v Identification of antiviral drug candidates against SARS-CoV-2 from FDA-approved drugs [Antiviral Agents] By aac.asm.org Published On :: 2020-05-04T08:49:24-07:00 Drug repositioning is the only feasible option to address the COVID-19 global challenge immediately. We screened a panel of 48 FDA-approved drugs against SARS-CoV-2 which were pre-selected by an assay of SARS-CoV and identified 24 potential antiviral drug candidates against SARS-CoV-2 infection. Some drug candidates showed very low micromolar IC50s and in particular, two FDA-approved drugs - niclosamide and ciclesonide – were notable in some respects. Full Article
v Evaluation of leishmanicidal activity of an in silico screened novel inhibitor against ascorbate peroxidase of Leishmania donovani [Mechanisms of Action] By aac.asm.org Published On :: 2020-05-04T08:49:24-07:00 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. Full Article
v Influence of CYP2C8, CYP3A4 and CYP3A5 host genotypes on early recurrence of Plasmodium vivax [Mechanisms of Resistance] By aac.asm.org Published On :: 2020-05-04T08:49:24-07:00 CYP450 enzymes are involved in biotransformation of chloroquine (CQ), but the role of the different metabolism profiles of this drug has not been properly investigated in relation to P. vivax recurrences. To investigate the influence of CYPs genotypes associated with CQ-metabolism on early recurrence rates of P. vivax, a case-control study was carried out. Cases included patients presenting an early recurrence (CQ-recurrent), defined as recurrence during the first 28 days after initial infection, plasma concentrations of CQ plus desethylchloroquine (DCQ, the major CQ metabolite) higher than 100 ng/mL. A control (CQ-responsive) with no parasite recurrence over the follow-up was also included. CQ and DCQ plasma levels were measured on Day 28. CQ CYPs (CYP2C8, CYP3A4 and CYP3A5) genotypes were determined by real-time PCR. An ex vivo study was conducted to verify CQ and DCQ efficacy in P. vivax isolates. The frequency of alleles associated with normal and slow metabolism was similar between the cases and controls for CYP2C8 (OR=1.45, 95% CI=0.51-4.14, p=0.570), CYP3A4 (OR=2.38, 95% CI=0.92-6.19, p=0.105) and CYP3A5 (OR=4.17, 95% CI=0.79-22.04, p=1.038) genes. DCQ levels were higher than CQ, regardless of the genotype. Regarding the DCQ/CQ rate, there was no difference between groups or between those patients who had a normal or mutant genotype. DCQ and CQ showed similar efficacy ex vivo. CYPs genotypes had no influence on early recurrence rates. Similar efficacy of CQ and DCQ ex vivo could explain the absence of therapeutic failure, despite presence of alleles associated with slow metabolism. Full Article
v 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] By aac.asm.org Published On :: 2020-05-04T08:49:24-07:00 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. Full Article
v Activity of epigenetic inhibitors against Plasmodium falciparum asexual and sexual blood stages. [Susceptibility] By aac.asm.org Published On :: 2020-05-04T08:49:24-07:00 Earlier genetic and inhibitor studies have shown that epigenetic regulation of gene expression is critical for malaria parasite survival in multiple life stages and a promising target for new anti-malarials. We therefore evaluated the activity of 350 diverse epigenetic inhibitors against multiple stages of Plasmodium falciparum. We observed ≥90% inhibition at 10 μM for 28% of compounds against asexual blood stages and early gametocytes, of which a third retained ≥90% inhibition at 1 μM. Full Article
v Comparative plasma pharmacokinetics of ceftriaxone and ertapenem between normoalbuminemia, hypoalbuminemia and with albumin replacement in a sheep model. [Pharmacology] By aac.asm.org Published On :: 2020-05-04T08:49:24-07:00 BackgroundOptimal concentrations of unbound antimicrobials are essential for maximum microbiological effect. Although hypoalbuminemia and albumin fluid resuscitation are common in critical care, the effects of different albumin concentrations on the unbound concentrations of highly protein-bound antimicrobials are not known. The aim of this study was to compare effects of different albumin states on total and unbound concentrations of ertapenem and ceftriaxone using an ovine model.MethodsDesignProspective, three phase intervention observational study.SubjectsHealthy Merino sheep.InterventionsEight sheep were subject to three experimental phases; normoalbuminemia, hypoalbuminemia using plasmapheresis and albumin replacement using a 25% albumin solution. In each phase, ceftriaxone 40 mg/kg and ertapenem 15 mg/kg were given intravenously. Blood samples were collected at pre-defined intervals and analyzed using an ultra-high-performance liquid chromatography tandem mass spectrometry method. Pharmacokinetic parameters such as area under the curve (AUC0-24), plasma clearance (CL) and apparent volume of distribution in the terminal phase (Vd) were estimated and compared between the phases.ResultsThe protein and albumin concentrations were significantly different between phases. Hypoalbuminemia resulted in a significantly lower AUC0-24 and higher CL of total and unbound concentrations of ceftriaxone compared to the other phases. Whereas albumin replacement led to higher AUC0-24 and lower CL compared to other phases for both drugs. The Vd for total drug concentrations for both drugs were significantly lower with albumin replacement.ConclusionsFor highly protein-bound drugs such as ceftriaxone and ertapenem, both hypoalbuminemia and albumin replacement may affect unbound drug exposure. Full Article
v Inhibition of SARS-CoV-2 infection by the cyclophilin inhibitor Alisporivir (Debio 025) [Antiviral Agents] By aac.asm.org Published On :: 2020-05-06T08:16:52-07:00 Cyclophilins play a key role in the lifecycle of coronaviruses. Alisporivir (Debio 025) is a non-immunosuppressive analogue of cyclosporin A with potent cyclophilin inhibition properties. Alisporivir reduced SARS-CoV-2 RNA production in a dose-dependent manner in VeroE6 cell line, with an EC50 of 0.46±0.04 μM. Alisporivir inhibited a post-entry step of the SARS-CoV-2 lifecycle. These results justify that a proof-of-concept Phase 2 trial be rapidly conducted with alisporivir in patients with SARS-CoV-2 infection. Full Article
v Google's Advanced Protection Expands to Phone-Only Users By www.pcmag.com Published On :: 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. Full Article
v The Cost of Avast's Free Antivirus: Companies Can Spy on Your Clicks By www.pcmag.com Published On :: Avast is harvesting users' browser histories on the pretext that the data has been 'de-identified,' thus protecting your privacy. But the data, which is being sold to third parties, can be linked back to people's real identities, exposing every click and search they've made. Full Article
v Save 30 Percent on Keeper, Never Click 'Forgot Password' Again By www.pcmag.com Published On :: The password-fatigued masses will be pleased to find Keeper's new 30 percent off deal, which brings it down to $20.99 per year from its typical $29.99. Full Article
v Avast Defends Data Harvesting, Plans to Get Users to Agree to It By www.pcmag.com Published On :: On Tuesday, Avast responded to a PCMag-Motherboard investigation into the company's browser history collection practices, saying it was entirely legal. Avast users should expect to see a prompt from the antivirus products, asking them to consent to the data harvesting. Full Article
v Avast to End Browser Data Harvesting, Terminates Jumpshot By www.pcmag.com Published On :: 'As CEO of Avast, I feel personally responsible and I would like to apologize to all concerned,' wrote Ondrej Vlcek following a PCMag-Motherboard investigation into the privacy risks around the data harvesting. Full Article
v New Coronavirus Strain? Nope, Just Hackers Trying to Spread Malware By www.pcmag.com Published On :: The hackers have been using files and emails that warn about a new coronavirus strain to trick users into opening them. Doing so can secretly deliver malware to the victim's machine. Full Article
v Google Photos Videos Were Shared With Strangers By www.pcmag.com Published On :: Google's Takeout service was designed to let people download their data, but accidentally sent videos from Google Photos accounts to strangers. Full Article
v Hackers Pose as Wall Street Journal Reporter to Phish Victims By www.pcmag.com Published On :: Watch out for suspicious interview requests. 'The main focus of this phishing campaign was stealing email account information of the victims, and finding information about their contacts/networks,' the cybersecurity experts at Certfa Lab warned on Wednesday. Full Article
v The Best Free Antivirus Protection for 2020 By www.pcmag.com Published On :: Windows Defender is improving, but you still shouldn't rely on Windows 10's security tools as your sole means of protection. Many free third-party security apps are more effective at keeping you safe. We've tested 17 no-cost services to help you find the best free antivirus for protecting your PC. Full Article
v Fin24.com | JSE wrap | Oil price drop drives further stock pessimism By www.fin24.com Published On :: Tue, 21 Apr 2020 17:59:20 +0200 The JSE fell on Tuesday as global markets tumbled on the back of a rout in crude oil prices. Full Article
v Fin24.com | Stocks struggle as antiviral drug hopes fade By www.fin24.com Published On :: Fri, 24 Apr 2020 16:55:37 +0200 Stock markets struggled on Friday as hopes of quickly finding a treatment for coronavirus were dashed, analysts said, and more crushing economic data delivered a body blow to confidence. Full Article
v Fin24.com | Stock markets rally on virus hopes, but oil tanks By www.fin24.com Published On :: Mon, 27 Apr 2020 15:31:18 +0200 Equity markets have rallied Monday as countries eased coronavirus lockdown measures, but oil prices tumbled as a supply glut offset output cuts. Full Article
v Fin24.com | Gold falls as moves to reopen economies erode appetite for havens By www.fin24.com Published On :: Tue, 28 Apr 2020 11:57:28 +0200 The precious metal eased for a third day after US equities hit the highest in almost seven weeks as states including Florida took steps toward easing restrictions. Full Article
v Fin24.com | Positive virus drug trial news spurs stocks By www.fin24.com Published On :: Wed, 29 Apr 2020 17:54:49 +0200 The surge in stocks was on the back of positive news from trials being conducted on a potential treatment for the coronavirus. With most economies looking to partially reopen their economies, this brought a jump across most asset classes including commodities. Full Article
v Fin24.com | Stock markets plunge on devastating growth data By www.fin24.com Published On :: Thu, 30 Apr 2020 19:16:44 +0200 Stock markets plunged on Thursday after economic growth data confirmed fears of Covid-19's bruising impact on the world economy. Full Article
v Fin24.com | Gold bars fight coronavirus kits for space on the plane By www.fin24.com Published On :: Sun, 03 May 2020 12:27:11 +0200 Swiss refiner Valcambi SA tried for five straight days last month to move a shipment of gold out of Hong Kong. Twice the metal was packed carefully onto a plane, only to be offloaded again. Full Article
v Fin24.com | Markets wrap | JSE retreats as global markets fret over economic growth By www.fin24.com Published On :: Mon, 04 May 2020 18:55:42 +0200 Deep losses were recorded across most European benchmarks except the FTSE 100 which managed to trade relatively flat on the day. Full Article
v Philanthropies Want to Fund Civics Education. But How? By feedproxy.google.com Published On :: Wed, 04 Dec 2019 00:00:00 +0000 A new paper sketches out the landscape and tensions in civic education as philanthropies look for ways to support the field. Full Article Philanthropy
v Grantmakers for Education Chief on Philanthropy's Response to Coronavirus By feedproxy.google.com Published On :: Wed, 29 Apr 2020 00:00:00 +0000 Funders have been both fast and thoughtful about how to work with national and local partners to listen to needs from the field, identify best practices, and deploy resources quickly, says Celine Coggins. Full Article Philanthropy
v Philanthropy Roundtable K-12 Chief on Funders' Response to Coronavirus By feedproxy.google.com Published On :: Fri, 01 May 2020 00:00:00 +0000 "This pandemic has given us an opportunity to think boldly about students' educational needs and how to creatively respond to them," says Katherine Haley. Full Article Philanthropy
v NewSchools Venture Fund CEO on Education Philanthropy During Coronavirus By feedproxy.google.com Published On :: Fri, 08 May 2020 00:00:00 +0000 "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. Full Article Philanthropy
v Performance of the Modified Boston and Philadelphia Criteria for Invasive Bacterial Infections By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND: The ability of the decades-old Boston and Philadelphia criteria to accurately identify infants at low risk for serious bacterial infections has not been recently reevaluated. METHODS: We assembled a multicenter cohort of infants 29 to 60 days of age who had cerebrospinal fluid (CSF) and blood cultures obtained. We report the performance of the modified Boston criteria (peripheral white blood cell count [WBC] ≥20 000 cells per mm3, CSF WBC ≥10 cells per mm3, and urinalysis with >10 WBC per high-power field or positive urine dip result) and modified Philadelphia criteria (peripheral WBC ≥15 000 cells per mm3, CSF WBC ≥8 cells per mm3, positive CSF Gram-stain result, and urinalysis with >10 WBC per high-power field or positive urine dip result) for the identification of invasive bacterial infections (IBIs). We defined IBI as bacterial meningitis (growth of pathogenic bacteria from CSF culture) or bacteremia (growth from blood culture). RESULTS: We applied the modified Boston criteria to 8344 infants and the modified Philadelphia criteria to 8131 infants. The modified Boston criteria identified 133 of the 212 infants with IBI (sensitivity 62.7% [95% confidence interval (CI) 55.9% to 69.3%] and specificity 59.2% [95% CI 58.1% to 60.2%]), and the modified Philadelphia criteria identified 157 of the 219 infants with IBI (sensitivity 71.7% [95% CI 65.2% to 77.6%] and specificity 46.1% [95% CI 45.0% to 47.2%]). The modified Boston and Philadelphia criteria misclassified 17 of 53 (32.1%) and 13 of 56 (23.3%) infants with bacterial meningitis, respectively. CONCLUSIONS: The modified Boston and Philadelphia criteria misclassified a substantial number of infants 29 to 60 days old with IBI, including those with bacterial meningitis. Full Article
v Efficacy of Melatonin in Children With Postconcussive Symptoms: A Randomized Clinical Trial By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 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. Full Article
v Validation of a Prediction Rule for Mortality in Congenital Diaphragmatic Hernia By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with a mortality of ~27%. The Congenital Diaphragmatic Hernia Study Group (CDHSG) developed a simple postnatal clinical prediction rule to predict mortality in newborns with CDH. Our aim for this study is to externally validate the CDHSG rule in the European population and to improve its prediction of mortality by adding prenatal variables. METHODS: We performed a European multicenter retrospective cohort study and included all newborns diagnosed with unilateral CDH who were born between 2008 and 2015. Newborns born from November 2011 onward were included for the external validation of the rule (n = 343). To improve the prediction rule, we included all patients born between 2008 and 2015 (n = 620) with prenatally diagnosed CDH and collected pre- and postnatal variables. We build a logistic regression model and performed bootstrap resampling and computed calibration plots. RESULTS: With our validation data set, the CDHSG rule had an area under the curve of 79.0%, revealing a fair predictive performance. For the new prediction rule, prenatal herniation of the liver was added, and absent 5-minute Apgar score was taken out. The new prediction rule revealed good calibration, and with an area under the curve of 84.6%, it had good discriminative abilities. CONCLUSIONS: In this study, we externally validated the CDHSG rule for the European population, which revealed fair predictive performance. The modified rule, with prenatal liver herniation as an additional variable, appears to further improve the model’s ability to predict mortality in a population of patients with prenatally diagnosed CDH. Full Article
v Perioperative Transfusions and Venous Thromboembolism By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 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. Full Article
v HIV Testing Among Adolescents With Acute Sexually Transmitted Infections By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND AND OBJECTIVES: Rates of sexually transmitted infections (STIs) have increased over the decade. Guidelines recommend HIV testing with incident STIs. Prevalence and factors associated with HIV testing in acute STIs are unknown in adolescents. Our objective was to determine the prevalence of completed HIV testing among adolescents with incident STIs and identify patient and health care factors associated with HIV testing. METHODS: Retrospective study of STI episodes (gonorrhea, Chlamydia, trichomoniasis, or syphilis) of adolescents between 13 and 24 years old from July 2014 to December 2017 in 2 urban primary care clinics. We performed mixed effects logistic regression modeling to identify patient and health care factors associated with HIV testing within 90 days of STI diagnosis. RESULTS: The 1313 participants contributed 1816 acute STI episodes. Mean age at STI diagnosis was 17.2 years (SD = 1.7), 75% of episodes occurred in females, and 97% occurred in African Americans. Only half (55%) of acute STI episodes had a completed HIV test. In the adjusted model, female sex, previous STIs, uninsured status, and confidential sexual health encounters were associated with decreased odds of HIV testing. Patients enrolled in primary care at the clinics, compared with those receiving sexual health care alone, and those with multipathogen STI diagnoses were more likely to have HIV testing. CONCLUSIONS: HIV testing rates among adolescents with acute STIs are suboptimal. Patient and health care factors were found to be associated with receipt of testing and should be considered in clinical practice. Full Article
v Transgender Youth Experiences and Perspectives Related to HIV Preventive Services By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND: In the United States, transgender youth are at especially high risk for HIV infection. Literature regarding HIV prevention strategies for this vulnerable, often-hidden population is scant. Before effective, population-based HIV prevention strategies may be adequately developed, it is necessary to first enhance the contextual understanding of transgender youth HIV risk and experiences with HIV preventive services. METHODS: Two 3-day, online, asynchronous focus groups were conducted with transgender youth from across the United States to better understand participant HIV risk and experiences with HIV preventive services. Participants were recruited by using online advertisements posted via youth organizations. Qualitative data were analyzed by using content analysis. RESULTS: A total of 30 transgender youth participated. The average age was 18.6 years, and youth reported a wide range of gender identities (eg, 27% were transgender male, 17% were transgender female, and 27% used ≥1 term) and sexual orientations. Four themes emerged: (1) barriers to self-efficacy in sexual decision-making; (2) safety concerns, fear, and other challenges in forming romantic and/or sexual relationships; (3) need for support and education; and (4) desire for affirmative and culturally competent experiences and interactions (eg, home, school, and health care). CONCLUSIONS: Youth discussed experiences and perspectives related to their gender identities, sexual health education, and HIV preventive services. Findings should inform intervention development to improve support and/or services, including the following: (1) increasing provider knowledge and skills to provide gender-affirming care, (2) addressing barriers to services (eg, accessibility and affordability as well as stigma and discrimination), and (3) expanding sexual health education to be inclusive of all gender identities, sexual orientations, and definitions of sex and sexual activity. Full Article
v Non-HDL Cholesterol Levels in Childhood and Carotid Intima-Media Thickness in Adulthood By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND: Elevated non–high-density lipoprotein cholesterol (HDL-C) levels are used to identify children at increased cardiovascular risk, but the use of non–HDL-C in childhood to predict atherosclerosis is unclear. We examined whether the National Heart, Lung, and Blood Institute classification of youth non–HDL-C status predicts high common carotid artery intima-media thickness in adulthood. METHODS: We analyzed data from 4 prospective cohorts among 4582 children aged 3 to 19 years who were remeasured as adults (mean follow-up of 26 years). Non–HDL-C status in youth and adulthood was classified according to cut points of the National Heart, Lung, and Blood Institute and the National Cholesterol Education Program Adult Treatment Panel III. High carotid intima-media thickness (cIMT) in adulthood was defined as at or above the study visit-, age-, sex-, race-, and cohort-specific 90th percentile of intima-media thickness. RESULTS: In a log-binomial regression analysis adjusted with age at baseline, sex, cohort, length of follow-up, baseline BMI, and systolic blood pressure, children with dyslipidemic non–HDL-C were at increased risk of high cIMT in adulthood (relative risk [RR], 1.29; 95% confidence interval [CI], 1.07–1.55). Compared with the persistent normal group, the persistent dyslipidemia group (RR, 1.80; 95% CI, 1.37–2.37) and incident dyslipidemia (normal to dyslipidemia) groups (RR, 1.45; 95% CI, 1.07–1.96) had increased risk of high cIMT in adulthood, but the risk was attenuated for the resolution (dyslipidemia to normal) group (RR, 1.17; 95% CI, 0.97–1.41). CONCLUSIONS: Dyslipidemic non–HDL-C levels predict youth at risk for developing high cIMT in adulthood. Those who resolve their non–HDL-C dyslipidemia by adulthood have normalized risk of developing high cIMT in adulthood. Full Article
v Predicting School-Aged Cognitive Impairment in Children Born Very Preterm By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND AND OBJECTIVES: Children born very preterm (VPT) are at high risk of cognitive impairment that impacts their educational and social opportunities. This study examined the predictive accuracy of assessments at 2, 4, 6, and 9 years in identifying preterm children with cognitive impairment by 12 years. METHODS: We prospectively studied a regional cohort of 103 children born VPT (≤32 weeks’ gestation) and 109 children born term from birth to corrected age 12 years. Cognitive functioning was assessed by using age-appropriate, standardized measures: Bayley Scales of Infant Development, Second Edition (age 2); Wechsler Preschool and Primary Scale of Intelligence (ages 4 and 6); and Wechsler Intelligence Scale for Children, Fourth Edition (ages 9 and 12). RESULTS: By 12 years, children born VPT were more likely to have severe (odds ratio 3.9; 95% confidence interval 1.1–13.5) or any (odds ratio 3.2; 95% confidence interval 1.8–5.6) cognitive impairment compared with children born term. Adopting a severe cognitive impairment criterion at age 2 under-identified 44% of children born VPT with later severe impairment, whereas a more inclusive earlier criterion identified all severely affected children at 12 years. Prediction improved with age, with any delay at age 6 having the highest sensitivity (85%) and positive predictive value (66%) relative to earlier age assessments. Inclusion of family-social circumstances further improved diagnostic accuracy. CONCLUSIONS: Cognitive risk prediction improves with age, with assessments at 6 years offering optimal diagnostic accuracy. Intervention for children with early mild delay may be beneficial, especially for those raised in socially disadvantaged family contexts. Full Article
v The Infantile Hemangioma Referral Score: A Validated Tool for Physicians By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 OBJECTIVES: Infantile hemangiomas (IHs) are common; some cases require timely referral and treatment to prevent complications. We developed and validated a reliable instrument for timely and adequate referral of patients with IH to experts by nonexpert primary physicians. METHODS: In this multicenter, cross-sectional, observational study, we used a 3-stage process: (1) development of the Infantile Hemangioma Referral Score (IHReS) tool by IH experts who selected a representative set of 42 IH cases comprising images and a short clinical history, (2) definition of the gold standard for the 42 cases by a second independent committee of IH experts, and (3) IHReS validation by nonexpert primary physicians using the 42 gold standard cases. RESULTS: A total of 60 primary physicians from 7 different countries evaluated the 42 gold standard cases (without reference to the IHReS tool); 45 primary physicians evaluated these cases using the IHReS questionnaire, and 44 completed retesting using the instrument. IHReS had a sensitivity of 96.9% (95% confidence interval 96.1%–97.8%) and a specificity of 55.0% (95% confidence interval 51.0%–59.0%). The positive predictive value and negative predictive value were 40.5% and 98.3%, respectively. Validation by experts and primary physicians revealed substantial agreement for interrater reliability and intrarater repeatability. CONCLUSIONS: IHReS, a 2-part algorithm with a total of 12 questions, is an easy-to-use tool for primary physicians for the purpose of facilitating correct and timely referral of patients with IH. IHReS may help practitioners in their decision to refer patients to expert centers. Full Article
v Trends in Pediatricians Developmental Screening: 2002-2016 By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND: Current guidelines from the American Academy of Pediatrics recommend screening children for developmental problems by using a standardized screening tool and referring at-risk patients to early intervention (EI) or subspecialists. Adoption of guidelines has been gradual, with research showing many children still not being screened and referred. METHODS: We analyzed American Academy of Pediatrics Periodic Survey data from 2002 (response rate = 58%; N = 562), 2009 (response rate = 57%; N = 532), and 2016 (response rate = 47%, N = 469). Surveys included items on pediatricians’ knowledge, attitudes, and practices regarding screening and referring children for developmental problems. We used descriptive statistics and a multivariable logistic regression model to examine trends in screening and referral practices and attitudes. RESULTS: Pediatricians’ reported use of developmental screening tools increased from 21% in 2002 to 63% in 2016 (P < .001). In 2016, on average pediatricians reported referring 59% of their at-risk patients to EI, up from 41% in 2002 (P < .001), and pediatricians in 2016 were more likely than in 2002 to report being "very likely" to refer a patient with global developmental delay, milestone loss, language delay, sensory impairment, motor delays, and family concern to EI. CONCLUSIONS: Pediatricians’ reported use of a standardized developmental screening tool has tripled from 2002 to 2016, and more pediatricians are self-reporting making referrals for children with concerns in developmental screening. To sustain this progress, additional efforts are needed to enhance referral systems, improve EI programs, and provide better tracking of child outcomes. Full Article
v Trends in Pediatric Malpractice Claims 1987-2015: Results From the Periodic Survey of Fellows By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 BACKGROUND: Pediatricians are less frequently sued than other physicians. When suits are successful, however, the average payout is higher. Little is known about changes in the risk of litigation over time. We sought to characterize malpractice lawsuit trends for pediatricians over time. METHODS: The Periodic Survey is a national random sample survey of American Academy of Pediatrics members. Seven surveys between 1987 and 2015 asked questions regarding malpractice (n = 5731). Bivariate and multivariable analyses examined trends and factors associated with risk and outcome of malpractice claims and lawsuits. Descriptive analyses examined potential change in indemnity amount over time. RESULTS: In 2015, 21% of pediatricians reported ever having been the subject of any claim or lawsuit, down from a peak of 33% in 1990. Report of successful outcomes in the most-recent suit trended upward between 1987 and 2015, greatest in 2015 at 58%. Median indemnity was unchanged, averaging $128 000 in 2018 dollars. In multivariate analysis, male sex, hospital-based subspecialty (neonatology, pediatric critical care, pediatric emergency medicine, and hospital medicine), longer career, and more work hours were associated with a greater risk of malpractice claim. CONCLUSIONS: From 1987 to 2015, the proportion of pediatricians sued has decreased and median indemnity has remained unchanged. Male pediatricians and hospital-based subspecialists were more likely to have been sued. Greater knowledge of the epidemiology of malpractice claims against pediatricians is valuable because it can impact practice arrangements, advise risk-management decisions, influence quality and safety projects, and provide data to guide advocacy for appropriate tort reform and future research. Full Article
v Continuous Albuterol With Benzalkonium in Children Hospitalized With Severe Asthma By pediatrics.aappublications.org Published On :: 2020-04-01T01:00:57-07:00 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. Full Article
v Home Chef Meal Delivery Service By www.pcmag.com Published On :: True to its name, Home Chef is the homiest of meal services we've tried. The recipes are simple and not too adventurous, but for some home chefs, that's a good thing. Full Article
v Trivantis Lectora Inspire By www.pcmag.com Published On :: 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. Full Article
v Apple iMovie By www.pcmag.com Published On :: Apple's excellent entry-level desktop video editing application can turn your footage and photos into impressive productions. Full Article
v Have a Question for PCMag? By www.pcmag.com Published On :: Need help with what to buy? On Twitter, reach out to @PCMag using the #PCMagPicks hashtag, and we'll track down an answer for you. Full Article
v SteelSeries Rival 710 By www.pcmag.com Published On :: Like its predecessor the Rival 700, the SteelSeries Rival 710 is a solid, pricey gaming mouse, with unique features (such as an on-body screen) that are more fun and flashy than technically useful. Full Article
v Champions League Fantasy: Captain marvel By www.uefa.com Published On :: Fri, 14 Feb 2020 18:00:00 GMT The UEFA Champions League is back and UEFA.com are here to guide #UCLfantasy managers through the first legs of the round of 16. Full Article general
v Paris v Dortmund facts By www.uefa.com Published On :: Fri, 21 Feb 2020 10:00:00 GMT Two Erling Braut Haaland strikes have given Dortmund an advantage to take to Paris, although Neymar's away goal could prove crucial. Full Article comp_matches
v Leipzig v Tottenham facts By www.uefa.com Published On :: Fri, 21 Feb 2020 10:00:00 GMT Timo Werner's penalty has given Leipzig a narrow advantage, although Spurs have history when it comes to turning round a 1-0 home defeat. Full Article comp_matches
v Liverpool v Atlético facts By www.uefa.com Published On :: Fri, 21 Feb 2020 12:00:00 GMT An early Saúl Ñíguez goal in Madrid means holders Liverpool once again face a second-leg deficit against Spanish visitors. Full Article comp_matches
v Valencia v Atalanta facts By www.uefa.com Published On :: Fri, 21 Feb 2020 21:00:00 GMT Valencia will need to must a remarkable home recovery to turn round their tie against Atalanta after a 4-1 first-leg defeat. Full Article comp_matches