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Antimicrobial resistance increases infection morbidity in both adults and children, necessitating the development of new therapeutic options. Telavancin, an antibiotic approved in the United States for certain bacterial infections in adults, has not been examined in pediatric patients. The objectives of this study were to evaluate the short-term safety and pharmacokinetics (PK) of a single intravenous infusion of telavancin in pediatric patients. Single-dose safety and PK of 10 mg/kg telavancin was investigated in pediatric subjects >12 months to ≤17 years of age with known or suspected bacterial infection. Plasma was collected up to 24-h post-infusion and analyzed for concentrations of telavancin and its metabolite for noncompartmental PK analysis. Safety was monitored by physical exams, vital signs, laboratory values, and adverse events following telavancin administration. Twenty-two subjects were enrolled: 14 subjects in Cohort 1 (12-17 years), 7 subjects in Cohort 2 (6-11 years), and 1 subject in Cohort 3 (2-5 years). A single dose of telavancin was well-tolerated in all pediatric age cohorts without clinically significant effects. All age groups exhibited increased clearance of telavancin and reduced exposure to telavancin compared to adults, with mean peak plasma concentrations of 58.3 µg/mL (Cohort 1), 60.1 µg/mL (Cohort 2), and 53.1 µg/mL (Cohort 3). A 10 mg/kg dose of telavancin was well tolerated in pediatric subjects. Telavancin exposure was lower in pediatric subjects compared to adult subjects. Further studies are needed to determine the dose required in phase 3 clinical trials in pediatrics.

Two coding-complete sequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were obtained from samples from two patients in Arkansas, in the southeastern corner of the United States. The viral genome was obtained using the ARTIC Network protocol and Oxford Nanopore Technologies sequencing.

Two coding-complete sequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were obtained from samples from two patients in Arkansas, in the southeastern corner of the United States. The viral genome was obtained using the ARTIC Network protocol and Oxford Nanopore Technologies sequencing.

Author(s): Madeleine Didsbury [sup.1] [sup.2] , Anita van Zwieten [sup.1] [sup.2] , Kerry Chen [sup.2] , Laura J. James [sup.1] [sup.2] , Anna Francis [sup.1] [sup.2] [sup.3] , Siah Kim [...]

Housing influences life chances and trajectories through many roles, differently and in relation to the socioeconomic characteristics of people and population groups. This article uses the concept – 'housing niches' to present an alternative, bottom-up, plural and bundled view of housing and advantage. Using a large, representative sample of an Australian rental population (the Australian Rental Housing Conditions Dataset [ARHCD]), our analysis describes housing as multidimensional, bound across other aspects of people's lives. Understanding advantage requires methodologies that capture risk as cumulative, mediated by multilevel social processes that expose and select particular populations to particular residential environments that contribute to people's multiple disadvantage. Housing niches compel research and debate on comprehensive housing policy as not only necessary, but to have an imperative of cumulative risk and more broadly, inequality and poverty reduction. [ABSTRACT FROM AUTHOR]

Pantoprazole is a proton pump inhibitor indicated for the treatment of gastroesophageal reflux disease, a condition that disproportionately affects children with obesity. Appropriately dosing pantoprazole in children with obesity requires understanding the body size metric that best guides dosing, but pharmacokinetic (PK) trials using traditional techniques are limited by the need for larger sample sizes and frequent blood sampling. Physiologically‐based PK (PBPK) models are an attractive alternative that can account for physiologic‐, genetic‐, and drug‐specific changes without the need for extensive clinical trial data. In this study, we explored the effect of obesity on pantoprazole PK and evaluated label‐suggested dosing in this population. An adult PBPK model for pantoprazole was developed using data from the literature and accounting for genetic variation in CYP2C19. The adult PBPK model was scaled to children without obesity using age‐associated changes in anatomical and physiological parameters. Lastly, the pediatric PBPK model was expanded to children with obesity. Three pantoprazole dosing strategies were evaluated: 1 mg/kg total body weight, 1.2 mg/kg lean body weight, and US Food and Drug Administration‐recommended weight‐tiered dosing. Simulated concentration–time profiles from our model were compared with data from a prospective cohort study (PAN01; NCT02186652). Weight‐tiered dosing resulted in the most (>90%) children with pantoprazole exposures in the reference range, regardless of obesity status or CYP2C19 phenotype, confirming results from previously published population PK models. PBPK models may allow for the efficient study of physiologic and developmental effects of obesity on PK in special populations where clinical trial data may be limited. [ABSTRACT FROM AUTHOR]

Discussion forums are a widely used activity in online courses. However, knowledge construction within online discussion rarely reaches higher levels. Therefore, it is important to understand which aspects of online discussion encourage learning and increase knowledge construction. This paper investigates the effect three Structured Divergent prompts (playground prompts, brainstorm prompts, and focal prompts) have on knowledge construction as compared to Convergent prompts. Participants (N = 58) were required to post in an online discussion thread during a graduate education course at a private university. The Interaction Analysis Model was used to determine the levels of knowledge construction demonstrated within students' posts. The posts were given a score using the following codes: 0-no post/no understandable post; 1-sharing information, 2-disagreeing; 3-negotiation of meaning; 4-testing co-construction; 5-agreement of the constructed meaning. The analysis revealed that two of the three Structured Divergent prompts (focal and brainstorm) yielded significantly higher levels of knowledge construction as compared to Convergent prompts.

Background: Racial and ethnic disparities in cesarean rates in the United States are well documented. This study investigated whether cesarean inequities persist in midwife‐led birth center care, including for individuals with the lowest medical risk. Methods: National registry records of 174,230 childbearing people enrolled in care in 115 midwifery‐led birth center practices between 2007 and 2022 were analyzed for primary cesarean rates and indications by race and ethnicity. The lowest medical risk subsample (n = 70,521) was analyzed for independent drivers of cesarean birth. Results: Primary cesarean rates among nulliparas (15.5%) and multiparas (5.7%) were low for all enrollees. Among nulliparas in the lowest‐risk subsample, non‐Latinx Black (aOR = 1.37; 95% CI, 1.15–1.63), Latinx (aOR = 1.51; 95% CI, 1.32–1.73), and Asian participants (aOR = 1.48; 95% CI, 1.19–1.85) remained at higher risk for primary cesarean than White participants. Among multiparas, only Black participants experienced a higher primary cesarean risk (aOR = 1.49; 95% CI, 1.02–2.18). Intrapartum transfers from birth centers were equivalent or lower for Black (14.0%, p = 0.345) and Latinx (12.7%, p < 0.001) enrollees. Black participants experienced a higher proportion of primary cesareans attributed to non‐reassuring fetal status, regardless of risk factors. Place of admission was a stronger predictor of primary cesarean than race or ethnicity. Conclusions: Place of first admission in labor was the strongest predictor of cesarean. Racism as a chronic stressor and a determinant of clinical decision‐making reduces choice in birth settings and may increase cesarean rates. Research on components of birth settings that drive inequitable outcomes is warranted. [ABSTRACT FROM AUTHOR]

Housing inequality is far more than a housing matter. To discover how housing inequality has been used across disciplines, and how this may inform future housing research, we performed a systematic scoping review. We found that housing inequality provides multiple understandings as well as a variety of uses, for example, as a measurement tool, a conceptual device, or as subject matter. To draw together useful lessons from this conceptually diverse body of work, we identify four principle uses of 'housing inequality' in the literature – an outcome, an experience, a product, and a construct. These four framings offer a level of conceptual clarity for thinking about, and researching, the different expressions of housing inequality. It contributes to housing research by providing an approach for taking into account the multiple and complex roles of housing, and its distribution and impacts across society. [ABSTRACT FROM AUTHOR]

Objective and Methods: The study examined sexual victimization among college students with disabilities (n = 187) using an online survey at a large southern university. Students reported one or multiple disabilities: physical disabilities, Attention Deficit Hyperactivity Disorder (ADHD)/Attention Deficit Disorder (ADD), learning disabilities, and emotional disabilities, with most students reporting more than one disability. Results: Overall, 71% of the sample experienced one or more types of lifetime sexual assault and/or rape, and 51% reported sexual victimization since attending the university. There were no significant differences in experiencing sexual assault and/or rape between students with one disability compared to students with more than one disability. Conclusions: Considering the high rates of sexual victimization among students with disabilities, and the dearth of research focusing on the context of sexual assault in this population, future research and research-based prevention initiatives are needed. Findings can inform future prevention efforts to address sexual violence among students with disabilities on campuses. [ABSTRACT FROM AUTHOR]

Children with asthma and obesity are more likely to have lower vitamin D levels, but the optimal replacement dose is unknown in this population. The objective of this study is identifying a vitamin D dose in children with obesity‐related asthma that safely achieves serum vitamin D levels of ≥ 40 ng/mL. This prospective multisite randomized controlled trial recruited children/adolescents with asthma and body mass index ≥ 85% for age/sex. Part 1 (dose finding), evaluated 4 oral vitamin D regimens for 16 weeks to identify a replacement dose that achieved serum vitamin D levels ≥ 40 ng/mL. Part 2 compared the replacement dose calculated from part 1 (50,000 IU loading dose with 8,000 IU daily) to standard of care (SOC) for 16 weeks to identify the proportion of children achieving target serum 25(OH)D level. Part 1 included 48 randomized participants. Part 2 included 64 participants. In Part 1, no SOC participants achieved target serum level, but 50–72.7% of participants in cohorts A‐C achieved the target serum level. In part 2, 78.6% of replacement dose participants achieved target serum level compared with none in the SOC arm. No related serious adverse events were reported. This trial confirmed a 50,000 IU loading dose plus 8,000 IU daily oral vitamin D as safe and effective in increasing serum 25(OH)D levels in children/adolescents with overweight/obesity to levels ≥ 40 ng/mL. Given the critical role of vitamin D in many conditions complicating childhood obesity, these data close a critical gap in our understanding of vitamin D dosing in children. [ABSTRACT FROM AUTHOR]