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Variation in Congenital Heart Surgery Costs Across Hospitals

Congenital heart disease is known to be a commonly treated and resource-intense condition across children’s hospitals, yet knowledge regarding the degree of cost variation across hospitals and associated factors is lacking.

Using a linked clinical and administrative data set, we establish benchmarks for hospital costs for common congenital heart operations, and demonstrate wide variation in cost between hospitals related in part to differences in length of stay and complications. (Read the full article)




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Patterns of Mobile Device Use by Caregivers and Children During Meals in Fast Food Restaurants

Mobile devices are ubiquitous in children’s lives, but how caregivers and children use them in everyday situations, and how use of devices affects caregiver–child interactions, has not been studied.

In naturalistic mealtime observations, we documented the behavior of many caregivers whose attention was highly absorbed in their mobile devices, with varying child reactions to this absorption. This study raises several hypotheses about mobile device use and caregiver-child interaction. (Read the full article)




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Interventions to Reduce Behavioral Problems in Children With Cerebral Palsy: An RCT

One in 4 children with cerebral palsy (CP) have a behavioral disorder. Parenting interventions are an efficacious approach to treating behavioral disorders. There is a paucity of research on parenting interventions with families of children with CP.

This is the first study to demonstrate the efficacy of a parenting intervention in targeting behavioral problems in children with CP. Further, results suggest that Acceptance and Commitment Therapy delivers additive benefits above and beyond established parenting interventions. (Read the full article)




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Postmarketing Trials and Pediatric Device Approvals

Medical devices approved for adults can be used to treat children despite the lack of rigorous evidence. In 2007, Congress passed the Pediatric Medical Device Safety and Improvement Act to stimulate pediatric device development.

Most pediatric devices approved since the legislative change have had limited premarket study in children, with pediatric patients representing <10% of trial participants. Postmarketing studies required by the US Food and Drug Administration also yielded limited additional pediatric data. (Read the full article)




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Variation in Emergency Department Admission Rates in US Children's Hospitals

There is substantial variation in the medical care provided to pediatric patients across diverse clinical settings. This variation raises concerns about whether every patient is receiving optimal care and whether more standardized approaches around clinical decisions are needed.

We observed wide variation in admission rates for common pediatric conditions across US children’s hospitals. Our findings highlight the need for greater focus on the standardization of decisions regarding hospitalization of patients presenting to the emergency department. (Read the full article)




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Childhood Obesity and Interpersonal Dynamics During Family Meals

Family meals are protective for child health, but there are inconsistent findings in relation to child weight status. More research is needed examining why family meals are protective for child health and whether there are differences by child weight status.

The current mixed-methods study used direct observational methods to examine family dynamics during family meals and child weight status. Results indicated that positive family interpersonal and food-related dynamics during family meals were associated with reduced prevalence of childhood obesity. (Read the full article)




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Motor Severity in Children With Cerebral Palsy Studied in a High-Resource and Low-Resource Country

There is variability in cerebral palsy prevalence estimates in low-resource countries, related to definitions, detection of milder cases, diagnosis age, and adequate training for clinicians. Thus, differences in prevalence and motor patterns between high- and low-resource countries remain unclear.

There were more children with dystonia and less with spasticity in Bangladesh compared with Australia (cerebral palsy diagnosis/motor classifications were consistent between settings). Differences in motor patterns between high- and low-resource countries have profound implications for early detection and appropriate interventions. (Read the full article)




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Cerebral Palsy Among Children Born Moderately and Late Preterm

The incidence of cerebral palsy is dependent on the gestational age in very preterm infants and risk factors have been identified for term infants. The risk has also proved to be greater among late preterm births compared with term.

The incidence of cerebral palsy was 24-fold in moderately preterm and 6-fold in late preterm infants compared with full-term infants. The most prominent risk factors included asphyxia and intracranial hemorrhage. The incidence diminished over time and with increasing gestational age. (Read the full article)




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Antimicrobial Stewardship Programs in Freestanding Children's Hospitals

Antibiotic overuse is common and is a major public health threat. The prevalence of antimicrobial stewardship programs in children’s hospitals is growing. Single-center studies reveal that antimicrobial stewardship programs are effective in reducing unnecessary antibiotic use. Multicenter evaluations are needed.

Antibiotic use is declining overall across a large network of freestanding children’s hospitals. Hospitals with formalized antimicrobial stewardship programs experienced greater reductions in antibiotic use than other hospitals, suggesting that these interventions are an effective strategy to address antibiotic overuse. (Read the full article)




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Potential Drug-Drug Interactions in Infant, Child, and Adolescent Patients in Children's Hospitals

Hospitalized pediatric patients are often exposed to many medications during an inpatient admission. Drug–drug interactions may increase the risk of developing medication-related adverse drug events, leading to serious clinical morbidity and mortality.

Exposure to "major" potential drug–drug interactions occurs in 41% of pediatric hospitalizations in children’s hospitals. One-half of all these exposures were due to less common specific drug pairs (≤3% of patients exposed per hospital day) and thus may be less clinically familiar. (Read the full article)




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New Pediatricians: First Jobs and Future Workplace Goals

Concern exists about the ability of new general pediatricians to find jobs that match their career goals.

A large majority of new pediatricians secure positions consistent with their career goals and desired responsibilities. (Read the full article)




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Factors Associated With Meaningful Use Incentives in Children's Hospitals

Meaningful use (MU) incentive payments have been developed to encourage adoption and use of electronic health records (EHRs). Several studies have revealed children’s hospitals have unique barriers to the use of EHRs but were relatively early adopters of information technology.

Although a minority of children’s hospitals have succeeded with MU incentives, freestanding children’s hospitals are significantly more likely to succeed. Improvement of EHRs for pediatric use should focus on information exchange, quality reporting, and MU relevance to pediatrics. (Read the full article)




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Trends of US Hospitals Distributing Infant Formula Packs to Breastfeeding Mothers, 2007 to 2013

Distribution of infant formula discharge packs to breastfeeding mothers is common practice in maternity care facilities in the United States. Receiving discharge packs is associated with shortened exclusive breastfeeding duration. Many efforts have been made to discourage this practice.

From 2007 to 2013, there has been a marked reduction in distribution of discharge packs containing infant formula to breastfeeding mothers in hospitals and birth centers in the United States. (Read the full article)




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Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

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)




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Safety of Botulinum Toxin Type A for Children With Nonambulatory Cerebral Palsy

Children with marked cerebral palsy (CP) are considered at greater risk of adverse events (AEs) after intramuscular injections of BoNT-A. To date there has been no randomized controlled trial examining safety of intramuscular BoNT-A injections in children with marked CP.

Children with nonambulatory CP had no greater risk of moderate or serious AEs after intramuscular injections of BoNT-A compared with a sham/control group. There was no greater risk of AEs for children receiving 2 compared with 1 episode of BoNT-A. (Read the full article)




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Variation in Utilization of Computed Tomography Imaging at Tertiary Pediatric Hospitals

Given the efforts to decrease the use of ionizing radiation in pediatric patients, there is significant variability in head computed tomography (CT) scan use in pediatric emergency departments for minor head trauma.

This study characterized variability in CT scan rates for all body regions in emergency department, observation, and inpatient encounters across 30 tertiary pediatric hospitals. Two-fold variation remained after case-mix adjustment, with higher volume hospitals having lower rates of CT scanning. (Read the full article)




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College of Engineering student marshals announced

Fifteen graduating seniors from the College of Engineering have been selected to serve as student marshals for Penn State’s spring commencement ceremony, to be held virtually on May 9.




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SB 16-86 EU nationals living in Scotland

03 November 2016 This briefing analyses the characteristics of EU nationals living in Scotland, based on the 2015 Annual Population Survey. The briefing also reviews evidence relating to the economic contribution of migrants.




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Eberly College of Science selects two student marshals for Spring 2020

Chemistry major Sojung Kim and microbiology major Cuyler Luck will represent the Eberly College of Science as student marshals during Penn State’s virtual spring commencement ceremonies on Saturday, May 9.




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Today's Deals: Get 35 Percent Off SanDisk Storage

You won't want to miss these great deals.




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Futsal officials

We offer a guide to the roles of the officials in futsal.




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Study reveals important flowering plants for city-dwelling honey bees

Trees, shrubs and woody vines are among the top food sources for honey bees in urban environments, according to an international team of researchers. By using honey bees housed in rooftop apiaries in Philadelphia, the researchers identified the plant species from which the honey bees collected most of their food, and tracked how these food resources changed from spring to fall. The findings may be useful to homeowners, beekeepers and urban land managers who wish to sustain honey bees and other bee and pollinator species.




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Burundi: Proposals for the Resumption of Bilateral and Multilateral Co-operation




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Behind the Problem of Conflict Minerals in DR Congo: Governance

As legislation requiring large U.S. companies to disclose the origins of the minerals they use is meant to come into force this year, Crisis Group sent a mission to North Kivu to assess the different strategies used to fight conflict minerals and their impact in the field.




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In Some States, ESSA Goals for English-Learners Are 'Purely Symbolic,' Report Finds

More than four years after the passage of ESSA, English-language-learner education policies across the country remain "disjointed and inaccessible," a new report concludes.




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Assessment of drug resistance during phase 2b clinical trials of presatovir in adults naturally infected with respiratory syncytial virus [Antiviral Agents]

Background: This study summarizes drug resistance analyses in 4 recent phase 2b trials of the respiratory syncytial virus (RSV) fusion inhibitor presatovir in naturally infected adults.

Methods: Adult hematopoietic cell transplant (HCT) recipients, lung transplant recipients, or hospitalized patients with naturally acquired, laboratory-confirmed RSV infection were enrolled in 4 randomized, double-blind, placebo-controlled studies with study-specific presatovir dosing. Full-length RSV F sequences amplified from nasal swabs obtained at baseline and postbaseline were analyzed by population sequencing. Substitutions at RSV fusion inhibitor resistance-associated positions are reported.

Results: Genotypic analyses were performed on 233 presatovir-treated and 149 placebo-treated subjects. RSV F variant V127A was present in 8 subjects at baseline. Population sequencing detected treatment-emergent substitutions in 10/89 (11.2%) HCT recipients with upper and 6/29 (20.7%) with lower respiratory tract infection, 1/35 (2.9%) lung transplant recipients, and 1/80 (1.3%) hospitalized patients treated with presatovir; placebo-treated subjects had no emergent resistance-associated substitutions. Subjects with substitutions at resistance-associated positions had smaller decreases in viral load during treatment relative to those without, but similar clinical outcomes.

Conclusions: Subject population type and dosing regimen may have influenced RSV resistance development during presatovir treatment. Subjects with vs without genotypic resistance development had decreased virologic responses but comparable clinical outcomes.




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The Als3 cell wall adhesin plays a critical role in human Serum amyloid A1 (SAA1)-induced cell death and aggregation in Candida albicans [Mechanisms of Resistance]

Antimicrobial peptides and proteins play critical roles in the host defense against invading pathogens. We recently discovered that recombinantly expressed human and mouse serum amyloid A1 (rhSAA1 and rmSAA1) proteins have potent antifungal activities against the major human fungal pathogen Candida albicans. At high concentrations, rhSAA1 disrupts C. albicans membrane integrity and induces rapid fungal cell death. In the current study, we find that rhSAA1 promotes cell aggregation and targets the C. albicans cell wall adhesin Als3. Inactivation of ALS3 in C. albicans leads to a striking decrease in cell aggregation and cell death upon rhSAA1 treatment, suggesting that Als3 plays a critical role in SAA1 sensing. We further demonstrate that deletion of the transcriptional regulators controlling the expression of ALS3, such as AHR1, BCR1, and EFG1 in C. albicans results in similar effects to that of the als3/als3 mutant upon rhSAA1 treatment. Global gene expression profiling indicates that rhSAA1 has a discernible impact on the expression of cell wall- and metabolism-related genes, suggesting that rhSAA1 treatment could lead to a nutrient starvation effect on C. albicans cells.




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Development of Novel Anti-influenza Thiazolides with Relatively Broad-spectrum Antiviral Potentials [Antiviral Agents]

Seasonal and pandemic influenza causes 650,000 deaths annually in the world. The emergence of drug-resistance to specific anti-influenza drugs such as oseltamivir and baloxavir marboxil highlights the urgency of novel anti-influenza chemical entity discovery. In this study, we report a series of novel thiazolides derived from an FDA-approved drug nitazoxanide with antiviral activity against influenza and a broad range of viruses. The preferred candidates 4a and 4d showed significantly enhanced anti-influenza potentials with 10-fold improvement, compared with nitazoxanide, and were effective against a variety of influenza subtypes including oseltamivir-resistant strains. Notably, the combination using of compounds 4a/4d and oseltamivir carboxylate or zanamivir displayed synergistic antiviral effect against oseltamivir-resistant strain. Mode of action analysis demonstrated that compounds 4a/4d acted at the late phase of viral infection cycle through inhibiting viral RNA transcription and replication. Further experiments showed that treatment with compounds 4a/4d significantly inhibited influenza virus infection in human lung organoids, suggesting the druggability of the novel thiazolides. In-depth transcriptome analysis revealed a series of up-regulated cellular genes that may contribute to the antiviral activities of 4a/4d. Together, our study pointed the optimization direction of nitazoxanide as anti-influenza drug, and discovered two novel-structured candidates 4a/4d with relatively broad-spectrum antiviral potential.




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Bad Flaw in Windows 10 Also Affects Chrome Browser

Security researchers are demonstrating how you can use the Windows 10 flaw, CVE-2020-0601, to spoof the trusted digital certificates for official website domains on Google's Chrome browser. These same certificates can warn you about hacking attempts.




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Malware Steals Data By Adjusting Screen Brightness

Malware on an air-gapped computer can transmit data like Morse code by changing screen brightness in a way that's invisible to the naked eye but easily recorded with a camera.




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Champions League Fantasy popular picks and potential differentials

Ahead of Matchday 7, UEFA.com looks at some obvious selections and some lesser-owned options.




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Penn State Health hospitals use recovered patients' plasma as COVID-19 treatment

Penn State Health has enrolled its first COVID-19 patient into an experimental treatment program called convalescent plasma therapy.




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Practical Nursing Program moves clinicals to virtual simulations

Lehigh Valley's Practical Nursing Program has moved to the Shadow Health Digital Clinical Experience so students can continue clinical rotations through virtual simulations.




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Fin24.com | Stokvel members urged to be vigilant over festive season as criminals ready to strike

Sabric, a financial crime information centre, shares its tips on staying safe over the festive season.




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Deals: Lenovo Flex 14, Dell Gaming Monitor, New Nintendo Switch

Today you can save $120 on the Lenovo Flex 14 2-in-1 laptop. Also, the 24-inch Dell S2419HGF 1080p monitor dropped is now just $149.99. Finally, the new Nintendo Switch, featuring improved battery life, is now available.




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#WU17EURO finals: all the results

Spain won their fourth title by beating Germany in the final while Finland pipped England to the FIFA U-17 Women's World Cup.




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Germany's Martinez equals UEFA finals scoring record

Germany's Shekiera Martinez, at 16, has written herself into UEFA's record books by scoring nine goals in a final tournament.




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UEFA Futsal EURO 2018 finals draw made

Hosts Slovenia have been handed a tough group with Italy and Serbia while France's debut finals match will be against holders Spain after the draw was made in Ljubljana.




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Resources Recommended for the Care of Pediatric Patients in Hospitals

It is crucial that all children are provided with high-quality and safe health care. Pediatric inpatient needs are unique in regard to policies, equipment, facilities, and personnel. The intent of this clinical report is to provide recommendations for the resources necessary to provide high-quality and safe pediatric inpatient medical care.




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Inter, Barcelona, Sporting and Győr reach finals

Holders Inter FS, two-time winners Barcelona, Sporting CP and Győr will contest the UEFA Futsal Cup finals in April after topping their elite round groups to make the last four.




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Zaragoza to stage UEFA Futsal Cup finals

The 10,700-capacity Pabellón Príncipe Felipe in Zaragoza will host the UEFA Futsal Cup finals in April involving Spain's Inter FS and Barcelona plus Portugal's Sporting CP and Győr of Hungary.




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Futsal Cup semi-finals: Inter-Barcelona, Győr-Sporting

Spanish co-hosts Inter FS and Barcelona will face off in the UEFA Futsal Cup semi-finals after being drawn together in the last four of this year's event in Zaragoza, while Győr face Sporting CP.




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UEFA Futsal Cup finals tickets on sale

Tickets for the UEFA Futsal Cup finals at Zaragoza's Pabellón Príncipe Felipe on 20, 22 April are on sale.




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Deals: Acer Computers, Blink XT2, 65-Inch Vizio P-Series Quantum X

Amazon is offering up to 30 percent off Acer laptops, desktops, and monitors. Plus, you can save $930 on the 65-inch Vizio P-Series Quantum X 4K TV.




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The Best Refurbished Desktop Deals

Whether you want a customizable full-size tower or a mini PC, there's something for nearly every budget. Here are the best refurbished desktop deals for January 2020.




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Deals: Gaming PCs, Dell Laptops, Fitbit Tracker, Anker Accessories

Dell's SAVE15 coupon is still live, the Dell Vostro 14 3000 is back down to just $299, and Walmart's Overpowered gaming desktop is $800 off right now.




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Deals: Apple AirPods, Dell Laptops, Nintendo Switch

Save on the second-generation Apple AirPods with the wireless charging case, Logitech gaming gear, Dell laptops, the Nintendo Switch, and more today.




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Deals: SanDisk Ultra MicroSDXC, Seagate Backup Plus Hub

Today you can save up to 30 percent on select laptops, networking devices, and storage drives at Amazon. Also, the highly anticipated game Cyberpunk 2077 is $10 off when you pre-order it.




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Deals: Echo Dot, 256GB Samsung MicroSDXC, MacBook Air

The 256GB Samsung EVO Select microSDXC card is back at just $39.99, the Echo Dot is half off, and the MacBook Air is $150 off.




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Deals: Samsung MicroSDXC, Samsung 4K TV, Dell XPS 15

Snag the Samsung EVO Select 512GB microSDXC card for $88, one of its lowest prices ever. Also, the 75-inch Samsung QLED 4K TV is more than $1,000 off and a Dell XPS 15 is $300 off.