At the onset of the coronavirus crisis, the Federal Reserve relied on repurchase agreements, or repos, as a large part...

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The volatility experienced this spring in the 7 trillion-dollar foreign exchange market was unprecedented. The JP Morgan G7 FX Volatility...

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Jamal Campbell was never quite sure how the box of food ended up at his home while growing up in the community of Jane and Finch in Toronto, but he understood what it meant to his family.

OM EAST produces a new booklet that brings a message of hope to women working in prostitution.

When Berlin Brandenburg Airport is put into operation at the end of October 2020, Schönefeld Airport will become Terminal 5 (T5) of BER. In order to avoid duplicate names of terminal sections, gates and car parks at BER, the building and car park infras...

NICOLA Sturgeon hopes to reopen IVF clinics “as quickly as possible” to stop the closure having a “devastating” impact on families’ lives during the pandemic.

THIS time last year the Scottish Government, Police Scotland and the Crown Office were united in great fanfare about groundbreaking new legislation designed to tackle domestic abuse.

WELL that didn’t take long. Scotland’s latest experiment in direct democracy was all but killed off this week, barely two months after Nicola Sturgeon announced it.

A high school basketball program in Virginia has been suspended indefinitely amid allegations of a sexual assault involving a 16-year-old boy, while junior varsity wrestlers in Oklahoma face similar allegations.

Two football players from John Jay High School in San Antonio, Texas, could be facing criminal charges after appearing to intentionally tackle a referee during a game on Friday night.

Yesterday, the House passed the Student Success Act, but there's still a ways to go before a final bill. Here's a checklist for a final bill to "fix" NCLB.

Children with sickle cell disease are at high risk of complications from influenza infection and have been recommended to receive annual influenza vaccine since the 1970s. Few safety studies, however, have examined the safety of influenza vaccine in this population.

This large cohort study did not find an association between influenza vaccination and hospitalization for sickle cell crises in children with sickle cell anemia. (Read the full article)

Computerized provider order entry (CPOE) has been recognized to enhance the efficiency, safety, and quality of medical work. Yet vendors and organizations have not determined best practices for customizations, resulting in systems that have poor usability and unintended consequences of use.

This study demonstrated that systematically developed order sets reduce cognitive workload and order variation in the context of improved system usability and guideline adherence. The concept of cognitive workload reduction is novel in the setting of computer order entry. (Read the full article)

Children with sickle cell anemia are at risk of central nervous system damage, including stroke. Even children without evidence of abnormality on neuroimaging are at risk of significant declines in neurocognitive function, starting at early ages.

This study adds the observation that poorer neurocognitive and behavioral function is associated with older age in infants and toddlers with sickle cell anemia, much earlier than previously expected. (Read the full article)

Children with sickle cell disease (SCD) have a higher basal metabolic rate, and have historically been underweight. In the general pediatric population, the average BMI percentile has been rising over the past 2 decades.

BMI percentiles for children with SCD in New England are higher than historically reported, mimicking the weight status in the general pediatric population. In children with SCD, higher hemoglobin levels increased the odds of being overweight and obese. (Read the full article)

Early detection for children with autism leads to better outcomes; early screening is critical. The Modified Checklist for Autism in Toddlers (M-CHAT) is a widely used instrument for early autism screening and is recommended by the American Academy of Pediatrics.

This large study provides empirical support for population screening for autism spectrum disorders and the use of the M-CHAT in primary care settings. This study provides updated results to facilitate use and scoring of the M-CHAT by clinical providers. (Read the full article)

Before the introduction of conjugate pneumococcal vaccines and routine penicillin prophylaxis, febrile patients with sickle cell disease were known to have a 3% to 5% risk of bacteremia. Consequently, hospitalization rates for febrile episodes are >70%.

We observed no mortality or morbidity among those managed completely as outpatients, and bacteremia occurred in <1%. Physicians should strongly consider outpatient management of febrile children with sickle cell disease if there are no other indications for admission. (Read the full article)

Persons with sickle cell anemia are known to have increased medical expenses, but little is known about the effects of hydroxyurea treatment on costs. In adults with severe sickle cell anemia, hydroxyurea has been reported to reduce expenses from hospitalization.

In this randomized placebo-controlled prospective multicenter trial of hydroxyurea in very young children with sickle cell anemia, not selected for severity, hydroxyurea was associated with significant medical cost savings due to a reduction in hospitalization expenses. (Read the full article)

As more children with sickle cell disease survive into adulthood, they are increasingly hospitalized in both children’s and general hospitals and managed by different provider specialists. But it is unknown if hospital type and provider specialty affect patient outcomes.

Using a large national administrative dataset, this study revealed that general hospitals were associated with higher rates of intubation and longer lengths of stay compared with children’s hospitals for adolescents and young adults with SCD admitted with acute chest syndrome. (Read the full article)

Vaso-occlusive episodes (VOEs) are a common complication of sickle cell disease, resulting in morbidity. Magnesium is a vasodilator and has been shown to improve red blood cell hydration. Previous small studies have suggested that treatment with magnesium may decrease VOEs.

Intravenous magnesium sulfate is well tolerated in relatively high doses but had no effect on the length of stay in hospital, pain scores, or cumulative analgesia used in children admitted with painful VOEs in sickle cell disease. (Read the full article)

Screening for autism spectrum disorders (ASDs) using the Modified Checklist for Autism in Toddlers (M-CHAT) improves early detection and long-term prognosis of ASD. Reducing the false-positive rate may increase implementation of screening for ASDs.

The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), simplifies wording of the original M-CHAT. The current validation study indicates that the M-CHAT-R/F improves the ability to detect autism spectrum disorders in toddlers screened during well-child care visits. (Read the full article)

Obstructive sleep apnea syndrome (OSAS) prevalence in children with sickle cell anemia is not well described. Although these children often experience nocturnal oxygen desaturation, it is unclear whether they are more likely to have OSAS.

Children with sickle cell anemia have a high prevalence of OSAS with typical symptoms, beyond just nocturnal oxyhemoglobin desaturation. This study supports the need for increased efforts to screen for, diagnose, and treat OSAS in this vulnerable population. (Read the full article)

Growth impairment in sickle disease has been a consistent finding in published reports. Hydroxyurea (HU) decreases vasoocclusive events and increases hemoglobin levels, which may improve growth. However, HU may adversely affect growth in young children by its effect on DNA synthesis.

Height, weight, and head circumference were normal in HU-treated children in the study as compared with the World Health Organization standards. Height, weight, and BMI z scores were similar in placebo and treatment groups. There were no harmful effects of HU on growth. (Read the full article)

Hydroxyurea is a treatment option for young patients with sickle cell disease (SCD). Establishing the safety of hydroxyurea is of paramount importance. The effect of hydroxyurea on immune function and immunizations in SCD has not been studied previously.

Children with SCD receiving hydroxyurea have lower lymphocyte, CD4, and memory T-cell counts compared with those receiving placebo, but still in the range for healthy children. Despite slower response to measles vaccine, measles, mumps, and rubella and pneumococcal vaccines are effective. (Read the full article)

Patients with sickle cell disease frequently express dissatisfaction with emergency department treatment of painful crises. Time to opioid administration has been suggested as a quality of care measure for painful crises.

Although not associated with hospital admission, time to opioid administration in sickle cell disease painful crises was associated with secondary outcomes including improvement between the first 2 pain scores, decreased pain score area under the curve at 4 hours, decreased emergency department length of stay, and increased total opioids. (Read the full article)

Source: www.brooklynpaper.com - Saturday, May 09, 2020
The owner of the iconic Park Slope events venue Grand Prospect Hall, Michael Halkias, died from COVID-19 on Wednesday. He was 82. Halkias’ death sent shockwaves throughout Brooklyn, where community leaders and friends remember him as a passionate, generous figure. “ He was a Brooklyn character for sure in the best sort of way,” said Randy Peers, president and CEO of the Brooklyn Chamber of Commerce. “He was larger than life.” Halkias and his wife Alice bought Grand Prospect Hall in 1984 and turned the extravagant Prospect Avenue building into an opulent catering hall. The space became a New York icon because of the its long-running, popular commercials, where Alice Halkias declares in a Greek accent, “We make your dreams come true!” Saturday Night Live spoofed the famous commercial in February of 2019, and the pair appeared on Jimmy Kimmel Live in October to remake the ad with Mets player Pete Alonso. Grand Prospect Hall, a Victorian banquet hall built in 1892, attracted big names such as dancer Fred Astaire and mafioso Al Capone during its heyday in the early 20th century — and boasted some of the borough’s oldest treasures, such as Brooklyn’s first reported elevator, which functions to this day. But by the 1980s, the landmarked building had fallen into disrepair: its walls had been painted black, molding had been stripped off the walls, and the chandeliers were gone, Halkias told Brooklyn Paper in 2004. The couple spent 20 yea

The justices hear arguments Nov. 12 on the Trump administration's effort to end deportation relief under Deferred Action for Childhood Arrivals, in a case pitting the administration and GOP-leaning states against a host of education and advocacy groups.

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

Objectives: Carbapenemase-producing Enterobacterales and specifically KPC-producing Klebsiella pneumoniae (KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than if caused by carbapenem-susceptible isolates.

Study design and methods: This is a retrospective cohort study of patients with VAP due to K. pneumoniae from a 35-bed polyvalent Intensive Care Unit in a university hospital (> 40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression).

Results. We analyze 69 cases of K. pneumoniae VAP of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/mL). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [lsqb]HR[rsqb] 1.25; 95% CI: 0.46–3.41). Adequate targeted therapy (HR 0.03; 95% CI: <0.01–0.23) was associated with all-cause mortality.

Conclussion. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible K. pneumoniae when appropriate treatment is used.

Polymyxins are increasingly used as the critical last-resort therapeutic options for multidrug-resistant gram-negative bacteria. Unfortunately, polymyxin resistance has increased gradually for the last few years. Although studies on mechanisms of polymyxin are expanding, system-wide analyses of the underlying mechanism for polymyxin resistance and stress response are still lacking. To understand how Klebsiella pneumoniae adapt to colistin (polymyxin E) pressure, we carried out proteomic analysis of Klebsiella pneumoniae strain cultured with different concentrations of colistin. Our results showed that the proteomic responses to colistin treatment in Klebsiella pneumoniae involving several pathways, including (i) gluconeogenesis and TCA cycle; (ii) arginine biosynthesis; (iii) porphyrin and chlorophyll metabolism; and (iv) enterobactin biosynthesis. Interestingly, decreased abundance of class A β-lactamases including TEM, SHV-11, SHV-4 were observed in cells treated with colistin. Moreover, we also present comprehensive proteome atlases of paired polymyxin-susceptible and -resistant Klebsiella pneumoniae strains. The polymyxin-resistant strain Ci, a mutant of Klebsiella pneumoniae ATCC BAA 2146, showed missense mutation in crrB. The crrB mutant Ci, which displayed lipid A modification with 4-amino-4-deoxy-L-arabinose (L-Ara4N) and palmitoylation, showed striking increases of CrrAB, PmrAB, PhoPQ, ArnBCADT and PagP. We hypothesize that crrB mutations induce elevated expression of the arnBCADTEF operon and pagP via PmrAB and PhoPQ. Moreover, multidrug efflux pump KexD, which was induced by crrB mutation, also contributed to colistin resistance. Overall, our results demonstrated proteomic responses to colistin treatment and the mechanism of CrrB-mediate colistin resistance, which may further offer valuable information to manage polymyxin resistance.

Klebsiella pneumoniae that produce extended spectrum beta lactamases (ESBLs) are a persistent public health threat. There are relatively few therapeutic options and there is undue reliance on carbapenems. Alternative therapeutic options are urgently required. A combination of cefepime and the novel beta lactamase inhibitor enmetazobactam is being developed for treatment of serious infections caused by ESBL-producing organisms. The pharmacokinetics-pharmacodynamics (PK-PD) of cefepime-enmetazobactam against ESBL-producing K. pneumoniae was studied in a neutropenic murine pneumonia model. Dose ranging studies were performed. Dose fractionation studies were performed to define the relevant PD index for the inhibitor. The partitioning of cefepime and enmetazobactam into the lung was determined by comparing area under the concentration time curve (AUC) in plasma and epithelial lining fluid. The magnitude of drug exposure for cefepime-enmetazobactam required for logarithmic killing in the lung was defined using 3 ESBL-producing strains. Cefepime 100 mg/kg q8h i.v. had minimal antimicrobial effect. When this background regimen of cefepime was combined with enmetazobactam half-maximal effect was induced with enmetazobactam 4.71 mg/kg q8h i.v. The dose fractionation study suggest both fT>threshold and fAUC:MIC are potentially relevant PD indices. The AUC_ELF:AUC_plasma for cefepime and enmetazobactam was 73.4% and 61.5%, respectively. A ≥2-log kill in the lung was achieved with a plasma and ELF cefepime fT>MIC of ≥20% and enmetazobactam fT>2 mg/L of ≥20% of the dosing interval. These data and analyses provide the underpinning evidence for the combined use of cefepime and enmetazobactam for nosocomial pneumonia.

Meropenem/vaborbactam resistance in Klebsiella pneumoniae is associated with loss of function mutations in the OmpK35 and OmpK36 porins. Here we identify two previously unknown loss of function mutations that confer cefuroxime resistance in K. pneumoniae. The proteins lost were NlpD and KvrA; the latter is a transcriptional repressor controlling capsule production. We demonstrate that KvrA loss reduces OmpK35 and OmpK36 porin production, which confers reduced susceptibility to meropenem/vaborbactam in a KPC-3 producing K. pneumoniae isolate.

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.

Students enrolled in a crisis management course are examining the pandemic and its lessons and developing recommendations that the government and even individuals can follow. It's the kind of real-world experience that students can expect to have at Penn State Abington.

School superintendents, principals, and school board members found a lot to like in a draft bill to renew the Elementary and Secondary Education Act.

House leaders may hold off on a final vote on a Republican-backed bill to rewrite the No Child Left Behind law, amid pushback from powerful GOP lobbying groups

The terminal sections and car parks at Schönefeld Airport will be given new names at the end of March. When Berlin Brandenburg Airport is put into operation at the end of October 2020, Schönefeld Airport will become Terminal 5 (T5) of BER. In order to a...

OM worker Andrew is encouraged to see the vibrancy of Jesus followers in Bangladeshi villages as one changed life impacts others.

A local web developer has set the cat among the pigeons after taking unusual steps to extract payment from a client.

Cases where a listed company's tax position is unclear because of a dispute with the taxman or legal uncertainty have been in the spotlight.

Complaint accuses family behind Purdue Pharma of consumer fraud, negligence, and nuisance  Attorney General Kathy Jennings Monday sued seven members of the Sackler family for their role in creating and sustaining the opioid crisis in Delaware. The individuals named in the Delaware Superior Court complaint controlled and directed opioid manufacturer Purdue Pharma’s two-decade course of falsely and deceptively marketing opioids, sowing the seeds […]

25-state coalition files briefs in Bankruptcy Court Attorney General Kathy Jennings, along with a bipartisan group of 24 attorneys general, filed today two briefs opposing a request by Purdue Pharma to stop all lawsuits against the company and the Sackler family. “The Sacklers extracted up to $13 billion from Purdue while drugs like OxyContin wreaked […]

SYNOPSIS INTRODUCTION: To mark the 44th anniversary of the landmark judgement of ADM Jabalpur, this article revisits the case. The article also talks about Justice H.R. Khanna, who has ben regarded as the brave, unsung hero of the India Justice sy

The latest promos of the ongoing Bigg Boss 13 show reveal that Rashami Desai's alleged boyfriend Arhaan Khan who entered as wild card contestant along with Hindustani Bhau(Vikas Fhatak), Khesari Lal Yadav, Shefali Jariwala, Himanshi Khurana and Tehseen Poonawalla, has already challenged the thick jodi of BB 13, Sidharth Shukla

"What mothers really want for mother's day but can't tell their kids," wrote Twinkle

Governor Markell shares his highlights from Governor’s Day at the 2015 Delaware State Fair.

The Division of Public Health (DPH) is reporting two more flu-related deaths that occurred during the last two weeks of February, bringing the 2017-2018 season death total to 30. This number breaks the previous single-season record of 28 flu-related deaths, set in 2014-2015. The deceased were both females, 83 and 84 years old, from New Castle and Kent counties, respectively. Both had multiple underlying health conditions.

Wilmington --

Location: Rockland Road (Bridge over Brandywine Creek) between Adams Dam Road and Rockland Falls, Wilmington.

Dates and Times: 9:00 a.m. until 2:00 p.m. on Wednesday, April 1, 2020, pending weather.

Rain Date: Thursday, April 2, 2020 from 9:00 a.m. until 2:00 p.m. [More]