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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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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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Zoho Books

Zoho Books is an excellent choice for cloud-based small business accounting, with an exceptional interface, an attractive price, and a rich set of tools. Its limited payroll offering may cause some users to look elsewhere, however.




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Leipzig v Tottenham facts

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.




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Seizing every opportunity

Buenos Aires, Argentina :: Maintenance crew share Christ's love with local welders helping repair Logos Hope.




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Hintzes commit $100,000 for emergency aid to students

Two of Penn State’s most generous supporters and prominent alumni leaders have made a new commitment to support students impacted by the COVID-19 crisis. Helen S. Hintz, 1960, and Edward “Ed” R. Hintz, 1959, have directed $100,000 to the Student Care and Advocacy Emergency Fund.




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Fin24.com | Gauteng, Western Cape and KZN top list for card fraud

Gauteng, the Western Cape and KwaZulu-Natal are the hot spots for card fraud in South Africa, according to a report on global fraud activity.




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COVID-19 in Children: Initial Characterization of the Pediatric Disease

Andrea T. Cruz
Apr 8, 2020; 0:peds.2020-0834v2-e20200834
COMMENTARY




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Germany's Martinez equals UEFA finals scoring record

Germany's Shekiera Martinez, at 16, has written herself into UEFA's record books by scoring nine goals in a final tournament.




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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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The Bizarre Disdain for High School Sports

Students who play high school sports get better grades, select more challenging courses, and are more likely to enroll in college.




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Slade recognized with Jackson Lethbridge Tolerance Award

Ebonie Slade, a senior majoring in biobehavioral health at Penn State Greater Allegheny, is the recipient of the 2020 Jackson Lethbridge Tolerance Award.




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Cybersecurity professional speaks to students via Zoom

Penn State Greater Allegheny’s current students recently joined a virtual conversation about Cybersecurity Analytics and Operations, Greater Allegheny’s newest 4-year program starting this fall.




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Seizing every opportunity

Buenos Aires, Argentina :: Maintenance crew share Christ's love with local welders helping repair Logos Hope.




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New Penn State Hazleton scholarship supports students in STEM

A new endowed scholarship has been created to support those studying science, technology, engineering or math at Penn State Hazleton.




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Penn State Hazleton fall 2019 dean's list announced

More than 200 students from Penn State Hazleton were recently named to the dean’s list for the fall 2019 semester.




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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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Couple pledges $100K estate gift to Penn State Hazleton

Drs. William and Jean Lovrinic have made an estate commitment to Penn State that will establish a $100,000 scholarship fund at Penn State Hazleton.




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Fish, wine, and social media: Hazleton virtual research fair winners announced

Wine, fish, and excessive use of social media were a few of the topics that earned students top honors in Penn State Hazleton's first-ever virtual Undergraduate Research Fair.




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Zaragoza to stage UEFA Futsal Cup finals

The 10,700-capacity Pabellón Príncipe Felipe in Zaragoza will host the UEFA Futsal Cup finals in April involving Spain's Inter FS and Barcelona plus Portugal's Sporting CP and Győr of Hungary.




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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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Velocity Micro Raptor Z55a (Ryzen 9 3950X)

The Velocity Micro Raptor Z55a is a clean, straightforward gaming desktop with excellent performance. It's a bit pricey, though, and doesn't do a lot to differentiate itself from its rivals.




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Deals: Acer Computers, Blink XT2, 65-Inch Vizio P-Series Quantum X

Amazon is offering up to 30 percent off Acer laptops, desktops, and monitors. Plus, you can save $930 on the 65-inch Vizio P-Series Quantum X 4K TV.




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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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The 30 Best Amazon Fire Tablet Apps

Amazon Fire is more than just an e-reader. Download some of the best apps from Amazon's Appstore to have fun, be productive, and get more organized.




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Weekend Deals: Logitech Webcam, 65-Inch Vizio, Dell Inspiron 15 5000

The Logitech C920 1080p webcam is back down to its Prime Day price, the 65-inch Vizio P-Series Quantum 4K TV is on sale for less than $1,000, and you can grab the new Dell Inspiron 15 5000 plus a $100 Visa prepaid card for just $600.




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Deals: Amazon Echo Dot, 55-Inch Vizio 4K Smart TV, More

Right now you can grab an Amazon Echo Dot two-speaker bundle for just $50. Plus, the 55-inch Vizio M-Series Quantum 4K Smart TV and Anker charging accessories are on sale.




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PNY Flash Drives, Memory Cards Are Up to 64 Percent Off at Amazon

You don't have to fork over a bunch of cash to get a bunch of storage. PNY flash drives, SD cards, and portable drives are on sale at Amazon, with prices starting as low as $5.84.




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Deals: Vizio M-Series 4K TV, XPS 15 With 4K OLED, Roborock S5

The 55-inch Vizio M-Series 4K TV is just $358, $40 less than its Black Friday price. Plus, Dell's XPS 15 laptop is $350 off and the Roborock S5 robot vacuum is $200 off.




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Pre-Super Bowl Deals: Vizio TVs, Samsung Soundbar, Roku Premiere

Save on a new TV, soundbar, or media streamer for the Big Game. Plus, the best deals of the week, including discounts on AirPods, Roombas, and Dell's XPS 13 laptop, are all still available.




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Ian Blackford hits out at family's 800-mile holiday to Motherwell as Scots poke fun at bizarre trip

A family who was fined for travelling more than 400 miles for the bank holiday weekend have been slammed online by politicians and Scots.




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Scholastic awards recognize academic excellence at Penn State Berks

Forty-nine Penn State Berks students received recognition for the University Scholastic awards on April 2, through personalized emails. The awards presented included the Evan Pugh Scholars Award,




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New Law Expanding Vouchers Placed on Hold in Arizona

Arizona's ambitious expansion of its school voucher program has officially been put on hold after opponents filed enough signatures to at least temporarily block the new law.




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Expansion of School Vouchers Gets Trounced in Arizona

Proposition 305 had become one of the most contentious ballot-box battles over school choice in the 2018 midterm elections. But its loss is not necessarily a defeat for school choice advocates.




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Vouchers Expansion Battle Will Be Fought at Arizona Polls

A ballot measure to expand the state's eligibility for so-called education savings account is contentious and confusing.




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Elizabeth Warren's Position on Vouchers: A Review

Massachusetts Sen. Elizabeth Warren's education plan landed on Monday, and among other consequences, it led to a conversation about her past statements addressing "vouchers."




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Randomized Placebo-controlled Trial of a 42-Day Tapering Course of Dexamethasone to Reduce the Duration of Ventilator Dependency in Very Low Birth Weight Infants: Outcome of Study Participants at 1-Year Adjusted Age

T. Michael O'Shea
Jul 1, 1999; 104:15-21
ARTICLES




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Longitudinal Growth of Hospitalized Very Low Birth Weight Infants

Richard A. Ehrenkranz
Aug 1, 1999; 104:280-289
ARTICLES




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Trends in Bronchiolitis Hospitalizations in the United States, 2000-2009

Kohei Hasegawa
Jul 1, 2013; 132:28-36
ARTICLES




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Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP), A Randomized, Controlled Trial. I: Primary Outcomes

The STOP-ROP Multicenter Study Group
Feb 1, 2000; 105:295-310
ARTICLES




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Prolonged Duration of Initial Empirical Antibiotic Treatment Is Associated With Increased Rates of Necrotizing Enterocolitis and Death for Extremely Low Birth Weight Infants

C. Michael Cotten
Jan 1, 2009; 123:58-66
ARTICLES




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Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System

Yong Y. Han
Dec 1, 2005; 116:1506-1512
ARTICLES




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Palivizumab, a Humanized Respiratory Syncytial Virus Monoclonal Antibody, Reduces Hospitalization From Respiratory Syncytial Virus Infection in High-risk Infants

The IMpact-RSV Study Group
Sep 1, 1998; 102:531-537
ARTICLES




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England presented with Maurice Burlaz Trophy

England won the 2017 Maurice Burlaz Trophy, the prize awarded to the nation that achieved the best results in UEFA's men's youth competitions over the previous two seasons.




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Martínez Munuera ready for final step on U19 journey

"I'm sure that when I get home, I'll be a better referee than when I arrived here." - We meet U19 EURO final referee Juan Martínez Munuera.




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Portugal pair share U19 EURO top scorers' prize

U19 EURO winners Trincão Francisco and João Filipe were also winners in the race for the golden boot at the tournament, finishing tied at the top with five goals.




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Penn State Harrisburg recognizes staff with 25 years of service

Penn State Harrisburg this spring recognized staff members who have served the college for 25 years.




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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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Penn State Harrisburg recognizes student achievement

Penn State Harrisburg recently honored students for accomplishments in academics, service, and leadership.