Staphylococcus capitis Central-Line-Associated Bloodstream Infections in the Neonatal Intensive Care Unit: A Single-Center, Four-Year Experience in Central-Line Management during Sepsis Treatment.

Coagulase-negative staphylococci (CoNS) are reportedly responsible for 50-60% of bloodstream infections in very preterm (<1500 g) infants in neonatal intensive care units (NICUs). Staphylococcus capitis is an increasingly prevalent pathogen in the neonatal setting, frequently causing central-line-associated bloodstream infections (CLABSIs) that can be difficult to eradicate. Central venous catheter (CVC) removal versus in situ treatment with CoNS CLABSIs is a controversial treatment strategy with no clear consensus. We reviewed all S. capitis CLABSIs in our NICU between 2019 and 2022, focusing on the role of catheter removal in eradication. Among the 25 patients, 17 CVCs were removed after diagnosis, leading to a 76.5% eradication rate in this group. Three infants had a persistently positive blood culture after CVC substitution. A new catheter was then inserted after a 48 h washout period, resulting in resolution of the infection. Only two of the eight patients (25%) who retained their catheter after diagnosis achieved infection eradication with antibiotic therapy alone. When feasible, catheter removal seems to be the most effective strategy for eradicating S. capitis CLABSIs, sometimes even requiring a 48 h washout period before reinsertion. Further studies on this topic are needed to better standardize the management of this type of infection.

Memoria episódica verbal en pacientes pediátricos intervenidos de cirugía de la epilepsia del lóbulo temporal: un estudio de seguimiento al año / Verbal episodic memory in children undergoing temporal lobe epilepsy surgery: a one-year follow-up study

Introducción La memoria episódica verbal (MEV) no suele resultar alterada en niños con epilepsia focal sometidos a resecciones del lóbulo temporal izquierdo, a diferencia de lo que cabría esperar si se tratara de un cerebro adulto. Los últimos hallazgos sugieren que la actividad epileptógena en los primeros años de vida disrumpe la lateralización del sistema mnésico, lo que conduce al desarrollo de una representación bilateral de la memoria. El presente estudio pretende analizar si la lateralidad de la epilepsia es un predictor significativo de cara al pronóstico posquirúrgico de la MEV en la cirugía de la epilepsia del lóbulo temporal (ELT) en edad pediátrica. Esta investigación también pretende aportar evidencias sobre la relación de la MEV con otros factores demográficos y clínicos relevantes, como el sexo, la edad de inicio de las crisis, la edad quirúrgica y la duración de la epilepsia, así como estudiar el impacto del rendimiento prequirúrgico en la MEV sobre los resultados posquirúrgicos. Pacientes y métodos Se extrajeron de la base de datos del Hospital Sant Joan de Déu y se analizaron retrospectivamente las puntuaciones prequirúrgicas y al año de seguimiento postoperatorio de una tarea de recuerdo de lista de palabras correspondientes a 25 niños intervenidos de ELT (ELT izquierdo, n = 11; ELT derecho, n = 14). Resultados No se encontraron diferencias intergrupales prequirúrgicas significativas al comparar las puntuaciones en MEV sobre la base de la lateralidad de la epilepsia (p > 0,5). En cuanto al grupo de ELT izquierdo, se encontró una alta correlación negativa entre la edad de inicio y la puntuación prequirúrgica del recuerdo libre a largo plazo (rho = –0,72; p = 0,01). No se encontraron cambios intragrupo significativos entre el pre- y el postoperatorio en relación con el rendimiento en la MEV, independientemente de la lateralidad de la epilepsia (grupo de ELT izquierdo, p > 0,56; grupo de ELT derecho, p > 0,12). Conclusiones ... (AU)

INTRODUCTION Verbal episodic memory (VEM) is often unimpaired in children with focal epilepsy undergoing left temporal lobe resections, unlike what we might expect in the adult brain. The latter findings suggest that epileptiform activity in early life disrupts memory system lateralization, leading to the development of bilateral memory representation. The present study aims to analyze whether the laterality of epilepsy is a major predictor for post-operative VEM prognosis in pediatric temporal lobe epilepsy (TLE) surgery. This research also pretends to provide evidence about the relationship of VEM performance with other relevant demographical and clinical factors such as sex, age at onset of seizures, age at surgery and duration of epilepsy, as well as to study the impact of presurgical VEM performance on postsurgical outcomes. PATIENTS AND METHODS Pre-operative and one-year follow-up post-operative word-list recall scores from 25 children who underwent TLE surgery (left-sided, n = 11; right-sided, n = 14) were extracted from the Hospital Sant Joan de Déu database and were retrospectively analyzed. RESULTS No significant presurgical intergroup differences were found when comparing VEM scores by laterality of epilepsy (p > 0.5). Looking at the left TLE group, a high negative correlation was found between the onset age and the pre-operative long-term free recall score (rho = –0.72, p = 0.01). No significant pre- to post-operative intragroup changes were found regarding VEM performance, regardless of epilepsy laterality (left TLE group, p > 0.56; right TLE group, p > 0.12). CONCLUSIONS The laterality of epilepsy does not show to be a significant factor in and of itself (AU)

Preschool-located influenza vaccination and influenza-like illness surveillance: an Italian pilot experience.

BACKGROUND: We describe the first school-located influenza vaccination campaign with quadrivalent live-attenuated influenza vaccine (LAIV) among pre-school children in Italy, coupled with an innovative school-centred influenza-like illnesses (ILIs) surveillance using a self-sampling non-invasive saliva collection method. METHODS: The pilot study was proposed during the 2021/2022 influenza season to fifteen pre-schools in the Milan municipality. LAIV was offered directly in school to all healthy children without contraindications. ILI differential diagnosis was conducted by real-time RT-PCR for influenza A/B and SARS-CoV-2. RESULTS: Five pre-schools were involved in the pilot project and overall, 135 families (31.2%) participated in the study, adhering to both surveillance and vaccination; 59% of families had an immigrant background. No pupil experienced adverse reactions after vaccination. Nineteen saliva samples were collected from sixteen children (11.8%). Six samples (31.6%) tested positive for SARS-CoV-2; none was positive for influenza A/B. CONCLUSIONS: The participation in the immunisation campaign was good, considering possible absences due to COVID-19 pandemic, and the intranasal administration was well tolerated and helped to overcome parental hesitancy. Saliva sampling represented a useful tool to reduce children's stress and increase parents' compliance. The high participation of families with an immigrant background suggests that school-based interventions can represent an effective strategy to overcome socioeconomic and cultural barriers.

Valoración de usuarios y profesionales sanitarios sobre la teleconsulta en Atención Primaria: estudio transversal / Evaluation of users and health professionals on teleconsultation in primary care: A cross-sectional study

Objetivo: Conocer la valoración y preferencias de usuarios y profesionales sanitarios sobre la teleconsulta en Atención Primaria. Diseño: Estudio transversal mediante encuesta, telefónica a usuarios y presencial a profesionales, en 2021. Emplazamiento: Atención Primara urbana. Sujetos: Muestra aleatoria de usuarios con teleconsultas en el último año, estratificados por sexo y edad, y médicos y enfermeros de los centros participantes. Mediciones: Variables Likert valorando la teleconsulta según motivos de consulta, preferencias y aspectos relacionados. Análisis descriptivo y comparación de proporciones y medias. Resultados: Responden 300 pacientes y 48 profesionales. Ambos valoran positivamente la teleconsulta para gestionar la receta electrónica (RE) (el 83 y el 83%, respectivamente), la incapacidad temporal (IT) (el 80 y el 64%) y cuestiones relacionadas con la COVID-19 (el 71 y el 58%). La valoración positiva de la teleconsulta disminuye para el tratamiento de las enfermedades agudas (el 47 y el 25%) y crónicas (el 49 y el 33%). Globalmente las personas <70 años valoran mejor la teleconsulta (p <0,001), sin diferencias entre sexos. Usuarios y profesionales prefieren la presencialidad para enfermedades crónicas (el 82 y el 83%) y agudas (el 82 y el 94%), y teleconsulta para RE (el 68,7% y el 88,6%). El 52% de los usuarios prefieren visita presencial para IT frente al 29% de los profesionales (p <0,05). Conclusiones: La teleconsulta se ha implementado con una buena valoración tanto de pacientes como profesionales. La visita presencial es la preferida para la enfermedad crónica y aguda, especialmente en personas mayores. Habrá que definir en qué casos la teleconsulta es la mejor herramienta según las características de cada población.(AU)

Objective: To evaluate the perceptions and preferences of users and health professionals on teleconsultation in primary care. Design: Cross-sectional study with a telephone survey of users and a face-to-face survey of professionals carried out at 2021. Setting: Urban primary health care. Participants: Random sample of users with teleconsultations in the last year, stratified by sex and age, and doctors and nurses from participating centres. Measurements: Likert variables assessing teleconsultation according to consultation motives, preferences and related aspects. Descriptive analysis and comparison of proportions and means. Results: Three hundred patients and 48 professionals answered the questionnaire. Both groups value positively the teleconsultation for the management of the electronic prescription (EP) (83% and 83%, respectively), sick leave (SL) (80% and 64%) and issues related to COVID-19 (71% and 58%). The positive assessment of teleconsultation decreases for the treatment of acute pathologies (47% and 25%) and chronic diseases (49% and 33%). Globally, people <70 years value teleconsultation more highly (P<.001), without differences between sexes. Users and professionals prefer face-to-face consultation for chronic diseases (82% and 83%) and acute pathologies (82% and 94%), and teleconsultation for EP (68.7% and 88.6%). 52% of users prefer face-to-face visits for SL compared to 29% of professionals (P<.05). Conclusions: Teleconsultation implementation has been well valued by both patients and professionals. The face-to-face visit is preferred for chronic and acute pathologies, especially in the elderly. It will be necessary to define in which cases teleconsultation is the best tool according to the characteristics of each population.(AU)

[Evaluation of users and health professionals on teleconsultation in primary care: A cross-sectional study]. / Valoración de usuarios y profesionales sanitarios sobre la teleconsulta en Atención Primaria: estudio transversal.

OBJECTIVE: To evaluate the perceptions and preferences of users and health professionals on teleconsultation in primary care. DESIGN: Cross-sectional study with a telephone survey of users and a face-to-face survey of professionals carried out at 2021. SETTING: Urban primary health care. PARTICIPANTS: Random sample of users with teleconsultations in the last year, stratified by sex and age, and doctors and nurses from participating centres. MEASUREMENTS: Likert variables assessing teleconsultation according to consultation motives, preferences and related aspects. Descriptive analysis and comparison of proportions and means. RESULTS: Three hundred patients and 48 professionals answered the questionnaire. Both groups value positively the teleconsultation for the management of the electronic prescription (EP) (83% and 83%, respectively), sick leave (SL) (80% and 64%) and issues related to COVID-19 (71% and 58%). The positive assessment of teleconsultation decreases for the treatment of acute pathologies (47% and 25%) and chronic diseases (49% and 33%). Globally, people <70 years value teleconsultation more highly (P<.001), without differences between sexes. Users and professionals prefer face-to-face consultation for chronic diseases (82% and 83%) and acute pathologies (82% and 94%), and teleconsultation for EP (68.7% and 88.6%). 52% of users prefer face-to-face visits for SL compared to 29% of professionals (P<.05). CONCLUSIONS: Teleconsultation implementation has been well valued by both patients and professionals. The face-to-face visit is preferred for chronic and acute pathologies, especially in the elderly. It will be necessary to define in which cases teleconsultation is the best tool according to the characteristics of each population.

Global variation in nonstructural carbohydrate stores in response to climate.

Woody plant species store nonstructural carbohydrates (NSCs) for many functions. While known to buffer against fluctuations in photosynthetic supply, such as at night, NSC stores are also thought to buffer against environmental extremes, such as drought or freezing temperatures by serving as either back-up energy reserves or osmolytes. However, a clear picture of how NSCs are shaped by climate is still lacking. Here, we update and leverage a unique global database of seasonal NSC storage measurements to examine whether maximum total NSC stores and the amount of soluble sugars are associated with clinal patterns in low temperatures or aridity, indicating they may confer a benefit under freezing or drought conditions. We examine patterns using the average climate at each study site and the unique climatic conditions at the time and place in which the sample was taken. Altogether, our results support the idea that NSC stores act as critical osmolytes. Soluble Sugars increase with both colder and drier conditions in aboveground tissues, indicating they can plastically increase a plants' tolerance of cold or arid conditions. However, maximum total NSCs increased, rather than decreased, with average site temperature and had no relationship to average site aridity. This result suggests that the total amount of NSC a plant stores may be more strongly determined by its capacity to assimilate carbon than by environmental stress. Thus, NSCs are unlikely to serve as reservoir of energy. This study is the most comprehensive synthesis to date of global NSC variation in relation to climate and supports the idea that NSC stores likely serve as buffers against environmental stress. By clarifying their role in cold and drought tolerance, we improve our ability to predict plant response to environment.

Drivers of population differentiation in phenotypic plasticity in a temperate conifer: A 27-year study.

Phenotypic plasticity is a main mechanism for organisms to cope with changing environments and broaden their ecological range. Plasticity is genetically based and can evolve under natural selection, such that populations within a species show distinct phenotypic responses to the environment if evolved under different conditions. Understanding how intraspecific variation in phenotypic plasticity arises is critical to assess potential adaptation to ongoing climate change. Theory predicts that plasticity is favored in more favorable but variable environments. Yet, many theoretical predictions about benefits, costs, and selection on plasticity remain untested. To test these predictions, we took advantage of three genetic trials in the northern Rocky Mountains, USA, which assessed 23 closely located Pinus ponderosa populations over 27 years. Mean environmental conditions and their spatial patterns of variation at the seed source populations were characterized based on six basic climate parameters. Despite the small area of origin, there was significant genetic variation in phenotypic plasticity for tree growth among populations. We found a significant negative correlation between phenotypic plasticity and the patch size of environmental heterogeneity at the seed source populations, but not with total environmental spatial variance. These results show that populations exposed to high microhabitat heterogeneity have evolved higher phenotypic plasticity and that the trigger was the grain rather than the total magnitude of spatial heterogeneity. Contrary to theoretical predictions, we also found a positive relationship between population plasticity and summer drought at the seed source, indicating that drought can act as a trigger of plasticity. Finally, we found a negative correlation between the quantitative genetic variance within populations and their phenotypic plasticity, suggesting compensatory adaptive mechanisms for the lack of genetic diversity. These results improve our understanding of the microevolutionary drivers of phenotypic plasticity, a critical process for resilience of long-lived species under climate change, and support decision-making in tree genetic improvement programs and seed transfer strategies.

Intervención comunitaria: el impacto de la lectura en la salud emocional / Community intervention: the impact of reading on emotional health

El malestar emocional es una queja habitual en lasociedad y en las consultas de Atención Primaria.La biblioterapia se ha mostrado eficaz en la mejora de síntomas de depresión y ansiedad leves.El siguiente estudio trata de valorar el impacto dela biblioterapia en la calidad de vida de pacientesdel centro de salud (CAP) El Carmel (Barcelona)con ansiedad y/o depresión leves diagnosticadas,con el objetivo de mejorar la percepción de la propia salud emocional.Se trata de un estudio piloto cuasi-experimentalen colaboración con la biblioteca municipal dondese valora, a lo largo de 1 año, la percepción dela propia salud de los pacientes antes y despuésde una intervención de biblioterapia por medio deescalas validadas, evidenciando una mejoría enla autopercepción de sintomatología ansiosa, nosiendo la mejoría estadísticamente significativaen el caso de la depresión. (AU)

The emotional distress is a habitual complaint in oursociety and in the Primary Care consultations. The bibliotherapy has shown efficient to improve the minordepression symptoms and anxieties.This research consists in assessing the impact of bibliotherapy in the quality of life in the patients of Carmel’s primary health care center (Barcelona). Theywere diagnosed with minor anxiety and depression.The target of this work is to enhance the perception oftheir own mental health.It is a pilot quasi-experimental study in collaborationwith the public library. Over a year, an evaluation takesplace about the perception of their particular mentalhealth before and after an intervention of bibliotherapy. The evidence is an improvement in the self-perception of anxiety symptomatology, not resulting asthe most significant statistic in the case of depressionsymptoms. (AU)

Improving Reading Skills Using a Computerized Phonological Training Program in Early Readers with Reading Difficulties.

In the last years, there has been a big effort to identify risk factors for reading difficulties and to develop new methodologies to help struggling readers. It has been shown that early intervention is more successful than late intervention, and that intensive training programs can benefit children with reading difficulties. The aim of our study is to investigate the effectiveness of an intensive computerized phonological training program designed to improve reading performance in a sample of children with reading difficulties at the early stages of their reading learning process. Thirty-two children with reading difficulties were randomly assigned to one of the two intervention groups: RDIR (children with reading difficulties following a computerized intensive remediation strategy) (n = 20) (7.01 ± 0.69 years), focused on training phonemic awareness, decoding and reading fluency through the computational training; and RDOR (children with reading difficulties following an ordinary remediation strategy) (n = 12) (6.92 ± 0.82 years), which consisted of a reinforcement of reading with a traditional training approach at school. Normal readers (NR) were assigned to the control group (n = 24) (7.32 ± 0.66 years). Our results indicate that both the RDIR and RDOR groups showed an increased reading performance after the intervention. However, children in the RDIR group showed a stronger benefit than the children in the RDOR group, whose improvement was weaker. The control group did not show significant changes in reading performance during the same period. In conclusion, results suggest that intensive early intervention based on phonics training is an effective strategy to remediate reading difficulties, and that it can be used at school as the first approach to tackle such difficulties.

HPV Vaccination in Young Males: A Glimpse of Coverage, Parental Attitude and Need of Additional Information from Lombardy Region, Italy.

Background: In the Lombardy Region, Italy, HPV vaccination is recommended and offered free of charge to 12-years-old males since 2017. The expected vaccination thresholds are still far to be reached. Methods: A cross-sectional survey to investigate parents' attitudes towards the HPV vaccine and knowledge about HPV was administered to parents of boys aged 6 to 18 years attending a large pediatric hospital for outpatient specialistic evaluations. Two parallel multiple logistic regression analyses were conducted to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for attitude towards HPV vaccination and perceived need for more information about HPV vaccination. Results: A positive attitude towards HPV vaccination was found in 74% of interviewed parents. Knowledge of HPV, having a generally positive attitude toward vaccination, and mothers filling in the survey were positively associated with a positive attitude to the HPV vaccine. Parents' perceived need for more information about HPV vaccination was positively associated with the child's age, general positive attitude toward vaccination, Christian religion, and positive attitude toward HPV vaccination; knowing that HPV vaccination is free of charge significantly reduced the risk of asking for more information on HPV vaccination. Conclusions: The majority of parents of male children and adolescents in our study have a positive attitude toward HPV vaccination. Attitude toward HPV vaccination and perceived need for more information on HPV vaccination were directly related to a positive attitude toward vaccines in general. In addition, knowledge of HPV and related pathologies favors a positive attitude toward HPV vaccination. Future health programs should target an even wider diffusion of evidence-based information on vaccines in general and on the HPV vaccine in young males, to support a positive attitude toward vaccines in the general population.

Plant carbohydrate storage: intra- and inter-specific trade-offs reveal a major life history trait.

Trade-offs among carbon sinks constrain how trees physiologically, ecologically, and evolutionarily respond to their environments. These trade-offs typically fall along a productive growth to conservative, bet-hedging continuum. How nonstructural carbohydrates (NSCs) stored in living tree cells (known as carbon stores) fit in this trade-off framework is not well understood. We examined relationships between growth and storage using both within species genetic variation from a common garden, and across species phenotypic variation from a global database. We demonstrate that storage is actively accumulated, as part of a conservative, bet-hedging life history strategy. Storage accumulates at the expense of growth both within and across species. Within the species Populus trichocarpa, genetic trade-offs show that for each additional unit of wood area growth (in cm2 yr-1 ) that genotypes invest in, they lose 1.2 to 1.7 units (mg g-1 NSC) of storage. Across species, for each additional unit of area growth (in cm2 yr-1 ), trees, on average, reduce their storage by 9.5% in stems and 10.4% in roots. Our findings impact our understanding of basic plant biology, fit storage into a widely used growth-survival trade-off spectrum describing life history strategy, and challenges the assumptions of passive storage made in ecosystem models today.

Congenital CMV, Lights and Shadows on Its Management: The Experience of a Reference Center in Northern Italy.

Congenital cytomegalovirus infection (cCMV) is the most common congenital viral infection, with a consistent rate of morbidity, mortality, and long-term sequelae, especially in the case of late diagnosis. Nevertheless, a universal screening for CMV is not currently recommended, and global awareness about this infection, as well as accurate and shared indications on follow-up and treatment, are still lacking. We reviewed data about 59 suspect cCMV cases who referred to our center from 2014 to 2021. We report 41 cases of confirmed cCMV diagnosed at birth, with clinical or radiological abnormalities in 36.6% of them. Other five patients received a late diagnosis and all presented neurological impairment. Twelve patients received therapy with Valganciclovir within the first month of life, with favorable outcome in nine cases. Therapy after the first month of life was attempted in four patients, with improvement in one case. The overall awareness about cCMV infection was 32.6%. Considering our population, maternal serological screening followed by targeted testing of neonates could be an effective strategy. Some aspects of cCMV infection management should be further investigated, such as indication of treatment after the first month of life or in asymptomatic patients. Awareness about the infection should be improved to implement preventive strategies.

Storage of carbon reserves in spruce trees is prioritized over growth in the face of carbon limitation.

Climate change is expected to pose a global threat to forest health by intensifying extreme events like drought and insect attacks. Carbon allocation is a fundamental process that determines the adaptive responses of long-lived late-maturing organisms like trees to such stresses. However, our mechanistic understanding of how trees coordinate and set allocation priorities among different sinks (e.g., growth and storage) under severe source limitation remains limited. Using flux measurements, isotopic tracing, targeted metabolomics, and transcriptomics, we investigated how limitation of source supply influences sink activity, particularly growth and carbon storage, and their relative regulation in Norway spruce (Picea abies) clones. During photosynthetic deprivation, absolute rates of respiration, growth, and allocation to storage all decline. When trees approach neutral carbon balance, i.e., daytime net carbon gain equals nighttime carbon loss, genes encoding major enzymes of metabolic pathways remain relatively unaffected. However, under negative carbon balance, photosynthesis and growth are down-regulated while sucrose and starch biosynthesis pathways are up-regulated, indicating that trees prioritize carbon allocation to storage over growth. Moreover, trees under negative carbon balance actively increase the turnover rate of starch, lipids, and amino acids, most likely to support respiration and mitigate stress. Our study provides molecular evidence that trees faced with severe photosynthetic limitation strategically regulate storage allocation and consumption at the expense of growth. Understanding such allocation strategies is crucial for predicting how trees may respond to extreme events involving steep declines in photosynthesis, like severe drought, or defoliation by heat waves, late frost, or insect attack.

Relative water content consistently predicts drought mortality risk in seedling populations with different morphology, physiology and times to death.

Predicted increases in forest drought mortality highlight the need for predictors of incipient drought-induced mortality (DIM) risk that enable proactive large-scale management. Such predictors should be consistent across plants with varying morphology and physiology. Because of their integrative nature, indicators of water status are promising candidates for real-time monitoring of DIM, particularly if they standardize morphological differences among plants. We assessed the extent to which differences in morphology and physiology between Pinus ponderosa populations influence time to mortality and the predictive power of key indicators of DIM risk. Time to incipient mortality differed between populations but occurred at the same relative water content (RWC) and water potential (WP). RWC and WP were accurate predictors of drought mortality risk. These results highlight that variables related to water status capture critical thresholds during DIM and the associated dehydration processes. Both WP and RWC are promising candidates for large-scale assessments of DIM risk. RWC is of special interest because it allows comparisons across different morphologies and can be remotely sensed. Our results offer promise for real-time landscape-level monitoring of DIM and its global impacts in the near term.

Alpine treeline ecotones are potential refugia for a montane pine species threatened by bark beetle outbreaks.

Warming-induced mountain pine beetle (Dendroctonus ponderosae; MPB) outbreaks have caused extensive mortality of whitebark pine (Pinus albicaulis; WBP) throughout the species' range. In the highest mountains where WBP occur, they cross alpine treeline ecotones (ATEs) where growth forms transition from trees to shrub-like krummholz, some of which survived recent MPB outbreaks. This observation motivated the hypothesis that ATEs are refugia for WBP because krummholz growth forms escape MPB attack and have the potential to produce viable seed. To test this hypothesis, we surveyed WBP mortality along transects from the ATE edge (locally highest krummholz WBP) downslope into the forest and, to distinguish if survival mechanisms are unique to ATEs, across other forest ecotones (OFEs) from the edge of WBP occurrence into the forest. We replicated this design at 10 randomly selected sites in the U.S. Northern Rocky Mountains. We also surveyed reproduction in a subset of ATE sites. Mortality was nearly absent in upper ATEs (mean ± SE percent dead across all sites of 0.03% ± 0.03% 0-100 m from the edge and 14.1% ± 1.7% 100-500 m from the edge) but was above 20% along OFEs (21.4 ± 5.2% 0-100 m and 32.4 ± 2.7% 100-500 m from the edge). We observed lower reproduction in upper ATEs (16 ± 9.9 cones/ha and 12.9 ± 5.3 viable seeds/cone 0-100 m from the edge) compared to forests below (317.1 ± 64.4 cones/ha and 32.5 ± 2.5 viable seeds/cone 100-500 m from the edge). Uniquely high WBP survival supports the hypothesis that ATEs serve as refugia because krummholz growth forms escape MPB attack. However, low reproduction suggests ATE refugia function over longer time periods. Beyond our WBP system, we propose that plant populations in marginal environments are candidate refugia if distinct phenotypes result in reduced disturbance impacts.

Functional connectivity alterations associated with literacy difficulties in early readers.

The link between literacy difficulties and brain alterations has been described in depth. Resting-state fMRI (rs-fMRI) has been successfully applied to the study of intrinsic functional connectivity (iFc) both in dyslexia and typically developing children. Most related studies have focused on the stages from late childhood into adulthood using a seed to voxel approach. Our study analyzes iFc in an early childhood sample using the multivariate pattern analysis. This facilitates a hypothesis-free analysis and the possible identification of abnormal functional connectivity patterns at a whole brain level. Thirty-four children with literacy difficulties (LD) (7.1 ± 0.69 yr.) and 30 typically developing children (TD) (7.43 ± 0.52 yr.) were selected. Functional brain connectivity was measured using an rs-fMRI acquisition. The LD group showed a higher iFc between the right middle frontal gyrus (rMFG) and the default mode network (DMN) regions, and a lower iFc between the rMFG and both the bilateral insular cortex and the supramarginal gyrus. These results are interpreted as a DMN on/off routine malfunction in the LD group, which suggests an alteration of the task control network regulating DMN activity. In the LD group, the posterior cingulate cortex also showed a lower iFc with both the middle temporal poles and the fusiform gyrus. This could be interpreted as a failure in the integration of information between brain regions that facilitate reading. Our results show that children with literacy difficulties have an altered functional connectivity in their reading and attentional networks at the beginning of the literacy acquisition. Future studies should evaluate whether or not these alterations could indicate a risk of developing dyslexia.

Plant carbohydrate depletion impairs water relations and spreads via ectomycorrhizal networks.

Under prolonged drought and reduced photosynthesis, plants consume stored nonstructural carbohydrates (NSCs). Stored NSC depletion may impair the regulation of plant water balance, but the underlying mechanisms are poorly understood, and whether such mechanisms are independent of plant water deficit is not known. If so, carbon costs of fungal symbionts could indirectly influence plant drought tolerance through stored NSC depletion. We connected well-watered Pinus ponderosa seedling pairs via ectomycorrhizal (EM) networks where one seedling was shaded (D) and the other kept illuminated (LD) and compared responses to seedling pairs in full light (L). We measured plant NSCs, osmotic and water potential, and transfer of 13 CO2 through EM to explore mechanisms linking stored NSCs to plant water balance regulation and identify potential tradeoffs between plant water retention and EM fungi under carbon-limiting conditions. NSCs decreased from L to LD to D seedlings. Even without drought, NSC depletion impaired osmoregulation and turgor maintenance, both of which are critical for drought tolerance. Importantly, EM networks propagated NSC depletion and its negative effects on water retention from carbon stressed to nonstressed hosts. We demonstrate that NSC storage depletion influences turgor maintenance independently of plant water deficit and reveal carbon allocation tradeoffs between supporting fungal symbionts and retaining water.

Forest restoration treatments in a ponderosa pine forest enhance physiological activity and growth under climatic stress.

As the climate warms, drought will increasingly occur under elevated temperatures, placing forest ecosystems at growing risk of extensive dieback and mortality. In some cases, increases in tree density following early 20th-century fire suppression may exacerbate this risk. Treatments designed to restore historical stand structure and enhance resistance to high-severity fire might also alleviate drought stress by reducing competition, but the duration of these effects and the underlying mechanisms remain poorly understood. To elucidate these mechanisms, we evaluate tree growth, mortality, and tree-ring stable-carbon isotope responses to stand-density reduction treatments with and without prescribed fire in a ponderosa pine forest of western Montana. Moderate and heavier cutting experiments (basal area reductions of 35% and 56%, respectively) were initiated in 1992, followed by prescribed burning in a subset of the thinned units. All treatments led to a growth release that persisted to the time of resampling. The treatments had little effect on climate-growth relationships, but they markedly altered seasonal carbon isotope signals and their relationship to climate. In burned and unburned treatments, carbon isotope discrimination (Δ13 C) increased in the earlywood (EW) and decreased in the latewood (LW) relative to the control. The sensitivity of LW Δ13 C to late-summer climate also increased in all treatments, but not in the control. Such increased sensitivity indicates that the reduction in competition enabled trees to continue to fix carbon for new stem growth, even when the climate became sufficiently stressful to stop new assimilation in slower-growing trees in untreated units. These findings would have been masked had we not separated EW and LW. The importance of faster growth and enhanced carbon assimilation under late-summer climatic stress became evident in the second decade post-treatment, when mountain pine beetle activity increased locally, and tree mortality rates in the controls of both experiments increased to more than twice those in their respective treatments. These findings highlight that, when thinning is used to restore historical forest structure or increase resistance to high-severity fire, there will likely be additional benefits of enhanced growth and physiological activity under climatic stress, and the effects may persist for more than two decades.

Acute Inflammation and Elevated Cardiac Markers in a Two-Month-Old Infant with Severe Acute Respiratory Syndrome Coronavirus 2 Infection Presenting with Cardiac Symptoms.

Severe acute respiratory syndrome coronavirus 2 infection in children mainly shows a milder course. In complicated cases, it is unknown whether inflammation is predictive of disease severity, as in adults. Moreover, cardiac involvement is anecdotally described. We report the case of a 2-month-old infant with severe acute respiratory syndrome coronavirus 2 infection presenting with fever, tachycardia and elevated interleukin-6, who was diagnosed with myocarditis and treated with immunoglobulins.

Perfil y factores pronósticos en el traumatismo craneoencefálico en la edad pediátrica / Prognostic factors and profi le in traumatic brain injury in the paediatric age

INTRODUCCIÓN: El traumatismo craneoencefálico (TCE) es una causa común de muerte y discapacidad en la población pediátrica, aunque la bibliografía en población española sea escasa. Desde la perspectiva de la vulnerabilidad temprana, los hallazgos de investigaciones recientes sugieren que la lesión cerebral temprana tiene peores secuelas y un mayor riesgo de impacto. OBJETIVOS: Analizar el perfil de la inteligencia, las funciones ejecutivas y el comportamiento, y examinar la asociación de la edad a la lesión, la gravedad del TCE y los factores ambientales para los resultados cognitivos y conductuales. PACIENTES Y MÉTODOS: Setenta y un participantes con TCE moderado a grave, con edades entre 6 y 16 años, fueron evaluados con medidas de inteligencia (cociente intelectual), funciones ejecutivas y comportamiento. RESULTADOS: Los niños con TCE tienen un mayor riesgo de discapacidad en todos los aspectos de inteligencia, funciones ejecutivas y comportamiento. Los niños que sufrieron una lesión cerebral traumática en la infancia y preescolar registraron más efectos globales en el cociente intelectual y algunos aspectos de las funciones ejecutivas. CONCLUSIONES: Los factores socioeconómicos y culturales son los mejores predictores para el cociente intelectual y el comportamiento. Estos hallazgos contribuyen a una mejor comprensión de las secuelas de TCE en los niños para ayudar en la planificación de rehabilitación y la readaptación a la vida funcional

INTRODUCTION: Traumatic brain injury (TBI) is a common cause of death and disability in the paediatric population, although the literature on the Spanish population is scarce. From the perspective of early vulnerability, recent research fi ndings suggest that early brain injury has worse sequelae and a higher risk of impact. Aims. To analyse the intelligence profi le, executive functions and behaviour, and examine the association between age at the time of the injury, severity of the TBI and environmental factors for cognitive and behavioural outcomes. PATIENTS AND METHODS: Seventy-one participants with moderate to severe TBI, from 6 to 16 years of age, were assessed with measures of intelligence (intelligence quotient), executive functions and behaviour. RESULTS: Children with TBI are at increased risk of disability in all aspects of intelligence, executive functions and behaviour. Children who suff ered a traumatic brain injury in infancy and the preschool period had more overall eff ects on intelligence quotient and some aspects of the executive functions. CONCLUSIONS: Socioeconomic and cultural factors are the best predictors for intelligence quotient and behaviour. These findings contribute to a better understanding of the sequelae of TBI in children, which will help in rehabilitation planning and re-adaptation to functional life