Strategies are needed to engage families of chronically ill children at home in an ongoing process of shared decision-making regarding treatment that is responsive to families’ concerns and goals and children’s evolving symptoms.

This study evaluated a novel patient portal that facilitates shared decision-making in asthma. The portal was feasible and acceptable to families, improved outcomes, and provides a model for improving care through an electronic health record portal. (Read the full article)

Smoking has been found to increase the risk of some specific congenital anomalies; however, results remain inconsistent. Nicotine replacement therapy (NRT) is increasingly being used as for smoking cessation in pregnancy although little is known about its association with congenital anomalies.

Being prescribed NRT while pregnant was not associated with major congenital anomalies (MCA), except a small increase in respiratory anomalies (3/1000 births). This must be considered in context of the rarity of MCAs and higher morbidities in the NRT group. (Read the full article)

Both obesity and developmental disabilities have increased in recent decades; however, the full long-term effects of prepregnancy obesity on a child’s psychosocial development remain unknown. Limited studies suggest associations between maternal prepregnancy obesity and child psychosocial development.

This study in 6-year-old children provides evidence that severe prepregnancy obesity is associated with adverse child psychosocial outcomes, including attention-deficit/hyperactivity disorder. These findings were not explained by many pregnancy and postpartum factors related to maternal obesity or child development. (Read the full article)

Parental adherence to recommended infant care practices (eg, breastfeeding; safe sleep) is below targeted goals. Adherence to practice recommendations increases when parents receive appropriate advice from multiple sources such as family and physicians.

Using a nationally representative sample, this study explores the advice mothers receive about safe sleep, immunization, breastfeeding, and pacifier use; the findings suggest infant care practices about which mothers receive little or inappropriate advice, suggesting possible targets for intervention. (Read the full article)

Apple is thought to be planning a merger of its app platforms, which means a developer can develop an app once and have it automatically run on iPhone, iPad, and Mac without any extra work. The initiative is called 'Marzipan.'

Kazakhstan, Albania, Israel, the Faroe Islands and best runners-up Moldova will progress to the qualifying group stage after coming through the preliminary round.

Under a fifth of South Africans over the age of 60 are receiving private pensions, a new report has shown.

A Fin24 reader currently under debt wants to know how lockdown will affect his monthly debt repayment order.

The Dallas String Quartet will deliver its passionate fusion of classical and contemporary music to the Community Arts Center at 7:30 p.m. Thursday, March 19.

When can schools use federal funds to help students with disabilities prepare for life after special education? A new resource from the federal education department offers a road map.

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.

This interactive map offers a quick way to examine state-by-state grades and summary data.

About two dozen teachers from across the country spent a week wrestling with questions about how to remember the Confederacy.

Allon Raiz is CEO of business incubator Raizcorp. In this series of articles, he offers entrepreneurs advice on surviving a crisis.

Now, more than ever, we need to be listening for market signals and ensuring that our businesses are primed to both take advantage of opportunities and to mitigate risks, says Allon Raiz.

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.

Extreme poverty and armed conflict in the diamond-rich areas of the Central African Republic (CAR) put thousands of lives in danger and demand urgent reform of the mining sector.

The international watchdog which seeks to prevent diamonds from fuelling conflict, the Kimberley Process, should take a very close look at the situation in the Central African Republic

The collapse of the state and the disappearance of security forces from a large part of the territory may turn the Central African Republic (CAR) into a source of instability in the heart of Africa.
Please note the full report is only available in French.

All this foreign involvement has failed to prevent the recent coup or stabilize its aftermath. BINUCA has not been able to implement a disarmament, demobilisation and reintegration program, and it failed to convince Bozizé’s regime to reform the security sector or consolidate the peace. ECCAS has been unable to restore order in one of the smallest capitals of Africa, and troop-contributing countries have proved unable to deliver the 600 extra soldiers they committed to provide in April. Paradoxically, France, while securing Bangui’s airport, is also hosting ousted president Bozizé, who declared from exile in Paris his wish to retake power by force with the “support” of private actors.

Since the March 24 coup by the Seleka, a loose coalition of Muslim rebels, the Central African Republic has been in free fall. There are about 400,000 internally displaced people, 64,000 refugees, and burned villages, largely in the western part of the country. Banditry, the rise of self-defense militias and clashes between Christian and Muslim communities are now part of daily life for this mineral-rich country in the heart of Africa. The expanding insecurity makes the delivery of humanitarian assistance difficult, and the United Nations has even warned of the risk of genocide.

Los conflictos en los países pequeños suelen agravarse debido a la indiferencia internacional. Sin embargo, en el caso de la República Centroafricana (RCA), el problema es ligeramente distinto. Hay una importante presencia internacional en este Estado, pero los actores principales han decidido mantenerse al margen y esperar en vez de intervenir activamente en la crisis.

As the Central African Republic (CAR) stares into an abyss of potentially appalling proportions, the international community must focus on the quickest, most decisive means of restoring security to its population.

By failing to engage when Crisis Group and others warned that the Central African Republic had become a phantom state, the international community has now had to become much more heavily involved, at much greater expense, after horrifying loss of life and massive displacement, with much greater odds of failure.

The United Nations Security Council decided on 10 April to deploy a peacekeeping mission in the Central African Republic (CAR) which will take over the mission of the African Union (MISCA), which itself succeeded the mission of the Economic Community of Central African States (MICOPAX).

In Central African Republic, the conflict between armed groups is now compounded by a conflict between armed communities. The roadmap to end the crisis including elections late 2015 presents only a short-term answer and risks exacerbating existing tensions. The transitional authorities and their international partners must address crucial issues by implementing a comprehensive disarmament policy and reaffirming that Muslims belong within the nation.

Federal law requires states to report student test scores in achievement levels, but leaders in the Golden State want to take a different approach.

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.

The quinoline MK-571 is the most commonly used inhibitor of multidrug resistance protein-1 (MRP-1) but was originally developed as a cysteinyl leukotriene receptor 1 (CysLTR1) antagonist. While studying the modulatory effect of MRP-1 on anti-hepatitis C virus (HCV) direct acting-antivirals (DAA) efficiency, we observed an unexpected anti-HCV effect of compound MK-571 alone. This anti-HCV activity was characterized in Huh7.5 cells stably harboring a subgenomic genotype 1b replicon. A dose-dependent decrease of HCV RNA levels was observed upon MK-571 administration, with an EC₅₀ of 9±0.3 μM and a maximum HCV RNA level reduction of approximatively 1 Log₁₀. MK-571 also reduced the replication of the HCV full-length J6/JFH1 model in a dose-dependent manner. However, probenecid and apigenin homodimer (APN), two specific inhibitors of MRP-1, had no effect on HCV replication. In contrast, the CysLTR1 antagonists SR2640 increased HCV-SGR RNA levels in a dose-dependent manner, with a maximum increase of 10-fold. In addition, a combination of natural CysLTR1 agonist (LTD4) or antagonists (zafirlukast, cinalukast, and SR2640) with MK-571 completely reversed its antiviral effect, suggesting its anti-HCV activity is related to CysLTR1 rather to MRP-1 inhibition. In conclusion, we showed that MK-571 inhibits HCV replication in hepatoma cell cultures by acting as a CysLTR1 receptor antagonist, thus unraveling a new host-virus interaction in the HCV life cycle.

Clostridioides difficile, the leading cause of nosocomial infections, is an urgent health threat worldwide. The increased incidence and severity of disease, the high recurrence rates, and the dearth of effective anticlostridial drugs have created an urgent need for new therapeutic agents. In an effort to discover new drugs for treatment of Clostridioides difficile infections (CDIs), we investigated a panel of FDA-approved antiparasitic drugs against C. difficile and identified diiodohydroxyquinoline (DIHQ), an FDA-approved oral antiamoebic drug. DIHQ exhibited potent activity against 39 C. difficile isolates, inhibiting growth of 50% and 90% of these isolates at the concentrations of 0.5 μg/mL and 2 μg/mL, respectively. In a time-kill assay, DIHQ was superior to vancomycin and metronidazole, reducing a high bacterial inoculum by 3-log₁₀ within six hours. Furthermore, DIHQ reacted synergistically with vancomycin and metronidazole against C. difficile in vitro. Moreover, at subinhibitory concentrations, DIHQ was superior to vancomycin and metronidazole in inhibiting two key virulence factors of C. difficile, toxin production and spore formation. Additionally, DIHQ did not inhibit growth of key species that compose the host intestinal microbiota, such as Bacteroides, Bifidobacterium and Lactobacillus spp. Collectively, our results indicate that DIHQ is a promising anticlostridial drug that warrants further investigation as a new therapeutic for CDIs.

We thank Kim and colleagues for their interest in our study....

Background

Optimal concentrations of unbound antimicrobials are essential for maximum microbiological effect. Although hypoalbuminemia and albumin fluid resuscitation are common in critical care, the effects of different albumin concentrations on the unbound concentrations of highly protein-bound antimicrobials are not known. The aim of this study was to compare effects of different albumin states on total and unbound concentrations of ertapenem and ceftriaxone using an ovine model.

Methods

Design

Prospective, three phase intervention observational study.

Subjects

Healthy Merino sheep.

Interventions

Eight sheep were subject to three experimental phases; normoalbuminemia, hypoalbuminemia using plasmapheresis and albumin replacement using a 25% albumin solution. In each phase, ceftriaxone 40 mg/kg and ertapenem 15 mg/kg were given intravenously. Blood samples were collected at pre-defined intervals and analyzed using an ultra-high-performance liquid chromatography tandem mass spectrometry method. Pharmacokinetic parameters such as area under the curve (AUC_0-24), plasma clearance (CL) and apparent volume of distribution in the terminal phase (V_d) were estimated and compared between the phases.

Results

The protein and albumin concentrations were significantly different between phases. Hypoalbuminemia resulted in a significantly lower AUC_0-24 and higher CL of total and unbound concentrations of ceftriaxone compared to the other phases. Whereas albumin replacement led to higher AUC_0-24 and lower CL compared to other phases for both drugs. The V_d for total drug concentrations for both drugs were significantly lower with albumin replacement.

Conclusions

For highly protein-bound drugs such as ceftriaxone and ertapenem, both hypoalbuminemia and albumin replacement may affect unbound drug exposure.

Six sources confirmed Apple changed its mind on end-to-end encrypted backups two years ago following an FBI complaint and concerns users could lose access to their own data.

The stunning allegation reportedly comes from a forensic analysis Amazon CEO Jeff Bezos commissioned to determine the culprit behind the hack, which resulted in his private photos ending up in the hands of the National Enquirer.

Watch out for suspicious interview requests. 'The main focus of this phishing campaign was stealing email account information of the victims, and finding information about their contacts/networks,' the cybersecurity experts at Certfa Lab warned on Wednesday.

Anne Jenks, Michelle Shory, Ed.S, Irina V. McGrath, Ph.D, Kim Jaxon, Dr. Beth Gotcher, Elizabeth Stringer Keefe, Ph.D., and Keisha Rembert share their suggestions for using tech effectively in class.

New research has found that inequality in SA has increased, with wealth becoming ever more concentrated among the rich.

Holders Germany, former winners Spain and Poland, England, the Netherlands, Finland and Italy have joined hosts Lithuania in May's finals.

The elite round line-up is set, with 26 teams earning spots alongside Germany and holders Spain in the 23 November draw.

Holders Spain, Austria, Denmark, England, Germany, Netherlands and Portugal have joined hosts Bulgaria in the finals.

The future of European futsal – male and female – was displayed over the last week in qualifying for the 2018 Youth Olympic games with Russia and Portugal coming out on top.

Having student board members with voting clout on school boards poses a number of logistical challenges, readers say in response to a recent Education Week feature.