US parents trust the health care system and bring their infant children in for preventive care. Previous studies have demonstrated the ability of health care systems to identify, and sometimes address, the economic needs of low-income families.

Families of newborns at a safety-net primary care center have high levels of economic hardship. Compared with controls, Developmental Understanding and Legal Collaboration for Everyone families had accelerated access to concrete supports, improved rates of on-time immunization and preventive care, and decreased emergency department utilization. (Read the full article)

Parental hesitancy about childhood vaccines is prevalent and related to delay or refusal of immunizations. Physicians are highly influential in parental vaccine decision-making, but may lack confidence in addressing parents’ vaccine concerns.

A physician-targeted communications intervention designed to reduce maternal vaccine hesitancy through the parent-physician relationship did not affect maternal hesitancy or physician confidence communicating with parents. Further research should determine the most effective approaches to addressing vaccine hesitancy. (Read the full article)

More than 200 million children <5 years are not reaching their developmental potential. Lack of stimulating caregiving is a major cause, and effective scalable interventions are needed. Integrating parenting with health services has been recommended, but there are few evaluations.

An innovative parenting intervention can be delivered at routine visits for primary health care, with benefits to child cognitive development and parenting knowledge. This approach using films, discussion, and practice has the potential for delivery at scale. (Read the full article)

Although treatment programs for childhood obesity can demonstrate success, long-term outcomes have seldom been evaluated. The benefit of intervention when overweight is identified in a screening assessment and parental recognition of the problem is minimal is understudied.

A low-dose (sessions every 1–3 months), but long-term (2 years), family-based intervention was effective at reducing BMI compared with usual care in children recruited via a weight screening initiative in which many parents had been unaware their child was overweight. (Read the full article)

Rudeness is routinely experienced by hospital-based medical teams. Individuals exposed to mildly rude behavior perform poorly on cognitive tasks, exhibit reduced creativity and flexibility, and are less helpful and prosocial.

Rudeness had adverse consequences on diagnostic and procedural performance of members of the NICU medical teams. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance. (Read the full article)

Intervention strategies are needed to reduce underage drinking. Meta-analyses of youth alcohol brief interventions (BIs) conclude that therapist-delivered BIs are efficacious; however, to maximize public health impact, recommendations include using technology to streamline intervention delivery, for which evidence is lacking.

A single-session BI, delivered by a computer or therapist in the emergency department, shows promise for underage drinkers. Findings for the stand-alone computer BI are particularly appealing given the ease of future implementation. (Read the full article)

The vitamin D concentration in breast milk of women taking 400 IU vitamin D per day is relatively low, leading to vitamin D deficiency in breastfeeding infants. As a result, the American Academy of Pediatrics recommends breastfeeding infant vitamin D supplementation within days after birth.

Maternal vitamin D supplementation alone with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy the requirement of her nursing infant and offers an alternate strategy to direct infant supplementation. (Read the full article)

Urethral catheterization is a painful, yet common procedure to obtain a sterile urine sample in young children. There are conflicting results regarding the effectiveness of lidocaine to reduce pain, and it is unclear if it should be routinely used.

In young children, combined topical and intraurethral lidocaine does not reduce pain during urethral catheterization and is associated with more pain than nonanesthetic lubricant during instillation. Clinicians should use noninvasive methods of analgesia during this painful procedure. (Read the full article)

Deferral of consent avoids delaying emergency interventions while ensuring consent to ongoing participation and use of data. Deferred consent is particularly important for enabling trials in pediatric settings, where many medicines and devices are unlicensed and untested for use.

Approaches for seeking deferred consent should balance the potential burden of obtaining consent against risk of bias due to outcome-related attrition. Ethics committees could consider approving data use when best efforts to obtain deferred consent are met with no response. (Read the full article)

Endotracheal intubation is a mandatory skill for neonatal trainees. It is a difficult skill to acquire, and success rates of junior doctors are low and falling.

Videolaryngoscopy allows the supervisor to share the intubator’s view of the airway and provide more informed guidance. Teaching intubation using a videolaryngoscope with the screen visible to the instructor results in significantly higher success rates for inexperienced doctors. (Read the full article)

Previous studies have evaluated separately the effects of brief education and reminder/recall intervention strategies to increase human papillomavirus vaccine coverage. None have examined if intervention effects varied by race/ethnicity.

When compared with a general adolescent vaccine brochure, human papillomavirus vaccine-specific educational materials increased 1-dose coverage among Hispanic but not black individuals. Recalls for doses 2 and 3 were effective in increasing 3-dose coverage for both racial/ethnic groups. (Read the full article)

Continuous conventional EEG video is currently gold standard for identifying neonatal seizures and a substantial proportion of neonatal seizures are electrographic. Currently there is no direct evidence that EEG monitoring, seizure identification, or treatment impacts long-term outcomes.

In neonates with hypoxic ischemic encephalopathy, EEG monitoring and treatment of electrographic seizures results in significant reduction in seizure burden. Increasing seizure burden is associated with more severe brain injury and significantly lower performance scores on Bayley Scales of Infant Development III. (Read the full article)

The impact of neonatal abstinence syndrome is of concern because the number of newborns showing symptoms of withdrawal after intrauterine drug exposure is increasing worldwide. Newborns developing neonatal abstinence syndrome require prolonged medical treatment and longer hospital admission after birth.

This first randomized controlled trial presents data on newborns with neonatal abstinence syndrome treated with laser acupuncture. The findings suggest that adjuvant laser acupuncture has the potential to reduce duration of morphine therapy and length of hospital stay. (Read the full article)

If you're into comic books but you don't want to deal with stacks of back issues or the hassle of going to your local comic shop, Amazon's Comixology is the way to go.

Comic books and graphic novels, popular in many language arts and social studies classes, are just now tiptoeing into the world of K-12 math.

There has been a distinct trend of consolidation among private medical schemes in South Africa, according to an actuarial specialist at Alexander Forbes.

A master’s degree thesis defense is difficult enough under normal circumstances, but due to COVID-19, integrated masters/bachelors student Sabrina Carrozzi defended her thesis on Zoom.

Strategic partnerships could be used to create win-win outcomes, says Sifiso Skenjana.

Le 1er juin dernier à Mugamba (province de Bururi), Pierre Nkurunziza a lancé un ultimatum. « Du haut d’une camionnette, micro à la main, sous très haute protection de l’armée et de la police », rapporte l’AFP, le président burundais a ordonné aux insurgés de cette commune du Sud du pays de déposer les armes dans les quinze jours : « Téléphonez à vos frères qui ont pris les armes, dites-leur que nous leur donnons quinze jours pour qu’ils y renoncent […] Quinze jours, pas plus. Dites-leur cela ». Hasard ou préméditation, la fin de cet ultimatum devrait coïncider avec la reprise prévue des discussions à Arusha, en Tanzanie, entre le gouvernement et l’opposition.

Contezolid (MRX-I), a new oxazolidinone, is an antibiotic in development for treating complicated skin and soft tissue infections (cSSTI) caused by resistant Gram-positive bacteria. This was a thorough QT study conducted in 52 healthy subjects who were administered oral contezolid at a therapeutic (800 mg) dose, a supratherapeutic (1600 mg) dose, placebo, and oral moxifloxacin 400 mg in 4 separate treatment periods. The pharmacokinetic profile of contezolid was also evaluated. Time-point analysis indicated that the upper bounds of the two-sided 90% confidence interval (CI) for placebo-corrected change-from-baseline QTc (QTc) were <10 ms for the contezolid therapeutic dose at each time point. The upper bound of the 90% CI for QTc were slightly more than 10 ms with the contezolid supratherapeutic dose at 3 and 4 hours postdose, and the prolongation effect on the QT/QTc interval was less than that of the positive control, moxifloxacin 400 mg. At 3 and 4 h after the moxifloxacin dose, the moxifloxacin group met the assay sensitivity criteria outlined in ICH Guidance E14 with having a lower confidence bound ≥5 ms. The results of a linear exposure-response model which were similar to that of a time point analysis demonstrated a slightly positive relationship between contezolid plasma levels and QTcF interval with a slope of 0.227 ms per mg/L (90% CI: 0.188 to 0.266). In summary, contezolid did not prolong the QT interval at a therapeutic dose and may have a slight effect on QT interval prolongation at a supratherapeutic dose.

Polymyxins are increasingly used as the critical last-resort therapeutic options for multidrug-resistant gram-negative bacteria. Unfortunately, polymyxin resistance has increased gradually for the last few years. Although studies on mechanisms of polymyxin are expanding, system-wide analyses of the underlying mechanism for polymyxin resistance and stress response are still lacking. To understand how Klebsiella pneumoniae adapt to colistin (polymyxin E) pressure, we carried out proteomic analysis of Klebsiella pneumoniae strain cultured with different concentrations of colistin. Our results showed that the proteomic responses to colistin treatment in Klebsiella pneumoniae involving several pathways, including (i) gluconeogenesis and TCA cycle; (ii) arginine biosynthesis; (iii) porphyrin and chlorophyll metabolism; and (iv) enterobactin biosynthesis. Interestingly, decreased abundance of class A β-lactamases including TEM, SHV-11, SHV-4 were observed in cells treated with colistin. Moreover, we also present comprehensive proteome atlases of paired polymyxin-susceptible and -resistant Klebsiella pneumoniae strains. The polymyxin-resistant strain Ci, a mutant of Klebsiella pneumoniae ATCC BAA 2146, showed missense mutation in crrB. The crrB mutant Ci, which displayed lipid A modification with 4-amino-4-deoxy-L-arabinose (L-Ara4N) and palmitoylation, showed striking increases of CrrAB, PmrAB, PhoPQ, ArnBCADT and PagP. We hypothesize that crrB mutations induce elevated expression of the arnBCADTEF operon and pagP via PmrAB and PhoPQ. Moreover, multidrug efflux pump KexD, which was induced by crrB mutation, also contributed to colistin resistance. Overall, our results demonstrated proteomic responses to colistin treatment and the mechanism of CrrB-mediate colistin resistance, which may further offer valuable information to manage polymyxin resistance.

Antibiotic resistance is a global concern; however, data on antibiotic-resistant Ureaplasma spp. and Mycoplasma hominis are limited in comparison to similar data on other microbes. A total of 492 Ureaplasma spp. and 13 M. hominis strains obtained in Hangzhou, China, in 2018, were subjected to antimicrobial susceptibility testing for levofloxacin, moxifloxacin, erythromycin, clindamycin, and doxycycline using the broth microdilution method. The mechanisms underlying quinolone and macrolide resistance were determined. Meanwhile, a model of the topoisomerase IV complex bound to levofloxacin in wild-type Ureaplasma spp. was built to study the quinolone resistance mutations. For Ureaplasma spp., the levofloxacin, moxifloxacin and erythromycin resistance rates were 84.69%, 51.44% and 3.59% in U. parvum and 82.43%, 62.16% and 5.40% in U. urealyticum, respectively. Of the 13 M. hominis strains, 11 were resistant to both levofloxacin and moxifloxacin, and five strains showed clindamycin resistance. ParC S83L was the most prevalent mutation in levofloxacin-resistant Ureaplasma strains, followed by ParE R448K. The two mutations GyrA S153L and ParC S91I were commonly identified in quinolone-resistant M. hominis. A molecular dynamics-refined structure revealed that quinolone resistance-associated mutations inhibited the interaction and reduced affinity with gyrase or topoisomerase IV and quinolones. The novel mutations S21A in the L4 protein and G2654T and T2245C in 23S rRNA and ermB gene were identified in erythromycin-resistant Ureaplasma spp. Fluoroquinolone resistance in Ureaplasma spp. and Mycoplasma hominis remains high in China, the rational use of antibiotics needs to be further enhanced.

The off-label use of third generation cephalosporin (3GC) during in ovo vaccination or vaccination of newly hatched chicks, was a common practice worldwide. CMY-2-producing Escherichia coli have been disseminated among broiler production. The objectives of this study were to determine the epidemiological linkage of bla_CMY-2-positive plasmids among broilers both within and outside Japan because grandparent stock and parent stock were imported in Japan. We examined the whole genome sequences of 132 3GC-resistant E. coli isolates collected from healthy broilers during 2002-2014. The predominant 3GC-resistance gene was bla_CMY-2, which was detected in the plasmids of 87 (65.9%) isolates. The main plasmid replicon types were IncI1-I (n=21; 24.1%), IncI (n=12; 13.8%), IncB/O/K/Z (n=28; 32.2%), and IncC (n=22; 25.3%). Those plasmids were subjected to gene clustering and network analyses and plasmid multi-locus sequence typing (pMLST). The chromosomal DNA of isolates was subjected to MLST and single nucleotide variant (SNV)-based phylogenetic analysis.

MLST and SNV-based phylogenetic analysis revealed high diversity of E. coli isolates. ST429 harboring bla_CMY-2-positive IncB/O/K/Z was closely related to isolates from broiler in Germany harboring bla_CMY-2-positive IncB/O/K/Z. pST55-IncI and pST12-IncI1-I and pST3-IncC were prevalent in western Japan. pST12-IncI1-I and pST3-IncC were closely related to those detected in E. coli isolates from chicken in American continent, whereas 26 IncB/O/K/Z were related to those in Europe. These data will be useful to reveal the whole picture of transmission of CMY-2-producing bacteria in and out of Japan.

The precious metal eased for a third day after US equities hit the highest in almost seven weeks as states including Florida took steps toward easing restrictions.

Global markets rallied on the back of optimism that most governments were gearing up to at least partially reopen their economies following lockdowns to prevent the spread of the coronavirus.

Deep losses were recorded across most European benchmarks except the FTSE 100 which managed to trade relatively flat on the day.

BACKGROUND:

Approximately 25% of children with concussion have persistent postconcussive symptoms (PPCS) with resultant significant impacts on quality of life. Melatonin has significant neuroprotective properties, and promising preclinical data suggest its potential to improve outcomes after traumatic brain injury. We hypothesized that treatment with melatonin would result in a greater decrease in PPCS symptoms when compared with a placebo.

Don't settle for the default settings on your Android device. With the right launcher, you can customize the screens and layouts of your phone.

Comixology Unlimited lets you dive into more than 20,000 digital comics for just $5.99 per month. Make the most of your subscription by starting with these 10 titles.

Superheroics. Crime capers. Historical fiction. Conspiracies. Put a world of wonderful stories in your pocket with these 10 excellent digital comics.

A new plan from Democratic presidential candidate and former special educator Elizabeth Warren touches on some glaring issues in special education: graduation disparities, hard-to-access school buildings, and discipline practices that disproportionately affect black, Latino, and Native American stud

T. Michael O'Shea
Jul 1, 1999; 104:15-21
ARTICLES

The STOP-ROP Multicenter Study Group
Feb 1, 2000; 105:295-310
ARTICLES

Lima, Peru, Apr 26, 2020 / 06:18 am (CNA).- An archbishop in Venezuela warned that desperation is growing in the country, as the national coronavirus quarantine measures have compounded a tenuous political and economic situation. He urged people in the country to resist violence and social unrest.

Extreme hunger “does not reason or know rules,” said Archbishop Ulises Gutiérrez of Ciudad Bolívar, adding that this desperate hunger “is becoming a fuel more dangerous than gasoline.”

Gutiérrez spoke with ACI Prensa, CNA’s Spanish language news partner, in an April 23 interview, after looting and protests broke out in seven states in Venezuela.

Protestors objected to price hikes on food and a gasoline shortage exacerbated by the ongoing quarantine that was imposed last month to halt the spread of the COVID-19 pandemic. According to the latest government report, there have been 298 cases and 10 deaths in the country due to the virus.

Even before the coronavirus pandemic, Venezuela has been marred by violence and social upheaval under the socialist administration of Nicolas Maduro, with severe shortages of food and medicine, high unemployment, power outages, and hyperinflation. Some 4.5 million Venezuelans have emigrated since 2015.

The current COVID-19 quarantine is “aggravating the situation,” the archbishop said, noting that the quarantine was implemented without accompanying measures to protect the most vulnerable.

As a result, families are suffering, and many cannot access clean water, electricity or gasoline.

The country is experiencing “a totally destroyed economy in which agricultural producers can’t get their products out because they’re not getting gasoline supplied to them, or they have to buy it on the black market for 2 or 3 dollars a liter,” he said. In some cases, crops are rotting in farmers’ fields due to lack of fuel to transport them to market.

Gutiérrez voiced concern over the hunger-fueled looting and protests throughout the country, as well as the government’s violent suppression of the protests.

“The common denominator in all these protests is hunger,” he stressed.

With equipment in short supply and many of the country’s doctors have already emigrated due to the political and economic crisis, Gutiérrez acknowledged, the pandemic poses a significant threat.

“In short, the outlook is very dark,” he said.

But despite the desperate situation, the archbishop urged people not to resort to looting and violence.

“[S]atisfying hunger short term [by committing robbery] only leads to the destruction of regular commerce,” he said.

“The situation we’re going through is very tough, difficult, and fragile,” Gutiérrez said, likening the conditions to a pressure cooker, “which could lead us to unprecedented explosive social unrest, which nobody wants, and which would bring with it more hunger and greater suffering for the people.”

Still, the archbishop said he has reason for hope: “Our trust is in God and his providence keeps us going, encouraging and accompanying our people, assisting them with our Caritas social programs.”

“We have community soup kitchens, a medicine bank, outpatient medical care, programs for infant nutrition and nursing mothers, etc., which although it’s impossible to reach everyone, is a sign of God’s love through the Church,” he said.

When she began the biology program at Penn State Schuylkill, senior Dominique Varra thought she wanted to study plants. But after conducting field research studying gray catbirds with Luke Redmond, assistant professor of biology, she has discovered a passion for ornithology. And all of her accomplishments have inspired the next generation of scientists, chiefly her five-year-old daughter Hayden, who hopes to follow in her mother’s footsteps.

Daniela Claudio Pagán, a graphic design senior from Puerto Rico, has been named the College of Arts and Architecture's 2020 student marshal.

Penn State Beaver students will give a special performance of Eve Ensler’s "The Vagina Monologues" at 5 p.m. Feb. 13 in the Penn State Beaver auditorium. The event is open to the public.

St. Pachomius can justifiabley be called the founder of cenobitic monasticism, monks who live in community. Even though St. Antony the Great was the first to go into the desert to live a life of seclusion pursuing evangelical perfection, he lived a heremitic life, that is, a primarily solitary life.Pachomius first started out as a hermit in the desert, like many of the other men and women in the third and fourth centuries who sought the most radical expression of Christian life. There he developed a very strong bond of friendship with the hermit Palemon. One day during prayer, he had a vision in which he was called to build a monastery, and was told in the vision that many people who were eager to live an ascetic life in the desert, but were not inclined to the solitary life of a hermit, would come and join him.  His hermit friend, Palemon, helped him to build the monastery and Pachomius insisted that his cenobites were to aspire to the austerity of the hermits.However, Pchomius knew that his idea was a radical one, because most of the men who came to live in his monastery had only ever conceived of the eremitic lifestyle. His great accomplishment was to reconcile this desire for austere perfection with an openness to fulfilling the mundane requirements of community life as an expression of Christian love and service. He spent most of his first years as a cenobitic doing all the menial work on his own, knowing that his brother monks needed to be gently inducted into serving their brothers in the same manner.  He therefore allowed them to devote all their time to spiritual exercises in those first years.  At his death, there were eleven Pachomian monasteries: nine for men and two for women.The rule that Pachomius drew up was said to have been dictated to him by an angel, and it is this rule that both St. Benedict in the west and St. Basil in the east drew upon to develop their better known rules of cenobitic life. St. Pachomius died in the year 346.

Elon Musk confirms that Disney+ is 'coming soon' to the Tesla Theater.

UEFA Best Women’s Player in Europe 2012/13 – Shortlist of top three announced

The Scottish Parliament will next week (Tuesday 10 March) be invited to nominate Stephen Boyle to Her Majesty the Queen for appointment as the new Auditor General for Scotland.

In India and China, indigenous drug manufacturers market arbitrarily combined parenteral β-lactam and β-lactamase inhibitors (BL-BLIs). In these fixed-dose combinations, sulbactam or tazobactam is indiscriminately combined with parenteral cephalosporins, with BLI doses kept in ratios similar to those for the approved BL-BLIs. Such combinations have been introduced into clinical practice without mandatory drug development studies involving pharmacokinetic/pharmacodynamic, safety, and efficacy assessments being undertaken. Such unorthodox combinations compromise clinical outcomes and also potentially contribute to resistance development.

Behavioral economics applies key principles from psychology and economics to address obstacles to behavior change. The important topic of pediatric firearm injuries has not yet been explored through a behavioral economic lens. Pediatric firearm-related injuries are a significant public health problem in the United States. Despite American Academy of Pediatrics guidelines advising that firearms be stored unloaded, in a locked box or with a locking device, and separate from ammunition, estimates suggest that ~4.6 million children live in homes with at least 1 loaded and unlocked firearm. In this article, we use behavioral economic theory to identify specific cognitive biases (ie, present bias; in-group, out-group bias; and the availability heuristic) that may influence parental decision-making around firearm storage. We illustrate situations in which these biases may occur and highlight implementation prompts, in-group messengers, and increased salience as behaviorally informed strategies that may counter these biases and subsequently enhance safe firearm storage. We also describe other opportunities to leverage the behavioral economic tool kit. By better understanding the individual behavioral levers that may impact decision-making around firearm storage, behavioral scientists, pediatric providers, and public health practitioners can partner to design and test tailored interventions aimed at decreasing pediatric firearm injuries. Further empirical study is warranted to identify the presence of specific biases and heuristics and determine the most effective behavior change strategies for different subpopulations.

Next-generation sequencing has revolutionized the diagnostic process, making broadscale testing affordable and applicable to almost all specialties; however, there remain several challenges in its widespread implementation. Barriers such as lack of infrastructure or expertise within local health systems and complex result interpretation or counseling make it harder for frontline clinicians to incorporate genomic testing in their existing workflow. The general population is more informed and interested in pursuing genetic testing, and this has been coupled with the increasing accessibility of direct-to-consumer testing. As a result of these changes, primary care physicians and nongenetics specialty providers find themselves seeing patients for whom genetic testing would be beneficial but managing genetic test results that are out of their scope of practice. In this report, we present a practical and centralized approach to providing genomic services through an independent, enterprise-wide clinical service model. We present 4 years of clinical experience, with >3400 referrals, toward designing and implementing the clinical service, maximizing resources, identifying barriers, and improving patient care. We provide a framework that can be implemented at other institutions to support and integrate genomic services across the enterprise.

A new supercapacitor based on manganese oxide could combine the storage capacity of batteries with the high power and fast charging of other supercapacitors, according to researchers at Penn State and two universities in China.

Single women dominated property sales in 2017, 2018 and 2019, compared to single men and even married couples, according to data analytics firm Lightstone.

Disguised in different roles–from rebellious teenagers to homeless people to prostitutes and pimps–community members responsible for the onshore segment of The Agency experience act out the types of least reached people in society.

During the third quarter, the smart earwear products accounted for 48.1 percent of all shipments in the wearables category, according to IDC. In addition, shipments for the earpieces grew a stunning 242.4 percent from the same period a year ago.

Fly your DJI drone using a first-person perspective up to a range of 2.5 miles and race with up to seven other drones using the same low-latency system.

This phase IIb randomized controlled trial demonstrates greater efficacy of phenobarbital than levetiracetam in the treatment of neonatal seizures; more adverse events occurred with phenobarbital.