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Nonconvulsive Status Epilepticus: The Encephalopathic Pediatric Patient

Nonconvulsive status epilepticus (NCSE) is the diagnosis for encephalopathy caused by continuous epileptic activity on EEG. It is a well-known cause of morbidity and mortality in critically ill adults and neonates. NCSE is increasingly reported in critically ill children.

We show that NCSE is common in all inpatient settings, not only in the critically ill. Key risk factors that should dramatically increase suspicion of NCSE in clinical practice include a history of convulsive seizure and acute imaging abnormalities. (Read the full article)




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Effect of a Single Inhalation of Laninamivir Octanoate in Children With Influenza

A single inhalation of laninamivir octanoate has previously been shown to be as effective as repeated doses of zanamivir in vitro and in vivo, but it is not known whether this is also the case for children.

Median time to fever resolution was not significantly different between laninamivir octanoate and zanamivir for pediatric patients with influenza. The severity of influenza symptoms and the frequency of complications were similar in the 2 groups. (Read the full article)




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Incidence of Chronic Bilirubin Encephalopathy in Canada, 2007-2008

Severe neonatal hyperbilirubinemia can lead to acute bilirubin encephalopathy and, subsequently, chronic bilirubin encephalopathy (CBE). This condition is preventable through routine identification and proper treatment; therefore, it is rare for permanent neurologic complications to occur.

This article describes the incidence of CBE in Canada, which is higher than previously reported in the literature. Furthermore, it describes the underlying causes of CBE and the spectrum of neurologic disease. (Read the full article)




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Erythropoietin for Neuroprotection in Neonatal Encephalopathy: Safety and Pharmacokinetics

Infants with hypoxic-ischemic encephalopathy suffer a high rate (>40%) of death or moderate to severe disability, even after therapeutic hypothermia. High-dose erythropoietin (Epo) reduces brain injury and improves neurologic function in animal models of neonatal hypoxic-ischemic brain injury.

Multiple doses of Epo (up to 2500 U/kg intravenously) given in conjunction with hypothermia are well tolerated in newborns with HIE. Epo doses of 1000 U/kg intravenously in cooled infants produce plasma concentrations that are neuroprotective in animal studies. (Read the full article)




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Antecedents of Neonatal Encephalopathy in the Vermont Oxford Network Encephalopathy Registry

Most term and late preterm infants with neonatal encephalopathy have not had recognized asphyxial birth events. Several nonasphyxial risk factors for neonatal encephalopathy have been identified in previous studies.

In a large sample, we confirm the association of several nonasphyxial factors with neonatal encephalopathy, including markers of intrauterine exposure to infection or inflammation, intrauterine fetal growth restriction, and birth defects. We identify steps that would improve studies of neonatal encephalopathy. (Read the full article)




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Hypothalamic-Pituitary-Adrenal Axis Suppression in Asthmatic School Children

Hypothalamic-pituitary-adrenal axis suppression caused by inhaled corticosteroids is considered rare. Adrenal crisis has been described in children treated with high doses of inhaled fluticasone propionate. It was recommended that doses licensed for children should not be exceeded.

Biochemically confirmed hypothalamic-pituitary-adrenal axis dysfunction may occur in two-thirds of children treated with corticosteroids. Suppression may occur at low doses and especially with concomitant nasal steroids. Children with poor adherence or obesity may be less prone to adrenal crisis. (Read the full article)




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Development at Age 36 Months in Children With Deformational Plagiocephaly

Infants and toddlers with deformational plagiocephaly (DP) score lower on developmental measures than children without DP and lower than expected relative to test norms.

This study is the first to examine developmental outcomes in preschool-aged children with DP relative to demographically similar children without DP using a standardized, clinician administered assessment. (Read the full article)




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Epidemiology and Predictors of Failure of the Infant Car Seat Challenge

The American Academy of Pediatrics recommends neonates born at <37 weeks’ gestation receive a predischarge Infant Car Seat Challenge, meaning up to 500 000 infants qualify annually. However, little is known about incidence and risk factors for failure in this group.

This is the largest study to date to examine incidence and risk factors for failure of the Infant Car Seat Challenge. We sought to identify infants most at risk for failure to narrow the scope of testing. (Read the full article)




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The Incidence of Positional Plagiocephaly: A Cohort Study

The incidence of plagiocephaly varies widely and is based on anecdotal evidence of increase in the number of referrals to specialty clinics. Five studies have produced varying results, indicating that the incidence of plagiocephaly ranges from 3.1% to 61.0%.

This is the first study to estimate the incidence of positional plagiocephaly using 4 community-based data collection sites in infants ranging from 7 to 12 weeks of age. The estimated incidence of positional plagiocephaly was found to be 46.6%. (Read the full article)




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Two-Year Outcomes of a Randomized Controlled Trial of Inhaled Nitric Oxide in Premature Infants

Bronchopulmonary dysplasia is associated with increased long-term neurodevelopmental and respiratory morbidity. Inhaled nitric oxide given to reduce morbidity in very preterm infants does not reduce the prevalence of bronchopulmonary dysplasia and has uncertain effects on long-term outcome.

Inhaled nitric oxide (5 ppm) given early in the course of respiratory illness in infants born before 29 weeks of gestation is not associated with changes in developmental or respiratory outcomes at 2 years of age corrected for prematurity. (Read the full article)




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Urinary Phthalates and Increased Insulin Resistance in Adolescents

Phthalate exposure has been associated with insulin resistance in animal studies and cross-sectional studies of adults, but has not been studied in adolescents.

We detect associations of urinary phthalate metabolites in a cross-sectional study of US adolescents. The association is highly robust to multiple sensitivity analyses, and specific to phthalates commonly found in food. Further longitudinal study of dietary phthalate exposures is needed. (Read the full article)




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Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

Etiology and timing of onset of neonatal hypoxic-ischemic encephalopathy continue to be controversial. Previous studies suggest antepartum events are the main contributing factors, but have used a broad definition of encephalopathy and included infants with genetic, congenital, and developmental abnormalities.

Our study suggests that when strict criteria defining hypoxic-ischemic encephalopathy are applied with supporting neuroimaging evidence of an acute hypoxic-ischemic insult, intrapartum events are the final and necessary pathway leading to this condition. (Read the full article)




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Ophthalmic Outcomes of Congenital Toxoplasmosis Followed Until Adolescence

In children with congenital toxoplasmosis, ocular lesions can be detected and may relapse after birth despite pre- and postnatal treatment. Long-term ocular outcome beyond puberty and associated prognostic factors are unknown due to limited follow-up.

Our study in 477 patients with treated congenital toxoplasmosis who were followed up to 22 years indicated that new ocular lesions can be detected well into adolescence (with a cumulative probability at 18 years of almost 50%), but they rarely cause severe visual impairment. (Read the full article)




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Long-term Motor and Cognitive Outcome of Acute Encephalitis

Encephalitis in children can cause significant neurologic sequelae, such as motor and cognitive impairment. Previous reported data are based mostly on questionnaires and clinical assessments.

Significant cognitive impairment, attention-deficit/hyperactivity disorder, and learning disabilities are common after childhood encephalitis. Even children who were considered fully recovered may be significantly affected. Identifiable pathogens, abnormal neuroimaging, and abnormal neurologic examination on discharge are risk factors of poor outcome. (Read the full article)




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Xenon Ventilation During Therapeutic Hypothermia in Neonatal Encephalopathy: A Feasibility Study

Hypothermia treatment of neonatal encephalopathy reduces death and disability from 66% to 50%; additional neuroprotective therapies are needed. We previously found in animal models that adding 50% xenon to the breathing gas during cooling doubled neuroprotection.

This clinical feasibility study used 50% xenon for 3 to 18 hours in 14 cooled infants with cardiovascular, respiratory, and amplitude-integrated EEG monitoring. This depressed seizures, with no blood pressure reduction. Xenon is ready for randomized clinical trials in newborns. (Read the full article)




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Neuroimaging in the Evaluation of Neonatal Encephalopathy

Computed tomography is commonly used for neuroimaging in newborn infants with neonatal encephalopathy despite concerns over potential harm from radiation exposure. Alternative neuroimaging options include MRI and cranial ultrasound.

Using a very large, international, multicenter database, we demonstrate utilization rates and compare diagnostic findings of computed tomography, MRI, and cranial ultrasound in the evaluation of neonatal encephalopathy. (Read the full article)




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The Transition to ICD-10-CM: Challenges for Pediatric Practice

The US health care system transition to the ICD-10-CM will occur in October 2015. The logistical and financial impact of the transition for billing codes frequently used by pediatricians has not been studied.

The findings of this study evaluate the government-provided mappings from ICD-9-CM to ICD-10-CM for accuracy and provide the diagnostic codes used by pediatricians, which may be adversely affected by the transition to ICD-10-CM. (Read the full article)




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Inhaled Nitric Oxide Use in Neonates With Congenital Diaphragmatic Hernia

The role of inhaled nitric oxide (INO) in the treatment of newborns with congenital diaphragmatic hernia (CDH) is poorly defined and not rigorously proven. Contemporary rates of INO use for CDH have not been reported.

INO use in neonates with CDH is widespread, and has increased in many US tertiary pediatric hospitals without associated decrease in extracorporeal membrane oxygenation use or mortality. (Read the full article)




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Serum Bilirubin and Bilirubin/Albumin Ratio as Predictors of Bilirubin Encephalopathy

Jaundiced newborns without additional risk factors rarely develop kernicterus if the total serum bilirubin is <25 mg/dL. Measuring the bilirubin/albumin ratio might improve risk assessment, but the relationships of both indicators to advancing stages of neurotoxicity are poorly documented.

Both total serum bilirubin and bilirubin/albumin ratio are strong predictors of advancing stages of acute and post-treatment auditory and neurologic impairment. However, bilirubin/albumin ratio, adjusted to the same sensitivity, does not improve prediction over total serum bilirubin alone. (Read the full article)




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Cognitive Outcomes After Neonatal Encephalopathy

Surviving infants with neonatal encephalopathy treated with hypothermia have lower rates of moderate to severe cerebral palsy and cognitive impairment at 18 to 24 months. Limited data exist on the association between cognitive functioning and neuromotor, behavioral, and school outcomes.

Although the incidence of death or IQ <55 is reduced after therapeutic hypothermia, survivors of neonatal encephalopathy with and without cerebral palsy are at elevated risk for subnormal IQ and the need for specialized educational services at 6 to 7 years. (Read the full article)




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Off-Label Use of Inhaled Nitric Oxide After Release of NIH Consensus Statement

Off-label prescription of inhaled nitric oxide (iNO) to neonates <34 weeks’ gestation has increased during the past decade. In early 2011, the National Institutes of Health determined that the available evidence did not support iNO use in this population.

Use of iNO among neonates <34 weeks’ gestation has increased since 2011, entirely from greater use in extremely preterm neonates. Off-label prescription of this drug now accounts for nearly half of all iNO use in American NICUs. (Read the full article)




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Infectious and Autoantibody-Associated Encephalitis: Clinical Features and Long-term Outcome

Encephalitis is a serious and disabling condition. There are infectious and immune-mediated causes of encephalitis, but many cases remain undiagnosed.

This large single-center study on childhood encephalitis provides insight into the relative frequency and clinicoradiologic phenotypes of infectious, autoantibody-associated, and unknown encephalitis. Risk factors for an abnormal outcome are also defined. (Read the full article)




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Ophthalmic Abnormalities and Reading Impairment

Dyslexia has a lifelong impact on learning. The consensus in the literature from clinical studies is that dyslexia is not caused by vision abnormalities. However, interventions and therapies directed at eye-related functions are still available.

In this cohort the majority of dyslexic children had normal results for all ophthalmic tests. These population-based data support the consensus that dyslexia is not primarily a vision problem and that vision-based therapies are not justified or likely to help. (Read the full article)




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Treating EEG Seizures in Hypoxic Ischemic Encephalopathy: A Randomized Controlled Trial

Continuous conventional EEG video is currently gold standard for identifying neonatal seizures and a substantial proportion of neonatal seizures are electrographic. Currently there is no direct evidence that EEG monitoring, seizure identification, or treatment impacts long-term outcomes.

In neonates with hypoxic ischemic encephalopathy, EEG monitoring and treatment of electrographic seizures results in significant reduction in seizure burden. Increasing seizure burden is associated with more severe brain injury and significantly lower performance scores on Bayley Scales of Infant Development III. (Read the full article)




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‘He was larger than life’: Brooklyn mourns death of Grand Prospect Hall owner Michael Halkias

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

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Response: 'Challenges Are a Natural Part of Mathematics'

Makeda Brome, Pia Hansen, Linda Gojak, Marian Small, Kenneth Baum and David Krulwich share their thoughts on the biggest challenges facing math teachers.




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Half-Life Game Series Will Finally Return With VR-Based Project

Valve's tweet describes the upcoming title Half-Life: Alyx as the company's 'flagship VR game.' So you'll probably need a virtual headset to play it. The company will reveal more details on Thursday.




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Half-Life: Alyx to Launch in March, But Requires VR Headset

On Thursday, Valve showed off footage for Half-Life: Alyx, which will be set before the events of Half-Life 2. Instead of using a mouse and keyboard, you'll need a VR headset to play it.




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College of Engineering student marshals announced

Fifteen graduating seniors from the College of Engineering have been selected to serve as student marshals for Penn State’s spring commencement ceremony, to be held virtually on May 9.




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Q&A Collections: Race & Gender Challenges

All posts from the past seven years on race & gender challenges - in one place!




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Q&A Collections: Race & Gender Challenges

All Classroom Q&A posts on race and gender challenges from the past eight years are described and linked to in this compilation post.




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Challenges Seen in Moving to Multimedia Textbooks

Most districts have the technology to support the basic digital textbooks of today, but not the interactive, multimedia-rich ones of the future.




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Eberly College of Science selects two student marshals for Spring 2020

Chemistry major Sojung Kim and microbiology major Cuyler Luck will represent the Eberly College of Science as student marshals during Penn State’s virtual spring commencement ceremonies on Saturday, May 9.




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Burundi Peace Process: Tough Challenges Ahead




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In Central Africa, an Urgent Challenge to American Leadership




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The Security Challenges of Pastoralism in Central Africa

Sensible, inclusive regulation of pastoralism that has mitigated tension in parts of the Sahel should be extended to the Democratic Republic of Congo (DRC) and the Central African Republic (CAR), where conflicts have worsened with the southward expansion of pastoralism.




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Comparative Genomic Analysis of Third Generation Cephalosporin-Resistant Escherichia coli Harboring blaCMY-2-Positive IncI1 group, IncB/O/K/Z, and IncC Plasmids Isolated from Healthy Broilers in Japan. [Epidemiology and Surveillance]

The off-label use of third generation cephalosporin (3GC) during in ovo vaccination or vaccination of newly hatched chicks, was a common practice worldwide. CMY-2-producing Escherichia coli have been disseminated among broiler production. The objectives of this study were to determine the epidemiological linkage of blaCMY-2-positive plasmids among broilers both within and outside Japan because grandparent stock and parent stock were imported in Japan. We examined the whole genome sequences of 132 3GC-resistant E. coli isolates collected from healthy broilers during 2002-2014. The predominant 3GC-resistance gene was blaCMY-2, which was detected in the plasmids of 87 (65.9%) isolates. The main plasmid replicon types were IncI1-I (n=21; 24.1%), IncI (n=12; 13.8%), IncB/O/K/Z (n=28; 32.2%), and IncC (n=22; 25.3%). Those plasmids were subjected to gene clustering and network analyses and plasmid multi-locus sequence typing (pMLST). The chromosomal DNA of isolates was subjected to MLST and single nucleotide variant (SNV)-based phylogenetic analysis.

MLST and SNV-based phylogenetic analysis revealed high diversity of E. coli isolates. ST429 harboring blaCMY-2-positive IncB/O/K/Z was closely related to isolates from broiler in Germany harboring blaCMY-2-positive IncB/O/K/Z. pST55-IncI and pST12-IncI1-I and pST3-IncC were prevalent in western Japan. pST12-IncI1-I and pST3-IncC were closely related to those detected in E. coli isolates from chicken in American continent, whereas 26 IncB/O/K/Z were related to those in Europe. These data will be useful to reveal the whole picture of transmission of CMY-2-producing bacteria in and out of Japan.




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Smeal supply chain student marshal points to professor as guiding force

Rachel Hooker, who will graduate May 9 with a 3.99 GPA in supply chain and information systems, has been selected as the Smeal College of Business’ spring 2020 supply chain and information systems student marshal.




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Leadership comes naturally to Penn State Smeal spring 2020 student marshal

Jake Griggs, who will graduate Saturday with a 3.95 GPA with dual majors in management and political science, has been named Smeal’s spring 2020 management and organization student marshal.




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Fin24.com | 3 challenges ahead for investors - strategist

There are three challenges facing investors going forward, HSBC chief market strategist at HSBC Private Bank tells Fin24.




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A 10-Year-Old's Shooting Death and the Challenge Schools Face Keeping Football Games Safe

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.




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Labor and Employment Relations student will be 2020 World Campus student marshal

As part of Penn State's 2020 spring commencement activities, Matthew Solovey will represent the College of the Liberal Arts as its World Campus student marshal.




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Samsung QLED Smart TVs Nearly Half Off Before Super Bowl Sunday

At Amazon right now, you can save up to 47 percent on a Samsung Q60 series QLED 4K Ultra HD smart TV with HDR support and Alexa and Google Assistant compatibility.




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Two education majors share role of student marshal

While Beane’s and Hunsicker’s paths to Penn State Berks were somewhat different, they arrived at the same destination, well prepared for careers in education.




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Tennessee voucher program challenge heads to court Wednesday




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Penn State Harrisburg recognizes spring 2020 student marshals

Penn State Harrisburg has selected six graduates to represent each academic school and graduate studies as student marshals for spring 2020.




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Faculty support each other through remote learning challenges and triumphs

Penn State Harrisburg faculty share their experiences – the challenges, triumphs and innovations – as they are adapting lesson plans and teaching processes during this time of social distancing.




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Schuylkill Speaks: Senior biology major Steve Shalamanda eyes optometry degree

Senior Steven Shalamanda began his education at Penn State Schuylkill knowing he was interested in becoming an optometrist. But it was this high-achieving biology student’s internship with a local practice that affirmed his vision for the future. In fall 2020, Shalamanda will begin his doctor of optometry program at the Pennsylvania College of Optometry.




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Penn State leaders to answer questions at May 19 virtual Town Hall

Penn State President Eric J. Barron will host a virtual Town Hall at 3:30 p.m. on Tuesday, May 19, to answer the University community’s questions regarding how the Penn State continues to manage the impacts of the coronavirus pandemic, including the recent announcements on workforce changes, plans for summer and work being done by the task groups to return students to campus and employees to work.




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College of IST announces spring 2020 student marshals

The College of Information Sciences and Technology will honor two graduates as student marshals at spring 2020 commencement. Genesis DuBon (information sciences and technology, security and risk analysis) will represent the college as student marshal, and Brett Sigoda (information sciences and technology) will serve as ROTC student marshal during the virtual commencement ceremony on May 9.