A firm recommendation: measuring the softness of infant sleep surfaces

Abstract Background Approximately 3600 sudden unexpected infant deaths (SUID) occur annually in the United States, and a quarter of SUIDs are caused by unintentional suffocation and strangulation in bed, with soft bedding use being a significant risk factor. Therefore, The American Academy of Pediatrics (AAP) recommends infants sleep on a “firm” surface, though neither an objective definition nor national standard has been established. The purpose of this study is to report on the performance of a device that measures mattress softness and to provide quantitative values of softness for various infant sleep surfaces. Methods In collaboration with the authors and a national child product safety organization (Kids in Danger), University of Michigan engineering students designed and validated a device that measures the vertical depression (softness) of a simulated 2-month-old’s head on a sleep surface. A total of 17 infant sleep surfaces − 14 household surfaces and 3 hospital mattresses - were measured between April 2019 and January 2020. The average softness of each surface was calculated. Surfaces were also measured with soft bedding, which included an infant fleece blanket, and firm and soft pillows. Results The average softness for the 14 household sleep surfaces ranged from 7.4–36.9 mm. The 2019 cribette playard and the 2018 infant spring had similar softness (21 mm) as the 2018 and 2019 adult foam and 2015 sofa. An infant’s fleece blanket folded once added an additional 2.3–6.5 mm of softness, folded twice added 4.8–11.6 mm, and folded three times added 11–21.8 mm. Using a firm pillow added 4.0–20.9 mm of softness while using a soft pillow added 24.5–46.4 mm. The softness for the 3 hospital sleep surfaces ranged from 14 to 36.9 mm, with the infant bassinet being the firmest and the pediatrics mattress being the softest. Conclusions We found a wide range of softness among sleep surfaces, with some infant mattresses as soft as some adult mattresses. Adding blankets and pillows to mattresses measurably increased softness. Quantifying sleep surface softness will advance our understanding of how softness relates to SUID risk. We hope this new information will further inform safe infant sleep recommendations and improve mattress safety standards nationally.

Download Full-text

A Firm Recommendation: Measuring the Softness of Infant Sleep Surfaces

10.21203/rs.3.rs-306462/v1 ◽

2021 ◽

Author(s):

Sheena Gillani ◽

Gina S. Lowell ◽

Kyran P. Quinlan

Keyword(s):

Engineering Students ◽

Significant Risk ◽

Significant Risk Factor ◽

The United States ◽

National Standard ◽

Infant Sleep ◽

University Of Michigan ◽

Safety Standards ◽

New Information ◽

Wide Range

Abstract BACKGROUND: Approximately 3600 sudden unexpected infant deaths (SUID) occur annually in the United States, and a quarter of SUIDs are caused by unintentional suffocation and strangulation in bed, with soft bedding use being a significant risk factor. Therefore, The American Academy of Pediatrics (AAP) recommends infants sleep on a “firm” surface, though neither an objective definition nor national standard has been established. The purpose of this study is to report on the performance of a device that measures mattress softness and to provide quantitative values of softness for various infant sleep surfaces.METHODS: In collaboration with the authors and a national child product safety organization (Kids in Danger), University of Michigan engineering students designed and validated a device that measures the vertical depression (softness) of a simulated 2-month-old’s head on a sleep surface. A total of 17 infant sleep surfaces -14 household surfaces and 3 hospital mattresses - were measured between April 2019 and January 2020. The average softness of each surface was calculated. Surfaces were also measured with soft bedding, which included an infant fleece blanket, and firm and soft pillows.RESULTS: The average softness for the 14 household sleep surfaces ranged from 7.4-36.9 mm. The 2019 cribette playard and the 2018 infant spring had similar softness (21mm) as the 2018 and 2019 adult foam and 2015 sofa. An infant’s fleece blanket folded once added an additional 2.3-6.5mm of softness, folded twice added 4.8-11.6mm, and folded three times added 11-21.8mm. Using a firm pillow added 4.0-20.9mm of softness while using a soft pillow added 24.5-46.4mm. The softness for the 3 hospital sleep surfaces ranged from 14-36.9mm, with the infant bassinet being the firmest and the pediatrics mattress being the softest.CONCLUSIONS: We found a wide range of softness among sleep surfaces, with some infant mattresses as soft as some adult mattresses. Adding blankets and pillows to mattresses measurably increased softness. Quantifying sleep surface softness will advance our understanding of how softness relates to SUID risk. We hope this new information will further inform safe infant sleep recommendations and improve mattress safety standards nationally.

Download Full-text

Polyamine Metabolism and Gene Methylation in Conjunction with One-Carbon Metabolism

International Journal of Molecular Sciences ◽

10.3390/ijms19103106 ◽

2018 ◽

Vol 19 (10) ◽

pp. 3106 ◽

Cited By ~ 19

Author(s):

Kuniyasu Soda

Keyword(s):

Dna Methylation ◽

Carbon Metabolism ◽

Methylation Status ◽

Significant Risk ◽

Significant Risk Factor ◽

Dna Methyltransferases ◽

Polyamine Metabolism ◽

Methyl Group ◽

Wide Range ◽

One Carbon Metabolism

Recent investigations have revealed that changes in DNA methylation status play an important role in aging-associated pathologies and lifespan. The methylation of DNA is regulated by DNA methyltransferases (DNMT1, DNMT3a, and DNMT3b) in the presence of S-adenosylmethionine (SAM), which serves as a methyl group donor. Increased availability of SAM enhances DNMT activity, while its metabolites, S-adenosyl-l-homocysteine (SAH) and decarboxylated S-adenosylmethionine (dcSAM), act to inhibit DNMT activity. SAH, which is converted from SAM by adding a methyl group to cytosine residues in DNA, is an intermediate precursor of homocysteine. dcSAM, converted from SAM by the enzymatic activity of adenosylmethionine decarboxylase, provides an aminopropyl group to synthesize the polyamines spermine and spermidine. Increased homocysteine levels are a significant risk factor for the development of a wide range of conditions, including cardiovascular diseases. However, successful homocysteine-lowering treatment by vitamins (B6, B12, and folate) failed to improve these conditions. Long-term increased polyamine intake elevated blood spermine levels and inhibited aging-associated pathologies in mice and humans. Spermine reversed changes (increased dcSAM, decreased DNMT activity, aberrant DNA methylation, and proinflammatory status) induced by the inhibition of ornithine decarboxylase. The relation between polyamine metabolism, one-carbon metabolism, DNA methylation, and the biological mechanism of spermine-induced lifespan extension is discussed.

Download Full-text

Kiberbiztonság a koronavírus idején – a COVID–19 nemzetbiztonsági aspektusai

Scientia et Securitas ◽

10.1556/112.2021.00001 ◽

2021 ◽

Vol 2 (1) ◽

pp. 78-87

Author(s):

Tamás Palicz ◽

Balázs Bencsik ◽

Miklós Szócska

Keyword(s):

Cyber Security ◽

Vaccine Development ◽

Significant Risk ◽

Significant Risk Factor ◽

Distance Measures ◽

Data Traffic ◽

Home Office ◽

Emergency Case ◽

Wide Range ◽

Almost All

Összefoglaló. A COVID–19 pandémia az információbiztonság területén új kihívásokat jelentett. A távolról végzett munka különböző formái jelentős mértékben növelték az online tér biztonsági kockázatát. Nőtt a hálózatok nagysága, az adatforgalom, és azon felhasználók száma, akiknek nem volt érdemi tapasztalatuk az online térben. A járvány ideje alatt a kibertérből érkező támadások szektoronként és időszakonként eltérő intenzitásúak voltak, a támadások típusa a phishingtől a malwareken keresztül az információs zavarkeltésig széles spektrumban változott. Számos jelenségnek nemzetbiztonsági vonatkozásai is voltak. Összefoglaló cikkünkben a fenti jelenségek nemzetközi és hazai tapasztalatait összegezzük, különös figyelmet szentelve az egészségügyi rendszernek, illetve a vakcinafejlesztés kibertérből érkező fenyegetéseinek. Summary. During the COVID-19 pandemic, new challenges emerged in the field of information security and cyber security. Home office, home schooling and distance learning, or even telemedicine hit some organizations unprepared. Security risks in online space have increased significantly: the number of network endpoints and the number of computers, laptops and mobile devices have increased with network data traffic as well as the number of users who had no significant experience in online space. They appeared as a significant risk factor. This has been exacerbated, especially in healthcare, by the extremely high workload, which has made systems highly vulnerable. During the epidemic, attacks from cyberspace varied in intensity from sector to sector and period to period. Statistics from international and national organizations have shown that from the end of the first quarter of 2020, the number of cyber security incidents jumped sharply and then remained high even after a small decline. The types of attacks had an extremely wide range: from phishing through malware to misinformation, almost all types of attacks occurred. Many phenomena also had national security implications. Ransomware virus attacks on health have affected almost all health systems and reached high levels by the end of 2020 in particular. It was during the first period that, in an emergency case, there is thought to be an association between a ransomware virus attack and the death of a patient who was not admitted because of the attack. In addition to distance measures and the associated increase in cyber threats, the emerging threats related to vaccination, which is central to the fight against the epidemic, should also be highlighted. This period has shed light on how many vulnerabilities there are, from vaccine development through drug trials to delivery to vaccines and the organization of vaccines, that cybercriminals are able to attack. In order to prevent and combat these threats and attacks, and to respond appropriately, complex, multidisciplinary collaborations are needed in which security science has a privileged place. In our review article, we summarize the international and national experiences of the above phenomena, paying special attention to the health care system and the threats coming from cyberspace in vaccine development.

Download Full-text

Decreasing Incidence of Skin and Soft-tissue Infections in 86 US Emergency Departments, 2009–2014

Clinical Infectious Diseases ◽

10.1093/cid/ciy509 ◽

2018 ◽

Vol 68 (3) ◽

pp. 453-459 ◽

Cited By ~ 12

Author(s):

Ethan Morgan ◽

Sam Hohmann ◽

Jessica P Ridgway ◽

Robert S Daum ◽

Michael Z David

Keyword(s):

United States ◽

Soft Tissue ◽

Hiv Infection ◽

Emergency Departments ◽

Medical Center ◽

Academic Medical Center ◽

Significant Risk ◽

Significant Risk Factor ◽

The United States ◽

Soft Tissue Infections

Abstract Background The incidence of skin and soft-tissue infections (SSTIs), for which human immunodeficiency virus (HIV) is a significant risk factor, in United States emergency departments (EDs) increased dramatically after 2000 with the emergence of community-associated methicillin-resistant Staphylococcus aureus. Few studies have examined SSTI incidence among HIV-infected and non–HIV-infected patients in the United States after 2010. Methods Data were obtained for patient encounters at all academic medical center EDs affiliated with the Vizient clinical data warehouse assigned an SSTI-associated code based on the International Classification of Diseases, Ninth Revision, between 1 January 2009 and 31 December 2014. The rate was calculated per 1000 ED encounters by year and stratified by SSTI, HIV infection, or both, and by age group, race, payer type, and region of care. Poisson regression was used to assess temporal change over the study period. Results In 2009–2014, a total of 47317 HIV-associated and 820440 SSTI-associated encounters were recorded among 25239781 ED patient encounters. The rate of SSTIs decreased by 8% among all patients and by 14.6%, among those with HIV infection. The SSTI incidence overall decreased from 32.0 to 29.7 per 1000 ED encounters between 2009 and 2014. HIV-infected patients had a significantly higher rate of SSTIs than HIV-uninfected patients (adjusted rate ratio, 1.91; 95% confidence interval, 1.84–1.99). Conclusions The decline in SSTI incidence in US EDs between 2009 and 2014 is a remarkable epidemiologic shift from the increase in SSTIs after 2000, and further research is necessary to assess reasons for this decrease.

Download Full-text

Past, Present and Future of Libraries in the Mirror of Rumyantsev Readings — 2019

Bibliotekovedenie [Library and Information Science (Russia)] ◽

10.25281/0869-608x-2019-68-4-435-447 ◽

2019 ◽

Vol 68 (4) ◽

pp. 435-447

Author(s):

Elena A. Ivanova

Keyword(s):

The United States ◽

Classification Systems ◽

Theory And Practice ◽

National Standard ◽

Electronic Communications ◽

Library Management ◽

Russian State ◽

Wide Range ◽

Library Staff ◽

State Library

International scientific and practical conference “Rumyantsev readings — 2019” was held on April 23—24 in the Russian State Library. The conference covered a wide range of issues: “Libraries and museums in the context of history”; “History of the Russian State Library”; “Disclosure of universal and specialized collections of libraries: forms and methods”; “Future of libraries: evaluations, studies, forecasts”; “Libraries as centres of information-bibliographic activities”; “Library collections and library-information services in the age of electronic communications”; “Professional development of library staff: demands of time. Library as educational centre”; “International cooperation of libraries. Library as a platform for intercultural dialogue”. The conference was attended by specialists from libraries, museums, archives, universities and research institutes, representatives of professional associations and organizations from various regions of Russia and from Australia, Belarus, Kazakhstan, Latvia, the United States of America, Tajikistan and Ukraine. Among the sections and round tables of “Rumyantsev readings” were both traditional, held within the framework of the conference on annual basis, and timed to the memorable dates and visits of foreign colleagues of the year. In 2019, the following sections were held: “Art editions in the collections of libraries: issues of study, preservation and promotion”, “Library classification systems”, “Rare and valuable books, book monuments and collections”, “Manuscript sources in the collections of libraries”, “Specialized collections in libraries”, “Collectors, researchers, keepers. Libraries in the context of history”, “Continuing education as a competence resource of library staff”, “Theory and practice of librarianship development at the present stage”, “Library digitalization: trends, problems, prospects”, “Effective library management: problems and solutions. (Pre-session meeting of the 32nd Section of the Russian Library Association on library management and marketing)”. Seminar from the series “Role of science in the development of libraries (theoretical and practical aspects)” “N.M. Sikorsky: scientist, organizer of book science and librarianship. To the 100th birth anniversary” took place. There were organized Round tables: “The new National standard for bibliographic description GOST R 7.0.100—2018 in the modern information environment”, “Library terminology in the context of digital space”, “Cooperation of libraries of the CIS countries: strategic directions”, “Flagship projects that shape the future of libraries”. The growing number of participants, the breadth of topics, the steady interest of specialists in traditional sections and the annual organization of new events in the form and content of the “Rumyantsev readings” allow the conference to stay among the largest scientific and practical events of library research in the country. The search for new topics and the introduction of topical issues on the agenda contribute to both activation of historical research and the search for ways of innovative development and intercultural interaction.

Download Full-text

Asthma and Keratoconus: An analysis of the risk factors association with the severity of keratoconus

10.21203/rs.3.rs-19388/v1 ◽

2020 ◽

Author(s):

Srujana Sahebjada ◽

Elsie Chan ◽

Jing Xie ◽

Grant Snibson ◽

Mark Daniel ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Risk Factor ◽

Significant Risk ◽

Significant Risk Factor ◽

Educational Background ◽

Cross Sectional Study ◽

Cross Sectional ◽

Wide Range ◽

Multivariable Regression

Abstract Background: A cross-sectional study was undertaken in Australia to explore a wide range of risk factors associated with keratoconus. A questionnaire addressing age, gender, educational background, ocular and medical history, smoking and alcohol consumption, and physical examination comprising anthropometric measurements was collected; eye examination was undertaken. The associations between a range of risk factors and keratoconus was determined using univariate and multivariable linear regression analyses.Main Text: A total of 260 keratoconus subjects were included in this study. Mean age of subject was 35.5 (SD= 14.8) years and the majority of the subjects were European 171 (68.2%). Initial univariate regression analysis identified the following risk factors at the p<0.1 level with keratoconus: higher body mass index, smoking cigarettes, diabetes, rheumatoid arthritis and asthma were associated with increased severity of keratoconus, whereas eczema was associated with less severe keratoconus. Following multivariable regression analysis, only asthma remained as a significant risk factor associated with 2.2 diopters (D) steeper average mean keratometry compared to keratoconus subjects having no asthma [p = 0.03; β= 2.18; 95% confidence intervals: 1.22, 4.14].Conclusion: Our study describes the comprehensive assessment of all the known risk factors in a large keratoconus cohort recruited in Australia. Our study has reported asthma as the only risk factor found to be significantly associated with keratoconus. The results of this study allow us to better understand the aetiology of keratoconus and such a knowledge could be useful in instigate systemic management of patients to slow or prevent keratoconus.

Download Full-text

Causal Analysis of Health Interventions and Environments for Influencing the Spread of COVID-19 in the United States of America

10.1101/2020.09.29.20203505 ◽

2020 ◽

Author(s):

zhouxuan Li ◽

Tao Xu ◽

Kai Zhang ◽

Hong-Wen Deng ◽

Eric Boerwinkle ◽

...

Keyword(s):

Risk Factor ◽

Unemployment Rate ◽

Additive Model ◽

Significant Risk ◽

Significant Risk Factor ◽

The United States ◽

Health Interventions ◽

Health Crisis ◽

The Us ◽

Pharmaceutical Interventions

As of August 27, 2020, the number of cumulative cases of COVID-19 in the US exceeded 5,863,363 and included 180,595 deaths, thus causing a serious public health crisis. Curbing the spread of Covid-19 is still urgently needed. Given the lack of potential vaccines and effective medications, non-pharmaceutical interventions are the major option to curtail the spread of COVID-19. An accurate estimate of the potential impact of different non-pharmaceutical measures on containing, and identify risk factors influencing the spread of COVID-19 is crucial for planning the most effective interventions to curb the spread of COVID-19 and to reduce the deaths. Additive model-based bivariate causal discovery for scalar factors and multivariate Granger causality tests for time series factors are applied to the surveillance data of lab-confirmed Covid-19 cases in the US, University of Maryland Data (UMD) data, and Google mobility data from March 5, 2020 to August 25, 2020 in order to evaluate the contributions of social-biological factors, economics, the Google mobility indexes, and the rate of the virus test to the number of the new cases and number of deaths from COVID-19. We found that active cases/1000 people, workplaces, tests done/1000 people, imported COVID-19 cases, unemployment rate and unemployment claims/1000 people, mobility trends for places of residence (residential), retail and test capacity were the most significant risk factor for the new cases of COVID-19 in 23, 7, 6, 5, 4, 2, 1 and 1 states, respectively, and that active cases/1000 people, workplaces, residential, unemployment rate, imported COVID cases, unemployment claims/1000 people, transit stations, mobility trends (transit) , tests done/1000 people, grocery, testing capacity, retail, percentage of change in consumption, percentage of working from home were the most significant risk factor for the deaths of COVID-19 in 17, 10, 4, 4, 3, 2, 2, 2, 1, 1, 1, 1 states, respectively. We observed that no metrics showed significant evidence in mitigating the COVID-19 epidemic in FL and only a few metrics showed evidence in reducing the number of new cases of COVID-19 in AZ, NY and TX. Our results showed that the majority of non-pharmaceutical interventions had a large effect on slowing the transmission and reducing deaths, and that health interventions were still needed to contain COVID-19.

Download Full-text

Perinatal Experiences of Low-Income and Incarcerated Women

10.1093/oxfordhb/9780199778072.013.004 ◽

2014 ◽

Author(s):

Julie Poehlmann ◽

Rebecca Shlafer

Keyword(s):

Pregnant Women ◽

Low Income ◽

Significant Risk ◽

Perinatal Outcomes ◽

Psychosocial Interventions ◽

Significant Risk Factor ◽

The United States ◽

Incarcerated Women ◽

Negative Effects ◽

Pregnancy And Postpartum

Poverty is a significant risk factor for suboptimal pregnancy and infant outcomes. Because of widespread recognition of the negative effects of poverty during pregnancy, federal programs in the United States and other health and psychosocial interventions are available to improve pregnancy and postpartum outcomes, with some success. Incarceration is increasingly recognized as a significant risk for pregnant women and their children. When they enter jail or prison, 6–10% of incarcerated women are pregnant, and more than 1,400 women per year give birth while incarcerated. Pregnant prisoners are more likely to experience risk factors associated with poor perinatal outcomes and are likely to receive inadequate prenatal care, and many states still allow shackling of incarcerated women during labor and birth. Although few interventions are available for incarcerated pregnant women, several progressive programs, such as those involving doulas or nursery programs, are available for a minority of affected women.

Download Full-text

Graft rejection after pediatric living related liver transplantation

10.52768/jjgastro/1019 ◽

2021 ◽

Vol 1 (4) ◽

Author(s):

Gihan Ahmed Sobhy ◽

◽

Hazem Mohamed Zakaria ◽

Haidy Mohammed Zakaria ◽

◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Chronic Rejection ◽

Transplant Rejection ◽

Significant Risk ◽

Significant Risk Factor ◽

Background Rejection ◽

Wide Range ◽

Potential Risk Factors ◽

Living Related

Background: Rejection is an important adverse event after pediatric liver transplantation (LT). Aim: We aimed to study the incidence and risk factors for post-transplant rejection in pediatrics. Methods: The study included 40 pediatric patients underwent LT. All patients' records were reviewed. A wide range of potential risk factors for rejection, were recorded. Results: Rejection occurred in 13/40 (32.5%) of recipients. For the 13 rejecters, a total of 24 rejection attacks have occurred. 25% of which occurred during the 1st month post-LT. Acute rejection accounted for 54% of total rejection attacks, while chronic rejection occurred in 46%. LT for biliary atrasia (BA) was a significant risk factor for rejection. The means of transaminases levels were 268 ± 141 (IU/L) AST and 221 ± 119 (IU/L) ALT, biliary enzymes were 962 ± 687 (IU/L) for the ALKP and 485 ± 347 (IU/L) for the GGT, total BIL was 6.5 ± 7.1 (mg/dl), and FKL levels were 10.4 ± 5.6 (ng/ml) during the rejection attacks. Chronic rejection contributed to death of only one of the cases. Conclusion: BA was a significant risk for rejection. Elevated transaminases and biliary enzymes but not FK trough level is alarming signs for presence of rejection. Keywords: liver transplantation; pediatrics; rejection.

Download Full-text

Recent changes in the treatment of hypertension

Mental Health Clinician ◽

10.9740/mhc.n197964 ◽

2014 ◽

Vol 4 (3) ◽

pp. 143-145

Author(s):

Bridget Bradley ◽

Lisa Janssen Carlson

Keyword(s):

European Society ◽

Treatment Guidelines ◽

Significant Risk ◽

Significant Risk Factor ◽

The United States ◽

Joint National Committee ◽

National Committee ◽

Treatment Of Hypertension ◽

European Society Of Cardiology ◽

Detection Evaluation

Hypertension affects a large portion of the United States' population and is a significant risk factor for cardiovascular events. A variety of treatment guidelines exist including the American Diabetes Association, European Society of Hypertension/European Society of Cardiology and the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines. The following is a summary of these guidelines regarding the effective treatment of hypertension.

Download Full-text