E484K mutation but remained detectable in a majority of patients. CONCLUSION: MMF, MTX and poor baseline humoral immune status, particularly low naïve B cell frequencies, are independently associated with impaired BNT162b2 mRNA antibody response, delineating patients with SLE who might need adapted vaccine regimens and follow-up.

Cross-cultural validation of a questionnaire to assess spinal pain in children / Validação transcultural de um questionário de avaliação da dor na coluna em crianças / Validación transcultural de un cuestionario para evaluar el dolor de espalda en niños

ABSTRACT Objective: To validate the cross-cultural adaptation of the English version of theYoung Spine Questionnaire (YSQ) to Portuguese. The questionnaire enables the evaluation, in children, of back pain prevalence and frequency, restrictions on activity, care-seeking behavior, and the influence that the parents' manifestations of back pain can have. Method: The research was conducted in a school setting, with a sample of 128 children aged 9 to 12 years (63 males and 65 females). The questionnaire was completed at two different moments. Test-retest reliability was used to evaluate the degree of reproducibility, and the intraclass correlation coefficient (ICC) between the two sets of observed values was estimated for p<0.05. Cronbach's alpha coefficient was used to assess the degree of reliability (internal consistency) of the questionnaire. Results: For most of questions, the ICC ranged between 0.527 and 0.870, with reasonable to excellent correlation to the reproducibility index. The exceptions were foritem c) in two of the first three questions, where the ICC values (0.149 and 0.277) were lower. The value of Cronbach's alpha calculation was 0.8, indicating high internal consistency. Conclusion: It was demonstrated that the cross-cultural adaptation of the YSQ had content validity, was well-understood, and suitable for use in studies with Portuguese children between 9 and 12 years of age. Level of evidence II; Development of diagnostic criteria.

RESUMO: Objetivo: Objetivo: Validar a adaptação transcultural da versão inglesa do "The Young Spine Questionnaire" (YSQ), para a língua portuguesa. O questionário permite avaliar, em crianças, a taxa de prevalência e a frequência de dor na coluna, as restrições de atividade, o comportamento de procura de cuidados e a influência que pode ter a dor de coluna manifestada pelos pais. Método: A pesquisa foi realizada em contexto escolar, com uma amostra de 128 crianças dos 9 aos 12 anos (63 do sexo masculino e 65 do sexo feminino). O questionário foi preenchido em dois momentos distintos. Para avaliar o seu grau de reprodutibilidade utilizou-se o Teste-Reteste, estimando-se o coeficiente de correlação intraclasse (ICC) entre os dois conjuntos de valores observados, para p<0,05. Também se recorreu ao coeficiente Alfa de Cronbach, para encontrar o grau de confiabilidade (consistência interna) do questionário. Resultados: Na maioria das questões o intervalo do ICC situou-se entre 0,527 e 0,870, correspondente a uma correlação situada entre razoável a excelente para índice de reprodutibilidade. A exceção foram dois dos itens c) das três primeiras questões, em que o ICC apresentou valores inferiores (0,149 e 0,277). O valor do cálculo do Alfa de Cronbach resultou em 0,8, apresentando elevada consistência interna. Conclusão: Ficou demonstrado que a adaptação transcultural do YSQ tem validade de conteúdo e é bem compreendida para ser utilizada em estudos com crianças portuguesas dos 9 aos 12 anos de idade. Nível de evidência II; Desenvolvimento de critérios de diagnóstico.

RESUMEN: Objetivo: Validar la adaptación transcultural de la versión inglesa del "The Young Spine Questionnaire" (YSQ) al portugués. El cuestionario permite evaluar, en los niños, la tasa de prevalencia y frecuencia del dolor de espalda , las restricciones de actividad, el comportamiento de búsqueda de atención y la influencia que puede tener el dolor de espalda manifestado por los padres. Método: La investigación se llevó a cabo en un entorno escolar, con una muestra de 128 niños de 9 a 12 años (63 niños y 65 niñas). El cuestionario se completó en dos momentos diferentes. Para evaluar su grado de reproducibilidad, se utilizó el "Test-Retest", estimando el coeficiente de correlación intraclase (CCI) entre los dos conjuntos de valores observados, para p <0,05. También se utilizó el coeficiente Alfa de Cronbach, para conocer el grado de confiabilidad (consistencia interna) del cuestionario. Resultados: En la mayoría de las preguntas, el CCI osciló entre 0,527 y 0,870, lo que corresponde a una correlación situada entre razonable y excelente para el índice de reproducibilidad. Las excepciones fueron dos de los ítems c) de las tres primeras preguntas, donde el ICC mostró valores más bajos (0,149 y 0,277). El valor del cálculo del Alfa de Cronbach dio como resultado 0,8, lo que demuestra una alta consistencia interna. Conclusión: Se demostró que la adaptación transcultural del YSQ tiene validez de contenido y es adecuada para ser utilizada en estudios con niños portugueses de entre 9 y 12 años. Nivel de evidencia II; Desarrollo de criterios diagnósticos.

Seguridad de las actividades extraescolares en tiempos de pandemia por SARS-CoV-2. Estudio prospectivo en población pediátrica / Safety of extracurricular activities in times of pandemic by SARS-CoV-2. Prospective study in paediatric population

Introducción: la epidemia de la enfermedad por coronavirus 2019 ha obligado a implementar diferentes medidas para mitigar el impacto de un aumento inevitable de casos de COVID-19, como fue el cierre de los colegios. A su reapertura, dado que la actividad deportiva en la infancia y adolescencia es clave para su óptimo desarrollo, nos planteamos: ¿son seguras las actividades extraescolares deportivas en tiempos de COVID? Material y métodos: estudio observacional descriptivo longitudinal. Se siguió a 717 escolares deportistas y monitores de una asociación deportiva municipal que participaron en alguna de las actividades deportivas ofrecidas durante el periodo de septiembre a diciembre del año 2020. Ante un caso positivo, se contactó con la familia, cumplimentando la hoja de recogida de datos y realizando seguimiento de los menores. Resultados: de los 679 escolares deportistas y 38 adultos monitores estudiados, únicamente se registró un caso de infección por virus SARS-CoV-2. El caso fue un jugador de baloncesto de 13 años por un contacto familiar, la sintomatología fue leve y tanto él como su grupo de convivencia estable mantuvieron 10 días de cuarentena sin aparición de nuevos casos positivos. Conclusiones: nuestros resultados indican que si la práctica deportiva se realiza en grupos controlados, en medios optimizados y respetando las normas sanitarias, pueden ser espacios seguros para nuestra población pediátrica, con una baja tasa de transmisión del virus SARS-CoV-2. No hemos observado ningún brote en nuestra muestra habiendo implantado las medidas preventivas oportunas y siendo los niños excelentes cumplidores de las mismas. No obstante, es importante disponer de un registro preciso del alumnado existente para el rastreo de contactos e incidir tanto en las medidas generales de prevención como en las específicas para actividades deportivas para minimizar los riesgos (AU)

Introduction: the coronavirus disease 2019 pandemic has compelled the implementation of various measures to mitigate the impact of an inevitable increase in COVID-19 cases, such as the closure of schools. Upon their reopening, given that physical activity in childhood and adolescence is crucial for optimal development, we considered whether extracurricular athletic activities are safe in the COVID age. Material and methods: we conducted a longitudinal, observational and descriptive study. We followed up 717 students and instructors from a municipal sports organization that participated in sports activities offered between September and December 2020. When a positive case was identified, the staff contacted the family, filling in the data collection form and monitoring the students. Results: there was only 1 detected case SARS-CoV-2 infection among the 679 students and 38 adult instructors included in the study. It occurred in an adolescent aged 13 years that played basketball and acquired the infection from a family member and developed mild symptoms; both the boy and the peers in his consistent contact group were quarantined for 10 days without identification of additional cases. Discussion: our results suggests that if athletic activities are carried out in controlled groups in optimised environments and adhering to health standards, sports facilities can be safe spaces for the paediatric population with a low SARS-CoV-2 transmission rate. We did not identify any outbreaks in the sample, having implemented the appropriate preventive measures and verified strict adherence by the students. Nevertheless, it is important to keep accurate records of current students for contact tracing and to guide the implementation of preventive measures, both general and specific to particular sports activities, with the aim of minimising risk (AU)