Variation in Dexamethasone Dosing and Use Outcomes for Inpatient Croup

2021 ◽  
Author(s):  
Amy Tyler ◽  
Mersine A. Bryan ◽  
Chuan Zhou ◽  
Rita Mangione-Smith ◽  
Derek Williams ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Regression Models ◽  
Random Effect ◽  
Patient Characteristics ◽  
Mixed Effects ◽  
Site Specific ◽  
Caregiver Education ◽  
Multivariable Analyses ◽  
Outcomes For Children ◽  
A Site

OBJECTIVES: Evaluate the association between dexamethasone dosing and outcomes for children hospitalized with croup. METHODS: This study was nested within a multisite prospective cohort study of children aged 6 months to 6 years admitted to 1 of 5 US children’s hospitals between July 2014 and June /2016. Multivariable linear and logistic mixed-effects regression models were used to examine the association between the number of dexamethasone doses (1 vs >1) and outcomes (length of stay [LOS], cost, and 30-day same-cause reuse). All multivariable analyses included a site-specific random effect to account for clustering within hospital and were adjusted for age, sex, race and ethnicity, presenting severity, medical complexity, insurance, caregiver education, and hospital. In cost analyses, we controlled for LOS. RESULTS: Among 234 children hospitalized with croup, patient characteristics did not differ by number of doses. The proportion receiving >1 dose varied by hospital (range 27.9%–57.1%). In adjusted analyses, >1 dose was not associated with same-cause reuse (odds ratio 0.87 [95% confidence interval (CI): 0.26 to 2.95]) but was associated with 45% longer LOS (relative risk = 1.45 [95% CI: 1.30 to 1.62]). When we controlled for LOS, >1 dose was not associated with differential cost ($−31.2 [95% CI $−424.4 to $362.0]). Eighty-two (35%) children received dexamethasone before presentation. CONCLUSIONS: We found significant interhospital variation in dexamethasone dosing and LOS. When we controlled for severity on presentation, >1 dexamethasone dose was associated with longer LOS but not reuse. Although incomplete adjustment for severity is one possible explanation, some providers may routinely keep children hospitalized to administer multiple dexamethasone doses.

scholarly journals Functional expression of a yeast mitochondrial intron-encoded protein requires RNA processing at a conserved dodecamer sequence at the 3' end of the gene.

1989 ◽  
Vol 9 (4) ◽  
pp. 1507-1512 ◽  
Author(s):  
H Zhu ◽  
H Conrad-Webb ◽  
X S Liao ◽  
P S Perlman ◽  
R A Butow
Keyword(s):  
Genetic Analysis ◽  
Rna Processing ◽  
Fold Increase ◽  
Functional Expression ◽  
Rrna Gene ◽  
Yeast Mitochondria ◽  
Wild Type ◽  
Site Specific ◽  
Var1 Gene ◽  
A Site

All mRNAs of yeast mitochondria are processed at their 3' ends within a conserved dodecamer sequence, 5'-AAUAAUAUUCUU-3'. A dominant nuclear suppressor, SUV3-I, was previously isolated because it suppresses a dodecamer deletion at the 3' end of the var1 gene. We have tested the effects of SUV3-1 on a mutant containing two adjacent transversions within a dodecamer at the 3' end of fit1, a gene located within the 1,143-base-pair intron of the 21S rRNA gene, whose product is a site-specific endonuclease required in crosses for the quantitative transmission of that intron to 21S alleles that lack it. The fit1 dodecamer mutations blocked both intron transmission and dodecamer cleavage, neither of which was suppressed by SUV3-1 when present in heterozygous or homozygous configurations. Unexpectedly, we found that SUV3-1 completely blocked cleavage of the wild-type fit1 dodecamer and, in SUV3-1 homozygous crosses, intron conversion. In addition, SUV3-1 resulted in at least a 40-fold increase in the amount of excised intron accumulated. Genetic analysis showed that these phenotypes resulted from the same mutation. We conclude that cleavage of a wild-type dodecamer sequence at the 3' end of the fit1 gene is essential for fit1 expression.

scholarly journals Consecutive sexual maturation observed in a rock shell population in the vicinity of the Fukushima Daiichi Nuclear Power Plant, Japan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshihiro Horiguchi ◽  
Kayoko Kawamura ◽  
Yasuhiko Ohta
Keyword(s):  
Power Plant ◽  
Nuclear Power Plant ◽  
Sexual Maturation ◽  
Nuclear Power ◽  
Tohoku Earthquake ◽  
Site Specific ◽  
Thais Clavigera ◽  
Rock Shell ◽  
Fukushima Daiichi ◽  
A Site

AbstractIn 2012, after the accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) that followed the Tohoku earthquake and tsunami in March 2011, no rock shell (Thais clavigera; currently recognized as Reishia clavigera; Gastropoda, Neogastropoda, Muricidae) specimens were found near the plant from Hirono to Futaba Beach (a distance of approximately 30 km). In July 2016, however, rock shells were again found to inhabit the area. From April 2017 to May 2019, we collected rock shell specimens monthly at two sites near the FDNPP (Okuma and Tomioka) and at a reference site ~ 120 km south of the FDNPP (Hiraiso). We examined the gonads of the specimens histologically to evaluate their reproductive cycle and sexual maturation. The gonads of the rock shells collected at Okuma, ~ 1 km south of the FDNPP, exhibited consecutive sexual maturation during the 2 years from April 2017 to May 2019, whereas sexual maturation of the gonads of specimens collected at Hiraiso was observed only in summer. The consecutive sexual maturation of the gonads of the specimens collected at Okuma might not represent a temporary phenomenon but rather a site-specific phenotype, possibly caused by specific environmental factors near the FDNPP.

scholarly journals “IF YOU DON’T KNOW ME BY NOW…”

2021 ◽  
pp. 1-28
Author(s):  
Ellen M. Whitehead ◽  
Allan Farrell ◽  
Jenifer L. Bratter
Keyword(s):  
Race And Ethnicity ◽  
Mate Selection ◽  
Racial Identities ◽  
Hispanic Origin ◽  
Socially Constructed ◽  
Attitudinal Factors ◽  
A Site ◽  
Intimate Partnerships ◽  
College Educated ◽  
Insight Into

ABSTRACT The racial composition of couples is a salient indicator of race’s impact on mate selection, but how well do those in intimate partnerships know the racial identities of their partners? While prior research has revealed that an individual’s race may be perceived differently than how they identify, most of what is known comes from brief interactions, with less information on established relationships. This study examines whether discrepancies in the reports of a person’s race or ethnicity can be identified even within intimate relationships, as well as which relational, social, and attitudinal factors are predictive of divergent or concordant reports. We draw on the Fragile Families and Child Wellbeing Study (n=3467), a U.S.-based dataset that uniquely provides both the father’s self-reported race and Hispanic origin and the mother’s report of the father’s race and ethnicity. We compare reports of the father’s race/Hispanic origin from both parents to assess the extent of mismatch, and we distinguish between whether mothers view the father’s race as similar to or different from her own. We find roughly 14% of mothers provide a race and Hispanic origin that is inconsistent with the father’s report, with a large share reflecting differences in the self-identified and perceived race of fathers who are reported as Hispanic. Among mismatched reports, mothers are more likely to report a race/ethnicity for the father that matches her own, depressing the number reporting interracial unions. Perceptions of racial homogamy are especially likely when mothers view racial sameness as important to marriage. Further, mismatches are more common in the midst of weak relational ties (i.e. non-marital relationships) and are less common when both parents are college-educated. These findings reveal that intimate unions are a site where race is socially constructed and provide insight into how norms of endogamy manifest within formed relationships.

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