Previous studies have identified barriers to providing optimal pediatric palliative care, including general communication issues between clinicians and family members. However, there is a paucity of data regarding the barriers specifically relating to advance care discussions.

This study identifies significant barriers to advance care discussions for children with life-threatening conditions. Clinicians perceive parental issues as the most common impediments to these discussions. Furthermore, providers believe that advance care discussions happen too late in the course of illness. (Read the full article)

Pneumonia is still a significant problem in young children from developing countries where zinc deficiency is prevalent. Although zinc supplementation reduces the risk of childhood pneumonia, the effect of adjunct zinc on severe pneumonia is unclear with conflicting results.

The overall effect, if any, of zinc as adjuvant therapy for World Health Organization–defined severe pneumonia in young children is small. (Read the full article)

The American Academy of Pediatrics recommends that all preterm infants receive human milk; however, little is known about the use of human milk in US advanced care neonatal units.

Routine use of human milk and use of donor milk in neonatal advanced care units increased from 2007 to 2011, particularly among units providing intensive care. There is geographic variation in the use of human milk in these units. (Read the full article)

As the number of chronically ill children grows in the United States, end-of-life discussions and advance directives (AD) will become increasingly important. Although pediatric palliative care is gaining interest, little is known about parental preferences regarding ADs for chronically ill children.

Knowledge about ADs is limited among caregivers of children who have chronic illness. However, interest in creating ADs is high, suggesting an unmet need and opportunity for health care providers to improve the care of children who have chronic illness. (Read the full article)

Although physicians worry that communicating about prognosis or life-threatening illness can take away hope, previous work suggests that prognosis communication may even enhance hope. The nature of hopes held by parents of children with advanced cancer was not previously understood.

Parents in our study frequently recognized their child’s poor prognosis, yet held many different hopes, including for cure, quality of life, and meaningful relationships. Parents who hoped for cure often recognized that this was not possible for their child. (Read the full article)

So, how do we manage? What do we do when consistently engaging in the difficult discussion about rape culture is hard on our hearts, but helpful for our students?

Treatment of Mycobacterium avium complex pulmonary disease (MAC-PD) is challenging partly due to high efflux pump expression. Thioridazine might block these efflux pumps. We explore thioridazine's efficacy against M. avium using minimum inhibitory concentrations (MICs), time-kill combination assays, ex vivo macrophage infection assays and efflux assays. Thioridazine is bactericidal against M. avium, inhibits intracellular growth at 2x MIC and blocks ethidium bromide efflux. However, its toxicity and low plasma concentrations, make it unlikely to add efficacy to MAC-PD therapy.

Staphylococcus aureus osteomyelitis is a debilitating infection of bone. Treatment of osteomyelitis is impaired by the propensity of invading bacteria to induce pathologic bone remodeling that may limit antibiotic penetration to the infectious focus. The nonsteroidal anti-inflammatory drug diflunisal was previously identified as an osteoprotective adjunctive therapy for osteomyelitis, based on the ability of this compound to inhibit S. aureus quorum sensing and subsequent quorum-dependent toxin production. When delivered locally during experimental osteomyelitis, diflunisal significantly limits bone destruction without affecting bacterial burdens. However, because diflunisal's "quorum-quenching" activity could theoretically increase antibiotic recalcitrance, it is critically important to evaluate this adjunctive therapy in the context of standard of care antibiotics. The objective of this study is to evaluate the efficacy of vancomycin to treat osteomyelitis during local diflunisal treatment. We first determined that systemic vancomycin effectively reduces bacterial burdens in a murine model of osteomyelitis, and identified a dosing regimen that decreases bacterial burdens without eradicating infection. Using this dosing scheme, we found that vancomycin activity is unaffected by the presence of diflunisal in vitro and in vivo. Similarly, locally-delivered diflunisal still potently inhibits osteoblast cytotoxicity in vitro and bone destruction in vivo in the presence of sub-therapeutic vancomycin. However, we also found that the resorbable polyurethane foams used to deliver diflunisal serve as a nidus for infection. Taken together, these data demonstrate that diflunisal does not significantly impact standard of care antibiotic therapy for S. aureus osteomyelitis, but also highlight potential pitfalls encountered with local drug delivery.

One of the reasons for the lengthy tuberculosis (TB) treatment is the difficult to treat non-multiplying mycobacterial subpopulation. In order to assess the ability of (new) TB drugs to target this subpopulation, we need to incorporate dormancy models in our pre-clinical drug development pipeline. In most available dormancy models it takes a long time to create a dormant state and it is difficult to identify and quantify this non-multiplying condition.

The Mycobacterium tuberculosis 18b strain might overcome some of these problems, because it is dependent on streptomycin for growth and becomes non-multiplying after 10 days of streptomycin starvation, but still can be cultured on streptomycin-supplemented culture plates. We developed our 18b dormancy time-kill kinetic model to assess the difference in the activity of isoniazid, rifampicin, moxifloxacin and bedaquiline against log-phase growth compared to the non-multiplying M. tuberculosis subpopulation by CFU counting including a novel AUC-based approach as well as time-to-positivity (TTP) measurements.

We observed that isoniazid and moxifloxacin were relatively more potent against replicating bacteria, while rifampicin and high dose bedaquiline were equally effective against both subpopulations. Moreover, the TTP data suggest that including a liquid culture-based method could be of additional value as it identifies a specific mycobacterial subpopulation that is non-culturable on solid media.

In conclusion, the results of our study underline that the time-kill kinetics 18b dormancy model in its current form is a useful tool to assess TB drug potency and thus has its place in the TB drug development pipeline.

Introduction: This study was performed to evaluate the impacts of vanA-positivity of Enterococcus faecium (EFM) exhibiting diverse susceptibility phenotypes to glycopeptides on clinical outcomes in patients with a bloodstream infection (BSI) through a prospective, multicenter, observational study.

Methods: A total of 509 patients with an EFM BSI from eight sentinel hospitals in South Korea during a two-year period were enrolled in this study. Risk factors of the hosts and causative EFM isolates were assessed to determine associations with the 30-day mortality of EFM BSI patients via multivariable logistic regression analyses.

Results: The vanA gene was detected in 35.2% (179/509) of EFM isolates; 131 EFM isolates exhibited typical VanA phenotypes (group vanA-VanA), while the remaining 48 EFM isolates exhibited atypical phenotypes (group vanA-Atypical), including VanD (n = 43) and vancomycin-variable phenotypes (n = 5). A multivariable logistic regression indicated that vanA-positivity of causative pathogens was independently associated with the increased 30-day mortality rate in the patients with an EFM BSI; however, there was no significant difference in the survival rates between the patients of the vanA-VanA and vanA-Atypical groups (log-rank test, P = 0.904).

Conclusions: A high 30-day mortality rate was observed in patients with vanA-positive EFM BSIs, and vanA-positivity of causative EFM was an independent risk factor for early mortality irrespective of the susceptibility phenotypes to glycopeptides; thus, intensified antimicrobial stewardship is needed to improve clinical outcome of patients with vanA-positive EFM BSI.

Methicillin-resistant Staphylococcus aureus (MRSA) has grown to become a major burden on healthcare systems. The cumulation of limited therapeutic options and worsened patient outcomes with persistent MRSA bacteremia has driven research in optimizing its initial management. The guidelines published by the Infectious Disease of America currently recommend combination therapy for refractory MRSA bacteremia, but the utility of combining antibiotics from the start of therapy is under investigation. The alternative strategy of early use of a β-lactam antibiotics in combination with vancomycin upon initial MRSA bacteremia detection has shown promise. While this concept has gained international attention, providers should give this strategy serious consideration prior to implementation. The objective of this review is to examine retrospective and prospective evidence for early combination with vancomycin and β-lactam antibiotics, as well as explore potential consequences of combination therapy.

Treatment of exacerbations of chronic Pseudomonas aeruginosa infections in patients with cystic fibrosis (CF) is highly challenging due to hypermutability, biofilm formation and an increased risk of resistance emergence. We evaluated the impact of ciprofloxacin and meropenem as monotherapy and in combination in the dynamic in vitro CDC biofilm reactor (CBR). Two hypermutable P. aeruginosa strains, PAOmutS (MIC_{ciprofloxacin} 0.25 mg/L, MIC_meropenem 2 mg/L) and CW44 (MIC_{ciprofloxacin} 0.5 mg/L, MIC_meropenem 4 mg/L), were investigated for 120h. Concentration-time profiles achievable in epithelial lining fluid (ELF) following FDA-approved doses were simulated in the CBR. Treatments were ciprofloxacin 0.4g every 8h as 1h-infusions (80% ELF penetration), meropenem 6 g/day as continuous infusion (CI; 30% and 60% ELF penetration) and their combinations. Counts of total and less-susceptible planktonic and biofilm bacteria and MICs were determined. Antibiotic concentrations were quantified by UHPLC-PDA. For both strains, all monotherapies failed with substantial regrowth and resistance of planktonic (≥8log₁₀ CFU/mL) and biofilm (>8log₁₀ CFU/cm²) bacteria at 120h (MIC_{ciprofloxacin} up to 8 mg/L, MIC_meropenem up to 64 mg/L). Both combination treatments demonstrated synergistic bacterial killing of planktonic and biofilm bacteria of both strains from ~48h onwards and suppressed regrowth to ≤4log₁₀ CFU/mL and ≤6log₁₀ CFU/cm² at 120h. Overall, both combination treatments suppressed amplification of resistance of planktonic bacteria for both strains, and biofilm bacteria for CW44. The combination with meropenem at 60% ELF penetration also suppressed amplification of resistance of biofilm bacteria for PAOmutS. Thus, combination treatment demonstrated synergistic bacterial killing and resistance suppression against difficult-to-treat hypermutable P. aeruginosa strains.

Peroxidases are a group of heterogeneous family of enzyme that plays diverse biological functions. Ascorbate peroxidase is a redox enzyme that is reduced by trypanothione, which plays a central role in the redox defence system of Leishmania. In view of developing new and novel therapeutics, we have performed in silico studies in order to search for ligand library and identification of new drug candidates and its physiological role against promastigotes and intracellular amastigotes of Leishmania donovani. Our results demonstrated that the selected inhibitor ZINC96021026 has significant anti-leishmanial effect and effectively killed both free and intracellular forms of the parasite. ZINC96021026 was found to be identical to ML-240, a selective inhibitor of Valosin-containing protein (VCP) or p97, a member of AAA-ATPase protein family which was derived from the scaffold of DBeQ, targeting the D2-ATPase domain of the enzyme. ZINC96021026 (ML-240) thus have broad range of cellular functions, thought to be derived from its ability to unfold proteins or disassemble protein complexes besides inhibiting the ascorbate peroxidase activity. ML-240 may inhibits the parasite's ascorbate peroxidase leading to extensive apoptosis and inducing generation of reactive oxygen species. Taken together, our results demonstrated that ML-240 could be an attractive therapeutic option for treatment against leishmaniasis.

Google has made it easier to join the company's Advanced Protection Program, which is designed to stop the most sophisticated hackers from breaking into your Gmail account. Before you needed two security keys to enroll. Now you just need a smartphone.

Trivantis Lectora Inspire is more expensive than fellow Editors' Choice pick Articulate Storyline 2. With that said, it's still worth checking out as it is a very powerful eLearning authoring tool.

The Penn State Board of Trustees Committee on Finance, Business and Capital Planning today (May 7) advanced a plan to adjust tuition schedules for the summer 2020 semester due to the ongoing financial challenges many students and families are experiencing as a result of COVID-19 disruptions. The measure will go to the full board for a final vote on Friday, May 8.

Denver Newsroom, Apr 28, 2020 / 05:17 pm (CNA).- Archbishop Michael Miller of Vancouver has announced that he is donating to the University of British Columbia’s research toward a COVID-19 vaccine.

“May the search for COVID-19 solutions also be a moment of solidarity, of collaboration, and of growing together as a visible sign to the world of the healing and reconciliation so needed right now,” Archbishop Miller said April 27 as reported by the B.C. Catholic.

Ryan Thomas, a special advisor to the archdiocese, told CNA that Archbishop Miller wanted to express, through his donation, the Catholic Church’s support for science and medicine that contribute to the common good.

“The Church— as Pope Francis has said from the beginning of his pontificate— is called to go out, we're called to engage, not called to retreat,” Thomas told CNA.

“From a scientific standpoint, that means identifying the research that is worthy of our investment, that meets the high standards that we have to protect life,” he said.

Thomas declined to specify the amount of the donation, but said that it was in the thousands of dollars.

The global effort to develop a COVID-19 vaccine includes at least 50 other research teams, the university says, many of which in the U.S. and Canada have received government funding and are being conducted by large pharmaceutical companies.

Pro-life leaders have warned in recent months that among the many COVID-19 vaccines currently in development worldwide, in some cases researchers are using old cell lines derived from the cells of aborted babies.

It was important to Archbishop Miller, Thomas said, that the Church be seen to be promoting research into a vaccine that Catholics can support in good conscience.

A group of Evangelical Christians and Catholics in Vancouver began to rally around the idea of supporting a vaccine that corresponded to Christian ethical standards, and eventually presented the idea of supporting UBC’s research to Archbishop Miller.

Thomas said Miller made sure to inquire about whether UBC’s vaccine research makes use of aborted fetal cells, which it does not.

Dr. Wilf Jefferies, the project’s lead researcher, told CNA via email that his research team is currently in the process of validating the potency of vaccine candidates in preclinical trials, in order to assess their potential toxicity before trying them in human subjects.

The UBC lab is using immune-boosting components called adjuvants in its vaccine candidate, with the hopes of reducing the dosage of vaccine required for complete protection against the disease. In addition, Jefferies hopes that UBC’s vaccine will continue to provide protection against COVID-19 even if the virus mutates over time.

“I am heartened by the unity and kindness that is being demonstrated during this pandemic,” Jefferies told CNA.

“I think the response by the archdiocese is an affirmative and practical way to address the critical need in our society to develop a vaccine...I am sincerely humbled by the support we have received from the archdiocese and from other groups and individuals.”

So far, Jefferies’ lab has received grants from the government-funded Michael Smith Health Research Foundation and the Sullivan Urology Foundation affiliated with the University of British Columbia, as well as a number of private donations.

There are at least 1,000 clinical trials currently taking place around the world to test potential COVID-19 vaccines.

A group of pro-life leaders in a letter to the Trump administration earlier this month reiterated that development of a COVID-19 vaccine should avoid unethical links to abortion.

“No American should be forced to choose between being vaccinated against this potentially deadly virus and violating his or her conscience,” reads the April 17 letter to Dr. Stephen M. Hahn, commissioner of the U.S. Food and Drug Administration.

“Fortunately, there is no need to use ethically problematic cell lines to produce a COVID vaccine, or any vaccine, as other cell lines or processes that do not involve cells from abortions are available and are regularly being used to produce other vaccines,” it continued.

The letter’s signers include Archbishop Joseph Naumann of Kansas City in Kansas, chair of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities; the heads of three other bishops’ conference committees; and leaders of many other Catholic and non-Catholic groups.

The Pontifical Academy for Life has noted that Catholics have an obligation to use ethically-sourced vaccines when available, and have an obligation to speak up and request the development of new cell lines that are not derived from aborted fetuses.

The 2008 Vatican document Dignitatis personae strongly criticized aborted fetal tissue research. However, as regards common vaccines, such as those for chicken pox and measles, mumps, and rubella (MMR), that may be derived from cell lines of aborted babies, the Vatican said they could be used by parents for “grave reasons” such as danger to their children’s health.

In a 2017 document on vaccines, the academy noted a “moral obligation to guarantee the vaccination coverage necessary for the safety of others… especially the safety of more vulnerable subjects such as pregnant women and those affected by immunodeficiency who cannot be vaccinated against these diseases.”

 

Four Penn State World Campus energy and sustainability policy majors spent the year working with Pennsylvania boroughs to inventory greenhouse gas emissions, and coming up with climate action plans for reducing them.

AP has managed to dodge the partisan pitfalls that have felled other ambitious curricular efforts—so far, write Chester E. Finn Jr. and Andrew E. Scanlan.

Selected poems of Rachelle Bowser, Rachel Mennies, Erin Murphy and Eleanor Stanford have been chosen to represent the Pennsylvania Center for the Book’s 2020 Public Poetry Project, with poetry interpreted into art posters for the annual event.

Concern for their students and adapting to remote teaching are only a few of the stressors that teachers are facing during the coronavirus pandemic. In response, the Pennsylvania State Education Association (PSEA) has partnered with Sebrina Doyle, a graduate fellow in the College of Education, to offer mindfulness-based stress reduction training via Zoom to their members – to help alleviate feelings of helplessness, fear and anxiety. Doyle offered the hour-long webinar two days this month to approximately 700 PSEA members.

OM France marks OM’s 60th anniversary, inviting International Director, Lawrence Tong, to grace this special occasion.

The first tickets for the UEFA Women's Champions League final in Vienna on 24 May are now on sale.

The lawsuit, filed in 2014, alleges that the state was severely underfunding schools, forcing school districts to lean heavily on property taxes, which especially disadvantages students in property-poor areas.

Leader of OM Germany serves in the kitchen during TeenStreet, OM’s annual week-long international youth congress that started on Saturday.

The Department of Education has denied 99 percent of applications for public service loan forgiveness under a temporary expanded program funded by Congress, a report finds.

THE MEZZANINE GALLERY TO EXHIBIT TERRANCE VANN’S “EDGE OF DESTINY” PAINTINGS Wilmington, Del. (February 23, 2018) – Edge of Destiny will be on view in the Mezzanine Gallery from March 2-29, 2018. A free opening reception to meet the artist will be held on Friday, March 2 from 5-7 p.m. Live music will be provided by […]

Policymakers, Public Join Together for Women’s History Month Celebration and Lecture DOVER, Del. – Governor John Carney, Delaware’s Office for Women’s Advocacy and Advancement, the Delaware Department of Human Resources, the Delaware Commission for Women, and Delaware Women’s Workforce Council, today hosted the first lecture of its kind titled “Redefining Women in the Workplace” in honor […]

Kobe and Gianna Bryant were among nine people who died in the January 26 helicopter crash in the mountains west of Los Angeles.

Kesavananda Bharati V. state of Kerala that outlined the basic structure doctrine of the constitution. The judgment was delivered by the largest SC bench so far i.e. 13 judges.

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Ivanka Trump's personal assistant has tested positive for the deadly coronavirus, making her the third White House staff member to be infected from COVID-19, a media report said on Saturday.

Governor Carney has ordered the United States and Delaware flags at state buildings and facilities be flown at half-staff beginning Friday morning, December 1 to mark the passing of former Delaware Representative John Van Sant. Mr. Van Sant served the people of the Thirteenth District in the Delaware House of Representatives for twenty four years. […]

Mr. Sullivan was appointed as the Chief Public Defender in 1970, serving 39 years when he retired in 2009. Under his direction, the Office of the Public Defender grew from 10 employees to a full-service law firm employing nearly 150 people and 70 attorneys.

 Prudential Guidelines on Restructuring of Advances by Banks <

For beginners, how marketers can learn to create advanced data models from time series data

Road mishaps cost India 3-5% of its gross domestic product every year. India amounts to one percent of the vehicles across the world, yet it contributes almost 6% of the road fatalities on the road.

This new standard health insurance policy available with every general and standalone health insurer takes care of basic health needs, and is a must for first-time buyers, especially in smaller towns

Datsun’s Go as well as Go+ models have now received a CVT option. These come in the top trim and boast a slightly higher fuel efficiency compared to their manual counterparts or at par. How are they to drive? Take a look at our video.

Force T1N passenger van will go into production later this year and will be priced around Rs 25 lakh. It is an 18-seater and will be exported as well.

The President of One America News Network, Charles Herring, has published a blistering letter calling on Vanity Fair to retract claims that Donald Trump’s eldest son secretly bought a stake in the news outlet.
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Democrat Senator Dianne Feinstein is being lambasted for apparent double standards after attacking Tara Reade, the former Joe Biden staffer who alleges the Democrat presidential candidate sexually assaulted her.
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Presently H1-B visas are frequently used by established companies and less by startups because the former, get the advantage in dealing with time and cost factors.US Immigration and the status of start upsThe present visa policies followed by U.S. make…

Udemy for Business is powered by Udemy, which enables the world’s experts to develop courses and share their knowledge.

Good work team!' is how External Affairs Minister Dr. S. Jaishankar termed India's biggest evacuation exercise on Thursday.

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Ivanka Trump, the president’s daughter and a top White House adviser, sent hundreds of e-mails about government business from a personal e-mail account last year, The Washington Post reported on Monday.

In the fiscal ended March 31, 2020, bank loans had decelerated to 6.14 per cent, a near five-decade low, due to slower economic growth, lower demand and as banks remained risk averse.