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Negative phases of the Interdecadal Pacific Oscillation, which alters hydroclimatic risk across the Pacific, have been shorter and less frequent than inferred from the instrumental record, suggests a 2,000-year ice core reconstruction.

The study of (Palmer et al 2015 Environ. Res. Lett. 10 124002 ) details a spatial reconstruction of drought across eastern Australia and New Zealand over the last 500 years. The authors used a global 0.5° by 0.5° gridded network of the self-calibrating Palmer drought severity index (scPDSI) spanning 1901–2012 as the basis for a nested point-by-point regression to reconstruct austral summer (DJF) scPDSI for this region. Their study used 176 tree rings from New Zealand, Indonesia and Australia, and one coral record from the Great Barrier Reef. In their paper Palmer et al ( 2015 ) compared three publically available proxy records and reconstructions derived from the Law Dome ice core (East Antarctica) to their reconstructed scPDSI. These were the LD summer sea salt (LDsss) series, which is a proxy for Western Pacific sea surface temperature and subtropical eastern Australian rainfall (Vance et al 2013 J. Clim. 26 710–25 , 2015 Geophys. Res. Lett. 42 129–37 , Tozer et al 2016 Hydrol. Earth Syst. Sci. 20 1703–17 ), and two Interdecadal Pacific Oscillation (IPO) reconstructions produced using two independent methods, namely the Piece-wise Linear Fit (PLF) and Decision Tree (DT) series (Vance et al 2015 Geophys. Res. Lett. 42 129–37 , 2016 Clim. Past 12 595–610 ). We show that the treatment of the Law Dome LDsss record and the PLF and DT IPO reconstructions mis-characterizes both the utility and targets of the three records.

Objectives: The presence of donor-specific antibodies against HLA before kidney transplant has been variably associated with decreased long-term graft survival. Data on the association between pretransplant donor-specific antibodies and rejection and cause of graft failure in recipients of donor kidneys are scarce., Materials and Methods: For this study of HLA antibody levels, we analyzed serum samples from 76 patients (48 women and 28 men) who were prepared for kidney transplant at the Baskent University İstanbul Hospital between 2017 and 2022. Levels were determined by using Lifecodes panel reactive antibody class I and II identification kits and Lifecodes LSA class I and II identification kits by the Luminex assay method., Results: Multiple antigen tests showed more than 70% sensitization detected against both class I and class II antigens in our patient group. When some samples were reevaluated with the single-antigen bead method, desensitization values were shown to be considerably reduced compared with values from multiple antigen methods., Conclusions: The single-antigen-coated bead method can be useful in determining the risk of donor-specific antibodies in highly sensitized patients.

Aim: This study aimed to examine Turkish healthcare professionals' beliefs and predictors of negative attitudes toward obesity and to investigate whether those beliefs and negative attitudes differ per their profession and sociodemographic and familial variables., Method: In this cross-sectional study, healthcare professionals (n = 495) working in four hospitals of Ankara completed a sociodemographic questionnaire and two self-report scales: the Attitudes Toward Obese Persons Scale and the Beliefs About Obese Persons Scale. Data were collected during May, 2018., Results: Female healthcare professionals had significantly higher (p = 0.03) positive attitude scores than males, and nurses had significantly higher (p = 0.04) Beliefs About Obese Persons Scale scores than physicians, representing their belief that obesity is not under the control of the individual. The Attitudes Toward Obese Persons Scale scores of university hospital healthcare professionals were significantly higher (p = 0.00) than those of public hospital and private hospital healthcare professionals, and Attitudes Toward Obese Persons Scale scores of healthcare professionals who have a family member with a chronic disease were significantly higher (p = 0.027) than those who do not., Conclusion: The work experience, spending more time with a patient, and having a member of the family with a chronic illness lead to a more positive attitude toward people with obesity. This result emphasizes the importance of interventions that promote sensitive and empathic communication skills.

Objective: The world is struggling with the damage caused by the coronavirus disease 2019 pandemic. Most countries have applied quarantines to combat the spread of coronavirus disease 2019. The aim of this study was to determine the mental health of smoking adolescents and the change in smoking behavior compared to their peers during the coronavirus disease 2019 quarantine., Materials and Methods: This study was conducted with adolescents registered in the adolescent outpatient clinic with no record of psychiatric illness. The mental health of smoking (n = 50) and non-smoking (n = 121) adolescents was evaluated using the Brief Symptom Inventory. Smoking adolescents have been questioned about the change in smoking behavior since quarantine began., Results: The rates of depression and hostility symptoms were significantly higher in smoking than in nonsmoking adolescents. Male smokers had significantly higher depression and hostility symptoms than male non-smokers. However, no significant difference was observed between the rates of female smokers and non-smokers. It was determined that 54% (27) of the smokers reduced their smoking, while 14% (7) smoked more than before and 3.5% of former smokers stated that they quit smoking during quarantine and these people were included in the non-smoker group., Conclusion: It is not surprising that the mental health of adolescents was affected by the coronavirus disease 2019 quarantine. Our findings revealed the necessity to closely monitor the mental health of smoking adolescents, especially males smokers. The results of our study suggest that encouraging adolescents who smoke to quit during the coronavirus disease 2019 pandemic may be more effective than before quarantine.

Objective: Tobacco use is an important, preventable public health problem, and its use usually begins in adolescence. For this reason, smoking intervention for tobacco control is considered one of the fields of pediatrics. This study aims to examine the knowledge and attitudes of pediatric residents toward tobacco control and smoking intervention., Materials and Methods: In this multicenter study, pediatric residents were asked about their knowledge and attitudes toward adolescent smoking intervention and tobacco control through an online questionnaire., Results: A total of 271 pediatric residents participated in the study, and 56% of the residents stated that they asked adolescents with respiratory tract symptoms whether they smoked or not. However, 22% of pediatric residents stated that they asked the same question to adolescents regardless of their symptoms, 92% of residents were unaware of the International Diagnostic Code for tobacco use, and 86% of the participants reported that they did not receive any training on tobacco control. It was determined that the residents, who knew the national smoking cessation hotline, were female, smokers, and seniors. They asked the adolescents whether they smoked or not and the results were statistically significant (P < .05)., Conclusion: The results show that pediatric residents have insufficient knowledge about tobacco control and cannot guide adolescents in smoking intervention. This research reveals that pediatric residents need a training program for adolescent smoking intervention in the pediatric resident curriculum. Pediatricians who are well trained in adolescent tobacco control can make important contributions to the prevention of tobacco use in adults.

Background: Reactivation of Hepatitis B (HBVr) related to immunosuppressive drug therapy (ISDT) in patients with resolved and past infection is a challenging entity. The number of prospective long-term studies is limited., Methods: Two groups of patients with resolved and past HBV infection were analyzed prospectively. The patients were further categorized as 266 patients receiving ISDT (group 1) and 246 patients receiving antineoplastic therapy (group 2)., Results: We did not detect any cases of HBVr among 108 patients receiving rituximab (71 of which were anti-HBc positive only), 111 patients receiving tumor necrosis factor inhibitors (66 of which were anti-HBc positive only), and 42 patients receiving high-dose glucocorticoids for more than 4 weeks (24 of which were anti-HBc positive only) during a mean follow-up time of more than 24 months. Subgroup analysis of the anti-HBs (+) patients showed that in group A (anti-HBs >1000 mIU/mL) the antibody levels did not change; in group B (anti-HBs between 100 and 1000 mIU/mL) the antibody levels changed non-significantly (P = .25), and in Group C (anti-HBs between 0 and 100 mIU/mL) the antibody levels declined significantly (P = .002). Furthermore, 16 patients in Group C had an anti-HBs loss during follow-up, but no HBVr was detected., Conclusion: The risk of HBVr by immunosuppressive therapy in this group may be lower than that suspected in the literature and anti- HBs levels may not seem to correlate with the risk of reactivation.

Aim: In Turkey, improvements in sanitation and the implementation of a vaccination program resulted in reduced rates of childhood exposure to hepatitis A virus. The incidence of symptoms and the complications of the disease are known to be increased in later ages. We aimed to describe changes in the seroprevalence of hepatitis A virus from the pre-vaccine era (2012) to the post-vaccine era (2018) in different age groups., Material and Methods: Levels of anti-hepatitis A virus immunoglobulin (Ig)-G of patients with no chronic disease and who were admitted to our hospital between 2013-2018 were obtained retrospectively from a single children's hospital database system., Results: A total of 3238 subjects were enrolled in the study (2820 children, 418 adults). The overall percentage of seropositivity was 60.5% in group 1 (age ≤2 years), 57.9% in group 2 (age 2-6 years), 31.2% in group 3 (age 7-11 years), 32.7% in group 4 (age 12-18 years), 44.6% in group 5 (age 19-24 years), and 73.9% in group 6 (age >25 years). Between 2013-2018, the increase in the number of seropositive individuals in group 2 (p<0.01), and the decrease in groups 3 and 4 were statistically significant from 2013 to 2018 (p=0.028, p<0.01)., Conclusion: According to the data of this single-center children's hospital in Turkey, hepatitis A virus seropositivity increases significantly in the preschool age group, but decreases in school-age children and adolescents after vaccination., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (Copyright: © 2020 Turkish Archives of Pediatrics.)

Objective: Adolescents with chronic disease are as likely to exhibit risk-taking behavior as their peers. The aim was to investigate the risk behaviors of adolescents with type 1 diabetes (T1D) and the effect of orthorexic eating behaviors (OEB) on glycemic control (GC)., Methods: This cross-sectional study was conducted with 107 adolescents with T1D, aged between 13-18 years and attending high school. The Risk Behavior Scale (RBS) and Orthorexic Behavior Scale (ORTO-11) were administered. A high RBS score indicates risky behavior; a low ORTO-11 score suggests a tendency to OEB. Participants hemoglobin A1c (HbA1c) status was used to assess GC: optimal GC (HbA1c ≤7%); or poor GC (HbA1c >7%)., Results: Among females, those with poor GC had significantly lower (p=0.031) ORTO-11 scores than those with optimal GC, which was not the case in males. A significant correlation (r=0.358, p<0.001) was found between HbA1c and total RBS, eating habits subscale, and suicidal tendency subscale scores. Participants with poor GC had significantly higher eating habits subscale, alcohol use, and tobacco use subscale scores (p<0.05). Among females, total RBS and suicidal tendency subscale score was found to be significantly higher in those with poor GC; among males, alcohol subscale score was found to be significantly higher in those with poor GC., Conclusion: This study is the first to show the effect of the tendency for OEB on GC among female adolescents with T1D. The study showed that, along with inappropriate eating behaviors, adolescents with T1D should also be assessed for other risk behaviors to help achieve optimal GC.

Objective: Irisin is a recently discovered protein and is defined as an adipomyokine. The relation of irisin with carbohydrate metabolism and other hormone parameters have been investigated. However, studies evaluating the relationship between irisin and puberty are limited and inconclusive. The aim was to evaluate serum concentrations of irisin during different pubertal stages in male adolescents., Methods: The study included normal weight pubertal male adolescents between the ages of 13 6/12 -14 11/12 who had entered puberty. Fasting serum irisin concentrations were evaluated, and bioelectrical impedance analysis was used to measure body fat ratio (BFR) and fat-free mass (FFM). BFR was also calculated by caliper measurement of subcutaneous fat at the triceps., Results: Sixty-eight adolescents were enrolled. The number of adolescents in pubertal stage 2, 3, 4 and 5 were n=17 (25%), n=13 (19.1%), n=21 (30.1%) and n=17 (25%), respectively. The median values of the irisin are 8.80, 8.20, 9.15 and 7.24 ng/mL according to the 2-5 pubertal stages, respectively. The levels of circulating irisin did not differ according to the pubertal stage. Additionally, there was no significant relationship between irisin levels and body fat percentage or FFM., Conclusion: Irisin levels do not differ after the onset of puberty or with progressing pubertal maturation. This study strengthens the evidence that there is no change in irisin concentration as puberty progresses. This may have important implications when using this adipomyokine in the future for diagnosis or treatment of obesity-related diseases.

Introduction: Previous studies have indicated that vitamin D deficiency is common in psychiatric patients, particularly in those with neuropsychiatric disorders such as autism and schizophrenia. Vitamin D is an important neurosteroid hormone and immunomodulatory agent that also has bone metabolic effects. There has been an increasing interest in immune-related neuropsychiatric symptoms that are triggered by group A beta-hemolytic streptococcal infections. In this study, we aimed to compare the serum levels of vitamin D between obsessive-compulsive disorder (OCD) patients with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and control subjects., Methods: Thirty-three OCD patients with PANDAS and 20 healthy controls were enrolled in the study. Serum 25-hydroxyvitamin D (25-(OH) D), calcium, phosphorus, alkaline phosphatase, and parathormone levels of the two groups were compared. Serum 25-(OH) D levels of <15 ng/mL were classified as vitamin D deficiency. The children's Yale-Brown Obsessive Compulsive Scale (YBOCS) and Clinical Global Impression (CGI) were used to assess the severity of OCD symptoms., Results: There was no significant difference in serum 25-(OH) D levels between the patient and control groups. However, vitamin D deficiency was significantly more frequent in the patient group than in the control group (48.5% vs. 20.0%; p=0.038). Moreover, OCD patients with vitamin D deficiency had higher rates of comorbid ADHD than those without vitamin D deficiency (87.5% vs. 52.6%; p=0.027). While serum phosphorus levels were negatively correlated with age as well as alkaline phosphatase and ASO levels, they were positively correlated with the YBOCS total score and global severity score. Serum parathormone levels were positively correlated with the YBOCS total score, compulsion score, obsession score, and global severity score., Conclusion: This study supports the hypothesis that an association between vitamin D metabolism and PANDAS-related OCD exists. We suggest that biochemical parameters predicting metabolic bone diseases are more common in PANDAS patients. There is a need for prospective studies to show a clear association between PANDAS and bone metabolic turnover based on autoimmune mechanisms., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Background/aims: The aim of the present study was to investigate whether Helicobacter pylori causes or triggers recurrent aphthous stomatitis (RAS) through cytokine gene polymorphism and/or cobalamin deficiency., Materials and Methods: Thirty-six patients with RAS and 130 patients without RAS were genotyped for IL-1β (-511C/T) and IL-6 (-174G/C) and evaluated for H. pylori infection and serum cobalamin level., Results: The patient groups according to RAS had similar rates of H. pylori gastritis and interleukin genotypes/alleles, and there was a non-significant difference between serum cobalamin levels (p>0.05). RAS patients with H. pylori gastritis showed a higher frequency (51.9%) of GC IL-6 genotype than RAS patients without H. pylori gastritis (11.1%) (p=0.036). Non-GG genotype and C allele were increased in patients without RAS and with H. pylori gastritis (p<0.05). Patients with H. pylori gastritis showed a lower value of serum cobalamin without statistical significance, although this difference was more prominent in RAS patients (p=0.07)., Conclusion: The carriage of the C allele of IL-6 may lead a susceptibility to chronic gastric inflammation after contamination with H. pylori. If H. pylori infection is justified as a predisposing factor for RAS and its severity by further studies, we can speculate that subjects with genetic susceptibility to this infection may benefit from H. pylori eradication treatment with respect to RAS.

Nicotine dependence is pointed out as the first reason of smoking behavior continuity and treatment failure. We investigated the nicotine dependence level (NDL) of health workers and the factors which affect it. We carried out the Fagerstrom test for nicotine dependence (FTND) and a questionnaire composed of 24 questions that evaluate demographic characters and the smoker ideas about smoking on health workers who staff at the a training hospital in Istanbul. NDL was not related with sex, age, education, marital status, child number and working time in health area (p> 0.05). There was correlation between NDL and daily smoked cigarette number (r= 0.71, p< 0.001). There was an opposite relationship among initiation age, regular use age and NDL (in order r= -0.16 and p= 0.013, r= -0.25 and p< or =0.001). 30% of the cases who had high NDL were smoking in everywhere of their home (p< 0.001). They also had high smoking ratios near surroundings of nonsmoker people (p= 0.003). The cases who had high NDL did not want to quit smoking (p= 0.028). Working in a hospital increased smoking ratio in 41.77% cases and did not affect the NDL (p= 0.3). It was thought that the cases that had high NDL did not take into consideration their surroundings and did not want to quit smoking. Health workers should be considered as a target population during antismoking campaigns, in order to make them willing in the struggle against tobacco.