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Acute respiratory viral infections pose a significant healthcare burden on the pediatric population globally, but data on the dissemination pattern in the community due to the COVID-19 pandemic are scarce. We conducted a two-year prospective multicenter study in Catalonia (Spain) that examined the prevalence and coinfection dynamics of respiratory viruses among 1276 pediatric patients from different age groups attending primary care. Coinfection analysis demonstrated complex patterns and revealed a coinfection rate of 23.8% for SARS-CoV-2, often in association with rhinovirus or influenza A. This study provides valuable data to understand post-pandemic viral interactions, which is imperative for public health interventions., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Ploidy variants can be utilized to increase yield, introduce sterility, and modify specific traits with an economic impact. Despite economic importance of Saccharina species, their nuclear DNA content in different cell types and life stages remain unclear. The present research was initiated to determine the nuclear DNA content and intraindividual variation at different life cycle stages of the Laminarialean kelp Saccharina latissima. Nuclear DNA content in embryonic and mature sporophytes, released and unreleased zoospores, female, and male gametophytes from Sør-Trøndelag county in Norway were estimated by image analysis using the DNA-localizing fluorochrome DAPI and chicken's red blood cells as a standard. DNA content of a total of 6905 DAPI-stained nuclei was estimated. This is the first study of nuclear DNA content which covered the life cycle of kelp. The lowest level of DNA content (1C) was observed in zoospores with an average of 0.76 pg. Male and female single spore gametophyte cultures presented higher average DNA content, more than double that of zoospores, suggesting the presence of polyteny. Female gametophyte nuclei were slightly larger and more variable in size than those of male gametophytes. The DNA content observed in embryonic sporophytes and in meristoderm cells from older sporophytes (1.51 pg) was 2C as expected and in the range of previously published studies of sporophytes of S. latissima. Mature sporophytes showed intra-plant variation with DNA content values ranging from 2-16C. The main difference was between meristoderm cells (mostly 2C) and cortical and medullary cells (2-16C)., (© 2022. The Author(s).)

Homogeneous Charge Compression Ignition (HCCI) combustion is a potential candidate for dealing with the stringent regulations on vehicle emissions while still providing very good energy efficiency. Despite the promising results obtained in preliminary studies, the lack of autoignition control has delayed its launch in the engine industry. In the development of the HCCI concept, the availability of reliable computer models has proved extremely valuable, due to their flexibility and lower cost compared with experiments using real engines. In order to obtain the best formulation of a fuel surrogate formulated with n-heptane, toluene and cyclohexane that efficiently estimate the autoignition behaviour, regression adjustments are made to the Root-Mean-Square Errors (RMSE) of experimental Starts of Combustion (SOC) from the modeled SOC. The canonical form of the Scheffé polynomials is widely used to fit the data from mixture experiments, however the experimenter might have only partial knowledge. In this paper we present the adaptation of the robust methodology for possibly misspecified blending model and an algorithm to obtain tailor-made optimal designs for mixture experiments, instead of using standard designs which are indiscriminately employed, to make good estimations of the parameters blending model. We maximize the determinant of the mean squared error matrix of the least square estimator over a realistic neighbourhood of the fitted regression mixture model. The maximized determinant is then minimized over the class of possible designs, yielding an optimal design. Thus, the computed desings are robust to the exact form of the true blending model. Standard mixture designs, as the simplex lattice, are around 25% efficient for estimation purposes compared with the designs obtained in this work when deviances from the considered model occur during the experiments. Once an optimal-robust design was selected (based on the level of certainty about model adequacy), we computed the optimal mixture that best reproduces the combustion property to be imitated. Optimal mixtures obtained when the considered model is inadequate agree with the results achieved in empirical studies, which validates the methodology proposed in this work., Competing Interests: The authors have declared that no competing interests exist.

Objective: Hyper-attendance is a significant problem in paediatric Primary Care clinics. The aim of our study was to analyse the level of attendance in these clinics and its relationship with certain psychosocial aspects of the families attending them., Patients and Methods: Observational descriptive study was conducted using questionnaires collected during a period of 6months, as well as recording the frequency of attendance in the previous 6months. A total of 346 questionnaires of children between 6months and 13years of age belonging to 2 urban Primary Care clinics in Madrid were completed. The raw data was analysed, and comparisons between groups and multivariate analysis were performed., Results: The mean number of consultations in the last 6months, of the total included in the study, was 3.06 in the Primary Care centre, and 0.77 in the emergency services. It was considered over-frequent for those who had attended the Primary Care health centre 6 or more times in this period (>p90), of which there were 33 children (9.53%). In the multivariate analysis, the variables related to being frequent users of Primary Care clinics were: the presence of high level of anxiety in the parents (OR=5.50; 95%CI: 2.49-12.17, P<.0001), and the age of the children (OR=0.73; 95%CI: 0.58-0.91, P=.005). The model presented an area under the curve of 0.761 (95%CI: 0.678-0.945, P<.0001)., Conclusions: The frequency of visits in paediatric Primary Care clinics is directly related to the high level of anxiety of the parents, and inversely to the age of the children. It would be advisable to detect and, if possible, intervene in cases of high parental anxiety in order to try to reduce the over-frequency in the paediatric primary health care., (Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To study the correlation between the levels of environmental pollutants and the number of paediatric consultations related to respiratory disease in Primary Health Care., Patients and Methods: An ecological study is performed, in which the dependent variable analysed was the number of paediatric consultations in an urban Primary Health Care centre in Madrid over a 3 year period (2013-2015), and specifically the consultations related to bronchiolitis, recurrent bronchospasm, and upper respiratory diseases. The independent variables analysed were the levels of environmental pollutants. Coefficients of correlation and multiple lineal regressions were calculated. An analysis has been carried out comparing the average of paediatric consultations when the levels of nitrogen dioxide (NO 2 ) were higher and lower than 40μg/m 3. RESULTS: During the period of the study, there were a total of 52,322 paediatric consultations in the health centre, of which 6,473 (12.37%) were related to respiratory diseases. A positive correlation was found between SO 2 , CO, NOx and NO 2 and benzene levels and paediatric consultations related to respiratory diseases, and a negative correlation with temperature. The number of consultations was significantly higher when NO 2 levels exceeded 40μg/m 3 . In the multiple lineal regression (P=.0001), the correlation was only positive between consultations and NO 2 levels (3.630, 95% CI: 0.691-6.570), and negative with temperature (-5,957, 95% CI: -8.665 to -3.248)., Conclusions: NO 2 environmental pollution is related to an increase in respiratory diseases in children. Paediatricians should contribute to promote an improvement in urban air quality as a significant preventive measure., (Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status., Patients and Methods: Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed., Results: In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001., Conclusions: The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status., (Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

This work presents optimum designs for reaction rates experiments. In these experiments, time at which observations are to be made and temperatures at which reactions are to be run need to be designed. Observations are performed along time under isothermal conditions. Each experiment needs a fixed temperature and so the reaction can be measured at the designed times. For these observations under isothermal conditions over the same reaction a correlation structure has been considered. D-optimum designs are the aim of our work for zeroth and first-order reaction rates. Temperatures for the isothermal experiments and observation times, to obtain the most accurate estimates of the unknown parameters, are provided in these designs. D-optimum designs for a single observation in each isothermal experiment or for several correlated observations have been obtained. Robustness of the optimum designs for ranges of the correlation parameter and comparisons of the information gathered by different designs are also shown., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: The purpose of this study is to analyse whether the use of hypotonic fluids increases the risk of iatrogenic hyponatraemia in children hospitalised with acute gastroenteritis (AGE)., Patients and Methods: Prospective study carried out on 205 patients with ages ranging from 1 to 28 months and admitted with a diagnosis of mild or moderate dehydration due to AGE and treated with intravenous hypotonic fluids in a paediatric department in Madrid (Spain). The degree of dehydration at presentation was estimated using standard clinical measures. 198 children received 0.3 % glucosaline solution and in 7 patients, with baseline hypernatraemia, 0.2 % gluco-hyposaline solution was administered. We analysed the results according to whether children were hyponatraemic, normonatraemic or hypernatraemic at presentation. The blood and urine samples were analysed and the concentration of sodium and fractional sodium excretion (EFNa) before and after intervention were considered as outcome measures., Results: The 205 patients included in the study were distributed in 3 groups according to the baseline natraemia results. In 37 cases we detected hyponatraemia (18.04%), in 133 cases isonatraemia (64.87%) and in 35 children hypernatraemia (17.07%). After administering hypotonic fluids we detected a significant difference between initial and final natraemia in all groups; in the group with hyponatraemia, sodium increased and in the groups with iso and hypernatraemia, sodium slightly decreased. A significant correlation between the EFNa and the evolution of natraemia was found. No cases of hyponatraemia post-infusion were seen and there was no correlation between free water administered and natraemia evolution., Conclusions: RESULTS show that the use of hypotonic fluids does not increase the risk of hospital acquired hyponatraemia in hospitalised children with normal renal function. Our children with gastroenteritis did not develop hyponatraemia even though they were all treated with hypotonic intravenous solutions.

Objective: [corrected] To study the utility of chest physiotherapy by increased exhalation technique with assisted cough in the acute bronchiolite of the hospitalized new-born babys., Patients and Methods: Double-blind clinical trial accomplished on 236 patients of age lower than 7 months and hospitalizad with diagnosis of acute bronchiolitis, first episode, in a pediatric department in Madrid.The patients were randomized in two groups: those who have received maneuvers of chest physiotherapy and those who have received maneuvers placebo. Only physiotherapist were aware of the allocation group of the infants. The days of hospitalization and the hours of oxygentherapy were used like result measurement., Results: From the totality of the studied children 57,6% received maneuvers of chest physiotherapy and 42,4% remaining received maneuvers placebo. In the group that received chest physiotherapy the average stay in the hospital was 4,56 days (95% confidence interval [CI] 4,36-6,06) and the average time of oxygentherapy was 49,98 (95% CI 43,64-67,13) hours opposite to 4,54 days (95%CI 3,81-5,73) and 53,53 hours (95% CI 48,03-81,40) respectively in the group that did not receive chest physiotherapy. In the patients with analytical print for VRS and that received chest physiotherapy less hours of oxygen therapy were needed 48,80 hours (95% CI 42,94-55,29) opposite to 56,68 hours (95% CI 55,46-65,52) respectively, being the only one turned out as per statistics significantly (P=.042)., Conclusions: Results show that chest physiotherapy has not been effective in reducing hospital stay or length of oxygentherapy in patients with acute bronchiolitis, but in the positive study of children with respiratory syncytial virus in nasopharyngeal aspirate showed a reduced need hours of oxygen. hours (P=.042)., (Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Background: Alternaria alternata is a risk factor for developing asthma.Alt a 1, which has been described as the major allergen in A alternata, shows a good correlation with A alternata spores only when they have germinated., Objectives: The objective of this study was to determine the correlation between spore counts and clinical symptoms in patients with allergic asthma and/or rhinitis monosensitized to A alternata., Methods: Two types of samplers were used to determine exposure: a Burkard spore trap to collect A alternata spores and a high-volume air sampler to collect airborne particles. A total of 366 air filters were collected. Alt a 1 levels were measured by monoclonal antibody-based enzyme-linked immunosorbent assay. Eighteen monosensitized patients were asked to record their daily symptoms throughout the year., Results: A alternata spores were detected throughout the year, whereas Alt a 1 was detected only between March and December. Symptoms showed positive and significant correlations with spore counts (r=0.459, P<.001), and Alt a 1 levels (r=0.294, P<.001). The correlation between spores and Alt a 1 was low. The negative binomial model proved that an increase of 10 pg/m3 in Alt a 1 levels increased the number of symptoms at a 3-day lag by 5%., Conclusions: In patients who are allergic to A alternata, Alt a 1 levels can be considered an important marker for predicting the risk of respiratory symptoms.

Objective: To determine the influence of socioeconomic status on healthcare demand and resource consumption in our population., Patients and Methods: We performed a cross sectional, retrospective study of socioeconomic status and healthcare and pharmaceutical consumption in randomly selected patients from five primary care pediatric clinics in Madrid. The chi-square test was used to compare percentages. For the remaining analyses, nonparametric tests were used after confirming that the data followed non-normal distribution., Results: We compared 684 questionnaires. Patients in the most disadvantaged socioeconomic levels consumed a greater number of drugs than those in more privileged levels (mean 0.79 vs. 0.47, p = 0.04). The mean pharmacological expenditure was also higher in the lowest socioeconomic levels than in the highest levels (5.28 Euros vs. 2.21 Euros, respectively; p = 0.001). No significant differences were found among socioeconomic levels in the number of consultations or diagnostic tests requested. The number of consultations was higher in younger patients (p < 0.001) or in those with chronic diseases (p = 0.001). Drug consumption was increased in the most disadvantaged levels (p = 0.002) and in patients with chronic diseases (p < 0.001). Lastly, pharmacological expenditure expressed in Euros was also higher in the lowest socioeconomic levels (p = 0.001) and in patients with chronic diseases (p < 0.001) but was lower if one of the parents was a foreigner (p = 0.031)., Conclusions: We found a relationship between socioeconomic level and drug consumption and its attributable cost. These data should be confirmed by broader studies.