Young age at first sexual intercourse (FSI) is related to risk-taking behaviors and negative outcomes. Previous studies using a cohort or cross-sectional design have concluded that younger age at menarche (AAM) is related to younger age at FSI.

This large birth cohort study is the first to address the temporal relationship between AAM and FSI. We found that younger AAM does not confer higher risk of early FSI, whether in terms of calendar age or time since menarche. (Read the full article)

Current guidelines recommend renal ultrasound as a screening test after febrile urinary tract infection, with voiding cystourethrogram (VCUG) only if the ultrasound is abnormal. Few studies have evaluated the accuracy of ultrasound as a screening test for VCUG-identified abnormalities.

This study shows that ultrasound is a poor screening test for genitourinary abnormalities identified on VCUG, such as vesicoureteral reflux. Neither positive nor negative ultrasounds reliably identify or rule out such abnormalities. Ultrasound and VCUG provide different, but complementary, information. (Read the full article)

Congenital pulmonary malformations are mostly identified prenatally. At birth, some children develop respiratory distress, which may be sufficiently severe to require mechanical ventilation and immediate surgery. The factors predictive of neonatal respiratory distress are not well defined.

Malformation volume and prenatal signs of intrathoracic compression are significant risk factors for respiratory complications at birth in fetuses with pulmonary malformations. In such situations, the delivery should take place in a tertiary care center. (Read the full article)

Urinary tract infection (UTI) is the most common bacterial infection in febrile infants aged 1 to 90 days. It is unclear if urine microscopy offers significant benefit beyond urine dipstick as a screening test for UTI in this population.

Dipstick may be an adequate screening test for UTI in infants aged 1 to 90 days with a negative predictive value (NPV) of 98.7%. Adding microscopy increases the NPV to 99.2% but results in 8 false-positives for every UTI missed by dipstick. (Read the full article)

Few studies have performed precise cardiovascular assessments and regular follow-up of congenital rubella syndrome (CRS) patients’ clinical courses. A few studies have reported mortalities among children who have CRS; however, the causes of death have not been precisely described.

A total of 38 CRS cases in Vietnam were studied after a rubella outbreak in 2011. The mortality associated with pulmonary hypertension was significantly high if untreated. Conducting careful cardiologic assessments and providing continuous follow-up for each patient is required. (Read the full article)

Little is known about the impact of tobacco smoke exposure on preterm children with bronchopulmonary dysplasia. It is essential to understand how environmental exposures, such as tobacco smoke, influence respiratory morbidities in this vulnerable population.

Chronic tobacco smoke exposure is common in children with bronchopulmonary dysplasia. In children who required home respiratory support, hair nicotine levels were a better predictor of hospitalization and activity limitation than caregiver self-report. (Read the full article)

The sensitivity of the urinalysis (UA) traditionally has been considered suboptimal in young infants. Whether the finding of a negative UA and a positive urine culture represents a false-negative UA versus a false-positive urine culture remains unclear.

In infants <3 months with bacteremic urinary tract infection, a condition that represents true infection, the UA sensitivity is higher than previously reported for urinary tract infection in general, suggesting that the UA is reliable even in young infants. (Read the full article)

Vesicoureteral reflux is recognized as an important risk factor for recurrent urinary tract infection and renal scarring. Less is known about the contribution of other risk factors to these outcomes.

This study found that information about vesicoureteral reflux and bladder and bowel dysfunction can be used to identify children at low, medium, and high risk of recurrent urinary tract infection, information that clinicians could use to select children for specific preventive therapies. (Read the full article)

Although existing analyses of inpatient pediatric pulmonary hypertension (PH) care have established an association with substantial morbidity and mortality, these investigations have been limited to small single-institution series or focused registries representative of selected patient subgroups.

This study provides the first contemporary, national trend analysis of inpatient care for children with PH. Pediatric PH is associated with a rapidly increasing number of hospital discharges and magnitude of resource utilization, and the makeup of this population is changing. (Read the full article)

In adults, there is significant increased length of stay, cost, and/or resource use associated with hospital-acquired conditions. Less is known about the epidemiology and impact of many hospital-acquired conditions in pediatric populations.

We find increased pediatric length of stay and costs due to venous thromboembolism and catheter-associated urinary tract infections. This is essential information for hospital administrators and safety departments who are planning interventions to reduce harm associated with these hospital-acquired conditions. (Read the full article)

The frequency of cardiac arrest is significantly lower in children than in adults, rendering the delivery of high-quality cardiopulmonary resuscitation more difficult. Metronome-based studies in adults showed improvement in adequate compression rate, with a detrimental effect on the depth of chest compressions.

This is the first pediatric study to confirm that the use of a metronome during cardiopulmonary resuscitation significantly improves the delivery of adequate rate without affecting the compression depth. This effect was more prominent among medical students and pediatric residents and fellows than nurses. (Read the full article)

Debutants Kosovo will make the short trip to Albania as the 16 FIFA Women's World Cup preliminary round entrants discovered their groups for April.

Kazakhstan, Albania, Israel, the Faroe Islands and best runners-up Moldova will progress to the qualifying group stage after coming through the preliminary round.

The Trump administration's move to narrowly define gender according to sex assigned at birth could impact transgender students and schools' policies with respect to their rights.

A studio course for architecture and landscape architecture students in the Stuckeman School prepares students for the collaborative design process they will take part in once they begin careers in their respective fields by blurring the boundaries between the disciplines in the college setting.

Since the March 24 coup by the Seleka, a loose coalition of Muslim rebels, the Central African Republic has been in free fall. There are about 400,000 internally displaced people, 64,000 refugees, and burned villages, largely in the western part of the country. Banditry, the rise of self-defense militias and clashes between Christian and Muslim communities are now part of daily life for this mineral-rich country in the heart of Africa. The expanding insecurity makes the delivery of humanitarian assistance difficult, and the United Nations has even warned of the risk of genocide.

Ibrexafungerp (formerly SCY-078) is a semisynthetic triterpenoid and potent (1->3)-β-D-glucan synthase inhibitor. We investigated the in vitro activity, pharmacokinetics, and in vivo efficacy of ibrexafungerp (SCY) alone and in combination with anti-mould triazole isavuconazole (ISA) against invasive pulmonary aspergillosis (IPA). The combination of ibrexafungerp and isavuconazole in in vitro studies resulted in an additive and synergistic interactions against Aspergillus spp. Plasma concentration-time curves of ibrexafungerp were compatible with linear dose proportional profile. In vivo efficacy was studied in a well established persistently neutropenic NZW rabbit model of experimental IPA. Treatment groups included untreated rabbits (UC) and rabbits receiving ibrexafungerp at 2.5(SCY2.5) and 7.5(SCY7.5) mg/kg/day, isavuconazole at 40(ISA40) mg/kg/day, or combinations of SCY2.5+ISA40 and SCY7.5+ISA40. The combination of SCY+ISA produced in vitro synergistic interaction. There was significant in vivo reduction of residual fungal burden, lung weights, and pulmonary infarct scores in SCY2.5+ISA40, SCY7.5+ISA40, and ISA40-treatment groups vs that of SCY2.5-treated, SCY7.5-treated and UC (p<0.01). Rabbits treated with SCY2.5+ISA40 and SCY7.5+ISA40 had prolonged survival in comparison to that of SCY2.5-, SCY7.5-, ISA40-treated or UC (p<0.05). Serum GMI and (1->3)-β-D-glucan levels significantly declined in animals treated with the combination of SCY7.5+ISA40 in comparison to those treated with SCY7.5 or ISA40 (p<0.05). Ibrexafungerp and isavuconazole combination demonstrated prolonged survival, decreased pulmonary injury, reduced residual fungal burden, lower GMI and (1->3)-β-D-glucan levels in comparison to those of single therapy for treatment of IPA. These findings provide an experimental foundation for clinical evaluation of the combination of ibrexafungerp and an anti-mould triazole for treatment of IPA.

Mucormycosis is a life-threatening infection with high mortality that occurs predominantly in immunocompromised patients. Manogepix (MGX) is a novel antifungal that targets Gwt1, an early step in the conserved glycosylphosphotidyl inositol (GPI) post-translational modification pathway of surface proteins in eukaryotic cells. Inhibition of inositol acylation by MGX results in pleiotropic effects including inhibition of maturation of GPI-anchored proteins necessary for growth and virulence. MGX has been previously shown to have in vitro activity against some strains of Mucorales. Here we assessed the in vivo activity of the prodrug fosmanogepix, currently in clinical development for the treatment of invasive fungal infections, against two Rhizopus arrhizus strains with high (4.0 μg/ml) and low (0.25 μg/ml) minimum effective concentration (MEC) values. In both invasive pulmonary infection models, treatment of mice with 78 mg/kg or 104 mg/kg fosmanogepix, along with 1-aminobenzotriazole to enhance the serum half-live of MGX in mice, significantly increased median survival time and prolonged overall survival by day 21 post infection when compared to placebo. In addition, administration of fosmanogepix resulted in a 1-2 log reduction in both lung and kidney fungal burden. For the 104 mg/kg fosmanogepix dose, tissue clearance and survival were comparable to clinically relevant doses of isavuconazole (ISA), which is FDA approved for the treatment of mucormycosis. These results support continued development of fosmanogepix as a first in class treatment for invasive mucormycosis.

There are limited treatment options for enterococcal urinary tract infections, especially vancomycin-resistant Enterococcus (VRE). Oral fosfomycin is a potential option, although limited data are available guiding dosing and susceptibility. We undertook pharmacodynamic profiling of fosfomycin against E. faecalis and E. faecium isolates using a dynamic in vitro bladder infection model. Eighty-four isolates underwent fosfomycin agar dilution susceptibility testing (E. faecalis MIC_50/90 32/64 μg/mL; E. faecium MIC_50/90 64/128 μg/mL). Sixteen isolates (including E. faecalis ATCC 29212 and E. faecium ATCC 35667) were chosen to reflect the MIC range and tested in the bladder infection model with synthetic human urine (SHU). Under drug-free conditions, E. faecium demonstrated greater growth restriction in SHU compared to E. faecalis (E. faecium maximal growth 5.8 ± 0.6 log₁₀ CFU/mL; E. faecalis 8.0 ± 1.0 log₁₀ CFU/mL). Isolates were exposed to high and low fosfomycin urinary concentrations after a single dose, and two-doses given daily with low urinary exposure. Simulated concentrations closely matched the target (bias 2.3%). E. faecalis isolates required greater fosfomycin exposure for 3 log₁₀ kill from the starting inoculum compared with E. faecium. The fAUC_0-72/MIC and f%T > MIC_0-72 for E. faecalis was 672 and 70%, compared to 216 and 51% for E. faecium, respectively. There was no rise in fosfomycin MIC post-exposure. Two doses of fosfomycin with low urinary concentrations resulted in equivalent growth inhibition to a single dose with high urinary concentrations. With this urinary exposure, fosfomycin was effective in promoting suppression of regrowth (>3 log₁₀ kill) in the majority of isolates.

Gepotidacin, a triazaacenaphthylene bacterial type II topoisomerase inhibitor, is in development for treatment of uncomplicated urinary tract infection (uUTI). This Phase 2a study in female participants with uUTI evaluated the pharmacokinetics (primary objective), safety, and exploratory efficacy of gepotidacin. Eligible participants (N = 22) were confined to the clinic at baseline, received oral gepotidacin 1,500 mg twice daily for 5 days (on-therapy; Days 1 to 5), and returned to the clinic for test-of-cure (Days 10 to 13) and follow-up (Day 28±3). Pharmacokinetic, safety, clinical, and microbiological assessments were performed. Maximum plasma concentrations were observed approximately 1.5 to 2 hours postdose. Steady state was attained by Day 3. Urinary exposure over the dosing interval increased from 3,742 μg.h/ml (Day 1) to 5,973 μg.h/ml (Day 4), with trough concentrations of 322 to 352 μg/ml from Day 3 onward. Gepotidacin had an acceptable safety-risk profile with no treatment-limiting adverse events and no clinically relevant safety trends. Clinical success was achieved in 19 (86%) and 18 (82%) of 22 participants at test-of-cure and follow-up, respectively. Eight participants had a qualifying baseline uropathogen (growth; ≥10⁵ CFU/ml). A therapeutic (combined clinical and microbiological [no growth; <10³ CFU/ml]) successful response was achieved in 6 (75%) and 5 (63%) of 8 participants at test-of-cure and follow-up, respectively. Plasma area under the free-drug concentration-time curve over 24 hours at steady state divided by the MIC (fAUC_0-24/MIC) and urine AUC_0-24/MIC ranged from 6.99 to 90.5 and 1,292 to 121,698, respectively. Further evaluation of gepotidacin in uUTI is warranted. (NCT03568942)

Objectives: Empiric antibiotic prescribing can be supported by guidelines and/or local antibiograms, but these have limitations. We sought to use data from a comprehensive electronic health record to use statistical learning to develop predictive models for individual antibiotics that incorporate patient-, and hospital-specific factors. This paper reports on the development and validation of these models on a large retrospective cohort.

Methods: This is a retrospective cohort study including hospitalized patients with positive urine cultures in the first 48 hours of hospitalization at a 1500 bed, tertiary care hospital over a 4.5 year period. All first urine cultures with susceptibilities were included. Statistical learning techniques, including penalized logistic regression, were used to create predictive models for cefazolin, ceftriaxone, ciprofloxacin, cefepime, and piperacillin-tazobactam. These were validated on a held-out cohort.

Results: The final dataset used for analysis included 6,366 patients. Final model covariates included demographics, comorbidity score, recent antibiotic use, recent antimicrobial resistance, and antibiotic allergies. Models had acceptable to good discrimination in the training dataset and acceptable performance in the validation dataset, with a point estimate for area under the receiver operating characteristic curve (AUC) that ranged from 0.65 for ceftriaxone to 0.69 for cefazolin. All models had excellent calibration.

Conclusion: In this study we used electronic health record data to create predictive models to estimate antibiotic susceptibilities for UTIs in hospitalized patients. Our models had acceptable performance in a held-out validation cohort.

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

With speed and ingenuity, more than 100 researchers across Penn State are shifting their research programs to address the COVID-19 crisis, thanks to funding from a seed grant initiative led by the Huck Institutes of the Life Sciences. In total, the initiative awarded $2.25 million to 47 teams of researchers from three campuses, 10 colleges and more than 25 departments.

MASC has successfully designed and delivered critical equipment and supplies needed to protect health care workers and patients during the COVID-19 pandemic.

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

Penn State Berks will hold a series of webinars throughout the month of May for both accepted and prospective students, providing participants with an opportunity to ask questions and connect with campus experts.

Alejandro Hoberman
Jul 1, 1999; 104:79-86
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Richard A. Ehrenkranz
Dec 1, 2005; 116:1353-1360
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Andrew T. Shennan
Oct 1, 1988; 82:527-532
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Many consumers are facing limited hours and product shortages at their neighborhood grocery stores and naturally are worried about the availability and safety of their food. A Penn State Extension webinar planned for noon to 1 p.m. May 14 will address these concerns, as well as provide suggestions on alternative places and methods for sourcing food.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

030 - Venues for finals of UEFA 2015 club competitions chosen

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

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.

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

Bouillabaisse, cassoulet, truffle omelette: the names of the French dishes alone make your mouth water. What sounds wonderful, also tastes delicious. The best way to see for yourself is to be there yourself – a culinary voyage of discovery through south...

CNA Staff, Mar 25, 2020 / 07:11 pm (CNA).- The Italian bishop of a missionary region of Ethiopia is the first Catholic bishop known to have died of the global coronavirus pandemic. He died March 25.

Bishop Angelo Moreschi, 67, was the leader of Ethiopia’s Apostolic Vicariate of Gambella, a missionary region of 25,000 Catholics in the western part of the country. He died Wednesday in the Italian city of Brescia, in the Lombardy region that has become the European epicenter of the pandemic.

A member of the Salesians of Don Bosco religious order, Moreschi had been a missionary in Ethiopia since 1991. He was ordained a bishop in January 2010.

“The Salesian community mourns the death of the Apostolic Vicar of Gambella (Ethiopia), namely Msgr. Angelo Moreschi, SDB, who died today, March 25, in Brescia (Italy) due to the coronavirus,” the Salesians of Don Bosco said in a statement released through the order’s information bureau.
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The secretary general of Ethiopia’s bishops’ conference announced the news in the country, announced conveying “deep condolences to the Clergy, religious, bereaved family and the lay faithful in the Apostolic Vicariate of Gambella.”

To the mourning people of the Gambella vicariate, the country’s bishops pledged the “closeness and prayers of members of the Catholic Bishops’ Conference of Ethiopia and the entire Catholic Church in Ethiopia. May his soul rest in peace.”

Bishop Moreschi was renowned in Ethiopia for his pastoral ministry to the service of young people and the poor. In the local dialect, he was afforded the title “Abba,” meaning “Father.”

“In his mission as prefect and then as apostolic vicar, he continued to embody the Salesian focus in helping children, accompanying them by his practical spirit and his strong apostolic zeal,” the Salesians of Don Bosco stated.

“In his visits to the villages, they still remember when the Salesian arrived with a battered SUV - or by motorboat in the villages along the Baro river when the roads were flooded - and he immediately began to distribute multi-vitamin biscuits to malnourished children.”

Bishop Moreschi died “after serving the young, the poor and his flock of souls as a Salesian for 46 years, as a priest for 38, and as a bishop for over 10,” the Salesians said.

More than 60 priests have died in the ongoing coronavirus pandemic, which has claimed more than 21,000 lives globally. Several bishops have contracted the virus.

 

This story was first reported by ACI Africa, CNA's African news partner. It has been adapted by CNA.

 

CNA Staff, May 2, 2020 / 04:30 pm (CNA).- A man claiming to have killed the murdered Nigerian seminarian Michael Nnadi has given an interview in which he says he executed the aspiring priest because he would not stop announcing the Christian faith in captivity.

Mustapha Mohammed, who is currently in jail, gave a telephone interview to the Nigerian newspaper Daily Sun on Friday. He took responsibility for the murder, according to the Daily Sun, because Nnadi, 18 years old, “continued preaching the gospel of Jesus Christ” to his captors.

According to the newspaper, Mustapha praised Nnadi’s “outstanding bravery,” and that the seminarian “told him to his face to change his evil ways or perish.”

Nnadi was kidnapped by gunmen from Good Shepherd Seminary in Kaduna on January 8, along with three other students. The seminary, home to some 270 seminarians, is located just off the Abuja-Kaduna-Zaria Express Way. According to AFP, the area is “notorious for criminal gangs kidnapping travelers for ransom.”

Mustapha, 26, identified himself as the leader of a 45-member gang that preyed along the highway. He gave the interview from a jail in Abuja, Nigeria, where he is in police custody.

On the evening of the abduction, gunmen, disguised in military camouflage, broke through the fence surrounding the seminarians' living quarters and opened fire. They stole laptops and phones before kidnapping the four young men.

Ten days after the abduction, one of the four seminarians was found on the side of a road, alive but seriously injured. On Jan. 31, an official at Good Shepherd Seminary announced that another two seminarians had been released, but that Nnadi remained missing and was presumed still in captivity.

On Feb. 1, Bishop Matthew Hassan Kukah of the Diocese of Sokoto, Nigeria, announced that Nnadi had been killed.

“With a very heavy heart, I wish to inform you that our dear son, Michael was murdered by the bandits on a date we cannot confirm,” the bishop said, confirming that the rector of the seminary had identified Nnadi’s body.

The newspaper reported that from “the first day Nnadi was kidnapped alongside three of his other colleagues, he did not allow [Mustapha] to have peace,” because he insisted on announcing the gospel to him.

According to the newspaper, Mustapha “did not like the confidence displayed by the young man and decided to send him to an early grave.”

According to the Daily Sun, Mustapha targeted the seminary knowing it was a center for training priests, and that a gang member who lived nearby had helped conduct surveillance ahead of the attack. Mohammed believed that it would be a profitable target for theft and ransom.

Mohammed also said that the gang used Nnadi’s mobile telephone to issue their ransom demands, asking for more than $250,000, later reduced to $25,000, to secure the release of the three surviving students, Pius Kanwai, 19; Peter Umenukor, 23; and Stephen Amos, 23.

Nnadi’s murder is one of an series of attacks and killings on Christians in the country in recent months.

Archbishop Ignatius Kaigama of Abuja called on Nigerian President Muhammadu Buhari to address the violence and kidnappings in a homily March 1 at a Mass with the Catholic Bishops’ Conference of Nigeria.

“We need to have access to our leaders; president, vice president. We need to work together to eradicate poverty, killings, bad governance and all sorts of challenges facing us as a nation,” Kaigama said.

In an Ash Wednesday letter to Nigerian Catholics, Archbishop Augustine Obiora Akubeze of Benin City called for Catholics to wear black in solidarity with victims and pray, in response to “repeated” executions of Christians by Boko Haram and “incessant” kidnappings “linked to the same groups.”

Other Christian villages have been attacked, farms set ablaze, vehicles carrying Christians attacked, men and women have been killed and kidnapped, and women have been taken as sex slaves and tortured—a “pattern,” he said, of targeting Christians.

On Feb. 27, U.S Ambassador at Large for Religious Freedom Sam Brownback told CNA that the situation in Nigeria was deteriorating.

“There's a lot of people getting killed in Nigeria, and we're afraid it is going to spread a great deal in that region,” he told CNA. “It is one that's really popped up on my radar screens -- in the last couple of years, but particularly this past year.”

“I think we’ve got to prod the [Nigerian President Muhammadu] Buhari government more. They can do more,” he said. “They’re not bringing these people to justice that are killing religious adherents. They don’t seem to have the sense of urgency to act.”

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

To view more press releases, please visit http://ir.wintrust.com/news.aspx?iid=1024452.

From age 17, Ana Maria prayed to serve God in Switzerland. While she waited, she became a dance instructor with no idea dance would become her ministry.

God uses Janet to reach people through one-on-one encounters at a bookshop in a closed country.

Gunnar's Work-Play gaming glasses react to sunlight, shifting from a blue-ray-reducing amber tint indoors to full-on sunglasses outside.

The line-up for October's main round is set after 16 teams progressed from the preliminary round on the road to Lithuania.