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 failure has been frequently reported in children who have obstructive sleep apnea syndrome (OSAS) owing to adenotonsillar hypertrophy. Adenotonsillectomy (AT) has been reported to accelerate weight gain in children who have OSAS in nonrandomized uncontrolled studies.

This randomized controlled trial of AT for pediatric OSAS demonstrated significantly greater weight increases 7 months after AT in all weight categories. AT normalizes weight in children who have failure to thrive, but increases risk for obesity in overweight children. (Read the full article)

Previous studies have examined state regulations for child care facilities and found substantial variation among states. None of these studies examined regulations related to healthy sleep practices, which is an important and often overlooked intervention target for obesity prevention.

We reviewed state regulations related to healthy sleep in child care and compared them to recent national recommendations put forth by the Institute of Medicine. We found that many states lacked regulations, highlighting an important and timely opportunity for improvement. (Read the full article)

The American Academy of Pediatrics has identified bedding such as pillows, blankets, and quilts as potentially hazardous for the infant sleep environment. Bedding use is a modifiable risk factor for sudden infant death syndrome and unintentional sleep-related suffocation.

Reported bedding use over or under the infant for infant sleep substantially declined from 1993 to 2010. However, about one-half of US infants are still placed to sleep with potentially hazardous bedding despite recommendations against this practice. (Read the full article)

Inadequate sleep has been identified as a risk factor for obesity and other outcomes. Screen time and the presence of a television in the bedroom have been associated with inadequate sleep, but little is known about small screens (eg, smartphones).

Among 2048 fourth- and seventh-graders, children who slept near a small screen reported shorter sleep durations and perceived insufficient rest or sleep. Presence of a television in the bedroom and more screen time were also associated with poorer sleep. (Read the full article)

Pediatric obstructive sleep apnea syndrome (OSAS) has been associated with decreased health-related quality of life (QoL). Observational studies suggest that adenotonsillectomy for pediatric OSAS improves QoL, but these studies did not use a randomized study design or a control group of children with OSAS managed nonsurgically.

A prospective, randomized controlled study of adenotonsillectomy for pediatric OSAS showed significantly greater QoL and symptom improvements in children undergoing adenotonsillectomy than in the nonsurgical control arm. The extent of improvement was not appreciably influenced by baseline OSAS severity or obesity. (Read the full article)

Obstructive sleep apnea syndrome (OSAS) is associated with significant comorbidity: behavioral problems, sleepiness, and impaired quality of life. However, the utility of OSAS symptoms versus polysomnography in the prediction of comorbidities or response to treatment is not well known.

Among children with OSAS, the Pediatric Sleep Questionnaire, a well-validated, simple 1-page symptom inventory, predicts key adenotonsillectomy-responsive OSAS comorbidities and their improvement after adenotonsillectomy. In contrast, polysomnographic results do not offer similar predictive value. (Read the full article)

Sleep deprivation is a worldwide problem in adolescents. The effectiveness of sleep education in enhancing sleep knowledge with consequent modification of sleep habits remains uncertain, in view of small sample sizes and lack of control groups in previous studies.

This large-scale, cluster randomized controlled study found that a school-based sleep education program was effective in enhancing sleep knowledge and improving behavioral and mental health, but it had no significant impact on sleep duration or pattern among adolescents. (Read the full article)

Adequate sleep is critical for adolescent health. Available data suggest a historical downward trend in sleep behavior, but there has been no rigorous evaluation of recent US trends.

The proportion of adolescents who regularly obtain ≥7 hours of sleep is decreasing. Decreases in sleep exhibit period effects that are constant across adolescents according to gender, race, socioeconomic factors, and urbanicity. The gender gap in adequate sleep is widening. (Read the full article)

Sleep disturbances in infants associate with individual differences in temperament. However, little is known about interindividual differences and potential moderating factors, such as genotype.

The results suggest that the cumulative effect of total sleep duration during the first 3 years of life on temperament is moderated by child 5-HTTLPR genotype following a differential susceptibility model. (Read the full article)

On Thursday, the company sent an email to third-party dealers, saying they would need approval to sell used Nintendo Games. Turns out the email was actually sent out in error, Amazon claims.

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The UK and the European Union are on course to miss a key milestone on the road to a Brexit deal after talks hit a roadblock. Negotiations are now paused, putting pressure on leaders to step into the breach later this week.

The founder and chief of his eponymous investment bank traveled to Riyadh to extol the virtues of friendship. He stood out as many of the titans of U.S. finance sat out the kingdom’s signature investment summit amid international outrage over the killing of government critic Jamal Khashoggi.

Our economy is in deep trouble, from whichever perspective you look at it. The economic battering taken by economically strong countries is frightening, leaving us in South Africa to fear the worst.

Despite the establishment of anti-corruption agencies, Burundi is facing a deepening corruption crisis that jeopardises prospects for lasting peace and stability.

The crisis that has been occurring in CAR is certainly the most dramatic in its history: more than 600 000 Central Africans are internally displaced or sought refuge in neighbouring countries; according to the United Nations, 1.7 million live in a constant situation of food insecurity and 878 000 need immediate medical assistance; Muslim communities are fleeing Bangui and the western region, subsistence economy no longer exists and the de facto partition of the country, caused by the sectarian violence, is gradually becoming a reality.

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.

The password-fatigued masses will be pleased to find Keeper's new 30 percent off deal, which brings it down to $20.99 per year from its typical $29.99.

UEFA.com delves into the numbers and finds clean sheets were at a premium in the first legs.

The "scare" reaction in the markets due to the coronavirus pandemic, has removed "froth" and returned risk markets to much fairer valuations, says an investment expert.

The shooting death of a 10-year-old spectator at a high school football game exposes a critical vulnerability and crucial responsibility for schools: keeping people safe at events outside school buildings.

Penn State Hazleton’s Student Services and Engagement team is continuing to forge personal connections with students while operating under the restrictions in the virtual environment created by the COVID-19 crisis.

If you’re having trouble sleeping, you may want to monitor your sleep cycle. Apple Watch makes it easy with these apps.

David Gozal
Sep 1, 1998; 102:616-620
ARTICLES

Deepfakes, or doctored videos, have mostly been used to harm the reputations of celebrities and politicians. Now the AI-assisted technology is being used to trick companies out of big money.

The STEM School shooting underscores the huge challenges educators face in keeping students safe, even as fatal and injurious gunfire inside K-12 schools remains statistically rare.

As schools apply more scrutiny to the methods and materials they use to teach early reading, educators and parents in some states have started to form new advocacy efforts—trying to pressure states and districts to adopt new approaches to teacher training and evaluating materials.

Microsoft will probably deliver critical patches after it ends Windows 7 support in January 2020. But it's not guaranteed, so users and organizations should upgrade to Windows 10 now.

During her three months mission trip to Paris, Madeline realised how precious it is to be a living testimony for the homeless.

As schools apply more scrutiny to the methods and materials they use to teach early reading, educators and parents in some states have started to form new advocacy efforts—trying to pressure states and districts to adopt new approaches to teacher training and evaluating materials.

The Raspberry Pi Foundation is the educational partner for 'Shaun the Sheep Movie 2: Farmageddon,' which hits theaters today. We spoke to Raspberry Pi Foundation CEO Philip Colligan to get the backstory on these low-cost PCs built for tinkerers.

Ukraine, Spain, Italy, Serbia and Russia all topped their groups unbeaten and the Czech Republic and Portugal also progressed to ensure all seven European sides made the last 16.

Europe's representatives Portugal, Russia, Italy, Ukraine, Kazakhstan, Azerbaijan and Spain all secured top-two finishes in the group stage to reach the last 16.

Prasa estimates revenue losses for the year of R757 million, due to the impact of the lockdown.

Through a city-school partnership in Nashville, Tenn., after-school programs are using data to tailor lessons to students' learning needs.

The Delaware State Housing Authority (DSHA), in partnership with five local housing counseling agencies, is hosting “Keeping Your Home Afloat”, a Statewide Foreclosure Prevention Open House, on Monday, July 22nd from 5:00pm to 7:30pm. Attendees will learn how the Making Home Affordable Program may be able to help them reduce the amount they owe on their mortgage. Homeowners who are “underwater”, or owe more than their homes are worth, are especially encouraged to come get more information about the MHA Program’s Principal Reduction Alternative.

Lets hope it’s for the right reasons.

The beauty of the EPS table is that you can spot the ‘sleepers’ – the companies that deserve wider recognition due to superior performance over five years.

Even in this extraordinary #MeToo era, ordinary women who've experienced harassment or assault at work are often reluctant to share their stories publicly. Arianna Prothero found that to be just as true as she reported on sexual harassment and assaults in schools and other K-12 workplaces.

When teachers open up their classrooms and their teaching to parents, they build mutual trust and respect and avoid the nasty business of conflict, Eoin Lenihan writes.

Lebanese banks are working on a national financial rescue plan that would preserve some of their capital rather than writing it all off as outlined in a government program, the banking association head said.

Work will begin this spring and continue into the summer of 2018.

The Myntra Extended Network Through Store Activation (MENSA), a kirana model, allows local business owners to earn by assisting in deliveries.