See volume, open interest, and other trading highlights for Fertilizer swaps and futures markets offered by CME Group.

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See volume, open interest, and other trading highlights for Fertilizer swaps and futures markets offered by CME Group.

eDrawings Pro 2020 now supports choosing your own 360˚ images as your custom environment in VR! This blog post will help walk you through the process of creating a 360˚ equirectangular image in SOLIDWORKS Visualize and adding it to your Virtual Reality scene in eDrawings Pro 2020.

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Various states have legalized marijuana for medical purposes and/or decriminalized recreational marijuana use. These changes coincide with a decrease in perceived harmfulness of the drug and an increase in its use among youth. This change is of critical concern because of the potential harmful impact of marijuana exposure on adolescents. Marijuana use has been associated with several adverse mental health outcomes, including increased incidence of addiction and comorbid substance use, suicidality, and new-onset psychosis. Negative impacts on cognition and academic performance have also been observed. As the trend toward legalization continues, the pediatric community will be called on to navigate the subsequent challenges that arise with changing policies. Pediatricians are uniquely positioned to provide innovative care and educate youth and families on the ever-evolving issues pertaining to the impact of marijuana legalization on communities. In this article, we present and analyze the most up-to-date data on the effects of legalization on adolescent marijuana use, the effects of adolescent use on mental health and cognitive outcomes, and the current interventions being recommended for use in pediatric office settings.

NEW YORK, USA (AP) — Queen Latifah, Rebecca Breeds, and Thomas Middleditch are set to star in three new CBS shows for the 2020-21 season as the network adds a reimagined Equalizer, a show based on The Silence of the Lambs and a comedy about organ donation.

OM teams in Costa Rica and El Salvador take Christmas to approximately 2,000 children during the run up to Christmas.

Dig into what two leading Democratic presidential candidates have to say in their platforms about charter schools with Education Week's detailed analysis.

Laurie Baker says the rural population should be considered a special population when considering education reforms.

One teacher embraced the technique, with encouragement from a former district administrator. But he was told he had to reverse course, in part because of parent complaints.

Dig into what two leading Democratic presidential candidates have to say in their platforms about charter schools with Education Week's detailed analysis.

A number of studies have examined the early impact of the varicella vaccination program on varicella-related hospitalizations and have found evidence of decline after vaccine implementation.

This study further documents the continued decline in varicella-related hospitalizations during the 1-dose varicella vaccination era and demonstrates statistically significant declines of >65% in all age groups. These data suggest that varicella vaccination prevented ~50 000 hospitalizations from 2000 to 2006. (Read the full article)

Corticosteroids inhibit the expression of many proinflammatory cytokines released during the course of community-acquired pneumonia infection. Corticosteroids have been found in some studies to be associated with improved clinical outcomes in adults with pneumonia. No studies have investigated corticosteroid use in children with pneumonia.

Results showed that corticosteroid treatment in children with pneumonia is common and its use is highly variable across institutions. Although corticosteroid therapy may benefit children with acute wheezing treated with β-agonists, corticosteroid therapy may lead to worse outcomes for children without wheezing. (Read the full article)

Clinical trials in children with severe traumatic brain injury (TBI) are challenging. To date, no work has been published that permits clinical investigators to estimate the number and compositional features of sites from which to recruit children with severe TBI into clinical trials.

Children with severe TBI are infrequent. Less than 5% of all US hospitals discharged more than 78% of severe TBI cases. To maximize enrollment efficiency for future clinical trials, attention has to be paid to selecting appropriate hospital sites. (Read the full article)

Predischarge serum or transcutaneous bilirubinometry (TcB) measurements are recommended as appropriate screening options for identifying infants at risk for neonatal hyperbilirubinemia (NH). Visual inspection for jaundice is not reliable at identifying infants with NH in the community.

When compared with visual inspection alone, coordinated TcB screening for NH in acute-care and community settings is associated with significant improvements in laboratory utilization, patient care, convenience, and safety. (Read the full article)

In the United States, drowning is the second leading cause of unintentional injury death among children (1–19), accounting for >1000 deaths per year. Total lifetime costs in 2000 were estimated to be $2.6 billion for children aged 0 to 14.

National trends in pediatric drowning hospitalizations by age and gender have not been reported. This study provides benchmarks that can be used for state and regional comparisons and monitoring of injury prevention efforts. (Read the full article)

Recent studies report that overall computed tomography utilization in the emergency department has continued to rise. Increased computed tomography use is concerning because of the association with radiation exposure and the potential risk of radiation-induced malignancy, which is highest in children.

Our data showed no overall increase in computed tomography utilization through 2010. In areas where alternative non–radiation-based modalities were options, there were decreased trends in computed tomography use and increased use of potential alternative non–radiation-based modalities. (Read the full article)

Community-acquired pneumonia (CAP) is a common pediatric illness caused by Streptococcus pneumoniae. New pediatric Infectious Diseases Society of America CAP guidelines are now available recommending ampicillin as empirical treatment of children hospitalized with uncomplicated CAP.

This study found that a CAP guideline led to an increase in the narrow-spectrum antibiotic ampicillin. Additionally, an increase in the use of amoxicillin at discharge was observed. Furthermore, change in therapy did not lead to increased adverse outcomes. (Read the full article)

Rural Alaska children have high rates of hospitalization with lower respiratory tract infections from a variety of pathogens. Past studies of risk factors for respiratory syncytial virus infection associated medically high-risk status, household crowding, and infant feeding practices with hospitalization.

This study reveals the importance of medically high-risk status and infant feeding practices as important factors in respiratory hospitalization. In addition, we identified woodstove use and the absence of 2 or more sinks in household as risk factors for hospitalization. (Read the full article)

A wide variety of prescription drugs are prescribed to US children. Although one of the steps in assessing the risk/benefit of therapies in the pediatric population is to understand how they are used, pediatric drug utilization is not well characterized.

By using large prescription databases, this study examines the frequency and patterns of national outpatient drug utilization (acute and chronic medications) in US infants, children, and adolescents for 2002 through 2010. (Read the full article)

Although several studies have demonstrated increased morbidity and mortality with pH1N1 in children, others have found its clinical course to be similar to seasonal influenza. Moreover, most studies were conducted at single centers, thus raising concerns about generalizability of findings.

This analysis provides national-level active hospital-based surveillance data comparing pH1N1 with 5 previous years of seasonal influenza A and demonstrates differences in risk factors and clinical presentation but not in ICU admission or mortality. (Read the full article)

Findings from 3 studies suggest that the diagnosis of venous thromboembolism in hospitalized US children has increased in recent years.

This study provides additional evidence of an increasing trend in the rate of venous thromboembolism-associated hospitalization in US children, as well as a concurrent increase in the prevalence of venous catheter procedures. (Read the full article)

There are limited data on current testing and treatment patterns for children hospitalized with pneumonia, and on whether institutional guidelines affect care.

The use of institutional clinical practice guidelines was not associated with changes in diagnostic testing, hospital length of stay, or costs for children hospitalized with pneumonia, but was associated with increased use of narrow-spectrum antibiotics. (Read the full article)

Patients living in rural versus urban counties encounter different health care environments. Whether these differences result in different health care utilization for rural versus urban infants is not known.

In this study, infants living in rural California counties were hospitalized less often than infants living in urban counties. Among those hospitalized, infants living in rural counties were hospitalized for fewer cumulative days than infants residing in urban counties. (Read the full article)

There is concern about the potential exploitation of children who are enrolled into clinical trials in developing and transition countries. Previous studies of globalization have only examined pediatric drug trials, and only 1 study has provided patient-level data by country.

The involvement of developing and transition countries depends on the product or indication under investigation and is greater for vaccines than for drugs or biologicals. Compared with our previous analysis, involvement of these countries in pediatric drug development has decreased. (Read the full article)

The medical home likely plays a positive role in outpatient health outcomes. Asthma is a common and frequent reason for pediatric hospitalization. It is unknown whether having a quality medical home can prevent readmission in children hospitalized for asthma exacerbations.

Poor access to a medical home was associated with increased readmission for asthma, whereas other measured aspects of medical home were not. Children with private insurance and good access to care had the lowest rates of readmission within a year. (Read the full article)

Skin and soft tissue infections (SSTIs) are a common pediatric condition often requiring inpatient management. Several studies describe recent increases in hospitalizations due to SSTIs.

In addition to rising hospitalizations, analysis of pediatric SSTI resource utilization trends revealed a twofold increase in incisions and drainages over a 13-year period. A growing number of incisions and drainages were performed in younger children. (Read the full article)

Accurately identifying ill hospitalized children with vital signs concerning for clinical deterioration is fundamental to inpatient pediatrics. Normal vital sign ranges for healthy children are useful for outpatient practice but have limited application to detecting deterioration in the hospital setting.

Percentile curves for heart and respiratory rate in hospitalized children were developed and validated. The distributions differed from existing reference ranges and early warning scores. They may be useful to identify vital signs deviating from ranges expected among hospitalized children. (Read the full article)

Studies suggest that young adults have worse access to health care, use less primary care, and visit emergency departments more frequently than adolescents. Whether these differences are present between adolescents and young adults with asthma is unknown.

Young adults with asthma were less likely to have a usual source of care and use primary care. In contrast, they were more likely to use the emergency department. Adjusting for insurance coverage reduced these differences partially but not completely. (Read the full article)

Yearly influenza immunization is recommended in patients with inflammatory bowel disease (IBD). However, concern regarding vaccine-related adverse events may limit uptake, and case reports in the literature detail disease flares after immunization.

Influenza immunization rates in children with IBD are low but immunization did not result in increased outpatient visits, hospitalizations or emergency visits. Immunization was associated with fewer IBD-related visits in the post-vaccine period, which may indicate protection against IBD symptoms. (Read the full article)

Hospitalizations under observation status are presumed to be shorter and less resource-intensive, but utilization for pediatric observation-status stays has not been studied.

Children’s hospitals use observation status with great variation. Resource utilization for pediatric patients under observation status overlaps substantially with inpatient-status utilization, calling into question the utility of segmenting pediatric patients according to billing status. (Read the full article)

Child welfare data show declines in child physical abuse since the early 1990s, but analysis of national data from hospitalized children in the Kids’ Inpatient Database showed an increased incidence of serious physical abuse in children from 1997 to 2009.

We found no significant change in hospitalization rates for injury from abuse in young children and increases in injury severity using the National Inpatient Sample from 1997 to 2009. This data helps provide a more complete perspective of the problem. (Read the full article)

Bronchiolitis is often cited as the leading cause of hospitalization for young children in the United States Previous studies reported increases in bronchiolitis hospitalizations through the 1990s. There are no recent efforts to assess national trends in bronchiolitis incidence and health care utilization.

Between 2000 and 2009, we found a significant decline in bronchiolitis hospitalizations among US children. By contrast, use of mechanical ventilation and hospital charges for bronchiolitis significantly increased over this same period. (Read the full article)

Although unnecessary for children with headache and normal history, computed tomography (CT) scans are widely used. Fewer than 1% of pediatric brain abnormalities present with headache as the only symptom. Furthermore, repeated CT scans may increase lifetime risk of cancer.

CT scans continue to be used to diagnose isolated pediatric headaches despite existing practice parameters. Although emergency department visits were correlated with greater likelihood of CT scan use, these scans were widely used across a variety of clinical settings. (Read the full article)

Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. Most estimates of RSV hospitalization rates are imprecise, having been calculated by using retrospective discharge diagnosis data and stratified age groups no narrower than 6 to 12 months.

Prospective, population-based surveillance data for infants hospitalized with laboratory-confirmed RSV infection were combined with birth certificate information to yield more precise age-specific hospitalization rates. These data should help determine priorities for the use of existing and future RSV prophylaxis strategies. (Read the full article)

Effective ventilation is fundamental to successful resuscitation of newborns, but face mask leak and airway obstruction are common during manual positive-pressure ventilation in the delivery room, which may compromise resuscitation.

Compared with a soft, round silicone face mask, using a nasal tube to provide respiratory support in the delivery room does not reduce the rate of intubation but may be a suitable alternative with equivocal efficacy. (Read the full article)

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)

Apnea is a life-threatening complication of bronchiolitis and has been associated with younger age, prematurity, and a parental report of apnea. Apnea is classically attributed to the respiratory syncytial virus, but little is known about the role of other viruses.

Among hospitalized children, low or high respiratory rates or low oxygen saturation on presentation were associated with subsequent apnea in the hospital. Several bronchiolitis pathogens were associated with apnea, with similar apnea risk across the major viral pathogens. (Read the full article)

Pertussis rates are on the rise in the United States. Infants often require hospitalization for pertussis. Vaccination can change hospitalization patterns for vaccine-preventable diseases. It is unknown if vaccinating adolescents for pertussis (recommended in 2006) might change infant hospitalization utilization.

Universal vaccination policy among adolescents against pertussis appears to have been effective in 3 of the 4 years we examined postvaccination. Further vaccination efforts among adolescents and adults are needed to prevent infantile hospitalization on a more consistent basis. (Read the full article)

Recent guidelines for the management of childhood pneumonia recommend narrow-spectrum antimicrobial agents (eg, ampicillin) for most children; however, few studies have directly compared the effectiveness of narrow-spectrum agents to the broader spectrum third-generation cephalosporins commonly used among children hospitalized with pneumonia.

By using data from 43 children’s hospitals in the United States, we demonstrate equivalent outcomes and costs for children hospitalized with pneumonia and treated empirically with either narrow- (ampicillin/penicillin) or broad-spectrum (ceftriaxone/cefotaxime) antimicrobial therapy. (Read the full article)

Socioeconomic status is known to influence health and health care utilization, but few studies have explored the relationship between community-level income and inpatient resource utilization for children.

In a large sample of pediatric hospitalizations, lower community-level household income is associated with higher inpatient costs of care for common conditions. These findings highlight the need to consider socioeconomic status in health care system design and reimbursement. (Read the full article)

Systematic health disparities in adults with systemic lupus erythematosus are well documented and are likely driven by biologic as well as modifiable factors. Sociodemographic factors and health care delivery characteristics have been associated with poor outcomes.

In hospitalized children with systemic lupus erythematosus, race and ethnicity were associated with increased risk for ICU admissions, end-stage renal disease, and death. Identification of sociodemographic factors associated with outcomes is important to address the needs of these vulnerable patients. (Read the full article)

An algorithm for neonatal early-onset sepsis risk based on Centers for Disease Control and Prevention 2002 guidelines for prevention of perinatal Group B Streptococcus disease results in the evaluation of ~12–15% of well-appearing term and late preterm infants.

A revised algorithm based on the Centers for Disease Control and Prevention 2010 guidelines eliminated 25% of all early-onset sepsis evaluations and resulted in significant cost savings, without short-term evidence of harm. (Read the full article)

Firearm injuries are the second leading cause of death among American children. Previous estimates of nonfatal injuries have relied on small samples of emergency department visits and do not allow a detailed understanding of these injuries among children and adolescents.

In 2009, there were 7391 hospitalizations for firearm-related injuries in US children and adolescents; 89% of hospitalizations occurred in males. Hospitalization rates were highest for 15- to 19-year-olds and for black males. Deaths in the hospital occurred in 6.1% of children and adolescents. (Read the full article)

Children who have experienced early psychosocial deprivation are at high risk of persistent, socially indiscriminate behaviors. These behaviors may decline slowly with high-quality caregiving but generally are associated with ongoing impairment.

This study suggests that placement in foster care reduces indiscriminate behaviors to an intermediate level between those in institutional care and community control subjects. It also demonstrates the importance of disorganized early attachment in predicting later indiscriminate behaviors. (Read the full article)

Viral wheezing is common in preschool-aged children. The efficacy of inhaled steroids in preventing viral wheezing is debated. Despite this debate, nebulized beclomethasone is widely prescribed (particularly in a few countries) to children with upper respiratory tract infections.

Findings from this study confirm that inhaled steroids are not effective in preventing viral wheezing. Moreover, no differences were found in the persistence of symptoms (eg, runny nose, sore throat) or in the parental perception of asthma-like symptom severity. (Read the full article)

Adolescents and young adults consume a significant amount of health care resources in our current medical system. With the Patient Protection and Affordable Care Act, a much larger number of previously uninsured young adults (aged ≥19) will be covered.

The Military Health System provides valuable information about the health utilization patterns of adolescents and young adults (aged 12–22) with universal insurance and excellent access to care. This information may help us understand the impact of new health care legislation. (Read the full article)

The pediatric mental health burden is substantial, with >4 million children meeting criteria for a mental health disorder. Mental health is a key priority for national pediatric inpatient quality measures, but little is known about admitted patients and their diagnoses.

Nationally, nearly 10% of hospitalizations in children >3 years are for primary mental health diagnoses. The most common and costly are depression, bipolar disorder, and psychosis. Fewer free-standing children’s hospitalizations (3%) were for mental health admissions, although diagnostic distributions were similar. (Read the full article)