Three-Dimensional Energy Transfer in Space Plasma Turbulence from Multipoint Measurement.

A novel multispacecraft technique applied to Magnetospheric Multiscale Mission data in the Earth's magnetosheath enables evaluation of the energy cascade rate from the full Yaglom's equation. The method differs from existing approaches in that it (i) is inherently three-dimensional, (ii) provides a statistically significant number of estimates from a single data stream, and (iii) allows visualization of energy flux in turbulent plasmas. This new "lag polyhedral derivative ensemble" technique exploits ensembles of tetrahedra in lag space and established curlometerlike algorithms.

Turbulence-Driven Ion Beams in the Magnetospheric Kelvin-Helmholtz Instability.

The description of the local turbulent energy transfer and the high-resolution ion distributions measured by the Magnetospheric Multiscale mission together provide a formidable tool to explore the cross-scale connection between the fluid-scale energy cascade and plasma processes at subion scales. When the small-scale energy transfer is dominated by Alfvénic, correlated velocity, and magnetic field fluctuations, beams of accelerated particles are more likely observed. Here, for the first time, we report observations suggesting the nonlinear wave-particle interaction as one possible mechanism for the energy dissipation in space plasmas.

An alveolar recruitment maneuver followed by positive end-expiratory pressure improves lung function in healthy dogs undergoing laparoscopy.

OBJECTIVE: To evaluate the effects of an alveolar recruitment maneuver (ARM) followed by 5 cmH2O positive end-expiratory pressure (PEEP) in dogs undergoing laparoscopy. STUDY DESIGN: Prospective, randomized clinical study. ANIMALS: A group of 20 dogs undergoing laparoscopic ovariectomy. METHODS: Dogs were sedated with acepromazine and methadone intramuscularly; anesthesia was induced with propofol intravenously and maintained with inhaled isoflurane. The following baseline ventilatory setting (BVS) was administered: tidal volume of 12 mL kg-1, inspiratory to expiratory ratio of 1:2, inspiratory pause 25% of inspiratory time, no PEEP and a respiratory rate to maintain end-tidal carbon dioxide tension between 5.3 and 7.3 kPa. Then, 10 minutes after the pneumoperitoneum, 10 dogs (RM) underwent a sustained inflation ARM followed by BVS plus 5 cmH2O PEEP, while 10 dogs (NO-RM) were left with BVS throughout the procedure. Gas exchange and respiratory system mechanics were evaluated before the pneumoperitoneum (PPpre), before ARM (PP10), 30 minutes later (PP30) and 20 minutes after pneumoperitoneum discontinuation (PPpost20). Data were analyzed using anova (p < 0.05). RESULTS: The Fshunt at PP30 and PPpost20 was lower (p < 0.001) in the RM (2.3 ± 2.2 and 4.7 ± 3.7%) than in the NO-RM (5.2 ± 2.1 and 11.1 ± 5.2%), and PaO2 at PP30 and PPpost20 was higher (p < 0.001) in the RM (67.3 ± 4.2 and 60.1 ± 9.4 kPa) than in the NO-RM (50.2 ± 7.4 and 45.5 ± 11.1 kPa). Static compliance of the respiratory system at PP30 and PPpost20 was greater (p < 0.001) in the RM (2.4 ± 0.2 and 2.1 ± 0.4 mL cmH2O-1 kg-1) than in the NO-RM (0.9 ± 0.4 and 1.2 ± 0.2 mL cmH2O-1 kg-1). CONCLUSIONS AND CLINICAL RELEVANCE: In dogs undergoing laparoscopy, ARM followed by 5 cmH2O PEEP improves gas exchange and respiratory system mechanics.

Aortic Arch Interruption and Persistent Fifth Aortic Arch in Phace Syndrome: Prenatal Diagnosis and Postnatal Course.

PHACE is a rare congenital neurocutaneous syndrome where posterior fossa malformations, hemangiomas, cerebrovascular anomalies, aortic arch anomalies, cardiac defects, and eye abnormalities are variably associated. We describe the prenatal detection and the postnatal course of a child with PHACE syndrome with a unique type of aortic arch anomaly consisting of proximal interruption of the aortic arch and persistence of the fifth aortic arch. The fifth aortic arch represented in this case a vital systemic-to-systemic connection between the ascending aorta and the transverse portion of the aortic arch allowing adequate forward flow through the aortic arch without surgical treatment.

A further experience of propranolol for severe infantile hemangiomas of the face: an observational study.

Infantile hemangiomas (IHs) are the most common proliferating embrional tumors of infancy, which are constituted by endothelial cell hyperproliferation. The authors want to report their observations of further 14 patients suffering from complicated IHs involving the facial district who were treated with propranolol. 14 patients, with ages between 3 and 12 months, completed a cycle of treatment with propanolol. The observational study aimed at focusing IHs involving the facial district. The treatment with propranolol showed good to very good results in the major part of the treated young patients. The authors want to report their experience and add more data in the confirmation of the use of ß-blockers for IH (either in efficacy or in safety profile), focusing on the efficacy of propanolol when IHs involve the face.

Effects of Cognitive and Physical Load of Acute Exercise on Inhibitory Control and Prefrontal Cortex Hemodynamics in Children.

INTRODUCTION: Evidence suggests that acute exercise benefits inhibitory control, but it remains unclear how physical and cognitive load influence this ability in preadolescent children, when faced with different types of distractors. We examined their moderating effects along with changes in prefrontal cortex hemodynamics. METHODS: Using a crossover design, 29 participants completed 10 min of exercise (with an interactive training wall) at 1) low physical and low cognitive load, 2) low physical and high cognitive load, 3) high physical and low cognitive load, and 4) high physical and high cognitive load in a randomized order. Before and after each condition, they performed a Standard and Affective Stroop task. During both tasks, the lateral oxygenation difference in the prefrontal cortex was measured by using functional near-infrared spectroscopy. RESULTS: For the Standard Stroop task, there was no effect of physical and cognitive load on performance. In contrast, exercise with low compared with high cognitive load was associated with a greater reduction of reaction time and increase in accuracy on the Affective Stroop task. This was accompanied by a decrease in lateral oxygenation difference on trials with low inhibitory control demands. CONCLUSIONS: Acute exercise with low compared with high cognitive demand benefits the ability to resolve emotional conflict, but the control over inhibition of nonemotional information remains unaffected. This effect of cognitive load is complemented by an increased efficiency of the left prefrontal cortex, when no emotional conflict resolution is required.

Health surveillance for SARS-CoV-2: infection spread and vaccination coverage in the schools of Modena province, Italy.

Introduction: In Italy, over 4.8 million individuals aged 0-19 years have been infected with SARS-CoV-2. This study aims to evaluate the spread of SARS-CoV-2 within schools in Modena province and the influence of anti-SARS-CoV-2 vaccination coverage. Methods: We performed a survey in the period 1 September-15 December 2021, involving student population aged 0-19 years and related teachers screened for SARS-CoV-2 infection using nasopharyngeal swab after the detection of an index case within their class. During the study period, vaccination against SARS-CoV-2 was actively offered to all subjects aged ≥12 years. Results: A total of 13,934 subjects were tested, 12,534 students and 1,400 teachers (594 classes). We identified a total of 594 and 779 index and secondary cases, respectively. We found that 9.8% of students and 10.6% of teachers were positive for SARS-CoV-2. Overall at the test time, 32.5% were vaccinated with at least one dose of anti-SARS-CoV-2 vaccine. Among secondary cases, 7.8% were vaccinated compared to 34.9% among negative tested subjects. A higher secondary attack rate was for non-vaccinated subjects rather than vaccinated ones (8.1% vs. 1.4%). Higher secondary attack rates were reported for subjects attending infant and primary school (5.9 and 9.6%, respectively). Lower secondary attack rates were for those who attended middle school (4.9%) and especially high school (1.7%). Conclusion: Our results highlight the differential spread of the infection within various educational settings and that the vaccination, available in the study period for the population aged ≥12, have mitigated SARS-CoV-2 spread in high and middle schools.

Physical and Sedentary Activities and Childhood Overweight/Obesity: A Cross-Sectional Study among First-Year Children of Primary Schools in Modena, Italy.

Children obesity is a serious public health issue. This study aimed to investigate physical/sedentary activities of first-year primary schools children in Modena, and their association with overweight/obesity and dietary habits of children and family characteristics to identify the risk factors for unhealthy lifestyles. Child physical/sedentary activities were gathered through an anonymous questionnaire administered to parents, as well as family characteristics and weight/height of child and parents. Logistic regression models, eventually adjusted for parents' sociodemographic characteristics, were used to analyze data. Questionnaires were delivered by 660 families (74.2%), of which 72 without anthropometric data were excluded. Three out of four children spent in physical activities less than 7 h/week, while 63.9% dedicated to sedentary activities two or more hours/day. From multivariate analysis, the habit significantly affecting children's overweight/obesity was spending time on tablets/Personal Computers/mobile phones/videogames. Higher parental education level resulted in a protective factor for implementing unhealthy lifestyles in terms of time dedicated to physical/sedentary activities. Our results suggest the need of interventions to increase time for physical activity and to promote a responsible use of digital media involving the entire families to reach all parents regardless of their education and nationality with a possible relapse on other family members.

Characteristics and risk factors of isolated and quarantined children and adolescents during the first wave of SARS-CoV-2 pandemic: A cross-sectional study in Modena, Northern Italy.

BACKGROUND AND AIM: In early 2020, SARS-CoV-2 was declared a pandemic by the WHO and Italy was one of the first and most severely affected country in Europe. Despite the global interest about COVID-19 pandemic, several aspects of this infection are still unclear, especially in pediatric population. This study aims to investigate the characteristics of the isolated or quarantined children and adolescents followed by the Public Health Department of the Italian province of Modena during the first wave of COVID-19. METHODS: The study population included all non-adult subjects aged 0-18 years who underwent isolation or quarantine during the first wave of SARS-CoV-2 pandemic from February 24 to June 18, 2020 in Modena province, Northern Italy. RESULTS: In Modena province, 1230 children and adolescents were isolated in case of SARS-CoV-2 infection (6.3%), or quarantined due to close contact with confirmed cases (88.7%) or travelling from a high-risk area (5.0%). Among 349 individuals who underwent swab testing, 294 (84.2%) reported close contact with an infected cohabiting relative and 158 (45.3%) were symptomatic. Among all tested subjects, 78 (22.4%) resulted positive, with a higher proportion of symptomatic subjects compared with the SARS-CoV-2-negative (78.2% vs. 35.8%). Fever was mostly present in SARS-CoV-2-positive children (48.7% vs. 12.6%). Both anosmia (58.3% vs. 41.7%) and dysgeusia (54.5% vs. 45.5%) had only slightly higher frequency in SARS-CoV-2-positive. CONCLUSIONS: These findings allow to expand the knowledge regarding characteristics of non-adult subjects isolated or quarantined during the first wave of SARS-CoV-2 pandemic. (www.actabiomedica.it).

Linking chronic tryptophan deficiency with impaired bone metabolism and reduced bone accrual in growing rats.

There is increasing evidence that serotonin may regulate bone metabolism. However, its role remains to be clarified. Serotonin seems to be either beneficial or detrimental for bone tissues depending on the pharmacological manipulation used. In this study we evaluated the impact of a reduction of serotonergic stores induced by chronic tryptophan (TRP) depletion on various bone parameters in growing rats. For this purpose rats received a TRP-free diet for 60 days. Bone mass, mineral content and density were measured by DXA and by pQCT in the appendicular skeleton. Bone metabolic markers included urinary deoxypyridinoline and serum osteocalcin measurements. IGF-I levels were also evaluated. In TRP-free diet rats, we found a decrease in body weight, a delayed femoral bone growth and bone mineral content as measured by DXA. pQCT analysis showed that these effects were related to a reduction of both cortical and trabecular bone and are associated with a reduction of bone strength. These effects are due to a negative shift in the balance between bone formation and resorption with a significant decrease in bone formation as evidenced by a reduction both in osteocalcin and IGF-I levels. The present data extend our overall knowledge on the participation of serotonin in the regulation of growing bone and could be of interest in studying the impairment of bone growth in depressed subjects under particular condition of rapid bone accrual such as childhood and adolescence.

Insomnia and Information and Communication Technologies (ICT) in Elderly People: A Systematic Review.

Background: Insomnia seems to be related to disability, risk of injury, metabolic syndrome, risk for cardiovascular diseases, cognitive impairment, depression and impaired quality of life. Objectives: The goals in this paper was (1) to keep track of technological concepts and approaches to improve insomnia in elderly people, and (2) to define the effect that information and communication technologies (ICT) is having on patients' care. Design: A systematic review was conducted from existing literature. Our selection criteria included: (1) age ≥ 60 years; (2) diagnosis of insomnia with the International Classification of Sleep Disorders (ICSD-II), (3) CBTi (cognitive behavioural therapy insomnia), (4) use of technological tools, and (5) associations between insomnia-related variables and indices of disability, quality of life, and global clinical assessments. Data analysis: 11 articles were included. An inductive content analysis was used for data extraction. Results: Our review revealed any technological systems that could purportedly rehabilitate elderly patients with insomnia. Three categories of research were identified from the review: (1) Internet Deliver-CBTi, (2) virtual coaches, and (3) sleep technologies. Conclusions: The potential for ICT to support insomnia care at home can improve the quality of life for families and reduce health care costs and premature institutional care.

Sun-Protection Behavior, Pubertal Development and Menarche: Factors Influencing the Melanocytic Nevi Development-The Results of an Observational Study of 1,512 Children.

Observational studies consistently show that melanocytic nevus prevalence increases with age and that phenotypic traits are significantly associated with nevus count in children. An observational study of 1,512 children and adolescents from 2010 to 2013 was conducted. Study dermatologists counted the full body, arm, and facial nevi of each participant. Children and their parents were asked to complete a survey to gather data on personal characteristics, pubertal development, and early-life sun exposure. The main aim of the study was to establish pediatric nevus prevalence and its relationship with age, phenotype, sex, menarche, early-life sun exposure, and sun-protection behaviors. Females had a significantly lower nevus count compared with males, but this sex-related difference was significantly modified by menarche. Sun exposure and sun-protection habits were all significantly associated with nevus count; in particular, children who used sunscreen with a sun-protection factor > 30 had a lower nevus count compared with sun-protection factor ≤ 30 sunscreen users. This study shows that sex, menarche status, and sun-protection practices significantly influence nevus count in this pediatric population.

Safety and effectiveness of oral propranolol for infantile hemangiomas started before 5 weeks and after 5 months of age: an Italian multicenter experience.

BACKGROUND: Despite not being licensed for the treatment of infantile hemangiomas (IH) in infants younger than 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience of 8 Italian pediatric and dermatologic centers regarding propranolol treatment for IH started before 5 weeks or after 5 months of age. METHODS: We retrospectively reviewed the records of patients followed up for IH, on propranolol treatment started before 5 weeks or after 5 months of age, and collected information on sociodemographic data, treatment indications, IH involution, IH relapse, and treatment side effects. RESULTS: A total of 343 patients were enrolled; 15 were started on propranolol before 5 weeks (group 1), 328 were started after 5 months of age (group 2). The most frequent indications were permanent aesthetical disfigurement (91.8%) and function threatening complications (42.6%). In most cases, the treatment was effective. The involution was partial in 67.7% of patients. In 11.8% of cases a relapse was observed. No relapse was observed in group 1. Treatment complications were reported in 15.8% of children, most frequently sleep disorders (6.6%), followed by irritability (5.1%) and diarrhea (2.2%). Only a case of mild constipation was observed in group 1. CONCLUSION: The safety and effectiveness profile of propranolol in infants younger than 5 weeks or older than 5 months may be acceptable. Taking in account propranolol's potential in preventing severe complications, further studies should assess the acceptability of propranolol treatment, especially in the <5-week age group .

Bullous pemphigoid in infant post vaccination: Myth or reality?

Bullous pemphigoid is rare in children and even rarer in infants. By presenting two cases of bullous pemphigoid related by their temporal proximity with a previous episode of vaccination, it will be carefully discussed if a relationship is or is not possible. Our final conclusion is that the association is mostly a myth rather than a reality and bullous pemphigoid is not a contraindication to continue with the normal vaccination schedule of infants. It is important to know about this clinical entity in order to perform adequate treatment that avoids any worsening or future relapse of this disease.

Autoimmune Thyroiditis, Pernicious Anaemia, Vitiligo and Scleroatrophic Lichen in a boy with short-chain acylCoA dehydrogenase deficiency.

Short-chain acylCoA dehydrogenase (SCAD) deficiency is a rare mitochondrial disorder involving the beta-oxidation of fatty acylCoA compounds in chains of 4-6 carbons. Unlike other mitochondrial disorders, cases involving autoimmune diseases have not been described. We report a 15-year-old boy with SCAD deficiency who suffered from pernicious anaemia, vitiligo, scleroatrophic lichen and autoimmune thyroiditis. As has been reported in other mitochondrial disorders, we hypothesised that autoimmune diseases are also present in SCAD deficiency. Furthermore, we discuss the possible pathogenetic relationship between these diseases.