Motor vehicle crashes, heavy drinking, and drug use are serious, interactive health concerns for the teenage population. Teenage alcohol-impaired driving behaviors are associated with heavy drinking, parenting practices, and exposure to drinking and driving.

Earliness of exposure to alcohol/drug impaired driving (DWI) and early licensure were independent risk factors for teenage DWI. A strong, positive dose-response existed between DWI and amount of prior exposure to DWI in the form of riding with an impaired driver. (Read the full article)

The widely disseminated National Institute on Alcohol Abuse and Alcoholism screening tool for adolescent alcohol use was developed based on epidemiologic data. It has not been validated in a clinical sample and does not screen for tobacco or drug use.

This study found that a measure that expanded the National Institute on Alcohol Abuse and Alcoholism adolescent alcohol use tool to include tobacco and drugs was sensitive and specific for identifying substance use disorders in a pediatric clinic patient population. (Read the full article)

Food insecurity is best measured by comprehensive assessments. However, rapid assessments can be useful in certain circumstances, but their validity is not characterized.

Rapid assessment of food insecurity is feasible among Inuit adults and children. (Read the full article)

In addition to seizures, school-aged children with epilepsy can have coexisting cognitive and behavioral difficulties, but the spectrum and prevalence of such difficulties are uncertain.

This study provides population-based data on the prevalence of common comorbid cognitive impairments and factors associated with such diagnoses in school-aged children with "active" epilepsy. (Read the full article)

Many population-based studies including pubertal children are based on self-assessment of pubertal maturation, the reliability of which is uncertain.

Self-assessment is not reliable for precise pubertal staging. Simple distinctions between prepuberty and puberty showed moderate agreement with clinical examinations. Parents and girls tended to underestimate and boys to overestimate pubertal development by up to 50% and 30%, respectively. (Read the full article)

Increased central adrenergic activity occurs with opiate withdrawal. Clonidine is an effective drug as an adjunct to morphine in the treatment of neonatal abstinence syndrome. It is unclear whether clonidine is effective as single-drug therapy.

Clonidine, a α₂-adrenergic agonist, seems to be as effective as morphine when used as a single-drug therapy for neonatal abstinence syndrome. Its administration results in improvement in neurobehavioral performance. (Read the full article)

Universal use of conjugated pneumococcal vaccines has resulted in dramatic decline in vaccine-type invasive pneumococcal disease. However, disease is not evenly distributed, and children with underlying clinical conditions are disproportionately represented, especially among children >5 years of age.

Invasive pneumococcal disease among children with comorbidity results in higher morbidity and mortality, and a large proportion of disease is due to serotypes not included in current conjugate vaccines. (Read the full article)

Although there is evidence regarding comorbidity of physical and mental disorders from clinical samples of specific disorders and treatment registries, there is limited evidence from systematic samples of youth with comprehensive information on the full range of mental and physical disorders.

This report is the first study to investigate the specificity of associations between a broad range of mental and physical conditions by using a large, systematically obtained pediatric sample with enriched information from electronic medical records and direct interviews. (Read the full article)

Although the psychometric properties of the school-age Strengths and Difficulties Questionnaire (SDQ) have been extensively examined by using longitudinal data, the preschool version of the SDQ has only been explored in a limited number of cross-sectional studies.

This is the first psychometric study of the preschool SDQ using longitudinal data. We report measurement invariance over time, satisfactory reliability, construct and criterion validity, and predictive utility for subsequent behavioral problems (4 years) and clinical disorders (2 years). (Read the full article)

The Respiratory Distress Assessment Instrument (RDAI) and the Respiratory Assessment Change Score (RACS) are the most frequently used measurement instruments in bronchiolitis clinical trials. Evidence is scarce regarding their measurement properties and their suitability for use as evaluative instruments in clinical trials.

The RDAI is an incomplete measure of respiratory distress in bronchiolitis, with poor to moderate construct validity. It has adequate discriminative properties but considerable test-retest measurement error. The RDAI and RACS were moderately responsive, but methodologic issues limit the interpretation of this finding. (Read the full article)

Studies on the risk of mortality and morbidities of extremely preterm infants of multiple gestation births have shown inconsistent results. Perinatal antecedents, admission status and severity of illness after birth can adversely affect outcomes of the extremely premature infants.

Preterm multiple gestation infants have increased risk of mortality but similar risk of major morbidities compared with singletons. Outcomes improved over time and all adverse outcomes, including mortality, were comparable between multiples and singletons in the most recent 5-year epoch. (Read the full article)

The etiology of juvenile idiopathic arthritis (JIA) is poorly understood. A recent study suggested a link between antibiotics and JIA but did not examine the potential for confounding from infections or the role of antibiotic timing.

Antibiotics were associated with newly diagnosed JIA in a dose- and time-dependent manner after adjusting for infection and other confounders. Antibiotics may play a role in the pathogenesis of JIA. (Read the full article)

The value of ultrasound imaging for the diagnosis, prognosis, and surgical planning of cryptorchidism is limited at best.

Ultrasound remains grossly overused by referring physicians throughout Ontario, Canada, which resulted in a 3-month delay to definitive surgery and unnecessary expenditures. (Read the full article)

Adolescent vaccination rates lag behind other childhood vaccines. Text messaging to improve uptake of adolescent vaccines has been shown to be effective in academic centers but has not been studied in other settings.

This study, done in 5 private and 2 safety-net practices, used a bidirectional text message as a behavioral prompt and showed text messaging was effective at increasing uptake of all adolescent vaccines. Costs were similar to other reminder/recall methods. (Read the full article)

Nvidia's GeForce Now streaming service lets you play many games from your Steam library on nearly any device.

Authorities unable or unwilling to face up to a reality that might reveal their own shortcomings and ineptitude, usually resort to pinpointing a scapegoat. This year, Covid-19 fits that bill, says Terry Bell.

L’image de havre de paix dans une région en proie aux conflits dont bénéficiait le Cameroun a volé en éclats depuis l’irruption de Boko Haram en 2013 au nord du pays. Ce mouvement, devenu l’Etat islamique en Afrique de l’Ouest en mars 2015, revendique son affiliation à Daech. Néanmoins, l’apparition brutale et sanglante de ce djihadisme africain est moins liée à l’essor de Daech en Irak et en Syrie qu’aux bouleversements du paysage religieux de l’Afrique en général et du Cameroun en particulier.

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.

Chromosomal and plasmid-borne AmpC cephalosporinases are a major resistance mechanism to β-lactams in Enterobacteriaceae and Pseudomonas aeruginosa. The new β-lactamase inhibitor avibactam effectively inhibits class C enzymes and can fully restore ceftazidime susceptibility. The conserved amino acid residue Asn³⁴⁶ of AmpC cephalosporinases directly interacts with the avibactam sulfonate. Disruption of this interaction caused by the N³⁴⁶Y amino acid substitution in Citrobacter freundii AmpC was previously shown to confer resistance to the ceftazidime-avibactam combination (CAZ-AVI). The aim of this study was to phenotypically and biochemically characterize the consequences of the N³⁴⁶Y substitution in various AmpC backgrounds. Introduction of N³⁴⁶Y into Enterobacter cloacae AmpC (AmpC_cloacae), plasmid-mediated DHA-1, and P. aeruginosa PDC-5, led to 270-, 12,000-, and 79-fold decreases in the inhibitory efficacy (k₂/K_i) of avibactam, respectively. The kinetic parameters of AmpC_cloacaeand DHA-1 for ceftazidime hydrolysis were moderately affected by the substitution. Accordingly, AmpC_cloacaeand DHA-1 harboring N³⁴⁶Y conferred CAZ-AVI resistance (MIC of ceftazidime of 16 µg/ml in the presence of 4 µg/ml of avibactam). In contrast, production of PDC-5 N³⁴⁶Y was associated with a lower MIC (4 µg/ml) since this β-lactamase retained a higher inactivation efficacy by avibactam in comparison to AmpC_cloacaeN³⁴⁶Y. For FOX-3, the I³⁴⁶Y substitution did not reduce the inactivation efficacy of avibactam and the substitution was highly deleterious for β-lactam hydrolysis, including ceftazidime, preventing CAZ-AVI resistance. Since AmpC_cloacaeand DHA-1 display substantial sequence diversity, our results suggest that loss of hydrogen interaction between Asn³⁴⁶ and avibactam could be a common mechanism of acquisition of CAZ-AVI resistance.

Probiotics might provide an alternative approach for the control of oral candidiasis. However, studies on the antifungal activity of probiotics in the oral cavity are based on the consumption of yogurt or other dietary products, and there is a necessary to use appropriate biomaterials and specific strains to obtain probiotic formulations targeting local oral administration. In this study, we impregnated gellan gum, a natural biopolymer used as a food-additive, with a probiotic and investigated its antifungal activity against Candida albicans. Lactobacillus paracasei 28.4, a strain recently isolated from the oral cavity of a caries-free individual, was incorporated in several concentrations of gellan gum (0.6% to 1%). All tested concentrations could incorporate L. paracasei cells while maintaining bacterial viability. Probiotic/gellan formulations were stable for 7 days when stored at room temperature or 4°C. Long-term storage of bacteria-impregnated gellan gum was achieved when L. paracasei 28.4 was lyophilized. The probiotic/gellan formulations provided a release of L. paracasei cells over 24 hours that was sufficient to inhibit the growth of C. albicans with effects dependent on the cell concentrations incorporated into gellan gum. The probiotic/gellan formulations also had inhibitory activity against Candida spp. biofilms by reducing the number of Candida spp. cells (p < 0.0001), decreasing the total biomass (p = 0.0003), and impairing hyphae formation (p = 0.0002), compared to the control group which received no treatment. Interestingly, probiotic formulation of 1% w/v gellan gum provided an oral colonization of L. paracasei in mice with approximately 6 log of CFU/mL after 10 days. This formulation inhibited the C. albicans growth (p < 0.0001), prevented the development of candidiasis lesions (p = 0.0013), and suppressed inflammation (p = 0.0006) when compared to the mice not treated in the microscopic analysis of the tongue dorsum. These results indicate that gellan gum is a promising biomaterial and can be used as a carrier system to promote oral colonization for probiotics that prevent oral candidiasis.

Ceftazidime–avibactam and cefiderocol are two of the latest generation β-lactam agents that possess expanded activity against highly drug-resistant bacteria, including carbapenem-resistant Enterobacterales. Here we show that structural changes in AmpC β-lactamases can confer reduced susceptibility to both agents. A multidrug-resistant Enterobacter cloacae clinical strain (Ent385) was found to be resistant to ceftazidime–avibactam and cefiderocol without prior exposure to either agent. The AmpC β-lactamase of Ent385 (AmpC^Ent385) contained an alanine–proline deletion at positions 294–295 (A294_P295del) in the R2 loop. AmpC^Ent385 conferred reduced susceptibility to ceftazidime–avibactam and cefiderocol when cloned into Escherichia coli TOP10. Purified AmpC^Ent385 showed increased hydrolysis of ceftazidime and cefiderocol compared with AmpC^Ent385Rev, in which the deletion was reverted. Comparisons of crystal structures of AmpC^Ent385 and AmpC^P99, the canonical AmpC of E. cloacae, revealed that the two-residue deletion in AmpC^Ent385 induced drastic structural changes of the H-9 and H-10 helices and the R2 loop, which accounted for the increased hydrolysis of ceftazidime and cefiderocol. The potential for a single mutation in ampC to confer reduced susceptibility to both ceftazidime–avibactam and cefiderocol requires close monitoring.

Importance Ceftazidime–avibactam and cefiderocol are newly approved β-lactam agents that possess broad spectrum activity against multidrug-resistant (MDR) Gram-negative bacteria. We show here that a two amino-acid deletion in the chromosomal AmpC β-lactamase, identified in a clinical strain of Enterobacter cloacae, confers reduced susceptibility to both agents. By crystallographic studies of free and drug-bound forms of enzyme, we demonstrate that this deletion in AmpC induces slanting of the H-9 helix that is directly connected with the R2 loop, and disappearance of the H-10 helix, is directly responsible for increased hydrolysis of ceftazidime and cefiderocol. These findings provide novel insights into how MDR Gram-negative bacteria may evolve their β-lactamases to survive selective pressure from these newly developed β-lactam agents.

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.

Jeffrey D. Horbar
Jun 1, 2012; 129:1019-1026
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Maureen Hack
Aug 1, 2005; 116:333-341
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Jeffrey D. Horbar
Jul 1, 2002; 110:143-151
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Lewis Macdonald MSP has been elected as a temporary Deputy Presiding Officer (DPO) of the Scottish Parliament. The election was held as part of the Parliament's response to the coronavirus pandemic.

Lewis Macdonald MSP has today chaired parliamentary proceedings for the first time as Deputy Presiding Officer of the Scottish Parliament.

Plans for further virtual scrutiny at the Scottish Parliament have today been announced by the Scottish Parliament’s Presiding Officer.

2019 is nearly over, so let's look ahead to what awaits the video game industry in the first year of the new decade. Informed opinions and hot takes abound.

An OMer encounters a French woman who converted to Islam but misunderstands both Islam and the Christian faith.

In the new A500 CPU cooler, two 2,400rpm fans can move up and down on the heatsink for greater flexibility, accommodating large RAM modules. Plus, an old-favorite Corsair keyboard gets leveled up.

Summary of TeenStreet 2016 in Oldenburg, Germany

Delaware’s Public Advocate today issued a letter to the White House asking the Trump administration to deny a request for emergency bailouts for aging coal and nuclear power plants owned by a large regional energy supplier.

Over the past decade, brands have begun embracing cultural fads en masse on their social media channels to stay relevant.

According to a study by Broadcast Audience Research Council India and Nielsen India, there has been a 44% increase in time spent on social media in the week of March 28 - April 3 over a sample pre-covid period in January and February.

Executive Order creates commission focused on reentry reform, and new office at DOC to oversee implementation WILMINGTON, Del. – Governor John Carney on Tuesday signed Executive Order #27, which focuses on improving reentry procedures for incarcerated individuals in Delaware. The Executive Order creates a commission focused on reentry reform, policies, and procedures, with a goal […]

Understanding your health coverage, getting familiar with the services covered and how much you will have to pay in case of an unfortunate eventuality is important.

CBDT said that assessees holding valid certificates for FY20 would get the benefit of extension, which otherwise would expire on March 31.

Digital transformation. Yup, I said it. It's over-hyped. But as SAS Chief Operating Officer and Chief Technology Officer Oliver Schabenberger says, "It's also real and powerful. Our world is being liquefied from physical assets into virtual assets, and analog processes into digital processes - the world is turning into bits [...]

SAS Customer Intelligence 360: Analytics as a guiding light was published on Customer Intelligence Blog.

The government of Denmark is having a negotiation with the industry regarding improvement of energy efficiency. The mutual agreement of 2012 has the ability to cut 12 per cent of energy usage in 2020, as compared to the same calculated in 2006. The agreement…

  This post is to help you learn on how to use Intel WiDi technology to project/beam your app onto a bigger screen (TV, Laptop, Monitor). We will be using the example of an app named "Grace" f...

Born in Ait Lahcene, near the Kabylie capital of Tizi Ouzou, then part of French Algeria, he studied to be a geologist, but his life took a turn in 1973 when he was called up as a last-minute replacement on the radio to sing the Berber lullaby 'A Vava Inouva.'

Since 1998, Northern Ireland's murals have shifted from glorifying gunmen towards depictions of happy times. The tributes to frontline healthcare workers could be a similar sign old wounds are healing

If you are looking for an entry level gaming laptop without spending too much, your best bets are laptops powered by NVIDIA’s new GTX 1050 or 1050Ti GPUs. These new GPUs are powerful enough to play AAA titles in Full HD resolution, but at low or medium settings. These GPUs are offered in entry-segment gaming laptops by almost all laptops makers, and some of these are already available in India. Here's taking a look at some of them.

A strong mathematical foundation is the key to an individual being able to upskill or reskill.

The Trump administration responded with a plan to authorise as much as $12 billion in aid

There will be very limited impact on affordable housing loans, most of which are backed by cash flow, and given mostly to the salaried class who have a steady income.

It said sectors with higher leverage, such as power, telecom, roads, textiles and fertilisers, will be the major beneficiaries and account for nearly 47 per cent of the total breather available.

The tenor of Sidbi’s lending to financial institutions will be 90 days. MSMEs have been cash-starved for a few years and the lockdown to control the spread of Covid-19 is a body blow to their revenues.