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Fin24.com | JSE erases earlier gains as global economy exhibits more strain

The local bourse had managed to open firmer following a rally in Asian stocks in earlier trading.




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Fin24.com | Stock markets plunge on devastating growth data

Stock markets plunged on Thursday after economic growth data confirmed fears of Covid-19's bruising impact on the world economy.




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Fin24.com | Gold bars fight coronavirus kits for space on the plane

Swiss refiner Valcambi SA tried for five straight days last month to move a shipment of gold out of Hong Kong. Twice the metal was packed carefully onto a plane, only to be offloaded again.




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Fin24.com | Markets wrap | JSE retreats as global markets fret over economic growth

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




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Fin24.com | Markets wrap | Firmer close in Asia lifts JSE All-Share Index

On the currency market, the rand traded softer against the greenback as it slipped to a session low of R18.77/$.




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Fin24.com | Markets wrap | Local stocks edge higher as optimism remains

Still, there was disappointment in terms of economic data following the release of the SACCI Business Confidence index data for April which came in at 77.8, compared to a forecast of 89.2.




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Fin24.com | Oil set for second weekly gain with market starting to rebalance

Oil headed for its first back-to-back weekly gain since February as output cuts from the biggest producers and a nascent recovery in demand began to rebalance a market awash with crude.




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Education Is the Darling of Wealthy Philanthropists, But K-12 Is Losing Its Luster

Around the world, education is the largest recipient of philanthropic giving by a large margin, but in the United States, funders are moving away from investing in K-12 schools in favor of early childhood and higher education.




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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.




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Trends in Regionalization of Emergency Care for Common Pediatric Conditions

BACKGROUND:

For children who cannot be discharged from the emergency department, definitive care has become less frequent at most hospitals. It is uncertain whether this is true for common conditions that do not require specialty care. We sought to determine how the likelihood of definitive care has changed for 3 common pediatric conditions: asthma, croup, and gastroenteritis.

METHODS:

We used the Nationwide Emergency Department Sample database to study children <18 years old presenting to emergency departments in the United States from 2008 to 2016 with a primary diagnosis of asthma, croup, or gastroenteritis, excluding critically ill patients. The primary outcome was referral rate: the number of patients transferred among all patients who could not be discharged. Analyses were stratified by quartile of annual pediatric volume. We used logistic regression to determine if changes over time in demographics or comorbidities could account for referral rate changes.

RESULTS:

Referral rates increased for each condition in all volume quartiles. Referral rates were greatest in the lowest pediatric volume quartile. Referral rates in the lowest pediatric volume quartile increased for asthma (13.6% per year; 95% confidence interval [CI] 5.6%–22.2%), croup (14.8% per year; 95% CI 2.6%–28.3%), and gastroenteritis (16.4% per year; 95% CI 3.5%–31.0%). Changes over time in patient age, sex, comorbidities, weekend presentation, payer mix, urban-rural location of presentation, or area income did not account for these findings.

CONCLUSIONS:

Increasing referral rates over time suggest decreasing provision of definitive care and regionalization of inpatient care for 3 common, generally straightforward conditions.




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Dietary Fats and Atherosclerosis From Childhood to Adulthood

BACKGROUND:

The association of dietary fat distribution with markers of subclinical atherosclerosis during early life is unknown. We examined whether success in achieving the main target of an infancy-onset dietary intervention based on the distribution of dietary fat was associated with aortic and carotid intima-media thickness (IMT) and distensibility from childhood to young adulthood.

METHODS:

In the prospective randomized controlled Special Turku Coronary Risk Factor Intervention Project trial, personalized dietary counseling was given biannually to healthy children from infancy to young adulthood. The counseling was based on Nordic Nutrition Recommendations, with the main aim of improving the distribution of dietary fat in children’s diets. IMT and distensibility of the abdominal aorta and common carotid artery were measured repeatedly at ages 11 (n = 439), 13 (n = 499), 15 (n = 506), 17 (n = 477), and 19 years (n = 429). The targeted distribution of dietary fat was defined as a ratio of saturated fatty acids to monounsaturated and polyunsaturated fatty acids of <1:2 and as an intake of saturated fatty acids of <10% of energy intake. Participants who met ≥1 of these 2 criteria were defined to achieve the main intervention target.

RESULTS:

Individuals who achieved the main intervention target had lower aortic IMT (age- and sex-adjusted mean difference 10.4 µm; 95% confidence interval: 0.3 to 20.5 µm) and better aortic distensibility (0.13% per 10 mm Hg; 95% confidence interval: 0.00% to 0.26% per10 mm Hg) compared with their peers who did not meet the target.

CONCLUSIONS:

Achieving the main target of an infancy-onset dietary intervention, reflecting dietary guidelines, was favorably associated with aortic IMT and distensibility during the early life course. These data support the recommendation of favoring unsaturated fat to enhance arterial health.




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Costs and Use for Children With Medical Complexity in a Care Management Program

BACKGROUND AND OBJECTIVES:

Children with medical complexity (CMC) comprise only 6% of the pediatric population, account for ~40% of pediatric health care spending, and provide an important opportunity for cost saving. Savings in this group can have an important impact on pediatric health care costs. The objective of this study was to assess the impact of a multicenter care management program on spending and use in CMC.

DESIGN AND METHODS:

We conducted a prospective cohort analysis of a population of 4530 CMC enrolled in a learning collaborative designed to improve care for CMC ages 0 to 21 years identified using 3M Clinical Risk Group categories 5b through 9. The primary outcome was total per-member per-year standardized spending; secondary outcomes included inpatient and emergency department (ED) spending and use. We used a 1:1 propensity score match to compare enrolled patients to eligible nonenrolled patients and statistical process control methods to analyze spending and usage rates.

RESULTS:

Comparison with the matched group showed a 4.6% (95% confidence interval [CI]: 1.9%–7.3%) decrease in total per-member per-year spending (P < .001), a 7.7% (95% CI: 1.2%–13.5%) decrease in inpatient spending (P = .04), and an 11.6% (95% CI: 3.9%–18.4%) decrease in ED spending (P = .04). Statistical process control analysis showed a decrease in hospitalization rate and ED visits.

CONCLUSIONS:

CMC enrolled in a learning collaborative showed significant decreases in total spending and a significant decrease in the number of hospitalizations and ED visits. Additional research is needed to determine more specific causal factors for the results and if these results are sustainable over time and replicable in other settings.




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Non-HDL Cholesterol Levels in Childhood and Carotid Intima-Media Thickness in Adulthood

BACKGROUND:

Elevated non–high-density lipoprotein cholesterol (HDL-C) levels are used to identify children at increased cardiovascular risk, but the use of non–HDL-C in childhood to predict atherosclerosis is unclear. We examined whether the National Heart, Lung, and Blood Institute classification of youth non–HDL-C status predicts high common carotid artery intima-media thickness in adulthood.

METHODS:

We analyzed data from 4 prospective cohorts among 4582 children aged 3 to 19 years who were remeasured as adults (mean follow-up of 26 years). Non–HDL-C status in youth and adulthood was classified according to cut points of the National Heart, Lung, and Blood Institute and the National Cholesterol Education Program Adult Treatment Panel III. High carotid intima-media thickness (cIMT) in adulthood was defined as at or above the study visit-, age-, sex-, race-, and cohort-specific 90th percentile of intima-media thickness.

RESULTS:

In a log-binomial regression analysis adjusted with age at baseline, sex, cohort, length of follow-up, baseline BMI, and systolic blood pressure, children with dyslipidemic non–HDL-C were at increased risk of high cIMT in adulthood (relative risk [RR], 1.29; 95% confidence interval [CI], 1.07–1.55). Compared with the persistent normal group, the persistent dyslipidemia group (RR, 1.80; 95% CI, 1.37–2.37) and incident dyslipidemia (normal to dyslipidemia) groups (RR, 1.45; 95% CI, 1.07–1.96) had increased risk of high cIMT in adulthood, but the risk was attenuated for the resolution (dyslipidemia to normal) group (RR, 1.17; 95% CI, 0.97–1.41).

CONCLUSIONS:

Dyslipidemic non–HDL-C levels predict youth at risk for developing high cIMT in adulthood. Those who resolve their non–HDL-C dyslipidemia by adulthood have normalized risk of developing high cIMT in adulthood.




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Salesforce Pardot

Although it's pricey, the intuitive Salesforce Pardot offers standout features, making it a leader among today's marketing automation platforms.




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Champions League Fantasy: Bargain signings

Players who provide excellent value for money are a key component of successful Fantasy sides; check out our suggestions.




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Champions League Fantasy: Captain marvel

The UEFA Champions League is back and UEFA.com are here to guide #UCLfantasy managers through the first legs of the round of 16.




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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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Paris v Dortmund facts

Two Erling Braut Haaland strikes have given Dortmund an advantage to take to Paris, although Neymar's away goal could prove crucial.




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Barcelona v Napoli facts

Antoine Griezmann's first-leg away goal has given Barcelona an advantage after the game in Naples finished 1-1.




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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.




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Serving God through coffee shops and carpentry

Jose, an Argentinian worker serving in Southeast Asia, tells of how he entered overseas service and what he has seen God do through his not-so-typical ministry.




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A transformed heart

An Albanian man's heart is forever changed after suffering a heart attack and meeting Jesus in his recuperation.




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An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




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Not your stereotypical missionary

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.




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Ordinary woman, extraordinary journey

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.




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Tech Company Wins Ed. Dept Award to Create Accessible Books

Benetech, a Palo Alto, Calif. based software company, is embarking on is third 5-year award with the U.S. Department of Education to create books for students with print disabilities.




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Could Artificial Intelligence Automate Student Note-Taking?

An AI-powered digital assistant to take notes for you? It’s already happening in the workplace, but classroom note taking could prove harder to automate.




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Technology Has No Impact on Teaching and Learning

If we truly want educational technology to take root in schools and finally live up to the promise we've been expecting for more than a decade, schools need to develop a cadre of well-trained tech instructional coaches.




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Michelle Darnell named director of Smeal's new Tarriff Center

Michelle R. Darnell, associate clinical professor in management and director of honor and integrity at Smeal, has been appointed as the inaugural director of the Tarriff Center for Business Ethics and Social Responsibility.




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Penn State Smeal names spring 2020 Senior Award honorees

The Penn State Smeal College of Business has announced the recipients of its spring 2020 Senior Awards.




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Smeal supply chain student marshal points to professor as guiding force

Rachel Hooker, who will graduate May 9 with a 3.99 GPA in supply chain and information systems, has been selected as the Smeal College of Business’ spring 2020 supply chain and information systems student marshal.




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Yaeger selected as the Eberly College Cooperative Education Student of the Year

Emilee Yaeger, an undergraduate student in the Science BS/MBA accelerated joint degree program, has been selected as the recipient of the 2019 Eberly College of Science Cooperative Education Student of the Year Award. The award recognizes the student’s academic achievements and contributions to the participating employer, the University, the community, and the field of cooperative education.




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Leadership comes naturally to Penn State Smeal spring 2020 student marshal

Jake Griggs, who will graduate Saturday with a 3.95 GPA with dual majors in management and political science, has been named Smeal’s spring 2020 management and organization student marshal.




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COVID-19: Researchers to model novel coronavirus for spread mitigation

In an effort to help mitigate the disruptive effects of the deadly COVID-19 virus, an interdisciplinary team of Penn State researchers are developing a novel methodology to analyze its spread and the impacts on policy to create better-prepared and more-resilient health care systems.




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New guide curates COVID-19 related resources for researchers

Penn State University Libraries has developed a curated guide to COVID-19 related resources for researchers, including ongoing research at Penn State.




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Seed grants jump-start 47 interdisciplinary teams to conduct COVID-19 research

With speed and ingenuity, more than 100 researchers across Penn State are shifting their research programs to address the COVID-19 crisis, thanks to funding from a seed grant initiative led by the Huck Institutes of the Life Sciences. In total, the initiative awarded $2.25 million to 47 teams of researchers from three campuses, 10 colleges and more than 25 departments.




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Penn State researchers collaborate to distribute COVID-19 survey globally

To assess public perceptions about COVID-19 and identify populations whose behaviors put them at risk of infection, researchers at Penn State have released an online survey for the general public.




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Penn State Health resumes construction to convert space to outpatient care

Penn State Health today resumed construction of Penn State Health Cocoa Outpatient Center, an expansion of medical services at the former CocoaPlex Center location.




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COVID-19 response at Penn State propelled by interdisciplinary connections

MASC has successfully designed and delivered critical equipment and supplies needed to protect health care workers and patients during the COVID-19 pandemic.




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Penn State cancer research center joins pandemic fight

The Penn State Center for Structural Oncology is shifting some of its focus from fighting cancer to fighting COVID-19, with three projects.




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Local Penn Staters participate in the fight against COVID-19

Two alumni and one community partner contribute clinical medicine and research experience during the pandemic




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Faculty member earns doctorate, selected as Fulbright specialist

Beth E. Michalec, lecturer of corporate communication at Penn State Lehigh Valley, earned a doctorate in rhetoric from Duquesne University. Michalec was selected as a Fulbright specialist in June 2019 by the U.S. Department of State.




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Penn State Lehigh Valley announces 2020 student life and athletics award winners

Students celebrated for athletic and student life achievements during the Finally Finished Fest




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Fin24.com | Beware of cowboy builders

Your smooth-talking builder may promise you the world, but you could end up in a world of pain, writes Angelique Ruzicka.




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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.




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Fin24.com | Gauteng, Western Cape and KZN top list for card fraud

Gauteng, the Western Cape and KwaZulu-Natal are the hot spots for card fraud in South Africa, according to a report on global fraud activity.




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Fin24.com | SA inequality grows as rich take larger share - report

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




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Fin24.com | South Africans are big borrowers and poor savers - expert

Reducing indebtedness and improving savings in South Africa is a major socio-economic challenge, warns an industry expert.




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Fin24.com | FSB to start scam adverts

Despite the many investment scams that the South African public is falling for, in many cases the Financial Services Board (FSB) finds its hands tied when it comes to protecting the public.




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Fin24.com | Debit order fraud: Beware of sharing your banking details

Payments Association of South Africa has warned consumers to be cautious when sharing personal information which can be used by fraudsters to make unauthorised debit orders.