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NewSchools Venture Fund CEO on Education Philanthropy During Coronavirus

"Folks in some foundations are quietly expressing frustration that they've been cautioned to stay in their lane and only fund things aligned with their pre-COVID strategy," says Stacey Childress.




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Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia

BACKGROUND AND OBJECTIVES:

Antibiotic therapy is often prescribed for suspected community-acquired pneumonia (CAP) in children despite a lack of knowledge of causative pathogen. Our objective in this study was to investigate the association between antibiotic prescription and treatment failure in children with suspected CAP who are discharged from the hospital emergency department (ED).

METHODS:

We performed a prospective cohort study of children (ages 3 months–18 years) who were discharged from the ED with suspected CAP. The primary exposure was antibiotic receipt or prescription. The primary outcome was treatment failure (ie, hospitalization after being discharged from the ED, return visit with antibiotic initiation or change, or antibiotic change within 7–15 days from the ED visit). The secondary outcomes included parent-reported quality-of-life measures. Propensity score matching was used to limit potential bias attributable to treatment selection between children who did and did not receive an antibiotic prescription.

RESULTS:

Of 337 eligible children, 294 were matched on the basis of propensity score. There was no statistical difference in treatment failure between children who received antibiotics and those who did not (odds ratio 1.0; 95% confidence interval 0.45–2.2). There was no difference in the proportion of children with return visits with hospitalization (3.4% with antibiotics versus 3.4% without), initiation and/or change of antibiotics (4.8% vs 6.1%), or parent-reported quality-of-life measures.

CONCLUSIONS:

Among children with suspected CAP, the outcomes were not statistically different between those who did and did not receive an antibiotic prescription.




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Efficacy of Melatonin in Children With Postconcussive Symptoms: A Randomized Clinical Trial

BACKGROUND:

Approximately 25% of children with concussion have persistent postconcussive symptoms (PPCS) with resultant significant impacts on quality of life. Melatonin has significant neuroprotective properties, and promising preclinical data suggest its potential to improve outcomes after traumatic brain injury. We hypothesized that treatment with melatonin would result in a greater decrease in PPCS symptoms when compared with a placebo.

METHODS:

We conducted a randomized, double-blind trial of 3 or 10 mg of melatonin compared with a placebo (NCT01874847). We included youth (ages 8–18 years) with PPCS at 4 to 6 weeks after mild traumatic brain injury. Those with significant medical or psychiatric histories or a previous concussion within the last 3 months were excluded. The primary outcome was change in the total youth self-reported Post-Concussion Symptom Inventory score measured after 28 days of treatment. Secondary outcomes included change in health-related quality of life, cognition, and sleep.

RESULTS:

Ninety-nine children (mean age: 13.8 years; SD = 2.6 years; 58% girls) were randomly assigned. Symptoms improved over time with a median Post-Concussion Symptom Inventory change score of –21 (95% confidence interval [CI]: –16 to –27). There was no significant effect of melatonin when compared with a placebo in the intention-to-treat analysis (3 mg melatonin, –2 [95% CI: –13 to 6]; 10 mg melatonin, 4 [95% CI: –7 to 14]). No significant group differences in secondary outcomes were observed. Side effects were mild and similar to the placebo.

CONCLUSIONS:

Children with PPCS had significant impairment in their quality of life. Seventy-eight percent demonstrated significant recovery between 1 and 3 months postinjury. This clinical trial does not support the use of melatonin for the treatment of pediatric PPCS.




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Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth

BACKGROUND AND OBJECTIVES:

Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations.

METHODS:

We conducted a secondary data analysis of ninth- and 11th-graders in the 2016 minnesota Student Survey (n = 68 785). We categorized youth into 4 subgroups based on housing status in the previous year: (1) unaccompanied homeless youth (0.5%), (2) runaway youth (4%), (3) youth who had both run away and been homeless (0.6%), and (4) stably housed youth (95%). We performed multivariable logistic regression to compare 4 mental health outcomes (self-injury, suicidal ideation, suicide attempts, and depressive symptoms) across groups, controlling for demographics and abuse history.

RESULTS:

Unstably housed youth had poorer mental health outcomes when compared with their stably housed peers (P < .05). For example, 11% of homeless youth, 20% of runaways, and 33% of youth who had experienced both had attempted suicide in the previous year compared with 2% of stably housed youth (adjusted odds ratios 2.4, 4.9, and 7.1, respectively). Other outcomes showed a similar pattern.

CONCLUSIONS:

Our findings suggest that runaway and homeless youth represent unique populations with high levels of mental health needs who would benefit from targeted clinical and community interventions. Pediatric clinicians represent one potential point of screening and intervention.




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Costs and Use for Children With Medical Complexity in a Care Management Program

BACKGROUND AND OBJECTIVES:

Children with medical complexity (CMC) comprise only 6% of the pediatric population, account for ~40% of pediatric health care spending, and provide an important opportunity for cost saving. Savings in this group can have an important impact on pediatric health care costs. The objective of this study was to assess the impact of a multicenter care management program on spending and use in CMC.

DESIGN AND METHODS:

We conducted a prospective cohort analysis of a population of 4530 CMC enrolled in a learning collaborative designed to improve care for CMC ages 0 to 21 years identified using 3M Clinical Risk Group categories 5b through 9. The primary outcome was total per-member per-year standardized spending; secondary outcomes included inpatient and emergency department (ED) spending and use. We used a 1:1 propensity score match to compare enrolled patients to eligible nonenrolled patients and statistical process control methods to analyze spending and usage rates.

RESULTS:

Comparison with the matched group showed a 4.6% (95% confidence interval [CI]: 1.9%–7.3%) decrease in total per-member per-year spending (P < .001), a 7.7% (95% CI: 1.2%–13.5%) decrease in inpatient spending (P = .04), and an 11.6% (95% CI: 3.9%–18.4%) decrease in ED spending (P = .04). Statistical process control analysis showed a decrease in hospitalization rate and ED visits.

CONCLUSIONS:

CMC enrolled in a learning collaborative showed significant decreases in total spending and a significant decrease in the number of hospitalizations and ED visits. Additional research is needed to determine more specific causal factors for the results and if these results are sustainable over time and replicable in other settings.




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Perioperative Transfusions and Venous Thromboembolism

BACKGROUND AND OBJECTIVES:

Annual incidence of venous thromboembolism (VTE) including postoperative VTE in hospitalized children is rising significantly. A growing body of evidence supports the role of red blood cells (RBCs) in pathologic thrombosis. In this study, we examined the association of perioperative RBC transfusion with postoperative VTE in pediatric patients.

METHODS:

The pediatric databases of the American College of Surgeons’ National Surgical Quality Improvement Project from 2012 to 2017 were used. Multivariable logistic regression was used to examine the association between perioperative RBC transfusion status and the development of new or progressive VTE within 30 days of surgery. The analyses were age stratified, as follows: neonates (≤28 days), infants (>28 days and <1 year), and children (≥1 year).

RESULTS:

In this study, we included 20 492 neonates, 79 744 infants, and 382 862 children. Postoperative development of VTE was reported in 99 (0.48%) neonates, 147 (0.2%) infants, and 374 (0.1%) children. In all age groups, development of VTE was significantly more common among patients with a perioperative RBC transfusion than patients without a perioperative RBC transfusion (neonates: adjusted odds ratio [aOR] = 4.1, 95% confidence interval [CI] = 2.5–6.7; infants: aOR = 2.4, 95% CI = 1.7–3.6; children: aOR = 2.2, 95% CI = 1.7–2.9). Among children who received an intra- or postoperative transfusion, the weight-based volume of RBCs (mL/kg) transfused was associated with postoperative VTE in a dose-dependent manner: second tertile (odds ratio = 2.3, 95% CI = 1.3–4.1) and third tertile (odds ratio = 4.1, 95% CI = 2.3–7.4) versus first tertile.

CONCLUSIONS:

Perioperative RBC transfusions are independently associated with development of new or progressive postoperative VTE in children, infants, and neonates. These findings need further validation in prospective studies and emphasize the need for evidence-based perioperative pediatric blood transfusion decisions.




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Continuous Albuterol With Benzalkonium in Children Hospitalized With Severe Asthma

BACKGROUND AND OBJECTIVES:

The albuterol dropper bottle used to prepare solutions for continuous nebulization contains the preservative benzalkonium chloride (BAC). BAC, by itself, has been shown to cause bronchospasm. We hypothesized that BAC would decrease the therapeutic efficacy of albuterol in patients with acute asthma exacerbations.

METHODS:

We performed a retrospective cohort study comparing the clinical outcomes of patients <18 years of age receiving continuous nebulized albuterol with and without BAC. For the primary end point (duration of continuous albuterol nebulization), we compared the 2 groups with Kaplan-Meier estimate of survival curves, conducted a log-rank test of difference, and adjusted for baseline characteristics using multivariable Cox regression. A P value <.05 was considered significant.

RESULTS:

A total of 477 patients were included in the analysis (236 exposed to BAC and 241 controls). The duration of continuous nebulization was significantly longer in the BAC group than in the control group (median of 9 vs 6 hours; 15.7% required continuous nebulization compared to 5.8% of controls at 24 hours). The control group was 79% more likely to stop continuous nebulization at any particular point in time (hazard ratio 1.79; 95% confidence interval: 1.45 to 2.22; P < .001) and 43% more likely to stop additional respiratory support (hazard ratio 1.43; 95% confidence interval: 1.16 to 1.75; P < .001).

CONCLUSIONS:

BAC is a functional albuterol antagonist associated with a longer duration of continuous albuterol nebulization treatment and additional respiratory support, suggesting that preservative-free albuterol formulations are safer for use in continuous nebulization.




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Nanit Plus

The Nanit Plus offers more features and data than any other smart baby monitor, including sleep tracking and breathing monitoring.




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Infusionsoft by Keap

Infusionsoft by Keap combines robust analytics with an intuitive interface and easily customizable dashboards to help you track your customers and email marketing campaigns.




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Juventus v Lyon facts

Lucas Tousart's first-leg goal gave Lyon a first win against Juventus, who once against face a round of 16 deficit on home soil.




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An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




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Getting Youth Technology Use Right




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A Better Use of Ed Tech




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Penn State Smeal panel explores pandemic's effects on sustainability, business

The Penn State Smeal College of Business Center for the Business of Sustainability recently hosted the first in a series of virtual fireside discussions titled “The Impact of Coronavirus on Sustainability and Social Impact,” to explore how recent momentum in sustainability efforts has been altered.




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COVID-19: Researchers to model novel coronavirus for spread mitigation

In an effort to help mitigate the disruptive effects of the deadly COVID-19 virus, an interdisciplinary team of Penn State researchers are developing a novel methodology to analyze its spread and the impacts on policy to create better-prepared and more-resilient health care systems.




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Penn State Health hospitals use recovered patients' plasma as COVID-19 treatment

Penn State Health has enrolled its first COVID-19 patient into an experimental treatment program called convalescent plasma therapy.




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New decontamination protocol permits reuse of N95 respirators

A new protocol using aerosolized hydrogen peroxide to decontaminate N95 respirators could allow them to be safely reused in hospital settings. The protocol, optimized by a team of Penn State researchers, inactivates viruses without deforming or damaging the respirator and could help hospitals overcome the current respirator shortage due to the COVID-19 pandemic.




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Fin24.com | Debit order fraud: Consumers 'frustrated' and 'annoyed' with banks

Fin24 users speak of their frustrations with banks, calling for a crackdown on debit order fraud that sees payments they didn't authorise being deducted from their bank accounts each month.




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Fin24.com | Credit card fraud spikes at 'alarming' rate in just 3 months – Banking Services Ombud

Credit card fraud increased to 19.47% as at the end of March 2019, compared to 12.2% reported at the beginning of January 2019.




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The Best Tech Gifts for Fitness Enthusiasts

If you're buying for someone who lives by the SoulCycle schedule, or wants to get in shape in 2020, this is the gift guide for you.




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Antibiotic Use and Outcomes in Children in the Emergency Department With Suspected Pneumonia

Matthew J. Lipshaw
Apr 1, 2020; 145:e20193138-e20193138
ARTICLES




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Fin24.com | Investors struggling to find returns and protect their capital in unusual prevailing climate

Extremely low or negative yields in global markets make it challenging for investors to generate meaningful returns, says Brian McMillan of Investec Structured Products.




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Fin24.com | Coronavirus and retirement savings: 5 things experts want you to think about

Instability in local and international stock markets – mainly due to concerns over the impact of the coronavirus – might have you concerned about preserving your retirement savings.




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Fin24.com | Coronavirus and investment: Keep your eye on the long-term prize

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.




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Spain, Italy, Russia among qualifiers as main round ends

Italy, Azerbaijan, Ukraine, Portugal, Spain, Kazakhstan and Russia joined hosts Slovenia in the finals by winning their main round groups while the eight play-off contenders are confirmed.




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An architect explores using his passion in missions

For years, Gustavo, an architect from Central America, felt drawn to working in the Arabian Peninsula. Then, on a short-term trip, he saw what it could be like to use his profession overseas.




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Penn Staters stock shelves, continue to serve students at campus pantries

Penn Staters across the Commonwealth are embodying the “We Are” spirit by keeping campus food pantries open and shelves stocked to continue to serve students in need during the coronavirus pandemic.




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Hazleton native joins campus athletics department as new trainer

Hazleton native Megan Bobish has joined the Penn State Hazleton Athletics Department as the newest member of its team.




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Virtual services keeping Hazleton students, campus connected during crisis

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.




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Hacked and Cut Off From the Public: This Is School Board Business in the Coronavirus Crisis

Social distancing is forcing school business to be conducted virtually, putting school boards in the difficult spot of making crucial decisions on spending and other issues without the same level of public input.




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How School Boards Should Respond to Coronavirus

It's vital that school boards make it clear that leaving students without access to meaningful instruction for 4-6 months is unacceptable, says national school board guru AJ Crabill.




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World Campus helps students find mental health services no matter where they are

Katie Marshall, Penn State World Campus mental health case manager, connects students learning online to resources in their own communities.




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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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Campus Recreation to host Virtual 5K

Campus Recreation, a unit of Penn State Student Affairs, is hosting the first ever “We Are Penn State Virtual 5K,” with the opportunity to benefit the Penn State Student Care and Advocacy Student Emergency Fund.




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World Campus students elect student government leaders for 2020-21

Online learners at Penn State have elected 10 leaders to the World Campus Student Government Association to serve in the 2020-21 school year.




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Abusive Head Trauma in Infants and Children

Abusive head trauma (AHT) remains a significant cause of morbidity and mortality in the pediatric population, especially in young infants. In the past decade, advancements in research have refined medical understanding of the epidemiological, clinical, biomechanical, and pathologic factors comprising the diagnosis, thereby enhancing clinical detection of a challenging diagnostic entity. Failure to recognize AHT and respond appropriately at any step in the process, from medical diagnosis to child protection and legal decision-making, can place children at risk. The American Academy of Pediatrics revises the 2009 policy statement on AHT to incorporate the growing body of knowledge on the topic. Although this statement incorporates some of that growing body of knowledge, it is not a comprehensive exposition of the science. This statement aims to provide pediatric practitioners with general guidance on a complex subject. The Academy recommends that pediatric practitioners remain vigilant for the signs and symptoms of AHT, conduct thorough medical evaluations, consult with pediatric medical subspecialists when necessary, and embrace the challenges and need for strong advocacy on the subject.




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Fin24.com | Unit trusts appeal to me because:

Unit trusts appeal to me because:




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How to Run Windows 10 From a USB Drive

Loading and running Windows 10 from a USB drive is a handy option when you're using a computer saddled with an older version of Windows.




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How to Restore Music on Your iPhone or iPad

Is your favorite music missing on your iPhone or iPad? Maybe you inadvertently turned off syncing or accidentally deleted those tunes. All is not lost; here's how to recover your music.




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Apple Music vs. Spotify: Which Is Best?

Today, Apple takes on the biggest name in music streaming, Spotify. How do they measure up to each other?




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Apple Needs New iPods, But Not for Music

New iPods can be a critical part of Apple's strategy. Just don't think of them as music players.




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Report: Apple Pushing iPods to Stores' Accessory Wall

Customers in the U.S. should begin noticing in-store changes starting today.




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Amazon Music Unlimited vs. Spotify: How Do They Compare?

The big difference between Spotify and Amazon Music Unlimited is Amazon offers an affordable tier of service available on just one Echo device. Here's how else they differ.




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Hands On: Lian Li's Strimer Plus, an RGB Riot for Your PC's Boring Cables

This sequel to Lian Li's original Strimer RGB PC-modding accessory has bolder lighting and more advanced patterns to make your build shine. We built it into a PC to see how it glows.




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11 Apps and Services to Help You Stay Safe on Campus

Don't take your safety for granted. These apps, services, and gadgets will help you communicate your location to trusted contacts and get help should trouble arise.




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Apple Music

Apple Music boasts a deep music well Siri and Apple Watch compatibility, but this well-rounded streaming music service falls just short of joining LiveXLive and Spotify as the best in class.




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The Best Android Launchers for Home Screen Customization

Don't settle for the default settings on your Android device. With the right launcher, you can customize the screens and layouts of your phone.




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Deals: SanDisk Ultra MicroSDXC, Seagate Backup Plus Hub

Today you can save up to 30 percent on select laptops, networking devices, and storage drives at Amazon. Also, the highly anticipated game Cyberpunk 2077 is $10 off when you pre-order it.




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Thanks to Microsoft, We Can Watch Superman for Thousands of Years

Microsoft's new write-once storage medium is constructed from quartz glass, stores data using lasers, and uses machine learning algorithms for decoding.




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Snag a 50-Inch Sceptre 4K Ultra HD TV for Just $200

Normally $399.99, the Sceptre U515CV-U is available at Walmart right now for just $199.99. Don't miss this chance to snag it for half off.