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Two weeks have passed since the beginning of the invasion of Ukraine. Despite 141 countries voting in the UN General Assembly for the Russian army to stop fighting and withdraw from another sovereign country, Ukraine, the fighting is increasingly bloody and brutal. The war has led to 2.5 million people including about 1 million children fleeing from their homes and becoming refugees. There are 79 children confirmed killed including 18 months old infant in Mariupol. Most of child fatalities result from attacks from the air or with rockets. We stand together with Ukrainian children, families and the heroic medical and nursing staff calling for the action now: • we ask the governments of our countries to do more to ensure the safety of children in Ukraine, to stop the war and first of all to stop rockets and bombs attacks on civil infrastructure of Ukraine; • we ask Russian paediatricians and especially leaders of paediatric organizations in Russia to express clear and loud position against the war in Ukraine and to do everything in their power to stop the war; • we confirm once again solidarity and professionalsupport for children’s doctors and nurses in Ukraine. Our voices are stronger than rockets and bombs! Slava Ukraine!

Transcranial magnetic stimulation is used to explore visual cortex hyperexcitability in migraine. We hypothesized that the phosphene threshold in subjects suffering from migraines with and without aura would be lower than in controls, and this phenomenon could be linked to higher pain and disability levels. We also implied that subjects with lower phosphene threshold could see more phosphenes of different colors and shapes. Our primary objective was to compare the phosphene threshold between migraine without aura, migraine with aura, and control groups and investigate which factors contribute to different phosphene parameters in migraineurs. Secondary objectives were to compare color, shape, and number of phosphenes between groups and assess pain and disability level correlation with the phosphene characteristics. Phosphene threshold in migraine without aura, migraine with aura, and control groups were 68 ± 9.5% vs. 75 ± 12%, vs. 80 ± 11%, respectively. Other phosphene parameters (number, color and shape) did not differ between groups. Average pain level during the attack did not correlate with phosphene threshold significantly, though the non-significant trend for negative correlation of migraine disability assessment scale score and a phosphene threshold has been found the higher was migraine disability assessment scale value, the lower was phosphene threshold (β = -0.255; P = 0.139). Other variables: gender, age, migraine subtype, migraine duration and use of hormone contraceptives – were not related to the phosphene threshold value. Our study provides additional data on visual cortex hyperexcitability in migraineurs, regarding transcranial magnetic stimulation with a figure-of-eight coil. Visual cortex excitability might be linked to higher disability.

Aim: To assess fatigue in children aged 2–17 years with asthma from both child and parent perspectives and describe associated factors. Methods: Fatigue scores were self‐reported by children aged 5–17 years old and proxy‐reported by parents or carers for all children. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale was used. Fatigue scores ranged from 0 to 100, higher scores meant less fatigue. Results: There were 527 children and parents enrolled. The mean overall fatigue score by self‐report was 72.7 ± 15.8 and by proxy report was 75.8 ± 16.3. Self‐reported fatigue score was lower in children aged 5–7 years (71.5 ± 15.9) compared to proxy‐reported score (76.3 ± 15.5). Proxy and self‐reported fatigue scores were similar between parents and older children. Fatigue scores were lower in association with poor asthma control and receipt of social support. Lower self‐reported, but not proxy‐reported, fatigue score was related to asthma severity. Lower proxy‐reported, but not self‐reported, fatigue score was related to the child being older and having shortness of breath. Conclusion: Parents underestimated the fatigue of younger children aged 5–7 years, but fatigue scores were similar between parents and older children. Both clinical and social factors are associated with fatigue in children with asthma. [ABSTRACT FROM AUTHOR]

Tobacco has long been known to be one of the greatest causes of morbidity and mortality in the adults, but the effects on the foetus and young children, which are lifelong, have been less well appreciated. Developing from this are electronic nicotine delivery systems or vapes, promulgated as being less harmful than tobacco. Nicotine itself is toxic to the foetus, with permanent effects on lung structure and function. Most vapes contain nicotine, but they also contain many other compounds which are inhaled and for which there are no toxicity studies. They also contain known toxic substances, whose use is banned by European Union legislation. Accelerating numbers of young people are vaping, and this does not reflect an exchange of vapes for cigarettes. The acute toxicity of e-cigarettes is greater than that of tobacco, and includes acute lung injury, pulmonary haemorrhage and eosinophilic and lipoid pneumonia. Given the worse acute toxicity, it should be impossible to be complacent about medium and long term effects of vaping. Laboratory studies have demonstrated changes in lung proteomics and the innate immune system with vaping, some but not all of which overlap with tobacco. It would be wrong to consider vapes as a weaker form of tobacco, they have their own toxicity. Children and young people are being targeted by the vaping industry (which is largely the same as the tobacco industry), including on-line, and unless an efficient legislative program is put in place, a whole new generation of nicotine addicts will result.

During 2019–2020, the Virgin Islands Department of Health investigated potential animal reservoirs of Leptospira spp., the bacteria that cause leptospirosis. In this cross-sectional study, we investigated Leptospira spp. exposure and carriage in the small Indian mongoose (Urva auropunctata, syn: Herpestes auropunctatus), an invasive animal species. This study was conducted across the three main islands of the U.S. Virgin Islands (USVI), which are St. Croix, St. Thomas, and St. John. We used the microscopic agglutination test (MAT), fluorescent antibody test (FAT), real-time polymerase chain reaction (lipl32 rt-PCR), and bacterial culture to evaluate serum and kidney specimens and compared the sensitivity, specificity, positive predictive value, and negative predictive value of these laboratory methods. Mongooses (n = 274) were live-trapped at 31 field sites in ten regions across USVI and humanely euthanized for Leptospira spp. testing. Bacterial isolates were sequenced and evaluated for species and phylogenetic analysis using the ppk gene. Anti-Leptospira spp. antibodies were detected in 34% (87/256) of mongooses. Reactions were observed with the following serogroups: Sejroe, Icterohaemorrhagiae, Pyrogenes, Mini, Cynopteri, Australis, Hebdomadis, Autumnalis, Mankarso, Pomona, and Ballum. Of the kidney specimens examined, 5.8% (16/270) were FAT-positive, 10% (27/274) were culture-positive, and 12.4% (34/274) were positive by rt-PCR. Of the Leptospira spp. isolated from mongooses, 25 were L. borgpetersenii, one was L. interrogans, and one was L. kirschneri. Positive predictive values of FAT and rt-PCR testing for predicting successful isolation of Leptospira by culture were 88% and 65%, respectively. The isolation and identification of Leptospira spp. in mongooses highlights the potential role of mongooses as a wildlife reservoir of leptospirosis; mongooses could be a source of Leptospira spp. infections for other wildlife, domestic animals, and humans. Author summary Leptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira. To better understand local reservoirs and risk factors to humans and animals, during 2019–2020, the Virgin Islands Department of Health (VIDOH) investigated Leptospira spp. in association with the small Indian mongoose (Urva auropunctata, syn: Herpestes auropunctatus) across the three main islands of the United States Virgin Islands (USVI) (St. Croix, St. Thomas, and St. John). Mongoose blood and kidney samples were evaluated by laboratory testing: microscopic agglutination test, fluorescent antibody test (FAT), real-time polymerase chain reaction (lipl32 rt-PCR), and culture. Of 256 mongooses, 34% were exposed to Leptospira spp. To assess active infection in mongooses, kidney samples were examined resulting 5.8% (16/270) FAT-positive, 10% (27/274) culture-positive, and 12.4% (34/274) rt-PCR-positive. Validity was compared between test types showing higher positive predictive value for FAT and rt-PCR testing for predicting successful culture, the reference standard for diagnosis. Through the detection and isolation of Leptospira spp. in mongooses across the USVI, we identified mongooses as potential disease vectors to the local population and added to the limited data for the Caribbean region. Furthermore, a validity assessment of reference testing provides data to potentially inform future leptospirosis diagnostics.

Objective: The rising global epidemic of childhood obesity is a major public health challenge. Despite the urgency, there is a lack of data on the awareness and implementation of preventative measures. The aim of this study was to identify areas for improvement in the prevention and management of childhood obesity worldwide. Methods: A cross-sectional electronic survey was distributed to 132 members of national pediatric societies of the International Pediatric Association. Results: Twenty-eight (21.2%) participants, each from a different country across six World Health Organization (WHO) regions completed the survey. Most participants reported that national prevalence data of childhood obesity is available (78.6%), and the number increased during the Coronavirus disease-2019 pandemic (60.7%). In most countries (78.6%), the amount of sugar and salt in children's products is provided but only 42.9% enacted regulations on children-targeted advertising. Childhood obesity prevention programs from the government (64.3%) and schools (53.6%) are available with existing support from private or non-profit organizations (71.4%). Participants were aware of WHO's guidance concerning childhood obesity (78.6%), while fewer were aware of The United Nations International Children's Emergency Fund's (UNICEF) guidance (50%). Participants reported that WHO/UNICEF guidance acted as a reference to develop policies, regulations and national programs. However, progress was hindered by poor compliance. Lastly, participants provided suggestions on tackling obesity, with responses ranging from developing and reinforcing policies, involvement of schools, and prevention across all life stages. Conclusion: There are different practices in implementing prevention measures to counter childhood obesity globally, particularly in statutory regulation on food advertising and national programs. While support and awareness was relatively high, implementation was hindered. This reflects the need for prompt, country-specific evaluation and interventions. [ABSTRACT FROM AUTHOR]

Pollen-induced allergies are among the most prevalent non-contagious diseases, with about a quarter of the European population being sensitive to various atmospheric bioaerosols. In most European countries, pollen information is based on a weekly-cycle Hirst-type pollen trap method. This method is labour-intensive and requires narrow specialized abilities and substantial time, so that the pollen data are always delayed and subject to sampling- and counting-related uncertainties. Emerging new approaches to automatic pollen monitoring can, in principle, allow for real-time availability of the data with no human involvement. The goal of the current paper is to evaluate the capabilities of the new Plair Rapid-E pollen monitor and to construct a first-level pollen recognition algorithm. The evaluation was performed for three devices located in Lithuania, Serbia and Switzerland, with independent calibration data and classification algorithms. The Rapid-E output data include multi-angle scattering images and the fluorescence spectra recorded at several times for each particle reaching the device. Both modalities of the Rapid-E output were treated with artificial neural networks (ANNs) and the results were combined to obtain the pollen type. For the first classification experiment, the monitor was challenged with a large variety of pollen types and the quality of many-to-many classification was evaluated. It was shown that in this case, both scattering- and fluorescence-based recognition algorithms fall short of acceptable quality. The combinations of these algorithms performed better, exceeding 80 % accuracy for 5 out of 11 species. Fluorescence spectra showed similarities among different species, ending up with three well-resolved groups: (Alnus, Corylus, Betula and Quercus), (Salix and Populus) and (Festuca, Artemisia and Juniperus). Within these groups, pollen is practically indistinguishable for the first-level recognition procedure. Construction of multistep algorithms with sequential discrimination of pollen inside each group seems to be one of the possible ways forward. In order to connect the classification experiment to existing technology, a short comparison with the Hirst measurements is presented and the issue of false positive pollen detections by Rapid-E is discussed.

Background: In allergic rhinitis and asthma, adolescents and young adult patients are likely to differ from older patients. We compared adolescents, young adults and adults on symptoms, control levels, and medication adherence. Methods: In a cross‐sectional study (2015–2022), we assessed European users of the MASK‐air mHealth app of three age groups: adolescents (13–18 years), young adults (18–26 years), and adults (>26 years). We compared them on their reported rhinitis and asthma symptoms, use and adherence to rhinitis and asthma treatment and app adherence. Allergy symptoms and control were assessed by means of visual analogue scales (VASs) on rhinitis or asthma, the combined symptom‐medication score (CSMS), and the electronic daily control score for asthma (e‐DASTHMA). We built multivariable regression models to compare symptoms or medication accounting for potential differences in demographic characteristics and baseline severity. Results: We assessed 965 adolescent users (15,252 days), 4595 young adults (58,161 days), and 15,154 adult users (258,796 days). Users of all three age groups displayed similar app adherence. In multivariable models, age groups were not found to significantly differ in their adherence to rhinitis or asthma medication. These models also found that adolescents reported lower VAS on global allergy, ocular, and asthma symptoms (as well as lower CSMS) than young adults and adults. Conclusions: Adolescents reported a better rhinitis and asthma control than young adults and adults, even though similar medication adherence levels were observed across age groups. These results pave the way for future studies on understanding how adolescents control their allergic diseases. [ABSTRACT FROM AUTHOR]