Multiplex PCR and Antibiotic Use in Children with Community-Acquired Pneumonia.

Antibiotics are frequently prescribed to children with pneumonia, although viruses are responsible for most cases. We aimed to evaluate the impact of multiplex polymerase chain reaction (mPCR) on antibiotic use. We conducted a prospective study of children under 14 years of age admitted for suspected viral pneumonia, from October 2019 to June 2022 (except March-November 2020). A mPCR respiratory panel (FilmArray® 2plus, bioMérieux, Marcy-l'Étoile, France) was performed within 72 h of admission. Patients with positive reverse transcription PCR for respiratory syncytial virus, influenza, or SARS-CoV-2 were excluded. We compared the patients with historical controls (2017-2018) who had suspected viral pneumonia but did not undergo an aetiological study. We included 64 patients and 50 controls, with a median age of 26 months. The respiratory panel detected viral pathogens in 55 patients (88%), including 17 (31%) with co-infections. Rhinovirus/enterovirus (n = 26) and human metapneumovirus (n = 22) were the most common pathogens, followed by adenovirus and parainfluenza (n = 10). There were no statistically significant differences in the total antibiotic consumption (83% of cases and 86% of controls) or antibiotics given for ≥72 h (58% vs. 66%). Antibiotics were prescribed in 41% of the cases and 72% of the controls at discharge (p = 0.001). Ampicillin was the most commonly prescribed antibiotic among the patients (44% vs. 18% for controls, p = 0.004), while azithromycin was the most commonly prescribed among the controls (19% vs. 48% for patients and controls, respectively; p = 0.001). Our findings underscore the need for additional interventions alongside molecular diagnosis to reduce antibiotic usage in paediatric community-acquired pneumonia.

Emotional faces interfere with saccadic inhibition and attention re-orientation: An fMRI study.

Modulation of reflex responses is crucial to adapt our behavior and cognition, and this is especially difficult when biological relevant stimuli are present such as emotional faces. The aim of this study was to identify the effect of peripherally presented happy and angry facial expressions in reflexive saccades and saccadic inhibition/re-orientation of attention. Behavior through eye-tracking technique and fMRI event-related BOLD signals activations were evaluated in adult males during the performance of an antisaccade task. fMRI signals obtained during task performance were compared to a baseline. Results showed that antisaccades had a lower percentage of correct responses and higher latency onsets than prosaccades. At the activation brain level, differences between both emotions and the baseline were found during stimuli presentation. Prosaccades for happy and angry faces recruited larger clusters with higher Z values mainly in occipito-parietal and temporal regions related to visual basic and integration processing, as well as regions of the oculomotor network. Meanwhile, when compared to the baseline, antisaccades recruited similar areas but a lower number of clusters with lower Z values as expected for peripheral processing of faces. At antisaccades, happy faces recruited parieto-occipital, temporal and cerebellar regions, while the angry faces added activation of orbital and ventrolateral prefrontal cortex related to emotional regulation. These results suggest that emotional facial expressions are being processed outside of the focus of attention. Particularly, angry expressions recruit a wider brain network in order to inhibit automatic behavior and re-orientate voluntary attention efficiently that may be due to its biological relevance.

Sex differences in cognitive processing: An integrative review of electrophysiological findings.

Sex differences in cognition and their underlying brain mechanisms have attracted increasing attention. Brain electrical activity (EEG) represents a reliable, high-temporal resolution approach to assessing the neural correlates of ongoing cognitive activity. The aim of the present work was to provide a comprehensive review of the literature regarding sex differences in brain electrical activity during cognitive processing, and their potential relation to behavioral performance. The cognitive domains addressed are perception, attention, language, visuospatial reasoning, and the executive functions. Overall, the literature reviewed shows sex differences in brain electrical activity during cognitive processing. Differences were observed in such EEG characteristics as hemispheric specialization, scalp topography, amplitudes of event-related potential components, temporal dynamics, and connectivity patterns. While these between-sex differences varied across the cognitive domains analyzed, there were consistent results for visuospatial reasoning and language. Regarding the relationships between behavioral manifestations of cognitive functions and underlying brain dynamics, further research is required to draw reasonable conclusions, since many of the EEG studies reviewed did not assess behavioral differences. Future research must contemplate several confounding factors, such as the precise characteristics of the experimental tasks employed, the phases of the menstrual cycle, individual traits, subjective stimuli saliency, and the interaction of brain development with educational and sociocultural factors. Despite these concerns, the present review contributes to supporting a broad debate that aims to optimize cognitive and behavioral abilities in order to improve teaching strategies and learning skills and thus expand the potentialities of each sex.

EEG functional brain connectivity strengthens with age during attentional processing to faces in children.

Studying functional connectivity may generate clues to the maturational changes that occur in children, expressed by the dynamical organization of the functional network assessed by electroencephalographic recordings (EEG). In the present study, we compared the EEG functional connectivity pattern estimated by linear cross-correlations of the electrical brain activity of three groups of children (6, 8, and 10 years of age) while performing odd-ball tasks containing facial stimuli that are chosen considering their importance in socioemotional contexts in everyday life. On the first task, the children were asked to identify the sex of faces, on the second, the instruction was to identify the happy expressions of the faces. We estimated the stable correlation pattern (SCP) by the average cross-correlation matrix obtained separately for the resting state and the task conditions and quantified the similarity of these average matrices comparing the different conditions. The accuracy improved with higher age. Although the topology of the SCPs showed high similarity across all ages, the two older groups showed a higher correlation between regions associated with the attentional and face processing networks compared to the youngest group. Only in the youngest group, the similarity metric decreased during the sex condition. In general, correlation values strengthened with age and during task performance compared to rest. Our findings indicate that there is a spatially extended stable brain network organization in children like that reported in adults. Lower similarity scores between several regions in the youngest children might indicate a lesser ability to cope with tasks. The brain regions associated with the attention and face networks presented higher synchronization across regions with increasing age, modulated by task demands.

Inhibitory control under emotional contexts in women with borderline personality disorder: An electrophysiological study.

Borderline personality disorder (BPD) is characterized by emotional dysregulation and difficulties in cognitive control. Inhibitory control, meanwhile, is modulated by the presence of emotional stimuli. The objective of the present study was to examine the effects of implicit emotional contexts on response inhibition in BPD patients. Participants performed a response inhibition task (Go-NoGo) under 3 background context conditions: neutral, pleasant and unpleasant. Behavioral performance did not differed between groups. Significantly higher P3NoGo amplitudes, shorter N2 latencies and lower global connectivity were observed in the patients regardless of the emotional valence of the background images compared to controls. In addition, higher P3NoGo amplitudes were correlated with more pronounced psychopathological symptoms. Emotional contexts enhanced N2 amplitudes compared to neutral ones in both groups. Results indicate that BPD required greater neural effort to successfully perform the inhibitory task. Finally, BPD showed lower synchronization between cortical regions, which may indicate a disruption in the effective temporal coupling of distributed areas associated with emotional stimuli-processing during both response and response inhibition.

Cystic fibrosis: current concepts.

Cystic fibrosis is an autosomal recessive genetic disease, mainly in Caucasian children and young adults. It is caused by pathogenic variants in the CFTR (cystic fibrosis transmembrane conductance regulator) gene, which results in increased viscosity and difficult mucus clearance. The main organ affected is the lung, the pancreas, sweat glands, intestine, liver, nasal mucosa, salivary glands, and reproductive tract. The clinical manifestations vary, ranging from the most frequent pulmonary symptoms of obstructive disease to gastrointestinal manifestations relatection of pathogenic variants in the CFTR gene allow the diagnosis to be integrated. Cystic fibrosis management consists of three main strategies: firstly, to keep the airway free of secretion; secondly, to keep the airway free of infection; and finally, to maintain an optimal nutritional status. Therapies that seek to correct alterations in the CFTR gene are focused on avoiding a pathogenic nonsense variant, correcting folding, increasing trafficking to the plasma membrane, or increasing the function of the CFTR channel. Other therapies still under development include gene therapy, genome editing, and antisense oligonucleotides to modify the expression of this gene.

La fibrosis quística es una enfermedad genética autosómica recesiva que se presenta principalmente en niños y adultos jóvenes caucásicos. Está causada por variantes patogénicas en el gen CFTR (regulador de la conductancia transmembrana de la fibrosis quística), lo que ocasiona un aumento de la viscosidad y un difícil aclaramiento del moco. El principal órgano afectado es el pulmón, seguido del páncreas, las glándulas sudoríparas, el intestino, el hígado, la mucosa nasal, las glándulas salivales y el aparato reproductor. Las manifestaciones clínicas son variables y van desde las más frecuentes, que son los síntomas pulmonares de enfermedad obstructiva, hasta manifestaciones gastrointestinales relacionadas con la malabsorción secundaria a la insuficiencia pancreática. Aunque existen múltiples pruebas diagnósticas para la fibrosis quística, el tamiz neonatal, el aumento en el tripsinógeno inmunorreactivo, la prueba de cloro en sudor y la detección de variantes patogénicas en el gen CFTR permiten integrar el diagnóstico. El manejo consta de tres niveles principales: el primero, mantener la vía aérea libre de secreción; el segundo, mantener la vía aérea libre de infección; y por último, mantener un estado nutricional óptimo. Las terapias que buscan corregir las alteraciones en el gen CFTR están enfocadas en evitar una variante patogénica sin sentido, corregir el plegamiento, aumentar el tráfico a la membrana plasmática o incrementar la función del canal CFTR. Otras terapias aún en desarrollo incluyen la terapia génica, la edición del genoma y los oligonucleótidos antisentido para modificar la expresión de este gen.

Emotional faces modulate eye movement control on an antisaccade task.

The ability to modulate automatic responses, in order to favor voluntary actions is crucial for cognition and behavior, and this is particularly difficult when dealing with highly salient stimuli as emotional faces. The aim of this study was to evaluate the effects of angry faces on cortical activity during preparation of saccadic inhibition and voluntary reorientation of attention. Behavioral performance, eye movements and presaccadic event-related potentials were evaluated as 30 participants performed an antisaccadic task with neutral and angry faces presented in the peripheral visual field. Two components of the presaccadic activity were measured: positive presaccadic slope and spike potential. Results showed lower accuracy in the presence of angry faces than neutral ones. Saccade onset latency was longer for angry faces than for neutral ones on the prosaccadic trials, but the opposite result occurred on the antisaccadic trials. Finally, higher spike potential amplitudes were observed for the angry faces than the neutral ones. These results suggest that potentially threatening stimuli like angry facial expressions require greater effort to achieve inhibitory control and voluntary reorientation of attention.

Emotional Contexts Exert a Distracting Effect on Attention and Inhibitory Control in Female and Male Adolescents.

Adolescents exhibit difficulties in behavioral regulation that become more evident when emotional contexts are involved, since these may hinder the development of socially-adaptive behaviors. The objectives of the present study were: to examine the influence of emotional contexts on adolescents' ability to inhibit a prepotent response, evaluated by ERPs, and to determine whether sex differences in response inhibition are observed in adolescents in those contexts. Participants performed a prepotent response inhibition task (Go-NoGo) under 3 background context conditions: neutral, pleasant, and unpleasant. While no differences in accuracy were observed, the presence of emotional contexts did prolong reaction times compared to the neutral context. Also, the unpleasant context caused an enhancement of N2 amplitudes compared to the neutral and pleasant contexts. Also, N2 and P3 latencies were longer in emotional contexts than in the neutral condition during both correct responses and correct inhibitions. No sex differences were found in amplitude, but females showed longer N2 and P3 latencies than males. These results confirm the idea that, in adolescents, unpleasant pictures receive preferential attention over neutral images and so generate greater difficulty in response inhibition. Finally, results demonstrate that sex differences in inhibition control in adolescence were observed only in relation to time-processing.

Sex differences in emotional contexts modulation on response inhibition.

The aim of the present study was to explore sex differences in the effects that emotional contexts exert on the temporal course of response inhibition using event-related potentials (ERP). Participants performed a Go-NoGo response inhibition task under 3 context conditions: with 1) neutral background stimuli, and 2) pleasant, and 3) unpleasant emotional contexts. No sex differences were found in relation to accuracy. Women showed higher N2NoGo amplitudes than men in both emotional contexts; whereas during inhibition men tended to show higher P3NoGo amplitudes than women in the unpleasant context. Both groups experienced a relevant effect of the presence of the unpleasant context during inhibition processing, as shown by the enhancement of the N2NoGo amplitudes in frontal regions compared to results from the neutral and pleasant conditions. In addition, women showed differences between the pleasant and unpleasant contexts, with the latter inducing higher amplitude values. Only in men did inhibition accuracy correlate with higher N2NoGo and lower P3NoGo amplitudes in the emotional context conditions. These findings suggest that when an inhibition task is performed in an emotionally-neutral background context no sex differences are observed in either accuracy or ERP components. However, when the emotional context was introduced -especially the unpleasant one- some gender differences did become evident. The higher N2NoGo amplitude at the presence of the unpleasant context may reflect an effect on attention and conflict monitoring. In addition, results suggest that during earlier processing stages, women invested more resources to process inhibition than men. Furthermore, men who invested more neural resources during earlier stages showed better response inhibition than those who did it during later processing stages, more closely-related to cognitive and motor inhibition processes.

Extramacrochaetae, a trans-acting gene of the achaete-scute complex of Drosophila involved in cell communication.

Phenotypic analyses of genetic combinations involving the gene extramacrochaetae (emc) reveal its participation in the differentiation of both sensory elements and wing veins. The study of near-amorphic alleles of emc in mitotitc recombination clones indicates that it also affects cell proliferation. These clones show abnormal sizes, shapes and spatial distribution. They differentiate extra sensory elements as well as extra veins. A gain of function mutation in the gene causes opposite phenotypes in both differentiation systems. The effects of the mutant on proliferation and patterning are consistent with the emc gene being involved in the transfer of information between neighbouring cells, which leads to the spatial expression of the achaetescute gene complex and genes involved in vein formation.