tc

Late Preterm Infants and Neurodevelopmental Outcomes at Kindergarten

Late preterm infants, compared with full-term infants, have less proficiency in reading and math at school age, with increased need for individualized educational plans and special education services. They also have lower cognitive performance on standardized IQ exams.

Late preterm infants have worse outcomes at school entry, and development is variable during the preschool years, so socioeconomic status, language spoken in the home, maternal education, maternal race, and being a late preterm infant have a large impact. (Read the full article)




tc

Unmet Health Care Need in US Adolescents and Adult Health Outcomes

Unmet health care need in adolescence is associated with poor contemporaneous health outcomes. Adolescence is increasingly recognized as an important stage of the life-course, when there may be a significant opportunity for health care interventions to improve later health outcomes.

The odds of adverse adult health outcomes were 13% to 52% higher among subjects who had reported unmet health care need in adolescence, compared with subjects with similar adolescent health outcomes, insurance coverage, and sociodemographic background but no unmet need. (Read the full article)




tc

Infection-Related Hospitalization in Childhood and Adult Metabolic Outcomes

Childhood inflammatory mediators are associated with adult obesity, but the stimuli that initiate and perpetuate chronic inflammation start in early life are largely unknown.

Childhood infection-related hospitalization was independently associated with adverse adult metabolic variables, which suggests that infections and/or their treatment in childhood may contribute to causal pathways leading to adult cardiometabolic diseases. (Read the full article)




tc

Outcome of Patients Initiating Chronic Peritoneal Dialysis During the First Year of Life

Historically, children with end-stage renal disease who initiated chronic dialysis during the first year of life were far less likely to survive or successfully receive a kidney transplant compared with those who initiated chronic dialysis at older ages.

In recent years, survival has improved markedly among children who initiate chronic peritoneal dialysis at <1 year of age. Among those infants who initiate dialysis after the neonatal period and later undergo kidney transplantation, graft survival has improved as well. (Read the full article)




tc

Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT

Preschool language delay predicts poorer academic performance, employment opportunities, and social relationships. Language for Learning, a systematic, population-based intervention for 4-year-olds with low language, is feasible, acceptable and has short-term benefits, but long-term benefits are unknown.

Population ascertainment at age 4 followed by a yearlong, one-on-one home program benefited phonological skills (an important literacy determinant) at age 6, but not the primary language outcomes. To be cost-effective, future follow-up would need to demonstrate lasting academic benefits. (Read the full article)




tc

Childhood Health and Developmental Outcomes After Cesarean Birth in an Australian Cohort

A number of studies have reported an association between birth by cesarean delivery and adverse childhood health outcomes such as obesity, asthma, atopy, and a number of neurodevelopmental abnormalities. However, these studies have had limited capacity to control for confounders.

Using a prospective cohort while controlling for birth factors, social vulnerability, maternal BMI, and breastfeeding, we found few differences between children delivered by cesarean delivery and those born vaginally. Higher child BMI was explained by maternal BMI. (Read the full article)




tc

Lion Cage pitch competition winner aiming to reduce rotator cuff re-tear rates

Saif Khalil, founder and CEO of Aevumed, won first place at the REV-UP Center for Entrepreneurship's Lion Cage pitch competition. Aevumed develops medical devices designed to help reduce rotator cuff re-tear rates.




tc

Netflix Series Reignites 'The Witcher 3' Interest on Steam

The Witcher 3 is more popular on Steam today than at its launch in May 2015, thanks in large part to the Netflix series based on the popular book series.




tc

Where to watch the UEFA Women's Champions League final

Fans across the world can enjoy Saturday's final between Lyon and Barcelona thanks to UEFA's broadcast partners and live streaming.




tc

Cuthbert's Chelsea strike named best goal: watch the top ten

Erin Cuthbert's strike for Chelsea at Lyon has been named goal of the season: watch the top ten.




tc

SB 09-76 Scotch Whisky Industry briefing

28 October 2009Restructuring announcements by large companies within the Scotch Whisky industry over the summer of 2009 have brought the industry under the public and political spotlight.




tc

Parents Report Obstacles in Filing Special Education Complaints, Watchdog Says

The Government Accountability Office finds that parents often have a hard time initiating complaints about special education services, but that these barriers don't affect all parents in the same way.




tc

Futsal match duration

We provide a guide to the timekeeping involved in a game of futsal.




tc

Fin24.com | WATCH: How would Saudi Arabia retaliate if US imposes sanctions?

An op-ed in Saudi-owned Al Arabiya news has warned of repercussions should the US impose sanctions on Saudi Arabia over the disappearance of journalist Jamal Khashoggi.




tc

Fin24.com | Sifiso Skenjana | How liquor could be used to improve health and economic outcomes post-coronavirus

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




tc

First hatches reported: Spotted lanternfly expert provides tips for management

Even before the recent news of the season’s first confirmed spotted lanternfly hatches in the Philadelphia region, homeowners in many parts of Pennsylvania were gearing up for their annual battle with the destructive pest.




tc

End of the Transition in Burundi: The Home Stretch




tc

Le gouvernement tchadien est tombé dans le piège pétrolier




tc

Tchad : La victoire facile d'un Etat fragile contre les institutions internationales

Dans de nombreux pays, le pétrole suscite des débats controversés sur son rôle de moteur de changements économiques, sociaux et géopolitiques. Depuis quelques années, les réflexions sur la question du pétrole ont démontré une corrélation négative entre son exploitation, le développement socioéconomique, la gouvernance et le regain des conflits dans les pays producteurs.




tc

Efficacy of early oral switch with beta-lactams for low-risk Staphylococcus aureus bacteremia. [Clinical Therapeutics]

Objectives. The aim of this study was to assess the safety of early oral switch (EOS) prior to 14 days for low-risk Staphylococcus aureus bacteremia (LR-SAB), which is the primary treatment strategy employed at our institution. Usually recommended therapy is 14 days of intravenous (IV) antibiotics.

Methods. All patients with SAB at our hospital were identified between 1 January 2014 and 31 December 2018. Those meeting low-risk criteria (healthcare-associated, no evidence of deep infection or demonstrated involvement of prosthetic material, and no further positive blood cultures after 72-hours) were included in the study. The primary outcome was occurrence of a SAB-related complication within 90 days.

Results. There were 469 SAB episodes during the study period, 100 (21%) of whom met inclusion criteria. EOS was performed in 84 patients. In this group, line infection was the source in 79%, methicillin-susceptible S. aureus caused 95% of SABs and 74% of patients received IV flucloxacillin. The median duration of IV and oral antibiotics in the EOS group was 5 (IQR 4-6) and 10 days (IQR 9-14), respectively. Seventy-one percent of patients received flucloxacillin as their EOS agent. Overall, 86% of oral step-down therapy was with beta-lactams. One patient (1%) undergoing EOS had SAB relapse within 90 days. No deaths attributable to SAB occurred within 90 days.

Conclusions. In this low MRSA prevalence LR-SAB cohort, EOS was associated with a low incidence of SAB-related complications. This was achieved with oral beta-lactam therapy in most patients. Larger prospective studies are needed to confirm these findings.




tc

A Comparison of Clinical Outcomes among Intensive Care Unit Patients Receiving Ceftriaxone 1 gram daily or 2 grams daily [Clinical Therapeutics]

Background: Intensive care unit (ICU) patients may experience ceftriaxone underexposure but clinical outcomes data are lacking. The objective of this study was to determine the impact of ceftriaxone dosing on clinical outcomes amongst ICU patients without central nervous system (CNS) infection.

Methods: A retrospective study of ICU patients receiving intravenous, empiric ceftriaxone for non-CNS infections was conducted. Patients ≥18 years of age who received ≤2 grams of ceftriaxone daily for ≥72 hours were included and categorized as receiving ceftriaxone 1 gram or 2 grams daily. The primary, composite outcome was treatment failure: inpatient mortality and/or antibiotic escalation due to clinical worsening. Propensity score matching was performed based on the probability of receiving ceftriaxone 2 grams daily. Multivariable logistic regression determined the association between ceftriaxone dose and treatment failure in a propensity-matched cohort.

Results: A total of 212 patients were included in the propensity-matched cohort. The most common diagnoses (83.0%) were pneumonia and urinary tract infection. Treatment failure occurred in 17.0% and 5.7% of patients receiving 1 gram and 2 grams daily, respectively (p=0.0156). Overall inpatient mortality was 8.5%. Ceftriaxone 2 gram dosing was associated with a reduced likelihood of treatment failure (adjusted odds ratio=0.190; 95% confidence interval: 0.059 – 0.607). Other independent predictors of treatment failure included sequential organ failure assessment score (aOR 1.440, 95% CI 1.254 – 1.653) and creatinine clearance at 72 hours from ceftriaxone initiation (aOR 0.980, 95% CI (0.971 – 0.999).

Conclusions: Ceftriaxone 2 grams daily when used as appropriate antimicrobial coverage may be appropriate for ICU patients with lower mortality risk.




tc

Evaluation of the effect of contezolid (MRX-I) on the corrected QTc interval: a randomized, double-blind, placebo- and positive-controlled crossover study in healthy Chinese volunteers [Clinical Therapeutics]

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.




tc

Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia

BACKGROUND AND OBJECTIVES:

Antibiotic therapy is often prescribed for suspected community-acquired pneumonia (CAP) in children despite a lack of knowledge of causative pathogen. Our objective in this study was to investigate the association between antibiotic prescription and treatment failure in children with suspected CAP who are discharged from the hospital emergency department (ED).

METHODS:

We performed a prospective cohort study of children (ages 3 months–18 years) who were discharged from the ED with suspected CAP. The primary exposure was antibiotic receipt or prescription. The primary outcome was treatment failure (ie, hospitalization after being discharged from the ED, return visit with antibiotic initiation or change, or antibiotic change within 7–15 days from the ED visit). The secondary outcomes included parent-reported quality-of-life measures. Propensity score matching was used to limit potential bias attributable to treatment selection between children who did and did not receive an antibiotic prescription.

RESULTS:

Of 337 eligible children, 294 were matched on the basis of propensity score. There was no statistical difference in treatment failure between children who received antibiotics and those who did not (odds ratio 1.0; 95% confidence interval 0.45–2.2). There was no difference in the proportion of children with return visits with hospitalization (3.4% with antibiotics versus 3.4% without), initiation and/or change of antibiotics (4.8% vs 6.1%), or parent-reported quality-of-life measures.

CONCLUSIONS:

Among children with suspected CAP, the outcomes were not statistically different between those who did and did not receive an antibiotic prescription.




tc

Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy

OBJECTIVES:

Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.

METHODS:

Participants (n = 148; ages 9–18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (n = 25 puberty suppression only; n = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.

RESULTS:

Affirmed males reported greater depression and anxiety at baseline, but these differences were small (P < .01). Youth reported large improvements in body dissatisfaction (P < .001), small to moderate improvements in self-report of depressive symptoms (P < .001), and small improvements in total anxiety symptoms (P < .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.

CONCLUSIONS:

Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.




tc

Efficacy of Melatonin in Children With Postconcussive Symptoms: A Randomized Clinical Trial

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.

METHODS:

We conducted a randomized, double-blind trial of 3 or 10 mg of melatonin compared with a placebo (NCT01874847). We included youth (ages 8–18 years) with PPCS at 4 to 6 weeks after mild traumatic brain injury. Those with significant medical or psychiatric histories or a previous concussion within the last 3 months were excluded. The primary outcome was change in the total youth self-reported Post-Concussion Symptom Inventory score measured after 28 days of treatment. Secondary outcomes included change in health-related quality of life, cognition, and sleep.

RESULTS:

Ninety-nine children (mean age: 13.8 years; SD = 2.6 years; 58% girls) were randomly assigned. Symptoms improved over time with a median Post-Concussion Symptom Inventory change score of –21 (95% confidence interval [CI]: –16 to –27). There was no significant effect of melatonin when compared with a placebo in the intention-to-treat analysis (3 mg melatonin, –2 [95% CI: –13 to 6]; 10 mg melatonin, 4 [95% CI: –7 to 14]). No significant group differences in secondary outcomes were observed. Side effects were mild and similar to the placebo.

CONCLUSIONS:

Children with PPCS had significant impairment in their quality of life. Seventy-eight percent demonstrated significant recovery between 1 and 3 months postinjury. This clinical trial does not support the use of melatonin for the treatment of pediatric PPCS.




tc

Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth

BACKGROUND AND OBJECTIVES:

Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations.

METHODS:

We conducted a secondary data analysis of ninth- and 11th-graders in the 2016 minnesota Student Survey (n = 68 785). We categorized youth into 4 subgroups based on housing status in the previous year: (1) unaccompanied homeless youth (0.5%), (2) runaway youth (4%), (3) youth who had both run away and been homeless (0.6%), and (4) stably housed youth (95%). We performed multivariable logistic regression to compare 4 mental health outcomes (self-injury, suicidal ideation, suicide attempts, and depressive symptoms) across groups, controlling for demographics and abuse history.

RESULTS:

Unstably housed youth had poorer mental health outcomes when compared with their stably housed peers (P < .05). For example, 11% of homeless youth, 20% of runaways, and 33% of youth who had experienced both had attempted suicide in the previous year compared with 2% of stably housed youth (adjusted odds ratios 2.4, 4.9, and 7.1, respectively). Other outcomes showed a similar pattern.

CONCLUSIONS:

Our findings suggest that runaway and homeless youth represent unique populations with high levels of mental health needs who would benefit from targeted clinical and community interventions. Pediatric clinicians represent one potential point of screening and intervention.




tc

Champions League Fantasy Matchday 7: What the numbers say

UEFA.com studies the statistics to find out which players are predicted for big Matchday 7 totals.




tc

Champions League Fantasy Matchday 7: The Scout squad

As the knockout stage kicks off this week, The Scout has put together a squad drawing on players from nine teams.




tc

Fantasy Football Matchday 7 lessons: Goalkeepers

UEFA.com delves into the numbers and finds clean sheets were at a premium in the first legs.




tc

Fantasy Football Matchday 7 lessons: Defenders

The start of the knockout rounds provided a reminder there is still plenty of value to be found at the defensive end of the field.




tc

Fantasy Football Matchday 7 lessons: Midfielders

Key differentials were once again to the fore in the round of 16 first legs, although Serge Gnabry took the headlines again.




tc

Fantasy Football Matchday 7 lessons: Forwards

Erling Braut Haaland and Robert Lewandowski continued to hit the net, although injury means the latter is likely to miss the second leg.




tc

Fin24.com | Watch out for loan scam, warns Sanlam

Unsuspected consumers are being targeted by fraudsters using the name of Sanlam to swindle cash out of them, the financial service provider has warned.




tc

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.




tc

Fossil Gen 5 Smartwatch

The Fossil Gen 5 Smartwatch features an attractive design and smooth performance, but its size isn't suitable for all wrists.




tc

Save $128 on Garmin's Premium Forerunner 935 GPS Watch

The Garmin Forerunner 935, which sits at the top of the Forerunner hierarchy thanks to highly customizable running and triathlon features, is $128 off on Amazon today.




tc

Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia

Matthew J. Lipshaw
Apr 1, 2020; 145:e20193138-e20193138
ARTICLES




tc

Where to watch Women's Under-17 EURO

Seven matches are being broadcast from the finals in Bulgaria: see where you can watch on TV or online below.




tc

Where to watch UEFA Futsal EURO 2018

You can watch UEFA Futsal EURO 2018 across Europe and the world thanks to UEFA's broadcast partners and the live streaming of games on UEFA.com and our YouTube channel UEFA.tv.




tc

Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment




tc

How to Free Up Space on Your Apple Watch

If you're running out of room on your Apple Watch, get rid of specific apps and content you no longer need. Here's how to free up space from the Watch app and the device.




tc

Ditch That Headphone Splitter: How to Share Audio With Apple's AirPods

With iOS 13.1 and iPadOS, Apple adds an Audio Sharing feature that lets you share with a friend what you're listening to on your Apple AirPods or select Beats headphones.




tc

22 Netflix Tips to Boost Your Binge-Watching

Getting started is as easy as picking a show and pressing play. However, there are a few tricks you can use to get the most out of your viewing experience, like killing autoplay trailers.




tc

How to Automate Your Life With Apple's iOS Shortcuts App

Apple's Shortcuts app can quickly and easily run a host of tasks on your Apple Watch or iOS or iPadOS device. Here's how to create and use shortcuts for Siri.




tc

How to Track Your Sleep on Apple Watch

If you’re having trouble sleeping, you may want to monitor your sleep cycle. Apple Watch makes it easy with these apps.




tc

The Digital Watch: A Brief History

Before there were smartwatches, digital watches were the most high-tech timepieces you could buy. We explore the evolution of the digital watch from 1972 to present day.




tc

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.




tc

Thanks to Microsoft, We Can Watch Superman for Thousands of Years

Microsoft's new write-once storage medium is constructed from quartz glass, stores data using lasers, and uses machine learning algorithms for decoding.




tc

Score a TCL Roku Smart TV for as Little as $119

All of the TVs on sale come standard with Roku TV, meaning you can access all of your favorite streaming platforms.




tc

Parents Report Obstacles in Filing Special Education Complaints, Watchdog Says

The Government Accountability Office finds that parents often have a hard time initiating complaints about special education services, but that these barriers don't affect all parents in the same way.