Traumatic brain injury (TBI) in children causes significant morbidity and mortality. Parental and coach awareness about brain injury due to sports has recently increased. Since 2001, pediatric emergency departments have seen a significant increase in sports-related TBI.

Pediatric, sports-related TBIs cared for in the emergency department and admitted to the hospital have both increased, resulting in no change in the percentage being admitted. However, patients admitted have had a significant reduction in injury severity. (Read the full article)

Certain characteristics of the sleep environment increase the risk for sleep-related, sudden, and unexplained infant death. These characteristics have the potential to generate asphyxia. The relationship between the deaths occurring in these environments and neurochemical abnormalities in the brainstem that may impair protective responses to asphyxia is unknown.

We report neurochemical brainstem abnormalities underlying cases of sudden infant death that are associated with and without potential asphyxial situations in the sleep environment at death. The means to detect and treat these abnormalities in infants at risk are needed. (Read the full article)

Greater numbers of invasive procedures from birth to term-equivalent age, adjusted for clinical confounders, are associated with altered brain microstructure during neonatal care and poorer cognitive outcome at 18 months’ corrected age in children born very preterm.

Altered myelination at school age is associated with greater numbers of invasive procedures during hospitalization in very preterm children without severe brain injury or neurosensory impairment. Greater numbers of invasive procedures and altered brain microstructure interact to predict lower IQ. (Read the full article)

After mild traumatic brain injury, most youth recover well. A minority of patients report persistent symptoms, which relate to both injury and noninjury factors. In adult studies, validity test performance is 1 noninjury factor that relates to persistent symptoms.

This is the first pediatric study to demonstrate that validity test failure is associated with increased symptoms after mild traumatic brain injury. The findings suggest that some symptoms conceptualized as injury-related "postconcussive" problems are better explained by exaggeration or feigning. (Read the full article)

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)

Preterm birth is strongly associated with alterations in brain development and long-term neurocognitive impairment that are not fully explained by environmental factors.

Common genetic variation in genes associated with schizophrenia and lipid metabolism modulates the risk for preterm brain injury; known susceptibilities to neurologic disease in later life may be exposed by the stress of preterm birth. (Read the full article)

After neonatal extracorporeal membrane oxygenation treatment, children are at risk for neurodevelopmental problems including delayed motor function. So far this has only been studied cross-sectionally until age 7 years.

We describe, in a nationwide evaluation, the longitudinal course of motor function development after neonatal extracorporeal membrane oxygenation with persisting problems up to 12 years. At risk are children with congenital diaphragmatic hernia and those with chronic lung disease. (Read the full article)

Term MRI can assist in identifying the nature and extent of brain injury in preterm infants. However, brain injury detected by MRI does not fully account for neurodevelopmental impairments, particularly cognitive and behavioral impairments, common in preterm survivors.

In addition to brain injury, an assessment of brain growth by using one-dimensional measurements on MRI is helpful for predicting neurodevelopment. Two different patterns of impaired brain growth are observed that relate independently to early cognitive development in preterm infants. (Read the full article)

Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS). Cerebral oxygenation and blood pressure are reduced in the prone sleeping position in healthy term infants. Preterm infants are at significantly increased risk of SIDS.

Preterm infants display reduced cerebral oxygenation compared with term infants, most prominently at 2 to 3 months corrected age in the prone position when blood pressure is concurrently reduced. This may contribute to the increased risk for SIDS among infants born preterm. (Read the full article)

The fetal origins of adult disease hypothesis proposes that suboptimal fetal development may condition the later risk of disease, particularly cardiovascular disease. However, this hypothesis has never been tested for diseases of the aging brain.

This first study of its kind provides clinical measures suggesting that small birth size, as an indicator of an adverse intrauterine environment, has lifelong consequences for brain tissue volume and cognitive function. In addition, it shows that the effects of a suboptimal intrauterine environment on late-life cognitive function were particularly present in those with lower educational levels. (Read the full article)

Physical activity programs have been shown to have positive implications for children’s cognitive performance and brain structure and function. However, additional randomized controlled trials are needed to determine whether daily physical activity influences executive control and its neural underpinnings.

The randomized controlled trial, designed to meet daily physical activity recommendations, used behavioral and electrophysiological measures of brain function to demonstrate enhanced attentional inhibition and cognitive flexibility among prepubertal children. (Read the full article)

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)

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)

Pediatric traumatic brain injury (TBI) contributes to impairments in functioning across multiple settings. Online family problem-solving therapy may be effective in reducing adolescent behavioral morbidity after TBI. However, less is known regarding maintenance of effects over time.

This large randomized clinical trial in adolescents with TBI is the only study to examine maintenance of treatment effects. Findings reveal that brief, online treatment may result in long-term improvements in child functioning, particularly among families of lower socioeconomic status. (Read the full article)

Although headache is a common symptom after minor blunt head trauma in children, controversy exists whether the presence of headache increases the risk of traumatic brain injury.

Clinically important traumatic brain injuries are rare, and traumatic brain injuries on computed tomography are very uncommon in children with minor blunt head trauma when headaches are their only sign or symptom. (Read the full article)

Permanent neuronal deletion and neurocognitive impairment after anesthetic exposure in animals raised substantial concern that similar effects occur in children. Human studies were equivocal but have not combined structural and intelligence tests in otherwise healthy children after childhood anesthesia.

Anesthetic exposure for surgery did not lead to measurable neuronal elimination in brain regions previously identified in animals. However, language comprehension and performance IQ were decreased in exposed children and associated with decreased gray matter, primarily in posterior brain regions. (Read the full article)

Attention is a prerequisite for neurocognitive and behavioral functioning, having a crucial role in academic and social child development. Children with traumatic brain injury have pronounced deficits in attention, but the nature and consequences of these deficits remain unclear.

Lapses of attention represent a core attention deficit after pediatric mild traumatic brain injury with risk factors for complicated traumatic brain injury, or moderate/severe traumatic brain injury. Importantly, lapses of attention explain the relation between intelligence and parent-rated attention problems. (Read the full article)

The American Academy of Pediatrics recommends parent-child reading from infancy through at least kindergarten, the span of maximal brain growth. Home literacy environment, including reading behaviors and access to books, has been shown to promote oral language and print concepts.

Home reading environment is positively associated with activation of brain areas supporting narrative comprehension and mental imagery in preschool children. This offers novel insight into the neurobiological foundations of emergent literacy and potential effect of shared reading during early childhood. (Read the full article)

Adding second-stage automated auditory brainstem response (ABR) testing for infants who failed the initial OAE test in a two-stage neonatal hearing screening has been shown to reduce false referrals to the hearing clinic.

Infants with hearing loss may be missed by a 2-stage hearing screening because they pass the automated ABR test. In our study, a significant number of infants with hearing loss >45 decibel hearing level passed screening with automated ABR. (Read the full article)

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)

With Pennsylvania Gov. Tom Wolf’s March 25 “Stay at Home” order, Penn State is updating the status of its Abington, Brandywine and Great Valley campuses.

"We can do better," Germany coach Silvia Neid concluded after her side joined France and Sweden in making it to the quarter-finals of the Olympic tournament in unspectacular fashion.

An educator's experience teaching math is important, but performance on math-content-certification tests is the best predictor of how well a teacher's students will perform in early algebra, finds a new study by the Regional Educational Laboratory Central at Marzano Research.

Boys and girls start out on the same biological footing when it comes to math, finds the first neuroimaging study of math gender differences in children, published this month in the journal Science of Learning.

Boys and girls start out on the same biological footing when it comes to math, according to the first neuroimaging study of math gender differences in children.

Boys and girls start out on the same biological footing when it comes to math, finds the first neuroimaging study of math gender differences in children, published this month in the journal Science of Learning.

Public libraries are moving deeper into digital learning, often in partnership with schools and other institutions, to help prepare students for the skills they'll need for college and careers.

A handful of districts and other groups are reshaping the after-school space to provide a wide range of social and linguistic supports for newcomer students.

OptrA is an ATP-binding cassette (ABC)-F protein that confers resistance to oxazolidinones and phenicols, and can be either plasmid or chromosomally encoded. We isolated 13 Enterococcus faecalis strains possessing linezolid MIC ≥ 4 mg/L from nursery pigs in swine herds located across Brazil. Genome sequence comparison showed that these strains possess optrA in different genetic contexts occurring in 5 different E. faecalis sequence type backgrounds. The optrA gene invariably occurred in association with an araC regulator and a gene encoding a hypothetical protein. In some contexts, this genetic island was able to excise and form a covalently closed circle within the cell which appeared to occur in high abundance, and to be transmissible by co-resident plasmids.

Carbapenem pharmacokinetic profiles are significantly changed in critically ill patients because of the drastic variability of the patients' physiological parameters. Published population PK studies have mainly focused on specific diseases and the majority of these studies had small sample sizes. The aim of this study was to develop a population PK model of imipenem in critically ill patients that estimated the influence of various clinical and biological covariates and the use of Extracorporeal Membrane Oxygenation (ECMO) and Continuous Renal Replacement Therapy (CRRT). A two-compartment population PK model with Creatinine clearance (CrCL), body weight (WT), and ECMO as fixed effects was developed using the non-linear mixed effect model (NONMEM). A Monte Carlo simulation was performed to evaluate various dosing schemes and different levels of covariates based on the pharmacokinetic/pharmacodynamic index (f%T>MIC) for the range of clinically relevant minimum inhibitory concentrations(MICs). The results showed that there may be insufficient drug use in the clinical routine drug dose regimen, and 750mg Q6h could achieve a higher treatment success rate. The blood concentrations of imipenem in ECMO patients were lower than that of non-ECMO patients, therefore dosage may need to be increased. The dosage may need adjustment for patients with CrCL ≤ 70ml/min, but dose should be lowered carefully to avoid the insufficient drug exposure. Dose adjustment is not necessary for patients within the WT ranging from 50-80 kg. Due to the large variation in PK profile of imipenem in critically ill patients, TDM should be carried out to optimize drug regimens.

Brain infections with Cryptococcus neoformans are associated with significant morbidity and mortality. Cryptococcosis typically presents as meningoencephalitis or fungal mass lesions called cryptococcomas. Despite frequent in vitro discoveries of promising novel antifungals, the clinical need for drugs that can more efficiently treat these brain infections remains. A crucial step in drug development is the evaluation of in vivo drug efficacy in animal models. This mainly relies on survival studies or post-mortem analyses in large groups of animals, but these techniques only provide information on specific organs of interest at predefined time points. In this proof-of-concept study, we validated the use of non-invasive preclinical imaging to obtain longitudinal information on the therapeutic efficacy of amphotericin B or fluconazole monotherapy in meningoencephalitis and cryptococcoma mouse models. Bioluminescence imaging (BLI) enabled the rapid in vitro and in vivo evaluation of drug efficacy while complementary high-resolution anatomical information obtained by magnetic resonance imaging (MRI) of the brain allowed a precise assessment of the extent of infection and lesion growth rates. We demonstrated a good correlation between both imaging readouts and the fungal burden in various organs. Moreover, we identified potential pitfalls associated with the interpretation of therapeutic efficacy based solely on post-mortem studies, demonstrating the added value of this non-invasive dual imaging approach compared to standard mortality curves or fungal load endpoints. This novel preclinical imaging platform provides insights in the dynamic aspects of the therapeutic response and facilitates a more efficient and accurate translation of promising antifungal compounds from bench to bedside.

Anidulafungin and micafungin were quantified in cerebrospinal fluid (CSF) of critically ill adults and in cerebral cortex of deceased patients. In CSF, anidulafungin levels (<0.01-0.66 μg/ml) and micafungin levels (<0.01-0.16 μg/ml) were lower than the simultaneous plasma concentrations (0.77-5.07 μg/ml and 1.21-8.70 μg/ml, respectively). In cerebral cortex, anidulafungin and micafungin levels were 0.21-2.34 μg/g and 0.18-2.88 μg/g, respectively. Thus, MIC values of several pathogenic Candida strains exceed concentrations in CSF and in brain.

Elizabeth Stringer Keefe, Becky Shiring, Katie Robinson, Dr. Sonny Magana and Dr. Monica Burns contribute their suggestions on using tech to differentiate instruction.

Own a Roku TV? Audio equipment can now be certified to be 'Roku TV Ready' meaning setup is simplified and control only requires one remote.

PARTICK Thistle today branded the SPFL a "disgrace" for failing to inform them that league reconstruction had been abandoned and revealed they are "deeply angered" by Ladbrokes Premiership clubs scuppering the plans.

An educator's experience teaching math is important, but performance on math-content-certification tests is the best predictor of how well a teacher's students will perform in early algebra, finds a new study by the Regional Educational Laboratory Central at Marzano Research.

Two Penn State University Libraries employees at Berks Thun Library, Penn State Berks, have been awarded the American Library Association’s 2020 Emerging Technologies Section 2020 Best Emerging Technology Application (BETA) Award, which recognizes a technology application that directly benefits library users.

Three Berks Thun Library employees received the 2020 Innovation in College Librarianship Award from the College Libraries Section of the Association of College & Research Libraries, a division of the American Library Association. The award honors librarians who demonstrate a capacity for innovation in working with or serving undergraduates or instructors in the areas of programs, services, and operations, or creating innovations for library colleagues that facilitate their ability to better serve the library’s community.

Terrie E. Inder
Feb 1, 2005; 115:286-294
ARTICLES

Teacher performance pay may soon be coming to the Cornhusker State.

Rio de Janeiro, Brazil, Apr 20, 2020 / 09:25 am (CNA).- On Friday, Brazil’s Federal Supreme Court will hold a virtual hearing to consider whether to decriminalize abortion for pregnant women infected with the Zika virus.

The legal intervention, called “Direct Action on Unconstitutionality-ADI 5581,” was filed with Brazil’s highest court by the National Association of Public Defenders. Supreme Court Justice Cármen Lúcia Antunes Rocha will present the legal action to the court, whose 11 members will have until April 30 to vote on the issue.

Several pro-life organizations have come out strongly against efforts to expand abortion, which is illegal in Brazil but is considered a “non-punishable crime” in cases of rape, a proven risk to life of the mother and, as of 2012, babies diagnosed with anencephaly.

“It’s a usurpation of powers because the Supreme Court does not have competency to rule on this matter,” said jurist José Miranda de Siqueira, president of the National Association of Citizens for Life. “This is a crime against the Federal Constitution of Brazil which in Article V guarantees the inviolability of the right to life.”

“We’re working with the Union of Catholic Jurists of Rio de Janeiro and will soon issue a strong statement on the issue,” continued Miranda, who is also a bioethics professor and authored a book on euthanasia, “O Poder sobre a Vida” (The Power over Life), which specifically addresses ADI 5581.

“Life is a preeminent right in the legal world. I’m asking people to pray and publicize this serious situation which is going on,” the lawyer added.

In an open letter to all Brazilians, the National Network for the Defense of Life and Family argued that the court challenge is “part of a strategy to introduce abortion in case of disabilities in general, or even abortion on demand, with the weak justification that the pregnant woman would be in a state of distress.”

“Eugenic abortion carries an enormous burden of prejudice and discrimination towards people with disabilities, sending an unseemly message that it would be better if they did not exist,” the pro-life organization added.

The Zika virus garnered international attention in 2015 after areas of Brazil noted a spike in cases of the birth defect microcephaly – a condition marked by abnormally small heads, brains, and developmental delays – following a recent outbreak of the virus in areas of northeastern Brazil.

Research on the virus suggested a link between Zika virus infection during pregnancy and severe neurological birth defects, including microcephaly and incomplete brain development.

A CitizenGo petition addressed to the Supreme Court justices called for the case to be removed from the docket and for the lives of the unborn to be respected. The petition was launched April 16. Within 24 hours, it had garnered 35,000 signatures and as of April 20 has 85,000.
 

Rio de Janeiro, Brazil, Apr 27, 2020 / 04:35 pm (CNA).- A majority of Brazil’s Supreme Federal Tribunal has voted against an intervention seeking to decriminalize abortion for expectant mothers diagnosed with the Zika virus.

The judges convened a virtual plenary session April 24 to hear arguments for and against the “Direct Action on Unconstitutionality-ADI 5581,” a legal intervention filed with the court by the National Association of Public Defenders.

While the court has until April 30 to vote on the matter, 7 of its 11 members have already voted in opposition, effectively rejecting the measure.

Abortion is illegal in Brazil but previous Supreme Court rulings have declared it a “non-punishable crime” in cases of rape, a proven risk to life of the mother and, as of 2012, babies diagnosed with anencephaly.

The Zika virus garnered international attention in 2015 after areas of Brazil noted a spike in cases of the birth defect microcephaly – a condition marked by abnormally small heads, brains, and developmental delays – following a recent outbreak of the virus in areas of northeastern Brazil.

Research on the virus suggested a link between Zika virus infection during pregnancy and severe neurological birth defects, including microcephaly and incomplete brain development.

However, some experts criticized what they described as technical and scientific flaws of the premise behind ADI 5581.
The Union of Catholic Jurists of Rio de Janeiro issued an official statement arguing that a causal relationship was never established between Zika virus and the microcephaly outbreak that occurred in Brazil.

Raphael Câmara, an obstetrician at the Federal University of Rio de Janeiro, said that when an attempt was made in 2016 to allow abortion in Zika cases, little was known about the virus.

“Since then, we have answers to many of the issues raised in ADI-5581 in support of allowing abortion,” Câmara said. “The first fact is that recent studies show that fetuses of infected mothers are affected only 5 to 14% of the time, with the majority having mild problems, as shown by research from the Centers for Disease Control and Prevention.”

“In addition, a study recently released by the CDC showed that 73% of Brazilian labs have a low accuracy rate for diagnosing the Zika virus, so the request is meaningless because we cannot talk about someone 'infected with Zika', but rather 'maybe infected by Zika.’ Is it based on this inaccuracy that we will kill fetuses?” the obstetrician continued.

Ahead of the Supreme Court ruling, pro-life groups in Brazil had spoken out against efforts to expand abortion in the country. A CitizenGo petition against the legal action drew more than 184,000 online signatures.

The Brazilian Bishops’ Conference had also opposed the attempt, calling on Catholics to defend life and oppose abortion. The conference wrote an open letter and also wrote privately to the Supreme Court, reiterating the duty to value the inviolable gift of life.

In 2017, the conference stated, “It does not belong to any public authority to selectively recognize the right to life or who will live or die. This discrimination is evil and exclusionary.”

 

This article was originally published by our sister agency, ACI Digital. It has been translated and adapted by CNA.

 

The winning writers of Penn State University Libraries Short Stories’ “April Showers” spring 2020 contest have been announced. Representing six Penn State campuses, the latest writing contest challenged Penn State students, faculty and staff across the commonwealth to unleash their best original short stories or poetry on the theme of weather.

Penn State Brandywine’s Sustainovation Team has partnered with Tyler Arboretum to host an online discussion club for podcasts, offering a creative solution for the local community to stay connected during the coronavirus (COVID-19) pandemic.

Meaghan Paige, a women’s fashion brand started by a Penn State Brandywine alumna, is supporting the local community by offering free, handmade cloth face masks during the novel coronavirus pandemic.